View larger version (88K): [in this window] [in a new window]   Figure 2. Photograph of a patient with a history of night grinding and clenching. An occlusal guard was constructed to protect the fixed prosthodontics from nocturnal parafunctional habits.

Together, the prosthodontist and surgeon should develop a yearly maintenance schedule for the patient.

DISCUSSION
Together, the prosthodontist and surgeon should develop a yearly maintenance schedule for the patient and decide who will perform each of the following steps:

– updating the patient’s medical and dental history;

– checking for adequate plaque removal and reviewing the patient’s plaque removal techniques;

– probing only unhealthy tissue with a plastic probe; healthy tissue should not be probed¹;

– checking the occlusion;

– checking the prosthesis;

– scaling with nonmetallic curettes;

– obtaining radiographs of the implant and prosthesis once a year.

Patients who develop periodontal problems should have more frequent recall appointments: every four, three or even two months. Patients with inadequate dexterity require innovations to their plaque cleaning aids, such as modified inter-proximal brushes and end-tuft brushes.

Fluoride rinses, which are neutral and will not etch porcelain, should be prescribed for caries-prone patients who have extensive porcelain or composite restorations.

CLINICAL IMPLICATIONS
The maintenance schedule provided above should be followed by the surgeon and prosthodontist, who share medical and dental updates, radiographs, occlusal analysis, restoration analysis and results of treatments performed. Their cooperation and communication provide the patient with the best care without duplication of services.

DO YOU HAVE A TIP TO SHARE?
Do you have a time- or work-saving clinical technique to share with your colleagues? Submit it to JADA’s Clinical Directions department. A Clinical Directions item should be a maximum of two double-spaced typed pages and should include no more than one figure or illustration. Submit items to Clinical Directions, JADA, 211 E. Chicago Ave., Chicago, Ill. 60611.