Finland is a rather conservative country when it comes to dental implant treatments. Unlike in many other European countries, where demand for implants is growing strongly as the population ages, the growth in Finland has remained relatively moderate over the past 10-15 years. However, the need for implants is no less in our country.

According to specialist dentist Pekka Kallio, around 30 000 new dental implants are placed in Finland every year. In relation to the population, the number of implants in Italy, for example, is four times higher than in Finland. Meanwhile, around 100 million implants have been placed in patients' mouths worldwide so far. Around 10 million new dental implant treatments are done every year.

According to Kallio, the high cost of implant treatment in Finland compared to many other countries is often a barrier to more significant growth in the implantology business.

- However, with implant surgery becoming increasingly digitally guided, it is possible that patients in Finland will not have to pay so much for their implant treatments in the future. Price competition in the sector has already increased in Finland, without compromising the quality of treatment, says Kallio. 

Kallio has been a specialist dentist himself for almost 25 years. He recalls that dental implants come in handy when, for example, a patient needs a strong foundation for crowns or bridges.

According to Kallio, the success of implant treatments depends on both the experience of the dentist and the choice of the patient. All the implant brands used in Finland are of high quality, so the success of implant treatment is not dependent on the implant itself. A patient's previous history of periodontitis is also not an obstacle to implant treatment.

- However, periodontal disease must be treated and well maintained before implant treatment. The most important risk factor for treatment failure is smoking. Diabetes is another important risk factor to consider in treatment, says Kallio.

A healthy mouth is the basis for successful implant treatment

Oral home care, including thorough daily brushing and flossing and regular dentist check-ups are essential for the prognosis of the treatment. There is room for improvement in the oral home care of implant patients. The idea that implants are eternal and better than one's own teeth is wrong, says Kallio.

Peri-implantitis is a serious gum disease that affects the well-being of implants and can lead to implant loss if left untreated. Although implant treatments generally have a good success rate, on average one implant is lost every four minutes. This translates into around 140,000 lost implants per year. Around 50% of implant patients develop peri-implantitis over time, according to figures from Dentognostics.

Kallio points out that successful implant treatment requires a healthy mouth.

- Periodontal disease and implant treatments are not at all compatible. The risk of infection is high and, in the long run, teeth weakened by periodontal disease will cause excessive pressure to dental implants and bridges.  

After implant surgery, the surgical site is tender. In addition, sutures make cleaning difficult. Today, antiseptic mouthwashes are used to kill oral bacteria after surgery. However, they have side effects, including discolouration of the teeth, says Kallio. 

Antibacterial Lumoral treatment has also shown good results in the treatment of dental implant-related infections.

- In my studies, the amount of plaque and gum bleeding in patients was significantly reduced compared to the initial situation, and there were no side effects associated with the use of Lumoral, says Hanna Lähteenmäki, a YAMK oral hygienist who was awarded the title of Oral Hygienist of the Year 2022.

Kallio also feels that Lumoral is a promising product for implant patients.

- I use it selectively with my patients who have challenges with oral home care or other factors that affect the prognosis of their treatment.

- I recommend using Lumoral daily for 2 weeks before surgery and 2 weeks after surgery.  Most patients continue to use it at the normal 2 times a week dosage.

Even with successful implant placement, implants do not always remain healthy. According to Kallio long term follow-up studies have show inflammation and bone loss around implants, known as peri-implantitis. It occurs in about one fifth of implants after a ten-year follow-up.  Treatment of these often requires complex treatment by a specialist dentist. 

- Here too, careful oral home care is a prerequisite for successful treatment.  Lumoral is, in my opinion, an affordable insurance not only to improve the long-term prognosis of implant treatment, but also to prevent many other oral health risks, such as caries and periodontitis. For patients with dry mouth problems, Lumoral provides a definite improvement. The ease of use of Lumoral and the immediate feeling of dental cleanliness it provides has brought many positive comments from my patients.

Finnish health technology company Koite Health has signed a distribution accord with Megagen Italia, which markets cutting-edge dental implant systems and advanced surgical devices. As a kickoff to the new collaboration, both companies will be present with a joint stand at the upcoming Expodental Meeting event in Rimini, Italy, on 18— 20 May 2023.

The global dental implants market is flourishing because of a growing prevalence of dental diseases and tooth loss, an aging population, and the rapid adoption of technology advancements and digital technologies, such as computer-aided design and 3D printing, in dental implant materials and design.

In Italy, dental implants are also very common. We are talking about over 2.5 million Italians yearly who resort to fixed prostheses. 

According to Mr. Federico Annoni from Megagen Italia, the implant market is constantly growing in Italy due to the rapidly aging population and because many people neglect their oral health. This contributes to the loss of natural teeth. Thus, the use of implants is necessary. 

Oral home care is very important for the health of dental implants. Proper oral hygiene combined with regular use of Lumoral could be decisive in preventing periodontitis and peri-implantitis.

Megagen sees Koite Heath as a great partner with its Lumoral teeth cleaning method since it brings innovation in oral hygiene and prevention of oral infections. This collaboration also brings in implant patients more awareness of oral health, says Annoni.

Lumoral brings many benefits to implant patients: it helps sustain oral bacterial diversity while reducing plaque bacteria, it reduces gingivitis and plaque and tartar formation, and treats and prevents periodontitis and peri-implantitis efficiently.

– We believe that it is an excellent idea that dentists would offer a Lumoral device to all their implant patients to help prevent peri-implantitis and help keep the implants healthy.

Megagen will participate at the upcoming Expodental Meeting event in Rimini, Italy, with two stands – one exclusively dedicated to Megagen products and another devoted solely to Lumoral where two of your specialists will be present, Annoni says.

Everyone could use Lumoral according to their needs, he adds. The device is easy to use regularly, and the method helps maintain better oral hygiene for those who suffer from serious infections such as peri-implantitis and periodontitis and those who do not suffer from them but want only to improve their oral health.

– We believe that Lumoral could be the next “big thing” in the oral health care market that will help boost the oral health of Italian people and, at the same time, help save public health care costs, Annoni concludes.

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Facts: Global Dental Implants Market 

Dental implants are an effective solution to fill any gaps or spaces within the mouth caused by missing or damaged teeth. Dental implants are metal devices surgically implanted into the jawbone below the gums to support artificial teeth. The process by which these implants fuse with the bone is called osseointegration, and they resemble screw-shaped prosthetic tooth roots. Once the dental implants are inserted into the jawbone, they fuse with the natural bone to create a sturdy foundation for one or more artificial teeth, called crowns. An abutment is attached to the dental implant to hold and support the crowns. Crowns can be customized to fit the shape and contour of natural teeth for a comfortable fit within the mouth.

Developed countries have more dental implant users, primarily due to their better resources, higher per capita income, a more significant concern for aesthetics, and heightened awareness. The Asia-Pacific region is expected to experience the highest growth rate during the forecast period due to its increasing economic stability and disposable income, as well as its dense population burdened by a growing senior population.

50 million implants have been inserted globally so far, while 10 million new implants are being inserted in patients' mouths each year. Maintaining the health of implants is crucial. 

Peri-implantitis is a serious gum disease that impacts the health of implants and can lead to loss of them, if left untreated. Despite impressive success rates, one implant is still lost every four minutes, which translates into 140,000 cases per year.

Around 50% of implant patients will develop peri-implant mucositis over time. Approximately one-third of all patients will develop clinically manifested peri-implantitis.

(Source: Dentognostics)

Periodontitis, or severe gingivitis, is a common disease that is estimated to affect about 20-50% of the global population – often without any symptoms at all. Now, for the first time, a Finnish study has produced encouraging results in identifying young people at risk of the  disease.

It is estimated that around 10% of young people in Finland have an onset of periodontal disease, but the susceptibility remains throughout life. The incidence of the disease increases significantly between the ages of 20 and 40.

“Therefore, identification of patients at risk should take place at an early age, preferably under the age of 20 when the onset and progression of this dental adhesive tissue disease can still be influenced,” says Ismo T. Räisänen, DDS, PhD, MSc(tech) from the University of Helsinki.

Räisänen has been part of a Finnish research team that has been actively searching for years for ways to overcome the serious gum disease, periodontitis, using modern methods of diagnosis and treatment.

A major focus of research has been the so-called immunological rapid test for active matrix metalloproteinase-8 (aMMP-8) developed by Professor Timo Sorsa of the Department of Oral and Maxillofacial Diseases at the University of Helsinki. It can be used to detect whether a periodontal breakdown of gum tissue is underway in a person's gum pockets even before it can be seen visually.

The effect of antibacterial photodynamic therapy (aPDT) in the prevention and treatment of gum infections including periodontitis and peri-implantitis has also been extensively studied and has also produced a large body of positive clinical evidence.

The Lumoral method, which is based on aPDT light therapy, hampers plaque formation and significantly reduces the amount of periodontal bacteria in the mouth. Elderly people, for example, are particularly well suited to the teeth cleaning method's user profile, as optimal oral self-care is critical in this age group. 

Dr Räisänen's recent thesis Risk factors and active matrix metalloproteinase-8 (aMMP-8) diagnostics for initial periodontitis in adolescents provides further confirmation of the usefulness of the aMMP-8 mouthrinse point-of-care (PoC) test for the identification of initial periodontitis in adolescents. Among other things, the study found that while saliva and mouthrinse are both useful in aMMP-8 diagnostics, mouthrinse appears to be more accurate than saliva.

The aMMP-8 test can be used to help assess the risk of the onset and progression of periodontitis. The aMMP-8 test can also be used to monitor the effectiveness of periodontal treatment by a professional.

“Based on the results of the thesis, it would be useful for every young person to have an aMMP-8 test done at least once before the age of 20, especially if they have other risk factors for periodontal disease.”

Test result in minutes

MMP-8 is an enzyme produced mainly by neutrophils, the most common white blood cells in humans. It plays a key role in inflammatory processes in the body. However, in the case of periodontitis, the inflammatory process of the body results in the activation of the MMP-8 (aMMP-8) enzyme and the breakdown of periodontal tissue that helps keep teeth in place.

The five-minute test that can help measure the risk of active periodontal adhesion tissue loss and its progression helps complement the diagnosis, outcome monitoring and maintenance treatment of periodontitis and peri-implantitis.

“At the same time, it enables early referral of young people at risk of developing severe gum disease for further investigation and treatment,” Räisänen explains.

Early signs of periodontal disease include red and bleeding gums and halitosis. Once established, the disease is a 'tenacious' companion that progresses if not treated carefully.

The cornerstone of treating gum disease is good oral hygiene, which requires professional help, as the oral biofilm that has hardened into tartar must first be removed from the tooth surface and gum pockets. This is followed by cleaning of the teeth through careful oral hygiene to prevent the formation of new tartar in the gum pockets.

According to the National Institute for Health and Welfare (THL), more and more people in Finland brush their teeth at least twice a day. However, there are still gaps in oral self-care. Although brushing teeth and interdental spaces is an effective way to clean teeth, studies show that brushing leaves up to half of the plaque on the tooth surface.

Careful prevention pays off

Räisänen stresses that prevention and timely treatment of periodontal disease are important both for the health of individuals and economic well-being of society.

The treatment of periodontitis, especially severe periodontitis, is expensive and ties up a lot of resources. It is also important to be aware that the harmful effects of periodontal disease are not limited to the mouth and teeth. It is linked to a number of underlying diseases such as diabetes, cardiovascular disease, pulmonary disease, various cancers and also to complications of COVID-19. According to one scientific study, a first heart attack is 30% more common in people with periodontal disease than in healthy people of the same age.

“Now is the time to start investing in oral disease prevention as public health care resources are already stretched. Early detection and treatment of periodontal disease is cost-effective at all ages. Good oral health is part of overall health and improves patients' quality of life,” says Anna Maria Heikkinen, Professor of Clinical Dentistry, Associate Professor of Clinical Periodontology, University of Tampere, Specialist Dentist in Healthcare and Clinical Dentistry.

According to Heikkinen, identifying young people at risk of periodontal disease can reduce over- and under-treatment. Individual risk factors should be taken into account and a oral home care plan should be drawn up for each individual on this basis, using appropriate dental care tools.

“This is cost-effective and can save money in the future by reducing the cost of treating adult periodontitis. Investing in young people is an investment in the future!”

Heikkinen says that, as research leader, she will launch a follow-up study in autumn 2023 to assess the oral health of young people, combining aMMP-8 diagnostics with antibacterial Lumoral treatment. The aim is to gain a broader understanding of how aPDT treatment, when used regularly, affects the oral health of adolescents.

Recent results in the adult population have been encouraging and more are expected later this year on the use of aPDT (Lumoral) in the treatment of oral diseases.

“We need information on how individualised prevention of oral diseases, both periodontal disease and tooth decay, can be improved and targeted with new methods in addition to standard home self-care in adolescents. The benefits of new innovations need to be examined through research before they are more widely adopted,” says Heikkinen.

In the adult population, there have recently been encouraging results on the use of aPDT (Lumoral therapy) in the treatment of oral diseases.

“Therefore, it is justified to investigate the benefits of aPDT in the prevention and treatment of incipient periodontitis and, why not, caries as well in adolescents. The impact will be evaluated in addition to and in support of normal self-care activities such as brushing teeth, cleaning between teeth and regular visits to the dentist and oral hygienist,” concludes Räisänen.

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International Gum Health Day celebrated on 12 May 2023

Gum Health Day, promoted by the European Federation of Periodontology (EFP), the umbrella organisation for periodontology in Europe, is celebrated annually on 12 May.

The aim of this anniversary, which highlights the importance of oral health, is to raise awareness among health professionals and the general public of the need for prevention, early diagnosis and treatment of periodontal and peri-implant diseases, and to highlight the importance of periodontal health as part of good general health.

The slogan for this year's Health Day is "Healthy gums look good. Protect them!". This is to highlight the importance of periodontal health as part of good general health, without forgetting the importance of aesthetics.