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Keeling Spring Textbook > 7. Peri Implantitis > Flashcards

7. Peri Implantitis Flashcards

1
Q

At a site level what is Peri Implant health

A

No erythema
NO BOP
No swelling
No suppuration

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2
Q

Whats the difference between periodontal health and peri implant health

A

PD is higher at implants

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3
Q

What are the clinical methods to assess implant health

A
  1. Visual
  2. Probing
  3. Digital Palpation
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4
Q

Why probe implants

A
  1. Assess BOP
  2. Monitor change in PD and mucosal margin
  3. Light probing is safe
  4. No PD indicates health
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5
Q

What is histological health

A

Mucosa 3 - 4 mm high

Ketatinized or non keratinized mucosa

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6
Q

What are the histological difference between periodontal health and peri implant health

A 
Impl:
No cementum
No PDL
No inserting fibers
Longer epithelium
Less vascular
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7
Q

Clinical signs of peri implant mucositis

A
  1. Bleeding on probing
  2. Erythema
  3. Swelling
  4. Suppuration
  5. No BL beyond normal remodelling

Must have inflamm to diagnose mucositis

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8
Q

What happens to probing depth in peri implant mucositis

A

Increase in probing depth due to swelling or decreased probing resistance

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9
Q

Is there good evidence for plaque aetiology of peri implantitis

A

Yes

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10
Q

Can it resolve

How long does this take

A

Yes

Takes 3/12

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11
Q

Risk indicators for Peri implant mucositis

A
  1. Plaque Accumulation
  2. Smoking
  3. Diabetis
  4. Radiotherapy
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12
Q

What is the histology of peri implant mucositis

A
  • Inflammation lateral to junctional epithelium
  • Infiltrate rich in vascular structure
  • Plasma cells
  • Lymphocytes
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13
Q

What is peri implantitis

A

A plaque assoc condition in tissue around an implant associated with inflammation and bone loss

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14
Q

What are the clinical signs of peri implantitis

A
  1. Inflammation
  2. BOP
  3. Suppuration
  4. Recession
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15
Q

What is the histology of peri implantits

A
  • Lesion apical to JE larger than mucositis
  • Plasma Cells
  • Macrophage
  • Neutrophil
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16
Q

What are the specific bacteria associated with Peri Implantitis

A

None.

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17
Q

What is the onset and progression of peri implantitis

What comes before it

A
  • Preceded by mucositis
  • Non Linear
  • Accelerating
  • Faster progression than periodontal disease
18
Q

What are the risk factors for peri implantitis

A
  1. History of periodontal disease
  2. Poor plaque control
  3. No maintenance
  4. Cement
  5. Occlusal Overload
  6. Ti Particles
  7. Overheat
  8. Micromotion
19
Q

What are the causes of recession of implant mucosa

A
  1. Malposition of implant
  2. Lack of buccal bone
  3. Lack of KT
  4. Surgical Trauma
  5. Status of adjacent teeth
20
Q

What is the influence of KT on peri implant health

21
Q

Discuss the height of the gingival papilla between implants

A

The height of papilla determined by the crest of bone between the implants

22
Q

With no previous data on a patient how do you determine peri implantitis

A
  • PD above 6 mm

- BL 3 mm below most coronal portion of intra osseous part of the implant

23
Q

What are the hard tissue deficiencies created by tooth loss

A

Alveolar bone loss

24
Q

What are the hard tissue deficiencies created by traumatic extraction

A

Changes from bone remodelling

25
What are the hard tissue deficiencies created by Periodontal disease
Changes in alveolar bone
26
What are the hard tissue deficiencies created by Endodontic disease
Bone resorption apically
27
What are the hard tissue deficiencies created by root fracture
Can cause bone resorption
28
What are the hard tissue deficiencies created by Trauma
Damage alveolar process
29
What are hard tissue deficiencies after implant placement
1. Defect in health - dehisence/fenestration 2. Malposition implant - Causes recession 3. Peri Implantitis - soft / hard tissue loss 4. Mechanical Overload - Not Proven
30
Soft tissue deficiencies prior to implant placement
1. Tooth loss - XLA cause soft tissue change 2. Perio Dx - Intuitive but not proven 3. Systemic Dx - Scare data
31
Soft tissue deficiencies after implant placement
1. Lack of buccal bone 2. Papilla Height 3. KT 4. Migration of teeth / growth changes
32
How are the lesions of Peri Implantitis different from mucositis
Mucositis - Lateral to JE | Implantitis - Apical to JE
33
How is bone loss in the Maxilla described
Centripetal
34
How is bone loss in the Man described
Centrifugal
35
% dehisence after implant placement
4.0%
36
% fenestration after implant placement
9.0%
37
What % of undercut in Man Anterior
36% - 66%`
38
What is the impact of placing an implant bucally
1 mm buccal cause 0. 22 mm lost at buccal crest
39
Bone loss thin : thick phenotypes
0.3 mm : 0.1 mm
40
What soft tissue impact does loss of teeth have
Bone loss 1-2 mm in first year, this effects pink
41
What is the influence of tooth migration
Interproximal contact loss.

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