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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

A

Unknown..

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
Q

What are the hard tissue deficiencies created by Periodontal disease

A

Changes in alveolar bone

26
Q

What are the hard tissue deficiencies created by Endodontic disease

A

Bone resorption apically

27
Q

What are the hard tissue deficiencies created by root fracture

A

Can cause bone resorption

28
Q

What are the hard tissue deficiencies created by Trauma

A

Damage alveolar process

29
Q

What are hard tissue deficiencies after implant placement

A
  1. Defect in health - dehisence/fenestration
  2. Malposition implant - Causes recession
  3. Peri Implantitis - soft / hard tissue loss
  4. Mechanical Overload - Not Proven
30
Q

Soft tissue deficiencies prior to implant placement

A
  1. Tooth loss - XLA cause soft tissue change
  2. Perio Dx - Intuitive but not proven
  3. Systemic Dx - Scare data
31
Q

Soft tissue deficiencies after implant placement

A
  1. Lack of buccal bone
  2. Papilla Height
  3. KT
  4. Migration of teeth / growth changes
32
Q

How are the lesions of Peri Implantitis different from mucositis

A

Mucositis - Lateral to JE

Implantitis - Apical to JE

33
Q

How is bone loss in the Maxilla described

A

Centripetal

34
Q

How is bone loss in the Man described

A

Centrifugal

35
Q

% dehisence after implant placement

A

4.0%

36
Q

% fenestration after implant placement

A

9.0%

37
Q

What % of undercut in Man Anterior

A

36% - 66%`

38
Q

What is the impact of placing an implant bucally

A

1 mm buccal cause 0. 22 mm lost at buccal crest

39
Q

Bone loss thin : thick phenotypes

A

0.3 mm : 0.1 mm

40
Q

What soft tissue impact does loss of teeth have

A

Bone loss 1-2 mm in first year, this effects pink

41
Q

What is the influence of tooth migration

A

Interproximal contact loss.

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