Efficacy of Treatment and Implants Flashcards
What are some indications for perio surgery?
- Failure to resolve inflammation with S/RP
- Regenerate or cosmetically improve periodontium
- Restorative needs
T/F: Surgical treatment alone will improve long term outcome.
False
Need maintenance
T/F: Perio maintenance patients should have PSR screening at each visit.
False
Full mouth charting
How often should maintenance be performed on a patient with hx of bone loss?
Every 3 months
T/F: Implant maintenance should involve probing.
True
Prefer plastic probe
T/F: Bodily movement of an implant is considered implant failure.
True
T/F: Treatment of peri-implantitis is predictable.
False
Periodontitis is predictable
T/F: Maintaining peri-implant tissue health is more costly compared to periodontal maintenance.
True
When placed in mature bone, how much bone is needed on all sides just to prevent resorption?
1 mm
T/F: A patient who grinds and clenches will need a wider/longer implant.
True
How much interocclusal distance is needed between the top of the implant to occluding teeth?
7 mm crown height
How much space is needed between adjacent implants? Implant and adjacent tooth?
Implants: 3 mm
Implant and tooth: 2-3 mm
What is a major consideration in mandibular implant surgery?
Know where the mental nerve is
Also jaw shape - be sure drill will not poke through bottom and cause bleeding under the tongue
How much bone do you need below the sinus to place an implant?
If less than 5 mm you must do a direct sinus lift
T/F: Immediate implant placement will prevent the physiologic bone modeling/remodeling..
False
What is a major contraindication for immediate implant placement?
Thin tissue or thin buccal bone
Roughly how long do you wait to place implant in early placement?
About 1 month - soft tissue healing
For immediate and early placement, how much bone must be left apical to the of the socket?
Must be 3mm to get primary implant stability
must be something to screw into
T/F: Thin tissue biotype is good for immediate or early implant placement.
False
T/F: Three out of four socket walls must be intact to place immediate or early implant.
True
Roughly how long do you wait for late implant placement?
16 weeks - the ridge is healed (no hole)
What is a major disadvantage of late implant placement?
Large variation in bone resorption
How much bone should you have buccal to the implant?
2mm
T/F: The oval shape of the sockets is beneficial for immediate implant placement.
False
Implants are circle so hard to prevent gaps
T/F: Full thickness flap is necessary for implant placement.
True
What is a two-stage implant placement procedure?
Cover implant and uncover it to place healing abutment after osseointegration phase
How long does osseointegration take for maxilla and mandible?
3 months for mandible
6 months for maxilla
What is the most common way to place implants?
Use two piece implant with one stage procedure
Place implant and healing abutment together without closing
T/F: Bone level implants must be submerged all the way into the bone.
True
Do not want rough surface exposed in tissue
T/F: Cover screws are flat and are used during one-stage placement of implants.
False
Cover screws are flat but used in two-stage
What are three contraindications for one-stage placement?
- Less than ideal primary stability
- Smokers!
- Thin tissue biotype
T/F: All perio problems should be solved prior to implant surgery.
True
How apical to the CEJ of adjacent teeth should the implant shoulder be placed?
2 mm
When are the first two post-op visits?
7-10 days - check for infection
1 month - if two-stage, make sure it is still covered
What is a stent?
Surgical guide
What is the amount of space between the shoulder and contact point that will avoid black triangles?
5 mm
T/F: Articulated casts are necessary for making a stent.
True
T/F: Vertical and inter-implant papillae bone augmentation are predictable surgeries.
False
Lateral is good
What is a hybrid?
Fixed implant supported denture
What is an overdenture?
Implant supported denture
What is the best way to diagnose peri-implantitis?
Serial radiographs
T/F: There will be some bone loss after loading of the implant.
True
Not peri-implantitis
What are some diagnostic findings of peri-implant infections?
- BoP
- Suppuration
- Probe depths
- Mobility
- Radiographic bone loss
T/F: There are methods to save a mobile implant.
False
It has failed
Can an implant with no function have peri-implantitis?
NO
If an implant fails before loading it never fully integrated - NOT peri-imlantitis
What is peri-implant mucositis?
Reversible inflammation in soft tissue around an implant
What is the treatment plan for a patient with an implant probe depth of less than 4 mm and no BoP or plaque?
Do nothing
What are the best treatment options for failing implants?
- Resolve inflammation
- Recontour gingiva (reduce pocket)
- Re-osseointegration
What is re-osseointegration?
Decontaminate the implant surface with citric acid or tetracycline and try GBR around it
When the vertical bone loss becomes circumferential around the entire implant, what class of peri-implantitis is this?
Class 3
Is GBR needed for Class 2 peri-implantitis?
Depends on if there are any localized vertical defects
What is imantoplasty?
Removing the grooves from the exposed implant surface
What is infuse?
A collagen sponge mixed with bone growth proteins placed under the packed bone to help infuse bone growth
T/F: Patients with implants must get at least 2 visits a year.
True
What is the furthest possible apical placement for the shoulder of the implant compared to the CEJ of adjacent tooth?
5 mm
2-5mm is acceptable
What is platform switching?
Placing an abutment that is narrower than the implant - could lower chance of peri-implantitis
T/F: Tissue around an implant is less capable of containing and repairing damage caused by plaque-induced inflammation.
True
