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xD2 Implantology > Eval and Maintenance > Flashcards

Eval and Maintenance Flashcards

1
Q

Why do we do maintenance if longitudinal implant studies seem to suggest that it is not required?

A

Report success based on survival not progression of bone loss and attachment loss. This is different from longitudinal periodontal studies which monitor attachment loss over time.

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2
Q

What are 2 main reasons for implant failure after loading?

A
  1. Bacterial infection

2. Mechanical failure

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3
Q

What is the key distinguisher between peri-implant mucocitis and periimplantitis?

A

Radiographic bone loss

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4
Q

A lot of mechanical failure is related to what?

A

Occlusion

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5
Q

Is there a biological width around implants?

A

Yes

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6
Q

Why is there a deeper probing depth around implants versus regular teeth?

A

No PDL

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7
Q

Is there more or less vascularization around an implant?

A

Less. Good because less inflammation, bad because less healing.

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8
Q

Should probing depth be considered a parameter for implant health?

A

No

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9
Q

Is bleeding on probing the same as for teeth and implants?

A

No

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10
Q

When is probing depth and bleeding on probing useful for implant health determination?

A

When compared over time

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11
Q

How is most diagnosis of implant health achieved?

A

Via X-rays

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12
Q

What is the cardinal sign of implant failure

A

Mobility (could be fractured or just a loose abutment)

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13
Q

What must make sure on radiograph with respect to threads?

A

Ensure bone is going in and out of threads

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14
Q

What is the recommended interval for radiographic assessment of your implant success?

A 
Day of fixture insertion 
Day of uncovering/abutment placement 
6-12 month intervals 
Annually for 1st 2 yrs 
Subsequent 2 yr intervals (if no complications)
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15
Q

What is a primary cause of implant failure?

A

Abnormal/excessive forces, e.g. cantilevers or lateral forces

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16
Q

What are 2 desires for implant occlusion?

A

Light centric contours, no excursive contacts

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17
Q

What are 4 criteria for implant success?

A
  1. No mobility
  2. No perifixtural radiolucency
  3. No more than 0.2mm bone loss annually after first year
  4. No signs or symptoms (Pain, infection, neuropathy, or paresthesia)
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18
Q

What is the only indication for using an instrument subgingivally around the implant?

A

Pathology or calculus

19
Q

What can be used for peri-implant mucocitis?

A

Local debridement, locally delivered antimicrobials

20
Q

Do implants require maintenance?

A

Yes (monitor them just like you monitor the health of natural teeth)

21
Q

What must not be used on a titanium implant?

A

Metal instruments

22
Q

What are the best monitoring method for implant health?

A

Radiographs

23
Q

What are the characteristics of peri-implant mucositis?

A 
Probing depth more than 4mm
Inflammation
No suppuration
No radiographic bone loss
No mobility
(Like gingivitia)
24
Q

What are the characteristics of peri-implantitis?

A 
Probing depth more than 4mm
Some or no suppuration
Radiographic bone loss present
Some or no mobility
(Like periodontitis)
25
Q

What should you watch for during implant maintenance?

A

Signs of ailing/failing implants

26
Q

What is the definition of “ailing”?

A

No mobility

May be treatable

27
Q

What is the definition of “failing”?

A

Not osseo-integrated
Possible mobility
May reverse torque
Must be extracted

28
Q

What does radiographic bone loss around an implant indicate?

A

Peri-implantitis

29
Q

What does mobility of the implant indicate?

A

Failure

30
Q

Does plaque grow around implants?

A

Yes and in some cases it may be even more difficult to remove than calculus on teeth. Plaque index can be determined.

31
Q

Does probing depth matter for implants?

A

Maybe, maybe not. You may get deeper probing depths around an implant because the probe can go alongside connective tissue parallel to the implant

32
Q

Is bleeding on probing a sign of inflammation with implants?

A

Yes but it may also represent tissue wounding

33
Q

Are probing depth and bleeding on probing the same with implants as they are with teeth?

A

Not completely.

34
Q

Is probing depth related to long term SURVIVAL of implants?

A

No, according to the study cited in the lecture

35
Q

Should plastic probes be used around implants?

A

Yes

36
Q

What is a better indicator of implant attachment loss than probing depth?

A

Longitudinal measurements

37
Q

Do we need keratinized tissue around implants?

A

Lack of keratinized tissue does not lead to increased progression of peri-implantitis BUT it is preferable.

38
Q

Is bone loss right below the connection between the abutment and the implant in a two-stage abutment normal or a sign of pathology?

A

It is normal but it should not be too far below that connection.

39
Q

Besides bone loss, what can you tell from radiographs?

A

Assess screw/fixture fit/fractures
In sudden onset failure, radiolucent changes may not be present
If failure is gradual, will see radiolucent peri-fixtural space

40
Q

What are two examples of abnormal/excessive forces that may be primary cause of implant failure?

A
  1. Cantilevers

2. Lateral forces

41
Q

What are NOT recommended for professional cleaning of implants?

A

Metal hand scalers
Metal ultrasonic scalers
Interdental brush with metal core

42
Q

What are some ways to treat peri-implant mucositis?

A
  1. Local debridement

2. Locally delivered antimicrobials (Atridox or Arestin)

43
Q

What are some ways to treat peri-implantitis?

A

Do the equivalent of root planing on the implant

xD2 Implantology (5 decks)

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