Final Flashcards
Bone loss we are looking for to identify periodontitist
Interproximal bone loss
Mucogingival Defect
1) not enough keratinized tissue
2) probe goes to or past mucogingival junction
Stillmans Cleft
Sign of chronic inflammation. Happens because papillae are so swollen they meet at a cleft. “Squishing two balloons together”
mccall festoon
Sign of chronic of gingival inflammation
Not a lot of K tissue thin bad
Probe for furcation
Nabers probe
Glickman Class I Furcation
Catch on probe
Not visible on X-ray
Glickman Class II Furcation
Catch and fuzzy on X-ray
Glickman Class III Furcation
Probe exits the other side
On 3 root-only 2 furcation have to communicate
Glickman Class IV Furcation
Any other class + gingival recession
Usual furcation communication
Mesial:buccal
Distal:buccal
On the maxilla the mesial distal furcation can only be accessed from
The palate
GM tells
Gingival margin to CEJ
Gingival recession
Positive or negative recession
(- is above CEJ)
PD
Gingival margin to base of sulcus
AL
Adding PD+GM
Interproximal bone follows
The line joining 2 CEJs
Crater defect
Only buccal and lingual wall remain
Horizontal walls
Are all lost
If the width of the interdental bone is more than
4.3 mm you can have 2 independent defects
What teeth are most likely to have horizontal bone loss
Anteriors
_____ followed by _____ bone loss
Horizontal
Angular
What cant be regenerating
0 wall (horizontal) 1 wall
Osseointegration
The direct attachment or connection of vital Ossetia tissue to the surface of an implant without intervening connective tissue
Rigid fixation
Clinical term to define osseointegration
24 hours after implantation
Resorption of cortical bone
Woven bone formation in the spongious bone
Blood clot formation
Proliferation of vascular structure into newly forming granulation tissue
1 week after implantation
Reparative macrophage and undifferentiated mesenchymal cells
Modeling at the apical trabecular region and at the furcation sites of a screw shaped implant
2 weeks after implantation
New bone formation can be detected at the furcation sites of the implant surface
Up to 6 weeks
Callus formation and lamellar compaction within woven bone
-shrinkage may have temp decrease in implant stability
Jumping distance concept
The distance that can be filled by new bone between the implant and the remaining host bone
Ideal tolerable jumping distance
20-40 um
Larger does not heal well
Accepted healing period for osseointegration
6 months maxilla
3 months mandible
____ is poor in blood supply
Cortical bone
Implant surface we use
SLA or HA/TCP
HA has issues with resorption over time
An implant should be surrounded with a minimum of
1mm of alveolar bone thickness
Minimum bone thickness between 2 implants
3 mm
Implant to implant
Minimum bone thickness between an implant and a tooth should be
4 mm
From root surface to implant
Coronal part of an implant should be placed
5 mm apical to adjacent CEJ
Maximum implant angle
20
transmucosal attachment
Barrier epithelium 2 mm
Zone of connective tissue 1-1.5mm high
Collagen fiber bundles parallel to implant surface
Zone that is adjacent to I place the surface is rich in _____but poor in ______
Fibroblasts
Blood vessels
Zone that is in lateral direction and contours with the first zone has
Fewer fibroblast but it is rich in collagen fibers and blood vessels
Blood supply coming only from
Superior periosteal blood vessels
Two stage implant placement
Submerged tech
One stage implant placement
Non-submerged
Microgap
Micro space that exists between implant fixture and abutment
-usually at alveolar crest
Optimum function
20 teeth needed
Criteria for successful implant
The implant is immobile
Absence of peri-implant radiolucency
Absence of pain, infection, neuropathy or parathesia
After 1st year in function,
Ailing Implant
Peri-implant mucosisitis
Peri-implantitis
Failing Implant
Peri-Impantitis
Failed Implant
Peri-implantitis with mobility and complete loss of of osseointegration
Peri-implant mucositits
Reversible inflammation of the mucosa surrounding the implant
Peri-implantitis
Inflammatory reactions associated with loss of supporting one around an implant IN FUNCTION
Mucositis almost always
Develops into peri-implantitis
At the time of placement if you placed implant 6mm
Apical to CEJ 90% will get implantitis
-build up with bone
Any form of inflammation on teeth surrounding implant
Peri-implantitis
Peri-implantitis are characterized by
Presence of numerous neutrophils in the tissue surrounding the implant
-not seen in periodontitis
In peri-implantitis there is direct contact between
Plaque on the implant surface and inflamed connective tissue
-not seen in periodontitis
Implants and teeth may have
Different microbiology which can impact treatment
______is a Secondary etiologic all factor of periodontal disease
Occlusal trauma
Occlusal trauma is a _______ etiological factor for peri-implant Disease
Primary
Class 1 Peri-implantitis
Slight horozontal bone with loss minimal peri-implant defects
Class 2 Peri-implantitis
Moderate horizontal bone loss with isolated vertical defects
Class 3 Peri-implantitis
Moderate to advanced horizontal bone loss with broad circular bony defects
Class 4 Peri-implantitis
Advanced horizontal bone loss with broad circumferential vertical defects as well as loss of the oral and or vestibular bony wall
Class 1 treatment
Reduce pocket
Reposition flaps at a bone edge
Decontaminate implant
Omplantoplasty if threads exposed
Class 2 treatment
Reposition but more apical than class 1 so more Implant is exposed
If 3 or more walls GTR techniques to restore
One or 2 walls osteoplasty
Class 3 and 4 Treatment
In peri-implantitis the presence of vertical defects almost always requires the use of GTR techniques
