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Periodontology 1 > Final; Dental Implants Infections > Flashcards

Final; Dental Implants Infections Flashcards

1
Q

What is the pattern of early microbial colonization in regards to titanium implants and teeth

A

They follow the same pattern

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2
Q

What is the main difference between plaque build-up regarding implants and teeth

A

with increasing the duration of plaque build up (3 months) the duration of the peri-implant mucosa expands more and progresses further “apically
than in the case of the gingiva

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3
Q

What is the difference between peri-implantitis and periodontitis

A

peri-implantitis is a microbial heterogenous infection with predominantly gram-negative species and is less complex

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4
Q

True or False

the peri-implant micro biome differs significantly from the periodontal community in both health and disease

A

true!

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5
Q

What type of etiological factor is occlusal trauma regarding peri-implant disease

A

a PRIMARY etiological factor

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6
Q

This can create complications for peri-implant disease

A

bruxism

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7
Q

What are 4 possible risk factors for peri-implant disease

A

smoking
uncontrolled systemic disease (effect on healing)
radiation therapy
patients with a history of periodontitis

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8
Q

What are two etiological factors involved in tooth loss

A

deficiency in immune response

genetics

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9
Q

What is the difference between peri-implant mucositis and peri-implantitis

A

PIM - only at soft tissue level; like gingivitis

PI - bone loss around implant

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10
Q

What is the difference between early and late implant complications

A

early - before loading

late - after loading

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11
Q

What can cause an ailing implant

A

Peri-implantitis or Peri-implant mucositis

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12
Q

What can cause a failing implant

A

Peri-implantitis

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13
Q

What can cause a failed implant

A

Peri-implantitis with mobility and complete loss of osseointegration

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14
Q

This is the reversible inflammation of the mucosa surrounding the implant

A

peri-implant mucositis

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15
Q

What clinical manifestations are indicative of PIM

A
  • presence of bacterial plaque and calculus
  • edema, redness, and mucosal hyperplasia
  • bleeding on probing
  • exudate or pus formation on occasions
  • no radiological evidence of bone resorption
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16
Q

The peri-implant mucosa seems less effective than the gingiva in what

A

encapsulating plaque-assocaited lesions; thus, the existence of gingivitis is riskier for implants

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17
Q

This is an inflammatory reaction associated with loss of supporting bone around an implant in function

A

peri-implantitis

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18
Q

PI lesions are characterized by what

A

the presence of numerous neutrophils in the tissue surrounding the implant (not seen in periodontitis)

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19
Q

In PI, there is direct contact between what

A

plaque on the implant surface and the inflamed connective tissue (not seen in periodontitis)

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20
Q

PIM occurs in what percentage of patients

A

75%

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21
Q

What are the 6 clinical factors used to evaluate peri-implant health

A
  1. absence of motility
  2. radiographic examination
  3. absence of bone loss ≥0.2mm/year follow the first year
  4. absence of any pain, complaint, or infection
  5. functional and esthetic acceptance of implant
  6. a success rate of 94-98% following 5 years, and 90-94% following 10 years
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22
Q

What are the factors that play into the decision making in tooth extraction and implant placement

A 
anatomy/bone quality
perio/restorative/endo status
systemic health
economics
compliance and motivation
23
Q

What are 5 diagnostic tools used regarding implants

A 
probing of peri-implant mucosa
bleeding on probing
suppuration
radiographic interpretation
mobility
24
Q

T/F
There is direct contact between plaque on the implant surface and inflamed connective tissue in peri-implantitis patients.

A

True

25
Q

Mobility of an implant shows what

A

lack of osseointegration, but check the abutment first

26
Q

The number of implants each year placed are (rising/declining)

A

Rising each year - 43 million placed in 2012 alone

27
Q

What are the 4 rules of successful implants?

A
  1. Implant CAN’T move
  2. NO radiolucency around the implant
  3. NO pain or infection
  4. Long term - No bone loss and proper function later in life
28
Q

Does the size matter?

A

Well yes! it does. In healthy patients it isn’t as big of a deal but in patients with Peri-implantitis it matters a great deal.

29
Q

Is it better to place a mini implant on a patient with inadequate bone or to take the time and do a bone graft and put a larger implant?

A

Larger implant will be more secure if there is ever bone loss down the road.

30
Q

If you have 6mm of bone buccal-lingual what size implant can you place?

A

4mm - you need 1mm in all directions surrounding the implant with sturdy bone

31
Q

What amount of bone loss would you expect to see each year in an implant patient?

A

.2mm - The same as in non-implant patients

32
Q

How early can an implant start failing?

A

As soon as it is placed?

33
Q

What is a 1st stage implant?

A

The restoration is placed right away, there is no second stage surgery to uncover the implant

34
Q

What is a 2nd stage implant?

A

The restoration goes on after tissue healing and you do a new incision to expose the implant subgingivally

35
Q

If there is exudate and pus what does this mean?

A

Bleeding and pus is a failure of implant osseointegration

36
Q

What is a primary failure to osseointegrate?

- What causes this? (4)

A

Immediate failure of implant

  • Too much torque or pressure was exerted
  • The bone was heated too high
  • Patient was on bisphosphonates
  • Or patient got an infection
37
Q

What is a secondary failure?

- When would this occur?

A

The implant begins to osseointegrate with 2mm pockets at the follow up appointments but you see the patient at a later date (say a year) and it has 6mm pockets are present - This is peri-implantitis

38
Q

If you have bone loss can your patient have peri-implant mucositis?

A

NO - Peri-implant mucositis is a precursor to implantitis which has bone loss

39
Q

What percent of peri-implant mucositis progresses to implantitis?

A

90%

40
Q

In studies of 6000 patients they found that implants placed _____mm or more apical to the CEJ of adjacent teeth got peri-implantitis

A

6mm or more

41
Q

If the tooth next to the implant has gingivitis or perio is it at risk of peri-implantitis or no?

A

Yes

42
Q

If you have a patient who comes in and they have gingivitis or plaque on their existing teeth is is advisable to start treatment for a graft or starting to place an implant?

A

NO

43
Q

Peri-implantitis lesions are characterized by the presence of numerous ________ in the tissue surrounding the implant

A

Neutrophils

44
Q

Is the bacteria found in patients with peri-implantitis the same or different than bacteria found in perio patients?

A

Different

45
Q

Since bacteria is different in peri-implantitis patients than perio patients what does this mean for treatment?

A

A flap and full debridement is necessary

Anti-biotics for these patients will not work the same as perio patients

46
Q

Occlusal trauma is a (primary / secondary) etiological factor for periodontal disease?

A

Secondary

47
Q

Occlusal trauma is a (primary / secondary) etiological factor for peri-implantitis?

A

Primary

48
Q

What is the ideal degree axis for an implant?

A

6 degrees or less from the axis

49
Q

What is the max degree axis for an implant? (the most it can diverge from zero degrees)

A

20 degrees is the max

50
Q

What are the classifications of peri-implantitis?

A

CLI - Slight horizontal bone loss with minimal peri-implant defects
CLII - Moderate horizontal bone loss with isolated vertical defects
CLIII - Moderate to advanced bone loss with broad circular bony defects
CLIV - Advanced horizontal bone loss with circumferential vertical loss, as well as loss of the oral/vestibular bony wall

51
Q

How to treat a CLI peri-implantitis cases

A

Surgical reduction of pocket depth, clean the implant

52
Q

How to treat a CLII peri-implantitis cases

A
  • Surgical reduction of pocket depth, Repositioning more apical, Performing implantoplasty
  • If ≥ 3 walls are affected restore using GTR technique
  • If 1-2 walls are affected osteoclasts or bone leveling
53
Q

How to treat CLIII and CLIV peri-implantitis cases

A
  • The presence of vertical defects almost always requires GTR techniques
  • Dr. Kumar says Explantation (Take that thing out)
54
Q

What is the percentage of peri-implantitis reoccurrence?

A

100%

Periodontology 1 (29 decks)

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