implant assessment & maintenance

Question 1

To private patients, what would the cost of dental implants be?

Answer 1

£2000-4000

Question 2

What percentage of patients with implants will have bone loss?

Answer 2

20%

Question 3

Which are the 3 main brands of implant?

Answer 3

1. Staumann
2. Nobel Biocare
3. Densply Sirona

Question 4

What diameter are standard implants?

Answer 4

3.5-5.5mm in width.

Question 5

Options for restoring implants.

Answer 5

1. Single crowns.
2. Bridges F-F or F-C
3. Full arch bridges.
4. Cement or screw retained (ideally screw)
5. Dentures - locators, balls and bars.

Question 6

What is used when taking impressions for implants?

Answer 6

Transfer Coping

Question 7

How many screws could be used for a metal ceramic full arch bridge (6-6)?

Answer 7

4 screws

Question 8

What attaches to locator abutments?

Answer 8

Dentures

Question 9

Why would a patient choose an implant retained denture over a conventional denture?

Answer 9

1. Not as many implants required to fit a denture than a bridge.
2. Soft tissue discrepancies

Question 10

Differences between teeth and implants:

Answer 10

1. Implants have no PDL - osseointegrated so less movement.
2. Implants have weak connective tissue attachment - no junctional epithelium.
3. Implants more susceptible to inflammation.
4. Implants are much narrower than the root they replace.
5. Crown of the implant has a greater emergence from ‘root’.

Question 11

Why does the crown of an implant have a greater emergence than a tooth?

Answer 11

Crown must be wider in order to support the soft tissues.

Question 12

Should a BPE be conducted around an implant site?

Answer 12

No - BPEs assume there is normal root structure and junctional epithelium.

Question 13

Which other factors are a greater indicator of implant health instead of pocketing?

Answer 13

1. Bone loss.
2. Pus (suppuration).
3. Bleeding
4. Changes in pocket depth.

Question 14

What kind of probe should be used to probe around peri-implant tissues?

Answer 14

Plastic probe - more flexible.

Question 15

Radiograph protocols for implant maintenance:

Answer 15

1. Baseline IOPA taken at time of restoration.
2. Review in 1-3 months, check OH.
3. 1 Year IOPA - common to see remodelling; new baseline.
4. Take IOPAs every 2 years OR sooner if change detected.

Question 16

Which factor determines the extent of bone loss following implant placement?

Answer 16

Mucosal Thickness

Question 17

What are the 4 diagnoses relating to peri-implant tissues?

Answer 17

1. Peri-implant health.
2. Peri-implant mucositis.
3. Peri-implantitis.
4. Peri-implant soft and hard tissue deficiencies.

Question 18

How would you define peri-implant health?

Answer 18

Absence of visual signs of inflammation and bleeding on probing.

Question 19

Define Peri-Implant Mucositis

Answer 19

Characterised by bleeding on probing and visual signs of inflammation

Question 20

Define peri-implantitis.

Answer 20

Plaque-associated pathologic condition associated with bone loss and bleeding on probing.

Question 21

In peri-implantitis, how would you describe the radiographic presentation of bone loss to be concerned about?

Answer 21

Cratering bone loss, u-shaped rather than V-shaped.

Question 22

What is the first step after detecting bleeding around peri-implant tissues?

Answer 22

Addressing risk factors.

Question 23

Techniques to minimise risk factors:

Answer 23

1. OHI - super floss.
2. Smoking Cessation
3. Diabetes Control
4. Look at prosthetic design.

Question 24

How is diabetes linked to peri-implantitis?

Answer 24

Bidirectional relationship.

Question 25

Problems with implants:

Answer 25

1. Peri-implant mucosal inflammation and peri-implantitis
2. Screw loosening and occasionally fracture (examine by movement).
3. Wear of overdenture components

Question 26

What amount of bone in mm would be best in order to have a successful dental implant?

Answer 26

1.5mm of bone all the way round the implant.