implant assessment & maintenance Flashcards
To private patients, what would the cost of dental implants be?
£2000-4000
What percentage of patients with implants will have bone loss?
20%
Which are the 3 main brands of implant?
- Staumann
- Nobel Biocare
- Densply Sirona
What diameter are standard implants?
3.5-5.5mm in width.
Options for restoring implants.
- Single crowns.
- Bridges F-F or F-C
- Full arch bridges.
- Cement or screw retained (ideally screw)
- Dentures - locators, balls and bars.
What is used when taking impressions for implants?
Transfer Coping
How many screws could be used for a metal ceramic full arch bridge (6-6)?
4 screws
What attaches to locator abutments?
Dentures
Why would a patient choose an implant retained denture over a conventional denture?
- Not as many implants required to fit a denture than a bridge.
- Soft tissue discrepancies
Differences between teeth and implants:
- Implants have no PDL - osseointegrated so less movement.
- Implants have weak connective tissue attachment - no junctional epithelium.
- Implants more susceptible to inflammation.
- Implants are much narrower than the root they replace.
- Crown of the implant has a greater emergence from ‘root’.
Why does the crown of an implant have a greater emergence than a tooth?
Crown must be wider in order to support the soft tissues.
Should a BPE be conducted around an implant site?
No - BPEs assume there is normal root structure and junctional epithelium.
Which other factors are a greater indicator of implant health instead of pocketing?
- Bone loss.
- Pus (suppuration).
- Bleeding
- Changes in pocket depth.
What kind of probe should be used to probe around peri-implant tissues?
Plastic probe - more flexible.
Radiograph protocols for implant maintenance:
- Baseline IOPA taken at time of restoration.
- Review in 1-3 months, check OH.
- 1 Year IOPA - common to see remodelling; new baseline.
- Take IOPAs every 2 years OR sooner if change detected.
Which factor determines the extent of bone loss following implant placement?
Mucosal Thickness
What are the 4 diagnoses relating to peri-implant tissues?
- Peri-implant health.
- Peri-implant mucositis.
- Peri-implantitis.
- Peri-implant soft and hard tissue deficiencies.
How would you define peri-implant health?
Absence of visual signs of inflammation and bleeding on probing.
Define Peri-Implant Mucositis
Characterised by bleeding on probing and visual signs of inflammation
Define peri-implantitis.
Plaque-associated pathologic condition associated with bone loss and bleeding on probing.
In peri-implantitis, how would you describe the radiographic presentation of bone loss to be concerned about?
Cratering bone loss, u-shaped rather than V-shaped.
What is the first step after detecting bleeding around peri-implant tissues?
Addressing risk factors.
Techniques to minimise risk factors:
- OHI - super floss.
- Smoking Cessation
- Diabetes Control
- Look at prosthetic design.
How is diabetes linked to peri-implantitis?
Bidirectional relationship.
Problems with implants:
- Peri-implant mucosal inflammation and peri-implantitis
- Screw loosening and occasionally fracture (examine by movement).
- Wear of overdenture components
What amount of bone in mm would be best in order to have a successful dental implant?
1.5mm of bone all the way round the implant.
