Implant Complications

Question 1

Types of Implant Complications

Answer 1

• Biologic
• Mechanical
• Esthetic

Question 2

Biologic Implant Complications

Answer 2

• Mucosal Inflammation (Bleeding, Edema)
• Mucosal Hyperplasia
• Increased PDs
• Bone Loss
• Thread Exposure
• Pain
• Mobility
• Suppuration
• Peri-implant diseases
  
  • mucositis
  • peri-implantitis

Question 3

Mechanical Implant Complications

Answer 3

• Screw Loosening
• Screw Fracture
• Framework Fracture
• Ceramic Fracture
• Implant Fracture

Question 4

Esthetic Implant Complication

Answer 4

• Poor Positioning
• Poor Restoration
• Inadequate tx planning-→Poor Appearance
• Recession
• Soft & hard tissue deficiency

Question 5

Excess Cement

Answer 5

• Signs of Peri-implant disease in 81%
• Increase in:
  
  • Plaque
  • Bleeding index
  • Suppuration
  • Fistula
• Radiographs cant detect
• Impossible to remove all cement when abutment margin ≥ 1mm sub-g

Question 6

What techniques can be used to minimize excess cement?

Answer 6

• Teflon Tape
• Dual Cord
• Venting
• Dummy Abutment

Question 7

Types of Cements

Answer 7

• Types of Cement→Proliferation of bacterial strains
  
  • Methacrylate→ bacterial colonization
    
    • Higher Undetection & peri-implant inflammation
  • Zinc Oxide Non-eugenol→ Less host response in vitro
  • Provisional Cement
    
    • unpredictable retentiveness
    • high solubility
  • Glass Ionomer
    
    • high solubility

Question 8

Screwed or Cement Retained

Answer 8

• Cemented
  
  • biological complications
    
    • implant loss
    • bone loss > 2 mm
    • Increased w/size of prosthesis
• Screw-retained
  
  • technical complications
  • preferred due to:
    
    • retrievability
    • high biological compatibility

Question 9

Cemented Restorations: Clinical Factors

Answer 9

• Implant Position
• Abutment Selection
• Retentive Design
• Position of restorative Margin

Question 10

Prosthetic Design

Answer 10

• Plaque Control
  
  • prevents most biologic complications
• Open Embrasures
  
  • allows interproximal devices
• Limits Biofilm Formation
• Biomaterials
  
  • high biocompaibility
  • high mechanical strength

Question 11

Fracture & loosen:

Answer 11

• Facilitate peri-implant disease
  
  • allows bacteria to colonize b/w prosthetic components

Question 12

Prosthesis Misfit

Answer 12

• Passive Misfit
  
  • increase burden on bone
  • increase colonization of microflora b/w spaces of prosthesis

Question 13

Lack of Keratinized Mucosa

Answer 13

• Increase:
  
  • plaque accumulation
  • inflammation
  • recession
  • attachment loss
• Negatively affect oral hygiene
• soft tissue graft →helps increased KM
  
  • reduce gingival complications (Overdentures)
    
    • physical compression
    • contact w/restorative material
    • biofilm

Question 14

Open Contacts

Answer 14

• Proximal Contact tightness
  
  • decrease over time
• Associated w/peri-implant diseases
• Solution:
  
  • Replace restoration, modify restoration, restore adjacent tooth

Question 15

Esthetic Complications

Answer 15

• Gingival Grafts

Question 16

Retrograde peri-implantitis

Answer 16

• When teeth adjacent to implant have had previous RCT
• When the extracted tooth had a peri-apical infection post-extraction that was not curretted well

Question 17

What is an ailing and failing implant?

Answer 17

• Ailing Implant
  
  • Radiographic Bone Loss
  • No Inflammation or Mobility
• Failing Implant (failed=mobile, nonfxnal)
  
  • Progressive Bone loss
  • Inflammation
  • No Mobility