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Periodontics 2 > Implant Complications, Peri-Implantitis and Treatment > Flashcards

Implant Complications, Peri-Implantitis and Treatment Flashcards

1
Q

BIOLOGY OF IMPLANT
Epithelial Attachment
(3)

A

2mm
Long junctional epithelium attached implant
Via basal lamina and hemidesmosomes

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2
Q

BIOLOGY OF IMPLANT
Connective Tissue
(3)

A

Parallel, circular “cuff-like” fiber bundles
Seal with a space of a 20nm wide proteoglycan layer
1-1.5mm high

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3
Q

Supracrestal connective tissue attachment
for Implants
– mm

A

3-4

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4
Q

Soft Tissue Assessment
(3)

A

Dimensions of the papilla
Probing
Dimensions of the buccal soft tissue

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5
Q

Osseointegration vs PDL
(2)

A

Periodontal mechanoreceptors
Higher stress at the neck of the screw/implant

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6
Q

PDL space ~
(2)

A

0.2mm
Sensory feedback

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7
Q

Timed occlusal contacts
Teeth opposing teeth: – microns
Implant opposing teeth: – microns
Implant opposing implant: – microns

A

20
48
64

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8
Q

Vascularity
(3)

A

Limited in peri-implant gingival mucosa
Sources are from alveolar bone and the connective tissue
Same inflammatory response to plaque

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9
Q

Proximity limitations:
Vertical soft tissue limitations:
Tooth-tooth
Tooth-implant
Implant-implant

A

1mm 5mm
1.5mm 4.5mm
3mm 3.5mm

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10
Q

NEW CLASSIFICATION
Peri-implant Diseases and Condition
(4)

A

Peri-implant health
Peri-implant mucositis
Peri-implantitis
Peri-implant hard and soft tissue deficiencies

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11
Q

Peri-implant mucositis
Prevalence:
–% of patients
–% of implants

A

79
50-90

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12
Q

Peri-implant mucositis
(4)

A

Caused by plaque accumulation.
Presence of inflammation.
Reversible condition.
Precursor of peri-implantitis.

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13
Q

Peri-implantitis
Prevalence:
–% of patients
–% of implants

A

20
10-56

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14
Q

Peri-implantitis
(4)

A

Caused by plaque accumulation.
Presence of inflammation.
Loss of supporting bone.
Non-reversible condition.

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15
Q

Peri-implant hard and soft tissue deficiencies
Contributing factors:
(6)

A

tooth loss, trauma, periodontitis, thin
soft tissue, lack of keratinized mucosa,
implant malposition, etc.

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16
Q

The microbiome may be different
although the opportunistic
periodontal pathogens can be
identified in —
patients

A

peri-implantitis

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17
Q

Stronger inflammatory response was
around

A

implants than teeth; need
longer time to complete reverse
peri-mucositis than gingivitis

18
Q

Peri-implantitis contained larger
proportions of (2) than in periodontitis

A

neutrophil granulocytes
and osteoclasts

19
Q

Peri-implantitis
risk factors/indicators
(7)
micromovement

A

Poor plaque control
Lack of regular
maintenance
Tissue quality: thin
phenotype, bone
deficiency
Iatrogenic factors:
malpositioning, poor
design of emergency
profile, inadequate
abutment/implant
seating
Excessive cement
Occlusal overload
Titanium particles:
implant corrosion,

20
Q

Peri-implantitis risk
indicators/modifiers
(4)

A

History of
periodontal disease
Smoking
DM
Genetic factors/
systemic condition

21
Q

Disease presentation
(4)

A

Inflammation:
redness, swelling
Pain
Suppuration
Bone loss

22
Q

CLINICAL EXAMINATION
(3)

A

Peri-implant tissue
Occlusion and mobility
Plaque, probing depth, BOP, exudates

23
Q

Peri-implant probing
CLINICAL EXAMINATION
Diagnostic Procedures
Variables in peri-implant probing:

A
  • Probe Positioning
  • Presence of Inflammation (BoP, Exudates)
    Plastic or Metal?
24
Q

Occlusal overload
(3)

A

Loosening of abutment screws
Implant failure
Prosthetic failure

25
Q

Successful and stable
osseointegrated implants
exhibited NO —

A

mobility

26
Q

Loose crown:
Loose abutment:
Loose implant body;

A

screw or cement has loosened/broken
abutment screw has loosened
Oh, no….

27
Q

Loose crown:
Loose abutment:
Loose implant body;
then

A

Take a radiograph
May need to remove the crown/bridge to evaluate implant body directly

28
Q

KERATINIZED TISSUE WIDTH
MUCOSA THICKNESS
INITIAL TISSUE THICKNESS
– mm

A

2

29
Q

RADIOGRAPH
AT PLACEMENT
Peri-implant radiolucency
Bone level
Assessment
< — bone loss per year after the 1st-year loading Albrektson
< — bone loss starting after loading

A

0.2mm
2mm

30
Q

TREATMENT MODALITIES
(4)

A

Mechanical
Debridement
Implant Surface
Decontamination
Anti-infective
Therapy
Surgical
Technique

31
Q

Mechanical
Debridement

A

SCALERS MADE OF STAINLESS STEEL AND ULTRASONIC TIPS CAN ROUGHEN THE IMPLANT SURFACES CREATING SCARRING AND PITTING.

32
Q

LOCAL DRUG-DELIVERY DEVICES

A

TETRACYCLINE-CONTAINING FIBERS/ DOXYCYCLINE-CONTAINING GEL/ MINOCYCLINE MICROSPHERES

33
Q

Surgical
Technique
(2)

A

IMPLANTOPLASTY
RESECTIVE SURGERY
REGENERATIVE SURGERY
BONE GRAFT
SOFT TISSUE GRAFT

34
Q

MAINTENANCE OF DENTAL IMPLANTS
Provide guidelines for …
Focus on both … around the
dental implant
Work as a team— patient are co-therapists in the
maintenance therapy
Prevent future complications by thorough (2)

A

maintaining the long term health
of the dental implant
hard and soft tissue stability
diagnosis
and treatment planning

35
Q

— early signs of disease
— corrective interventions
Important clinical decisions must be reached
at several stages during treatment and
maintenance of implant patients

A

Detect
Plan

36
Q

Establish useful set of clinical parameters to
evaluate dental implants
Components
(3)

A

Assessment of home care
Examination of peri-implant soft tissue
Radiographic examination

37
Q

Examples of varying protocols are:
(3)

A

Initial placement: 3 months, 6 months, 12 months, every 2 years.
Initial placement: 6 months, 12 months, and every 2 years if no pathology present.
Initial placement: every 6 months if pathology present.

38
Q

A thorough review of —
and modifications
— removal from implant/prosthesis surfaces
Appropriate use of —
Reevaluation of the present — with modification as dictated by the
clinical presentation

A

oral hygiene reinforcement
Deposit
antibiotics
maintenance interval

39
Q

nterproximal brushes can effectively
penetrate up to — into a gingival
sulcus and may effectively clean a
peri-implant sulcus

A

3mm

40
Q

Maintenance treatment should be customized
according to each patient’s systemic and local
risk factors.
Patients with history of periodontitis with
acceptable self-care: —recare interval
Patients with no systemic or local risk factors:
— recare interval

A

3-month
6 month

41
Q
A

Periodontics 2 (13 decks)

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