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DMD3 sem 2 > Implant Maintain and Complications > Flashcards

Implant Maintain and Complications Flashcards

1
Q

What are the success criteria for implant patients?

A

No mobility

No radiographic peri implantitis signs

BL <0.2mm after year 1

No pain or parasthesia

Aesthetic success

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2
Q

How does a dental implant compare with natural tooth?

A

Connection in tooth: PDL, bone, and cementum.
Connection in implant: Ankylosis

JE in tooth: HD, complex BL
JE in dental implant: HD and BL

Connective tissue: Tooth = 13 groups, implant = 2 groups

BOP is more reliable in natural tooth than implants

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3
Q

What is peri-implantitis caused by?

A

Systemic illness

Smoking

Alchohol

Occlusal problems

Iatrogenic

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4
Q

What causes peri-implant mucositis?

A

Residual cement

Poor oral hygiene

Poorly contoured restorations

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5
Q

How common is mucositis and peri-implantitis?

A

Mucositis = 48%

Peri-implantitis = 6 - 61%

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6
Q

How common is mucositis and peri-implantitis?

A

Mucositis = 48%, 63.4%

Peri-implantitis = 6 - 61%, 18.8%

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7
Q

What are the characteristics of peri-implantitis?

A

Pus formation

Plaque and PPD

Redness and BOP

Mucositis

PD > 5mm

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8
Q

Is peri-implantitis correlated with periodontitis?

A

21% correlation. Not significant.

Regular maintenance following implant placement reduced frequency of peri-implantitis to 14.3%

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9
Q

Why are there more complications in using implants?

A

Increase in number of implants placed and number of dentists placing implants.

Limited undergraduate exposure to implants

Need to learn from industry short run courses.

Placement using aggressive protocols in compromised sites

High success rates reported in the courses

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10
Q

What are the risk factors for complications when placing implants?

A

Infection

Tissue trauma

Occlusal overload

Iatrogenic

Smoking

Poor oral hygiene

History of periodontitis

Prosthesis design

Implant surface (rough has higher risk)

Bone overheating

Micromovement during healing

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11
Q

What iatrogenic risk factors increase risk of peri-implantitis?

A

Band of keratinised tissue <2mm

Polyglactin sutures (Vicryl)

Narrow implants <3.5mm

Poor placement

Operator skill (First 100 implants worst success rates)

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12
Q

What causes early implant complications?

A

Infection

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13
Q

What causes late implant complications?

A

Infection / Overload

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14
Q

What are the symptoms that differentiate peri-implantitis due to infection from that due to trauma?

A

Infection: Pain, BOP, pus, PD>7mm, High gingival index and plaque index, Granuloma

Trauma and infection: Pain in some trauma cases, mobility, and peri-implant radiolucency

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15
Q

What other complications can arise due to implants?

A

Aesthetics due to recession and gingival asymmetry

Pain

Parasthesia

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16
Q

Is there an association between success of implants and past periodontitis?

A

Yes, 96% compared to 90%.

17
Q

How should peri-implant maintenance be done?

A

Assess: Colour, crater, texture, and keratinised tissue. Assess prosthesis type.

Identify: Probe around the implant (Very lightly 0.15 - 0.2N), check for pus, bleeding, and exudate.

Monitor: Diagnostic parameters.

Specialist referral

18
Q

How can complications be treated?

A

If plaque/BOP -> Mechanical therapy (plaque removal)

If Pd 4 - 6mm -> Antiseptics (alcohol/listerine)

If Pd 6mm +/- pus -> AB-local/systemic

If Pd and pus -> Resective/regenerative

19
Q

What instruments are used to clean plaque around instrument?

A

US with sleeve

Plastic teflon nylon coated instruments

Titanium and polishing paste

Air powder abrasive sprays

Rotating titanium brushes

20
Q

What non-surgical therapies are used for peri-implantitis?

A

Debridement

Irrigation

Laser debridement

PDT

Local antimicrobials

Systemic ABs

21
Q

What are the types of surgical therapy for peri-implantitis?

A

Resective (thick tissues fare better)

Regenerative (total defect fill/reintegration?)

Explantation (explantation SR drop)

22
Q

Which treatment is best at reducing periodontal probing depth?

A

GBR > Access flap = Bone grafting > Resection

All methods are effective in increasing CAL gain.

23
Q

How are implant surfaces decontaminated?

A

Curettes plastics Stainless steel

Saline/CHX

Lasers

Implantoplasty

Antimicrobials

24
Q

How does surgical treatment compare to non-surgical treatment for decontaminating implant surfaces?

A

Non surgical treatment decreased PPD and CAL by 1mm

Short term reduction in inflammation

Surgical was better than non surgical (quality of decontamination)

Danger of microcracks with laser treatment

DMD3 sem 2 (69 decks)

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