Implant Mx

Question 1

NP attends CO of food packing and numbness following implant placement 2 years ago - explain to pt why numb

Answer 1

Advised when lower posterior implants are placed there is a risk of damaging the inferior alveolar nerve
This is nerve which supplies the teeth, lip and chin
If injured can present different ways

Question 2

What are 4 different ways a nerve injury can present?

Answer 2

Anaesthesia - lack of sensation
Paraesthesia - altered sensation
Hypoesthesia - reduced sensation
Dyasthesisa - abnormal, unpleasant sensation

Question 3

What causes dyasesthesia?

Answer 3

Damage to the peripheral nerves

Question 4

If a nerve is stretched or bruised, what is the most likely type of damage?

Answer 4

Temporary

Question 5

If a pt has numbness after 18 months would expect sensation to return?

Answer 5

Very unlikely

Question 6

What signs may indicate implant failure in future?

Answer 6

Bleeding on brushing - peri-implantitis
Implant mobility - lack of osseous-integration
Pain on biting

Question 7

If suspect implant is failing, what radiographs could be considered?

Answer 7

Long cone PA - first shoice
OPT
CBCT

Question 8

What signs on RAD would suggest implant failure?

Answer 8

Bone loss surrounding implant
Radiolucent line around length of implant

Question 9

Following implant placement, what should be done to reduce chance of failure?

Answer 9

OH instruction
Follow up
Maintenance

Question 10

What OH instruction to give to implant pt?

Answer 10

brush 2x daily, daily interprxoimal cleaning

Question 11

How should dental implants be maintained?

Answer 11

Scaling to remove plaque and calculus - titanium scalers should. be used to minimise scratching

Question 12

What factors affect implant success?

Answer 12

MH
SH - smokers
Poor OH - inc past/ current perio

Question 13

What MH should be looking out for if placing implants?

Answer 13

Osteoporosis
Drugs - bisphosphonates/ steroids
Previous radiotherapy to implant site