Implant Success or Failure Clinical Assessment Flashcards
often used for evaluation of implant success
periodontal indices
criteria to determine implant success
- pain
- rigid fixation
- probing depth
- bone loss
- bleeding index
- peri-implant disease
- percussion
- radiographic evaluation
forces where pain should be absent for implant success
vertical and horizontal forces
implant is almost never temperature sensitive but can become tender from ______________
percussion
T or F: implant tenderness indicates failed treatments
F; may have success
indicates an absence of clinical mobility of an implant under 1 to 500g vertical or horizontal forces
rigid fixation
implants with this horizontal movement may return to rigid fixation and zero mobility
less than 0.5 mm horizontal movement
computer-mechanical device that measures he damping effect against an object
periotest
pocket probing depth of stable rigid fixated implants
2-6mm
implant sulcus measurements that favors loss of bone
6mm or more
uses fixed reference points on the abutment; allows evaluation of crestal bone loss
probing
other factors revealed by probing besides crestal bone loss
- tissue consistency
- bleeding
- exudate
used in probing to prevent scratching implant surface
plastic probes
level of ________ around an endosteal implant should be compared to the initial placement position of the implant
crestal bone
may evaluate bone loss more accurately than radiograph
probing depth
(bone loss) implant is at significant risk when…
more than 1/3 of the implant height has lost crestal bony contact
most commonly used bleeding index for implants
Loe and Silness gingival index (GI)
indicated for sulcus depth of less than 5mm and increased bleeding index
chlorhexidine
(bleeding index) more common BOP sulcus depth; usually requires reentry surgery
bleeding on probing with sulcus depths more than 5-6mm
indicated for 1 year of stable probing depths
- spot check examinations
- maintenance appointments
Loe & Silness Gingival Index Scores
0 - normal gingiva
1 - mild inflammation
2 - moderate inflammation
3 - severe inflammation
(GI) Score 0
normal gingiva
(GI) Score 1
- mild inflammation
- slight change in color
- slight edema
- no BOP
(GI) Score 2
- moderate inflammation
- redness
- edema and glazing
- BOP
(GI) Score 3
- severe inflammation
- marked redness and edema
- ulceration
- spontaneous bleeding
pathologic process involving the region of the soft tissue
above the crest of bone
gingivitis
gingivitis can be…
- plaque-associated
- acute necrotizing
- ulcerative
- hormonal
- drug-induced
- spontaneously occuring
(peri-implant disease) indicates peri-implantitis and consequent bone loss
exudate
(peri-implant disease) can occur due to reduced amount of bone
secondary occlusal trauma
treatment for peri-implant disease
- short-term antibiotic treatment
- chlorhexidine
- aggressive professional and patient care
treatment for presence of exudate persisting for more than 1-2 weeks
- force reduction
- surgical management of condition
neither an indicator of clinical health nor of the state of rigid fixation
percussion
“ringing” sound in percussion corresponds to…
presence of “some” bone at the interface
most useful diagnostic tool in determination of a healthy implant
crestal bone region
used primarily to determine the need for initial preventive therapy
crestal bone loss
usually a result of stress at the perimucosal site
early loss of crest bone
implant failure indications
- horizontal mobility beyond 1mm or any clinical observed vertical movement under less than 500g force
- rapid progressive bone loss regardless of stress reduction or peri-implant therapy
- pain during percussion or function
a scale presented for implant quality based on clinical evaluation; first established by James and modified by Misch
Implant Quality Scale
Implant Quality Scale groups
- Group 1
- Group 2
- Group 3
- Group 4
- Group 5
(Implant Quality Scale) Group 1
- optimum conditions
- bleeding index: 0-1; early indicator of soft tissue problems
(Implant Quality Scale) Group 2
- implants are stable but show history of clinical problems
- bleeding index: 0-2
(Implant Quality Scale) Group 3
- questionable quality
- warrants clinical therapy
- exudate: may last more than 1-2 weeks in preceding 3 years
- bleeding index: 1-3
(Implant Quality Scale) Group 4
- clinical failure
- should be removed under 5 conditions
5 conditions of Group 4 implant removal
- pain on palpation or function
- > 1mm mobility horizontally
- any vertical mobility or progressive bone loss
- uncontrolled exudate
- generalized radiolucency “sleepers”
(Implant Quality Scale) Group 4
- implants surgically removed or exfoliated
- no longer in mouth
