Implant Success or Failure Clinical Assessment

Question 1

often used for evaluation of implant success

Answer 1

periodontal indices

Question 2

criteria to determine implant success

Answer 2

1. pain
2. rigid fixation
3. probing depth
4. bone loss
5. bleeding index
6. peri-implant disease
7. percussion
8. radiographic evaluation

Question 3

forces where pain should be absent for implant success

Answer 3

vertical and horizontal forces

Question 4

implant is almost never temperature sensitive but can become tender from ______________

Answer 4

percussion

Question 5

T or F: implant tenderness indicates failed treatments

Answer 5

F; may have success

Question 6

indicates an absence of clinical mobility of an implant under 1 to 500g vertical or horizontal forces

Answer 6

rigid fixation

Question 7

implants with this horizontal movement may return to rigid fixation and zero mobility

Answer 7

less than 0.5 mm horizontal movement

Question 8

computer-mechanical device that measures he damping effect against an object

Answer 8

periotest

Question 9

pocket probing depth of stable rigid fixated implants

Answer 9

2-6mm

Question 10

implant sulcus measurements that favors loss of bone

Answer 10

6mm or more

Question 11

uses fixed reference points on the abutment; allows evaluation of crestal bone loss

Answer 11

probing

Question 12

other factors revealed by probing besides crestal bone loss

Answer 12

• tissue consistency
• bleeding
• exudate

Question 13

used in probing to prevent scratching implant surface

Answer 13

plastic probes

Question 14

level of ________ around an endosteal implant should be compared to the initial placement position of the implant

Answer 14

crestal bone

Question 15

may evaluate bone loss more accurately than radiograph

Answer 15

probing depth

Question 16

(bone loss) implant is at significant risk when…

Answer 16

more than 1/3 of the implant height has lost crestal bony contact

Question 17

most commonly used bleeding index for implants

Answer 17

Loe and Silness gingival index (GI)

Question 18

indicated for sulcus depth of less than 5mm and increased bleeding index

Answer 18

chlorhexidine

Question 19

(bleeding index) more common BOP sulcus depth; usually requires reentry surgery

Answer 19

bleeding on probing with sulcus depths more than 5-6mm

Question 20

indicated for 1 year of stable probing depths

Answer 20

• spot check examinations
• maintenance appointments

Question 21

Loe & Silness Gingival Index Scores

Answer 21

0 - normal gingiva
1 - mild inflammation
2 - moderate inflammation
3 - severe inflammation

Question 22

(GI) Score 0

Answer 22

normal gingiva

Question 23

(GI) Score 1

Answer 23

• mild inflammation
• slight change in color
• slight edema
• no BOP

Question 24

(GI) Score 2

Answer 24

• moderate inflammation
• redness
• edema and glazing
• BOP

Question 25

(GI) Score 3

Answer 25

- severe inflammation - marked redness and edema - ulceration - spontaneous bleeding

Question 26

pathologic process involving the region of the soft tissue above the crest of bone

Answer 26

gingivitis

Question 27

gingivitis can be...

Answer 27

1. plaque-associated 2. acute necrotizing 3. ulcerative 4. hormonal 5. drug-induced 6. spontaneously occuring

Question 28

(peri-implant disease) indicates peri-implantitis and consequent bone loss

Answer 28

exudate

Question 29

(peri-implant disease) can occur due to reduced amount of bone

Answer 29

secondary occlusal trauma

Question 30

treatment for peri-implant disease

Answer 30

- short-term antibiotic treatment - chlorhexidine - aggressive professional and patient care

Question 31

treatment for presence of exudate persisting for more than 1-2 weeks

Answer 31

- force reduction - surgical management of condition

Question 32

neither an indicator of clinical health nor of the state of rigid fixation

Answer 32

percussion

Question 33

"ringing" sound in percussion corresponds to...

Answer 33

presence of "some" bone at the interface

Question 34

most useful diagnostic tool in determination of a healthy implant

Answer 34

crestal bone region

Question 35

used primarily to determine the need for initial preventive therapy

Answer 35

crestal bone loss

Question 36

usually a result of stress at the perimucosal site

Answer 36

early loss of crest bone

Question 37

implant failure indications

Answer 37

- 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

Question 38

a scale presented for implant quality based on clinical evaluation; first established by James and modified by Misch

Answer 38

Implant Quality Scale

Question 39

Implant Quality Scale groups

Answer 39

- Group 1 - Group 2 - Group 3 - Group 4 - Group 5

Question 40

(Implant Quality Scale) Group 1

Answer 40

- optimum conditions - bleeding index: 0-1; early indicator of soft tissue problems

Question 41

(Implant Quality Scale) Group 2

Answer 41

- implants are stable but show history of clinical problems - bleeding index: 0-2

Question 42

(Implant Quality Scale) Group 3

Answer 42

- questionable quality - warrants clinical therapy - exudate: may last more than 1-2 weeks in preceding 3 years - bleeding index: 1-3

Question 43

(Implant Quality Scale) Group 4

Answer 43

- clinical failure - should be removed under 5 conditions

Question 44

5 conditions of Group 4 implant removal

Answer 44

1. pain on palpation or function 2. > 1mm mobility horizontally 3. any vertical mobility or progressive bone loss 4. uncontrolled exudate 5. generalized radiolucency "sleepers"

Question 45

(Implant Quality Scale) Group 4

Answer 45

- implants surgically removed or exfoliated - no longer in mouth