Implants Flashcards
What are the two types of complications seen in implants?
Early implant failure.
Late implant failure.
What is early implant failure?
Failure of integration during the biological healing phase.
What is the early implant failure due to?
Poor surgical technique.
Inability to achieve primary fixation.
Implant loading.
Systemic conditions.
What are late biological failures due to?
Biological failures.
Mechanical failures.
What are the areas to focus on when maintaining implants?
Reduction of risk factors.
Patient education and motivation.
Screening
Instrumentation and intervention.
What are the local risk factors that affect implants?
Radiotherapy
Smoking
Poor bone quality
Periodontal disease
Occlusal trauma
Parafunctional habits
Periapical lesions in adjacent teeth.
Unrealistic patient expectations.
Poor soft tissue biotype.
What are the systemic risk factors that affect implants?
Uncontrolled diabetes.
Immunosuppression.
Medications (Bisphosphonates).
How can risk factors for peri-implant disease be reduced?
Patient factors
Prosthetic design
Soft tissue quality
Patient education
Implant design
Plaque presence
Why is smoking a contraindication to implant placement?
Due to the increased risk of peri-implant infection, crestal bone loss and poor wound healing.
What causes peri-implantitis?
An adherent layer of plaque on the implant is responsible for altering the biocompatibility of implant surfaces.
What OHI should be given to patients with implants?
Correct use of toothbrush.
ID cleaning is essential.
Sub-gingival cleaning with single tufted brush.
When can the cross-over floss technique be used?
In the aesthetic zone when the implant is placed in the ideal position.
What can a good flossing technique lead to with implants?
Good subgingival flossing will result in epithelialized sulcular tissue down to the implant neck.
When should the patients OH be reviewed?
2 weeks after placement.
What can poor cleaning technique lead to?
Self induced peri-implantitis from trauma.
When should radiographs be taken of implants?
Periapical radiographs should be taken: -
After placement.
At 1 year.
Bi-annually
Signs or symptoms.
What amount of bone loss is acceptable around an implant?
<1.5mm in the first year.
0.2mm there after.
What can be used to assess bone loss around implants?
The implant shoulder.
The distance between implant threads.
Baseline radiographs.
What is biological width?
The dimension of soft tissue which is attached to the portion of the tooth to the crest of the alveolar bone.
What is the biological width around an implant?
2-3mm
What is the biological width of an implant made of?
2mm epithelial attachment.
1mm supra crestal connective tissue attachment.
Why is the biological width important in implant placement?
It is important to the position of the restorative margins and impact on post surgical tissue.
What can violations in biological width result in?
Gingival inflammation.
Gingival recession with bone loss.
What is thin scalloped gingivae more at risk of?
Recession
