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CK REVISION LECTURES > IMPLANTS > Flashcards

IMPLANTS Flashcards

1
Q

What are 4 reasons for early implant failure which usually arise from failure of the initial integration to take place during biological healing phase?

A
  • poor surgical technique
  • inability to achieve primary fixation
  • inadvertent implant loading
  • infection and systemic conditions
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2
Q

What are 2 reasons for late implant failure?

A
  • biological failures: caused by plaque-induced peri-implant diseases
  • mechanical failures: caused by unfavourable loading conditions
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3
Q

What are the 4 approaches to implant monitoring and maintenance?

A
  • reduction of risk factors
  • patient education and motivation
  • screening and surveillance
  • instrumentation and intervention
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4
Q

What are 8 local risk factors for implant failures?

A
  • radiotherapy
  • smoking
  • occlusal trauma
  • parafunctional habits and bruxism
  • poor soft tissue biotype
  • poor bone quality and density
  • endo/periapical lesions in adjacent teeth
  • perio disease
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5
Q

What are 3 systemic conditions which contribute to implant failures?

A
  • uncontrolled diabetes
  • immunosuppression
  • bisphosphonates
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6
Q

What are 6 general risk factors for implant failures?

A
  • patient factors; smoking, systemic disease, meds etc
  • host susceptibility; perio, plaque control, control of co-morbidities
  • implant design; roughness of implant surface
  • motivation; patient education
  • prosthetic design; occlusal overload
  • soft tissue quality and quantity; mechanically thick, keratinised, non-mobile mucosa
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7
Q

What are 3 reasons why smoking is a contraindication for implants?

A
  • poor wound healing
  • risk of peri-implant infection
  • crestal bone loss
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8
Q

What advice should be given to smokers prior to implant placement?

A
  • advise to stop smoking before implant placement
  • placement can occur in smokers, but advice and careful monitoring is a must
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9
Q

Which flossing technique should be adopted for patients with implants?

A

cross-over flossing technique

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10
Q

In the first year of implant placement, what is the expected amount of bone loss?

A

<1.5mm

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11
Q

After the first year of implant placement, what is the expected amount of bone loss after this period?

A

0.2mm

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12
Q

The presence of peri-implant radiolucency or crestal bone loss is checked, what is used as the reference point for this?

A

implant shoulder

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13
Q

When estimating bone loss post implant placement, what is used to calculate the magnification factor?

A

distance between implant threads

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14
Q

When should radiographs be taken of an implant?

A
  • at fit
  • 1 year
  • biannually
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15
Q

What is meant by biological width?

A

defined as the dimension of soft tissue which is attached to the portion of the tooth coronal to the crest of the alveolar bone

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16
Q

What is the biological width around implants?

A

2-3mm
2mm is the epithelial attachment
1mm is the supracrestal connective tissue attachment

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17
Q

Violations to the biological width may result in which 2 things?

A
  • gingival inflammation only
  • gingival recession with bone loss
18
Q

Thin, fragile, highly scalloped gingiva is more at risk of what?

A

recession

19
Q

Thin alveolar bone is more at risk of what?

A

horizontal bone loss

20
Q

Thick alveolar bone is more at risk of what?

A

vertical bone loss

21
Q

Probing of implants can be limited by which 3 factors?

A
  • contour of prostheses
  • depth of implant shoulder
  • design of implant shoulder/abutments
22
Q

What is the routine management of implants?

A
  • presence of exudate, bleeding or swelling should be noted together with PPD measurements
  • 6PPC if applicable annually
  • removal of bacteria to improve peri-implant maintenance
23
Q

Which testing can be used to check absence of mobility of implants?

A

a percussion test

24
Q

Which 4 indices should be assessed regularly?

A
  • plaque index
  • bleeding on probing
  • peri-implant probing depth
  • presence of exudate, discharge, sinus or fistula
25
Q

What should be done as part of supportive implant maintenance? (8)

A
  • 3-12 monthly intervals for exams
  • BoP, PPD, plaque, suppuration, mobility
  • check crestal bone levels
  • OHI, smoking cessation
  • check stability of pre-existing health conditions
  • check occlusal trauma
  • check removable prostheses
  • educate/re-inforce implant care
26
Q

Which instruments are not recommended due to scratching the titanium?

A

steel instruments

27
Q

Which instruments are not recommended due to being bulky and known to shed particles not bio-compatible?

A
  • teflon
  • plastic
28
Q

Which bacteria is mostly responsible for the failure of implants?

A

gram negative anaerobes

29
Q

When is an implant considered a failure?

A
  • lost
  • mobile
  • bone loss greater than 1.5 in first year and greater than 0.2 in the following years
30
Q

Which factor plays the most important role in the failure of implants?

A

bacterial infections

31
Q

What are 7 factors in the onset and development of peri-implantitis?

A
  • excessive mechanical stress
  • poor design of the implant
  • diabetes
  • osteoporosis
  • long term use of steroids
  • radiotherapy
  • smoking
32
Q

What is the following the definition of?
a reversible inflammatory change of the peri-implant soft tissues without bone loss

A

peri-implant mucositis

33
Q

What is the following the definition of?
an inflammatory process around osseointegrated implants in function affecting the mucosa and resulting in the loss of supporting bone around the implant

A

peri-implantitis

34
Q

Why are implants more susceptible to infection?

A

the connective tissue attachment in implants has fewer fibre bundles and their orientation tends to run parallel to the implant surface, resulting in less overall protection from invading pathogens

35
Q

What are 6 signs and symptoms of peri-implantitis?

A
  • radiological evidence of vertical destruction of the crestal bone, the defect is usually saucer shaped and there is osseointegration of the apical part of the fixture
  • vertical bone destruction associated with the formation of a peri-implant pocket
  • increasing probing depths
  • bleeding and suppuration on probing
  • possible swelling of the peri-implant tissues and hyperplasia
  • pain is an unusual feature, if present, is associated with an acute infection
36
Q

What are 6 signs and symptoms of peri-implant mucositis?

A
  • swelling
  • bleeding
  • discharge or suppuration
  • pain or tenderness
  • increased pocket depths
  • no evidence of bone loss
37
Q

What is cement associated peri-implantitis?

A

cement is a biofilm retentive factor and once bacteria attaches to it, they are resistant to anti-microbial agents and host defences, cement cannot be removed any more than 1.5mm thus causing plaque retention

38
Q

What are 7 clinical markers that are used to determine the presence and severity of inflammation around an implant?

A
  • plaque and calculus accumulation
  • inflammation of the peri-implant tissues
  • increase in PPD
  • bleeding on probing
  • suppuration from the peri-implant tissues
  • mobility
  • radiographic changes
39
Q

Why do implants have deeper probing depths when compared to natural teeth?

A

no attachment of the junctional epithelium around implant so therefore less resistance, pockets of 2-4mm in health

40
Q

What are 5 risks that are vital for therapists to monitor?

A
  • smoking cessation
  • diabetes control
  • patient education
  • plaque control
  • monitoring health of implant

CK REVISION LECTURES (8 decks)

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