Maintenance Of Dental Implant Patients

Question 1

Natural tooth v implant

Tooth structure

Answer 1

Question 4

Natural tooth v implant

Implant structure

Answer 4

Question 5

Peri implant diseases and conditions

World workshop on classifications of periodontal and peri implant diseases and conditions

Answer 5

2018 - a new classification
- period implant health
- peri implant mucosistis
- peri implantitis
- peri implant soft and hard tissue deficiencies

Question 6

Peri implant health peri implant health

Answer 6

• no inflammation / BOP
• no increase in probing depths
• no bone loss beyond crystal bone level changes resulting from initial bone remodelling

Question 8

Peri implant mucositis

Answer 8

Localised swelling
Redness of tissues
Bleeding / suppuration on gentle probing
No bone loss beyond crystal bone levels since initial bone remodelling

Question 9

Can peri mucositis be reversed

Answer 9

Yes with measures aimed at eliminating plaque

Question 10

Peri implantitis

Answer 10

Visual inflammatory change sin the peri implant soft tissues combined with BOP or suppuration

Increase in probing pocket depths

Progressive bone loss in relation to the radiographic bone level at yr 1

Radiographic evidence of bone level >3mm and / or probing depths 6>mm in conjunction with profuse bleeding

Question 11

When to monitor implants

Answer 11

Monitor at every recall as per the natural dentition

Question 12

Assessment of implants

Answer 12

1. Determine health of peri implant tissue
2. Routine exam 3/6/12 months intervals recommended depending on severity of case / RF for disease development
3. Clinical evaluation of soft tissue around implant (OHR/presence of biofilm on implants and restorations)
4. Dental implants should be visually evaluated and probed routinely (at leats 1x yr)
5. Pocket probing on implants should be conducted with light force 0.25N
6. Peri implant pockets should be <5mm

Question 13

Assessment of implants - what should be recorded

Answer 13

Bleeding on probing BOP
Check for mobility
Intra oral RG evaluation of bone levels around implants
RG to check crystal bone levels

Question 14

Probing

Answer 14

No harm in routine peri implant probing
Calibrated metal or plastic probe
Presence of exudate
BOP
Swelling should be recorded
Presence or absence of plaque
6PPC

Question 15

Radiographs

Answer 15

Baseline RG at time of implant placement
Repeated after first year in function

Question 16

Assessment of pt

Answer 16

Check / reinforce pt technique / OHR
Reassess / reinforce plaque control / smoking cessation

Question 17

Predictive RF

Answer 17

Smoking
Diabetes
History of periodontal disease
Poor plaque control / compliance
Pt not enrolled in regular maintenance programme

Question 18

Support for implant pt

Answer 18

Should be enrolled on a supportive periodontal therapy programme

Question 19

Mechanical scalers

Answer 19

Stainless steel - cuts and damages implant
Plastic - lacks efficiency / shreds on implant threads leaving residue

PEEK (Polyether ether keton)
- superior biofilm removal
- thermo plastic reduces risk of overheating / melting
- no change to implant surface

Question 20

Air polishing

Answer 20

Safe for implant surface
Removes biofilm from implant threads
Air water powder
Effective biofilm removal
No risk of damage / scratching

Question 21

Gentle polishing

Answer 21

Rubber polishing cup
Low abrasive polishing paste
Gentle prophy to avoid trauma / damage of marginal tissues

Question 22

Oral hygiene

Answer 22

Interproximal cleaning
- floss / tepe
- super floss
- IDA

Chemical agents
Chlorhexidine m/w
Listening m/w