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Perio lectures > Management of dental implants. > Flashcards

Management of dental implants. Flashcards

1
Q

Fiber orientation on implant v natural teeth

A 
Teeth
perpendicular attachment
Implant
parallel with no attachment to the implant
-So PD will be deeper
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2
Q

What to monitor at Annual exam

A 
 Oral hygiene
 Inflammation
 Bleeding
 Suppuration
 Probe depth
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3
Q

Implant BOP and bone loss

A

Sensitivity of consistent BOP at
implants 60-100% for
progressive bone loss

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4
Q

Periimplant mucositis

A

A disease in which
the presence of inflammation is confined to
the mucosa surrounding a dental implant
with no signs of loss of supporting bone.

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5
Q

Perimplantitis

A

An inflammatory process
around an implant which includes both soft
tissue inflammation and loss of supporting
bone.

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6
Q

Classification of Periimplantitis

A

early
moderate
advanced

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7
Q

Early Peri-implantitis

A

PD ≥ 4 mm with bleeding and/or
suppuration and bone loss <25% of
implant length

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8
Q

Moderate peri-implantitis

A

PD ≥ 6 mm with bleeding
and/or suppuration and bone loss 25-
50% of implant length

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9
Q

Advanced Peri-implantitis

A

PD ≥ 8 mm with bleeding
and/or suppuration and bone loss >50%
of implant length

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10
Q

AAP Threshold for Periimplantitis

A

Radiographic bone loss ≥ 2
mm beyond normal crestal
remodeling

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11
Q

Peri-implant mucositis prevalence

A

 30.7% of implants

 63.4% of patients

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12
Q

Peri-implantitis prevalence

A

 9.6% of implants

 18.8% of patients

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13
Q

AAP recommended maintenance interval

A

6 month

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14
Q

Plastic instruments and implant cleaning

A

 Majority of current evidence shows plastic
instruments are ineffective on implants
 Priority = plaque removal

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15
Q

Types of implant complications

A

Prosthetic
spft tissue
hard tissue

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16
Q

Prosthetic complications

A

Screw fractures
Loose screws/cement
Phonetic masticatory or esthetic problems
growth following placement

17
Q

Excess Cement

A 
Excess cement found in
81% of implants with
peri-implantitis
 Excess cement found in
0% of healthy controls
 74% of cases returned
to health following
endoscopic cement
removal
18
Q

Ailing implant def

A

– Soft tissue complications only
 Complications without bone loss
 Can be non-responsive to therapy

19
Q

Failing implant

A

 Involves bone loss

 Clinical signs without mobility

20
Q

Failed Implant

A

Implant is clinically mobile

requires removal

21
Q

Early v late failure

A

– Early: failure to integrate

– Late: failure to maintain integration

22
Q

Soft Tissue Complications

A 
 Mucositis
 Enlargement
 Loose abutment
 Insufficient
keratinized tissue
23
Q

First step in solving peri implant mucositis

A

Start with oral hygeine

24
Q

Nonsurgical tx for Peri implant mucositis

A 
– Hand scalers
– Ultrasonic
– Subgingival
irrigation
– Superfloss
25
Q

Do you need CHX for tx

A

No studies show no difference v OH alone

26
Q

Mucogingival procedures

A 
– Free soft tissue autograft
– Subepithelial connective tissue graft
– Acellular dermal matrix allograft
 AlloDerm®
– Mucograft®
27
Q

Goals of tx of peri implantitis

A

– Soft tissue health
– Surface decontamination
– Regeneration or resection

28
Q

Bony defect regen sequence

A

– Removal of prosthesis
– Regeneration procedure with or without
submerging implant

29
Q

Regen material for bony defects

A

– Similar to GBR

– Must involve implant decontamination

30
Q

Surface decon of implant

A 
 Citric acid
 Tetracycline
-both harmful to soft tissue
Clindamycin preferred
 Chlorhexidine
31
Q

Surface decon contact time

A

5 min then glycine powder air abrasion

32
Q

Tx of Peri-Implantitis

 Sequence

A 
– Surface decontamination – Air powder
abrasive / TCN / saline
– EMD on implant surface
– FDBA or Bio-Oss + PDGF
– Absorbable collagen membrane
– Connective tissue graft if lacking KT
33
Q

Two categories for failure

A 
– Bacterial: similar flora to chronic
periodontitis
– Biomechanical
 Poor bone quality
 Load transmission
 Parafunction
 Prosthetic superstructure
34
Q

Methods of implant removal

A 
 Use of hand drivers
 Trephines
 Extraction forceps
 Fingers?
 Implant removal kit
35
Q

Dental readiness and implants

A 
 Class I - healthy,
integrated, restored
 Class II or III - ailing,
requiring restoration,
requiring maintenance
 Class III - failing or
failed
 Record should be
stamped on 603a

Perio lectures (10 decks)

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