Peri implant disease and maintenance Flashcards
peri-implant health; definition
absence of clinical signs of inflammation
absence of bleeding or suppuration on gentle probing
no increase in pocket depth compared to previous examinations
absence of bone loss beyond crestal bone level changes resulting from initial bone remodelling
allows for the presence of a single bleeding spot around the implant
peri-implant mucositis: definition
an inflammatory lesion of the peri-implant mucosa, in the absence of continuing marginal bone loss
- reversible
peri-implant mucositis signs and symptoms
erythema
bleeding on probing
swelling/suppuration
increase in pocket depth (due to oedema)
peri-implantitis: definition
peri-implant biolfim-associated pathological condition, occurring in tissues around dental implants, and characterised by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone
peri-implantitis signs and symptoms
inflmmation
bleeding on probing and/or suppuration
increased probing depth and/or recession of the mucosal margins
radiographic bone loss compared to previous examinations
aetiology of peri implant mucositis
plaque, smoking, radiation therapy
aetiology of peri-implantitis
plaque, lack of regular supportive peri-implant care
implants - hidden costs
costs of maintaining implants estimated to be approx 5 times the cost of maintaining teeth
cost to treat peri-implantitis - £1500
primordial prevention - aim
preventing the development of risk factors
inpatients waiting implant placement, it is recommended that you:
carry out through assessment of patient’s risk profile
manage modifiable risk factors/indicators for peri-implant disease
complete guideline conformed treatment of gingivitis and periodontitis to a stable endpoint and adherence to a supportive care program prior to implant placement
assessing implants
palpate buccal bone/mucosa around implant
- soreness/suppuration?
compare radiograph to baseline
6ppc around implant tooth every assessment
peri implantitis: how to diagnose in the absence of previous examination data
presence of bleeding and/or suppuration on gentle probing
PPD of greater than or equal to 6mm
bone levels greater than or equal to 3 mm apical of the most coronal portion of the intraosseous part of the implant
peri-implant disease predisposing factors
history of severe periodontitis
poor plaque control
no regular supportive peri-implant care
smoking
diabetes
local factors that may predispose to peri-implant disease
submucosal cement
positioning of implants limiting access to oral hygiene and maintenance
absence of peri-implant keratinised mucosa
occlusal overload
presence of titanium particles within peri-implant tissues
bone compression necrosis, overheating, micro motion or bio corrosion
role of the GDP in implant cases
regular routine holistic care of the patient before and after implants
patient prepration
- clinical
- emotional
information resource
- technical aspects - what pt should expect
- where to go and who to see
making the referral
after care and ongoing maintenance
implants - working out what is happening
why does person need an implant
- congenitally missing teeth
- tumour resscetion
- trauma
- endodontic failure
- perio
- aesthetic
is there disease present?
dental specialities likely to be involved in implants
oral surgery
periodontology
restorative
prosthodontics
how to assess a dental implant and its restoration
look for inflammation or infection
check OH
probe around implant
check restoration for signs of cracks, loosening and cleansability
radiograph
