Peri-implant Disease / Maintenance

Question 1

Define peri-implant health

Answer 1

Absence of inflammation

Absence of bleeding (1 spot of bleeding allowed) / supparation

No increase in pocket depth compared to previous examinations - (up to 5mm)

Absence of bone loss beyond crestal bone level changes

Question 2

Define PI mucositis

Answer 2

Inflammation, bleeding or suppuration on probing of the implant in the absence of marginal bone loss

Question 3

Good identifier if bone has been lost around implant?

Answer 3

Bone is not covering all the threads of the implant

Question 4

What is peri-implantitis

Answer 4

Peri-implant biofilm associated pathological condition occurring in tissues around dental implants, characterised by inflammation and loss of supporting bone’

• pocket depth >5mm
• bleeding / suppuration (maybe)

Question 5

What % of people with implants have peri-implant mucositis and implantitis?

Answer 5

Mucositis - 43%

Implantitis - 22%

Question 6

What perio chart is needed for an implant?

Answer 6

6ppc for the implant, and each implant, regardless of health

Question 7

Pre-dispose to peri-implant disease?

Answer 7

History of severe perio

Poor plaque control

No-regular supportive peri-implant care

Smoking

Diabetes

Local
- XS cement
- poor imp positioning
- occlusal overload
- absence of keratinised mucosa around implant

Question 8

Risk factors for peri-implant disease?

Answer 8

Smoking
Diabetes
Periodontal disease
Likelihood of further tooth loss
Lack of adherence to maintenance care
Inadequate OH
Prosthesis design / placement

Question 9

How can the prosthetic itself cause implant disease?

Answer 9

Poorly fitting crown / margins
- not cleanable / impeding on tissues

Question 10

A perio pt asking about implants, what must I inform them of and do?

Answer 10

Increased risk of peri-implant disease
- including poor implant placement, poor implant choice etc

Advise increased need of maintenance care

Control risk factors and active disease

Communicate patients periodontal condition to appropriate individuals

Question 11

What can be expected with regards to the periodontium / hard tissues after implant placement?

Answer 11

Bone remodelling
- no more than 0.2mm annual crestal bone loss should be expected
- osseointegration successful ? Rare to lose implant

Question 12

Why is regular review and maintenance of implants beneficial to clinician?

Answer 12

Prevent inflammation developing round an implant

Identify problems at early stage

Provide support for prosthesi

Enhance longevity of prosthesis