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Implantology > Peri-Implant Diseases > Flashcards

Peri-Implant Diseases Flashcards

1
Q

Peri-Implant Health

A
  • No Inflammation
  • No BOP
  • No Suppuration
  • No ⇡ PDs
  • No Bone Loss
    • only bone remodeling
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2
Q

Peri-Implant Mucositis

A
  • BOP
  • Suppuration-maybe
  • No PD Change
    • with or without
  • No Bone Loss
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3
Q

Peri-Implant Implantitis

A
  • BOP
  • Suppuration-maybe
  • ⇡ PD
  • Bone Loss
  • if no previous exam data:
    • BOP
    • Suppuration (maybe)
    • PD ≥ 6mm
    • Bone Level ≥ 3mm apical to most coronal intraosseous part of implant
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4
Q

Peri-Implant Hard and Soft Tissue Deficiences

A
  • Hard Tissue
    • Before Implant Placement
      • Systemic Diseases
      • Tooth Loss
      • Trauma
      • Trauma from Tooth Extraction
      • Periodontitis
      • Endo Infection
      • Longitudinal Root Fractures
      • Posterior Maxilla Bone Height
    • After Implant Placement
      • Systemic Diseases
      • Healthy Defects
      • Implant Malposition
      • Peri-implantitis
      • Mechanical Overload
      • Soft Tissue Thickness
  • Soft Tissue:
    • Before Implant placement:
      • Systemic Diseases
      • Tooth Loss
      • Periodontal Disease
    • After:
      • No Buccal Bone
      • Papilla Height
      • Keratinized Tissue
      • Tooth Migration
      • Life-Long Skeletal Changes
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5
Q

Peri-implantitis vs Peri-mucositis: Etiology & Tx

A
  • Mucositis:
    • Etiology: Xs Cement (86%)
    • remove XS and GBR
  • Implantitis:
    • Etiology: Plaque
    • mechanical debridement
      • resolves in 3 weeks
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6
Q

Clinical Differences b/w healthy periodontal and peri-implant tissues

A
  • No visual differences
  • PD:
    • Implant > Tooth
  • Interproximal Papilla:
    • Implant=Shorter
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7
Q

What does a peri-implant exam consist of?

A
  • Inflammation:
    • visual
    • probing
      • BOP
      • PD
      • Mucosal Margin migration
    • Palpation
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8
Q

Ailing Implant vs Failing Implant vs Failed Implant

A
  • Ailing:
    • No Mobility
    • No Inflammation
    • Radiographic Bone Loss
  • Failing Implant:
    • No Mobility
    • Inflammation
    • Progressive Bone Loss
  • Failed:
    • Mobile
    • Non-functional
    • Need to remove
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9
Q

CIST

A
  • Cumulative Interceptive Supportive Therapy
  • Based one periodic diagnosis
  • 4 Treatment Modalities:
    • A= Mechanical
    • B= Antiseptic Treatment
    • C: Antibiotic Tx
    • D: Regeneratie or resectie surgery
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10
Q

Peri-implant disease: Risk Factors

A
  • Poor Plaque Control
  • No Maintenace
  • Smoking/Diabetes
  • History of Perio
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11
Q

What should you do after finishing implant supported prosthesis?

A
  • Baseline:
    • radiographs
    • PD
  • Radiographs after loading period
    • Bone Level Reference after remodeling
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12
Q

Patient Plaque Control around Implant

A
  • Methods:
    • Floss
    • Sulcular Bass Brushing Technique
      • Cleans under mucosa
      • caution with Narrow WKG
    • After osseointegration:
      • Interdental Brush
      • Rubber Tip
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13
Q

Professional Plaque Control around Implant

A
  • Perio Maintenance:
    • 3-4 months if tooth loss due to caries or perio
  • Minimal Damage to transmucosal surfaces when removing plaque and calc
    • ex: Polished titanium implant collar
  • Gold or ceramic surfaces
    • use most scalers and curettes w/no damage
    • ex: Plastic, gold coated, stainless steel
  • Metal Probe
    • no concern→Minimal surface alteration
    • Plastic Probe=Effective
  • Rubber Cup & Polishing Paste
    • remove biofilm
    • machined and polished surfaces
  • Ultrasonic Instruments w/metal tips
    • Magnetostrictive or Pizoelectric
      • ex: Cavitron
    • Caution→Surface irregularities
      • use special tip
  • Friendly Materials for Abutment:
    • Teflon
    • Titanium
    • Gold
    • Plastic Tips
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14
Q

What to evaluate for Implant Prosthesis: At Delivery vs F/u Visits

A
  • Delivery:
    • Radiograph=Baseline
    • Complete seating
      • Implant Abutment Interface
    • Cement retained
      • No XS cement
  • F/u Visits
    • loose screws or fractures
      • Replace:
        • Loose screws & toque down
        • worn out retentive parts
          • Hader Clips
          • Locator attachment inserts
    • Occlusal guards
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15
Q

What are the main peri-implant diseases?

A
  • Health
  • Mucositis
  • Implantitis
  • Hard & Soft Tissue Defiicencies
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16
Q

What are the main treatment modalities for peri-implantitis?

A
  • Mechanical Debridement
  • Antiseptic Tx
  • ANtibiotic Tx
  • Regenerative or Resective Sx
17
Q

Why does excess cement cause peri-implantitis?

A
  • Allows bacterize to colonize→ ⇡Inflammation around implant
18
Q

Types of Implant Complications?

A
  • Biologic
  • Esthetic
  • Mechanical
19
Q

Biologic Implant Complications

A
  • Mucosal Inflammation
  • Mucosal Hyperplasia
  • Mobility
  • BOP
  • Suppuration
  • ⇡ PD
  • BL
  • Thread Exposure
  • Peri-implant diseases
  • Pain
20
Q

Esthetic Implant Complications

A
  • Poor positioning
  • Poor Restoration
  • Poor Appearance
    • inadequate tx planning
  • Recession
  • Hard & Soft Tissue Deficiency
21
Q

Mechanical Implant Complication

A
  • Screw Loose
  • Screw Frature
  • Meshwork Fracture
  • Ceramic Fracture
  • Implant Fracture
22
Q

Prosthetic Design

A
  • Proper Assessment
    • crucial for dx and tx plan
    • proper emergence profile
  • Innaccurate assessment
    • Prosthesis Misfit
      • Passive Misfit ⇡Burden on Bone
      • Bacteria Colonize space b/w prosthesis
    • Biocompatabilty
      • Zirconia > Metal
23
Q

Excess Cement

A
  • Peri-implantitis (81%)
    • Increase:
      • Plaque
      • Bleeding index
      • Suppuration
      • Fistula
  • Radiographs can’t detect
  • Cement Types→ proliferation of bacterial strains
  • Impossible to remove all excess when abutment margin≥ 1 mm subg
24
Q

Types of Cement

A
  • Methacrylate
    • Bacterial Colonization
  • Zinc Oxide Non-Eugenol
    • Less host response in vitro
25
Q

What are some techniques to minimize excess cement?

A
  • Teflon Tape
  • Venting
  • Dual Cord
  • Dummy abutment
26
Q

Cemented retained vs Screw Retained Complications

A
  • Cemented Retained
    • BIologic complications
      • plaque control to prevent
  • Screw Retained
    • Technique Complication
    • preferred due to:
      • retrievability
      • High Biologic compatibility
27
Q

What are some crucial factors for cement retained restorations?

A
  • Implant position
  • Abutment selection
  • Retention Design
  • Margin Position
28
Q

Fracture and Loosening?

A
  • Facilitate Peri-implant disease
    • bacteria colonize spaces
29
Q

Lack of Keratinized Mucosa

A
  • Increase:
    • Plaque accumulation
    • inflammation
    • recession
    • attachment loss
  • Increase Keratinized Tissue w/Tissue Graft
    • Reduce Gingival Complications:
      • physical compression
      • contact w/ restorative material
      • Biofilm
30
Q

Open Contacts

A
  • Proximal Contact tightness Decreases overtime
    • replace restoration
    • Modify restoration
    • restore adjacent tooth
  • associated w/peri-implantitis
31
Q

Retrograde implantitis

A
  • Previous RCT on Adjacent teeth
    • not curetted well after extraction

Implantology (15 decks)

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