Peri-implant diseases

Question 1

What are the four classifications of peri-implant diseases and conditions?

Answer 1

Peri-implant health, peri-implant mucositis, peri-implantitis, and peri-implant soft and hard tissue deficiency.

Question 2

What is the primary difference between implant survival and implant success?

Answer 2

Implant survival refers to the implant remaining in place, while success includes functional and biological health.

Question 3

What are the key clinical features of peri-implant health?

Answer 3

Absence of inflammation, no bleeding on probing, and stable bone levels.

Question 4

What is the recommended probing force for peri-implant health assessment?

Answer 4

0.25 N (light force).

Question 5

What is the maximum acceptable probing depth for a healthy implant?

Answer 5

≤5 mm.

Question 6

What radiographic finding indicates peri-implant health?

Answer 6

Absence of bone loss beyond initial remodeling (≤2 mm after the first year).

Question 7

What are the visual signs of peri-implant health?

Answer 7

Pink tissue, no swelling, and firm tissue consistency.

Question 8

What is the definition of peri-implant mucositis?

Answer 8

Inflammation of the soft tissues around an implant without bone loss.

Question 9

What is the primary cause of peri-implant mucositis?

Answer 9

Accumulation of bacterial biofilm around the implant.

Question 10

What are the clinical signs of peri-implant mucositis?

Answer 10

Redness, swelling, bleeding on probing, and suppuration.

Question 11

What is the significance of bleeding on probing in peri-implant mucositis?

Answer 11

It indicates inflammation but must be distinguished from trauma-induced bleeding.

Question 12

What radiographic finding is associated with peri-implant mucositis?

Answer 12

No bone loss beyond initial remodeling (≤2 mm after the first year).

Question 13

What is the definition of peri-implantitis?

Answer 13

Inflammation of the mucosa with progressive bone loss around an implant.

Question 14

What is the primary difference between peri-implant mucositis and peri-implantitis?

Answer 14

Peri-implantitis involves bone loss, while mucositis does not.

Question 15

What radiographic finding indicates peri-implantitis?

Answer 15

Bone loss beyond initial remodeling (>2 mm after the first year).

Question 16

What are the risk indicators for peri-implantitis?

Answer 16

Poor oral hygiene, history of periodontitis, and lack of maintenance care.

Question 17

What is the significance of probing depths ≥6 mm in peri-implantitis?

Answer 17

It is a diagnostic criterion for peri-implantitis when combined with bone loss.

Question 18

What are the types of hard-tissue deficiencies at implant sites?

Answer 18

*Intra-alveolar,
* dehiscence,
* fenestration,
* horizontal ridge,
* vertical ridge defects.

Question 19

What are the common causes of soft-tissue deficiencies at implant sites?

Answer 19

Tooth loss, periodontitis, peri-implantitis, and implant malpositioning.

Question 20

What is the significance of keratinized tissue around implants?

Answer 20

At least 2 mm of keratinized mucosa is associated with lower plaque scores.

Question 21

What is the effect of implant malpositioning on soft tissue?

Answer 21

It can lead to buccal mucosal recession and prosthetic difficulties.

Question 22

What is the role of guided bone regeneration (GBR) in tissue deficiencies?

Answer 22

GBR is used to augment bone volume for implant placement.

Question 23

What is the goal of mechanical debridement in peri-implantitis treatment?

Answer 23

To remove plaque and calculus from the implant surface.

Question 24

Why are steel curettes not recommended for implant debridement?

Answer 24

They are harder than titanium and can scratch the implant surface.

Question 25

What is the role of air-abrasive systems in peri-implantitis treatment?

Answer 25

They modify the implant surface to promote cellular re-attachment.

Question 26

What is the primary use of antiseptics in peri-implantitis treatment?

Answer 26

To prevent bacterial recolonization after mechanical debridement.

Question 27

What is the limitation of local delivery antibiotics in peri-implantitis?

Answer 27

They show short-term effectiveness but lack long-term benefits.

Question 28

What is the role of systemic antibiotics in peri-implantitis treatment?

Answer 28

They are used as adjuncts to mechanical debridement for bacterial control.

Question 29

What is the primary limitation of laser therapy in peri-implantitis?

Answer 29

It lacks cell-stimulatory properties and requires further research.

Question 30

What is photodynamic therapy, and how does it work?

Answer 30

It uses light and photosensitizers to generate reactive oxygen species for antibacterial effects.

Question 31

What is the goal of access flap/open flap debridement in peri-implantitis?

Answer 31

To decontaminate the implant surface and conserve soft tissues.

Question 32

What is the purpose of apically repositioned flaps in peri-implantitis?

Answer 32

To clean the implant surface and enhance self-performed oral hygiene.

Question 33

What is implantoplasty, and when is it used?

Answer 33

It involves de-threading the exposed implant surface and is used in resective techniques.

Question 34

What is the main drawback of apically repositioned flaps?

Answer 34

Increased postoperative recession, limiting its use to non-esthetic areas.

Question 35

What is the goal of regenerative techniques in peri-implantitis treatment?

Answer 35

To reconstruct tissue dimensions and promote re-osseointegration.

Question 36

What materials are used in regenerative techniques?

Answer 36

Bone grafts and barrier membranes.

Question 37

What type of bony defect is best treated with regenerative techniques?

Answer 37

Circumferential infrabony defects with intact walls.

Question 38

What is the recommended surgical approach for suprabony defects in non-esthetic areas?

Answer 38

Apically repositioned flaps with resective techniques.

Question 39

What is the role of systemic antibiotics in surgical treatment?

Answer 39

They are recommended as adjuncts to improve outcomes.

Question 40

What factors should clinicians consider before surgical treatment?

Answer 40

Muscle activity, frenal pull, and defect morphology.

Question 41

What is the resorption pattern of the mandible after tooth loss?

Answer 41

Centrifugal (outward).

Question 42

What is the resorption pattern of the maxilla after tooth loss?

Answer 42

Centripetal (inward).

Question 43

How does periodontitis contribute to hard-tissue deficiencies?

Answer 43

It causes resorption of the tooth-supporting alveolar bone.

Question 44

What systemic diseases can affect hard and soft tissues around implants?

Answer 44

Osteogenesis imperfecta and ectodermal dysplasia.

Question 45

What is the effect of radiotherapy on peri-implant tissues?

Answer 45

Increased bone loss and soft-tissue recession.

Question 46

What is the significance of papilla height between implants?

Answer 46

It affects esthetics, especially in the visible area.

Question 47

What is the recommended minimum width of keratinized tissue around implants?

Answer 47

At least 2 mm.

Question 48

What is the primary goal of treating peri-implantitis?

Answer 48

To resolve inflammation, stop bone loss, and maintain healthy tissues.

Question 49

What is the role of air polishing in non-surgical treatment?

Answer 49

It helps clean the implant surface and may promote re-osseointegration.

Question 50

What is the significance of probing depths in diagnosing peri-implantitis?

Answer 50

Depths ≥6 mm with bone loss indicate peri-implantitis.

Question 51

What is the role of barrier membranes in regenerative techniques?

Answer 51

They help contain bone grafts but do not significantly improve outcomes.

Question 52

What is the main challenge in treating peri-implant soft tissue deficiencies?

Answer 52

Lack of sufficient soft tissue to cover augmented bone.