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Implant Dentistry > Peri-Implantitis Diagnosis and Prevention > Flashcards

Peri-Implantitis Diagnosis and Prevention Flashcards

1
Q

PERI-IMPLANTITIS

A

“a plaque-associated pathologic condition occurring
in tissue around dental implants, characterized by
inflammation in the peri-implant mucosa and
subsequent progressive loss of supporting bone”

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2
Q

NEW CLASSIFICATION
(4)

A

Peri-implant health
Peri-implant mucositis
Peri-implantitis
Peri-implant hard and soft tissue deficiencies

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3
Q

Peri-implant health

A

Absence of erythema, bleeding on
probing, swelling and suppuration.

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4
Q

Peri-implant mucositis
Caused by —
Presence of —.
— condition.
Precursor of —

A

plaque accumulation.
inflammation
Reversible
peri-implantitis.

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5
Q

Peri-implant mucositis
Prevalence: –% of patients and –% of implants

A

79
50-90

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6
Q

Peri-implantitis
Caused by —
Presence of —.
Loss of —
— condition

A

plaque accumulation.
inflammation
supporting bone.
Non-reversible

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7
Q

Peri-implantitis
Prevalence: –% of patients and –% of implants

A

20
10-56

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8
Q

TOOTH VERSUS IMPLANT: Epithelial Attachment

Similarities with –
Long junctional epithelium attached implant ~

A

tooth surface
2mm long
via basal lamina and hemidesmosomes

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9
Q

TOOTH VERSUS IMPLANT: Connective Tissue

Similarities to —
Differences with —
fiber bundles:
A space of — wide proteoglycan layer
— rich but cell poor
Supracrestal connective tissue zone —high

A

tooth surface
tooth surface
Parallel, circular “cuff-like”
20nm
Collagen
~ 1-1.5mm

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10
Q

TOOTH VERSUS IMPLANT: Soft Tissue Assessment
(3)

A

Probing
Dimensions of the buccal soft tissue
Dimensions of the papilla

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11
Q

Probing force –

A

0.25N

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12
Q

TOOTH VERSUS IMPLANT: Osseointegration vs PDL (2)

A

Periodontal mechanoreceptors
Higher stress at the neck of the screw/implant

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13
Q

Implant patients
have less awareness
of occlusal
interferences
Timed occlusal contacts
Teeth opposing teeth:
Implant opposing teeth:
Implant opposing implant:

A

20 microns
48 microns
64 microns

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14
Q

PDL space ~ –

A

0.2mm

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15
Q

TOOTH VERSUS IMPLANT: Vascularity
(3)

A

Vascularity in peri-implant gingival mucosa is limited
Vascularity in connective tissue under sulcular/junctional epithelium is similar
Inflammatory response to plaque is the same way

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16
Q

Periodontal disease vs Peri-implant disease
The microbiome may be different
although the opportunistic
periodontal pathogens can be
identified in — patients.

A

peri-implantitis

17
Q

Stronger inflammatory response was
around implants than teeth; need
— time to complete reverse peri-
mucositis than gingivitis

A

longer

18
Q

Peri-implantitis contained larger
proportions of (2) than in periodontitis

A

neutrophil granulocytes
and osteoclasts

19
Q

Peri-implantitis
risk factors/indicators

(7)

A

Poor plaque control
Lack of regular
maintenance
Tissue quality: thin
phenotype, bone
deficiency
Iatrogenic factors:
malpositioning, poor
design of emergency
profile, inadequate
abutment/implant
seating
Excessive cement
Occlusal overload
Titanium particles:
implant corrosion,
micromovemen

20
Q

Peri-implantitis risk
indicators/modifiers
(4)

A

History of
periodontal disease
Smoking
DM
Genetic factors/
systemic condition

21
Q

Disease presentation
(4)

A

Inflammation:
redness, swelling
Pain
Suppuration
Bone loss

22
Q

CLINICAL EXAMINATION
(4)

A

Plaque and calculus
Peri-implant tissue
Occlusion and mobility
Probing depth, BOP, exudates

23
Q

Peri-implant probing

A

Diagnostic Procedures
Variables in peri-implant probing
- Probe Positioning
- Presence of Inflammation
Plastic or Metal?

24
Q

Bleeding on Probing

A

There is a positive correlation between bleeding on
probing and histologic signs of inflammation at
peri-implant sites.

25
Q

Exudates?
Definitely there’s — inflammation

A

chronic

26
Q

Occlusal Evaluation
Occlusal overload: (3)

A

Loosening of abutment screws
Implant failure
Prosthetic failure

27
Q

Implant-Protected Occlusion
(3)

A
  • Occlusal contact position
  • No occlusal interference
  • Timed occlusal contacts
    (light contact)
28
Q

Successful and stable osseointegrated implants
exhibited no —

A

mobility

29
Q

Loose crown:
Loose abutment:
Loose implant body: Oh, no….

Take a radiograph
May need to — to evaluate implant body directly

A

screw or cement has loosened/broken
abutment screw has loosened

remove the crown/bridge

30
Q

RADIOGRAPH: Assessment
Peri-implant radiolucency
Bone level
Assessment
< — bone loss per year after the 1st-year loading
< — bone loss starting after loading

A

0.2mm
2mm

31
Q

Examples of varying protocols are:
Initial placement:
Initial placement: — if no pathology present.
Initial placement: — if pathology present.

A

3 months, 6 months, 12 months, every 2 years.
6 months, 12 months, and every 2 years
every 6 months

32
Q

“HEALTHY
IMPLANT”
(5)

A

No plaque/calculus
No sign of inflammation
Probing depth ≤ 5mm
No mobility
Bone loss < 2mm
HAPPY LIFE

33
Q

WHY
(3)

A

Detect early signs of disease
Plan corrective interventions
Important clinical decisions must be reached
at several stages during treatment and
maintenance of implant patients

34
Q

MAINTENANCE OF DENTAL IMPLANTS
(4)

A

Provide guidelines for maintaining the long
term health of the dental implant
Focus on both hard and soft tissue stability
around the dental implant
Work as a team— patient are co-therapists in
the maintenance therapy
Prevent future complications by thorough
diagnosis and treatment planning

35
Q

HOW

A

Establish useful set of clinical parameters to
evaluate dental implants

36
Q

Components
(3)

A

Assessment of home care
Examination of peri-implant soft tissue
Radiographic examination

37
Q

WHAT
(4)

A

A thorough review of oral hygiene reinforcement
and modifications
Deposit removal from implant/prosthesis surfaces
Appropriate use of antibiotics
Reevaluation of the present maintenance
interval, with modification as dictated by the
clinical presentation

38
Q

ORAL HYGIENE MODIFICATION
Interproximal brushes can effectively
penetrate up to — into a gingival
sulcus and may effectively clean a
peri-implant sulcus

A

3mm

39
Q

WHEN

A

Maintenance treatment should be customized
according to each patient’s systemic and local
risk factors.
Patients with history of periodontitis with
acceptable self-care: 3-month recare interval
Patients with no systemic or local risk factors:
6 month recare interval

Implant Dentistry (15 decks)

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