Supporting Periodontal Therapy in Implant Patients

Question 1

what patients are likely to have implants

Answer 1

congenitally missing
oral cancer
dental trauma
full dentures unable to tolerate
caries but stable dentition

Question 2

what is peri-implant disease

Answer 2

inflammatory reaction of tissues surrounding osseointegrated implants

Question 3

what is peri-implantitis

Answer 3

inflammation of hard and soft tissues surrounding osseointegrated implant

Question 4

what are the aetiological factors of peri-implantitis

Answer 4

poor OH
status of tissue surrounding implant
impaired host defence
implant design
operator placement
degree of roughness
excessive mechanical forces

Question 5

how do you monitor the tissues around implants

Answer 5

routine examination including radiographs
pocket chart
modified plaque and bleeding

Question 6

how do you detect peri-implantitis

Answer 6

probe penetrates to bone
increased probing depth and BOP
suppuration
mobility
radiographs

Question 7

what is peri-implant mucositis

Answer 7

inflammation of mucosa at implant area with no loss of supporting bone

Question 8

what are the signs of peri-implant mucositis

Answer 8

BOP and redness and swelling
no radiological sign
pain
increased pocket depth

Question 9

what is the aetiology of peri-implant mucositis

Answer 9

inadequate plaque control

Question 10

what type of bone loss is present in peri-implantitis that can cause implant failure

Answer 10

crestal bone loss

Question 11

what bacteria are involved in peri-implantitis

Answer 11

p. gingivalis
bacteroides forsythus
p. intermedia
fusobacterium nucleatum
AA
staphylococcus

Question 12

what is grade 1 peri-implantitis

Answer 12

BOP, PPD <4mm, bone loss <2mm

Question 13

what is grade 2 peri-implantitis

Answer 13

BOP, PPD 4-6mm, bone loss <2mm

Question 14

what is grade 3 peri-implantitis

Answer 14

BOP, PPD >6mm, bone loss >2mm

Question 15

what is treatment for grade 1 peri-implantitis

Answer 15

remove abutment and non-surgical instrumentation and disinfection

Question 16

what is treatment for grade 2 peri-implantitis

Answer 16

remove abutment, non-surgical and disinfection

Question 17

what is treatment for grade 3 peri-implantitis

Answer 17

remove abutment, surgical access, instrumentation, antibiotics, refer

Question 18

what factors affect implant success

Answer 18

access for oral hygiene
poor oral hygiene
smoking
history of perio disease
poorly controlled diabetes
occlusal forces

Question 19

what pre-installation prevention should we give to patients

Answer 19

warn that implants are high maintenance
control risk factors
stop smoking
meticulous plaque control
OHI
supportive therapy

Question 20

what post-op prevention should we give to patients

Answer 20

chlorhexidine gel/wash
soft toothbrush
tailored oral hygiene measures
ID brushes, superfloss
smoking cessation
preventive programme tailored for patient