8 Peri-Implant Health & Diseases

An artificial root made of titanium with porcelain is known as a _______

dental implant

What part of the implant is embedded into the bone?

implant body

What part of the implant connects the implant body to the crown?

abutment post

T or F: Implants contain PDL

False

On implants, what is the Junctional Epithelium (JE) referred to?

peri-mucosal seal

Implant is in direct contact with the bone without any intervening connective tissueo

osseointegration

Does osseointegration mean success or failure of the implant?

Success

T or F: During the first year, initial crestal bone loss of 1-2 mm is expected & normal

T

During the first year, initial crestal bone loss of _______ mm is expected & normal

1-2

After the first year, crstal bone loss of no more than _____ mm per year is normal

.1 - .2

Implants are ____ or _______ based

titanium or ceramic

Why are implants coated or sprayed?

to create a rough surface

What does creating a rough surface from spraying an implant do?

• creates more surface area for osseointegration

• creates better implant-to-bone adherence

What are the different types of implant sprays?

• Titanium plasma spray

• Titanium beads

• Grit blasted-acid etched

• Calcium-phosphate ceramics

Where can implants be placed in the mouth

both anterior and posterior

Why might an edentulous patient have an implant?

• Fixed prosthesis (dentures)

• Implant-supported overdentures

What are benefits of implants of edentulous people?

• adds stability to denture

• stops alveolar ridge resorption

What is the cause of a bacteria infection of peri-impplant tissues?

bacteria from plaque & host’s inflamatory response

T or F: Peri-mucositis always progresses to peri-implantitis

False

The rate of destruction is more rapid in ________

peri-implantitis

Plque-induced gingivitis in tissues surrounding the implant

• reversible - no bone loss

peri- mucositis

Periodontitis in tissues surrounding osseointegrated implant

• rapid bone loss

peri implantitis

How to treat Peri-implantitis with slight problems?

Treat with OHI & nonsurgical local therapy (debridement, antibiotics, mouthrinse)

How to treat Peri-implantitis with moderate problems?

Treat with systemic antibiotics or flap surgery

How to treat Peri-implantitis with severe problems?

Flap surgery & regenerative therapy or removal of implant

Overall, what are some of the treatments for failing implants?

• Nonsurgical periodontal instrumentation

• Use of antimicrobial rinses

• Local/systemic antibiotics

• Flap surgery

• Air polishing with glycine powder (may reduce inflammation)

What are some of the risk factors for implant failure?

• History of previous periodontal disease

• Poor plaque biofilm control

• Smoking

• Residual cement

• Biomechanical overload

• Spacial placement of implants

Collective forces placed on an implant:

Biomechanical overload

Biomechanical overload can be influeced by what factors?

• Position of implant fixture

• Number of implants supporting prosthesis

• Occlusal force distribution among implants and remaining teeth

T or F: Losss of osseointegration may occur with excessive forces

True

What are the things you should assess in every soft tissue evaluation?

color, contour, consistency, & texture

What else should be evaluated for those with implants?

erythema, edema, & suppuration

What pressure is needed when probing an implant?

gentle pressure

What are the effects of probing to firm?

Probing may create a pathway for bacteria to enter through peri-implant seal

Probing pressure must be different since there is a lack of _________

connective tissue attachment

Changes in probing depth measurements over a period of time may indicate what?

disease activity

What do you do if you have BOP of an implant?

• visually inspect presence of biofilm; BOP might be from probing force, not inflammation

How often should you have a radiograph of an implant?

Every 6-12 months

Implant success is achieved when ________ mm or less bone is lost yearly

.2

When someone has a prosthesis, it is recommended to remove it every _______ to test the implant & abutment for mobility

year

How much mobility should an implant have?

None

How do you test the mobility of the suprastructure?

Wedging a curette between prosthesis & abutment head

Implant mobility could mean:

• Lack of osseointegration

• Loose abutment

• Loos internal screws

• Fracture of implant

• Prosthetic failure between components

What are some good hygiene aids for those with implants?

• Water pik

• Super floss

• End-tufted brushes

• Proxy brushes

• Mechanical instruments

• Antimicrobial rinses

What material of instruments can be used around impalnts?

Tatanium, plastic, graphite, teflon, or nylon

Can stainless steel or carbon steel be used on implants?

No

Do implants require polishing?

No

Supragingival air polishing with ________ is safe, effective, biocompatible & gentle on soft tissues

glycine powder

Ruber cups with _________ polishing paste can be used as needed

nonabrasive