Perio 14 - Intro to Peri-implant Health and Disease (Dr. Chinipardaz)

titanium

What are dental implants typically made of?

Dental implant

Define the following:

An artificial tooth root, typically made of titanium, surgically placed into the jawbone to support a replacement tooth or bridge. It serves as an anchor for dental prosthetics and integrates with the bone through a process called osseointegration.

osseointegration

Define the following:

The direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. In dentistry, it refers to the process by which bone tissue integrates with the titanium surface of a dental implant, providing stable anchorage for a prosthetic dental crown.

- Essential for long-term implant success

- Affects patient's oral health and quality of life

- Prevents complications and implant failure

What is the importance of peri-implant health?

- Peri-implant mucosa

- Junctional epithelium

- Connective tissue

What are the three soft tissue components of peri-implant tissues?

- Alveolar bone

- Osseointegration zone

What are the two hard tissue components of peri-implant tissues?

- Cementum

- PDL

What two periodontal components do peri-implant tissues lack?

longer

Is peri-implant epithelium often shorter or longer?

true

T/F: There are no inserting fibers into the implant surface

less

Is there more or less vascularization between bone crest and junctional epithelium in peri-implant tissues?

natural

Natural tooth anatomy or implant anatomy?

- Bone support includes a periodontal ligament (PDL) with connective tissue fibers (Sharpey's fibers) inserting into the dentin

implant

Natural tooth anatomy or implant anatomy?

- Supporting bone is directly in contact with the surface, with no PDL

natural

Natural tooth anatomy or implant anatomy?

- A connective tissue zone sits above the bone crest

implant

Natural tooth anatomy or implant anatomy?

- Connective tissue fibers run parallel, not inserting into the surface

natural

Natural tooth anatomy or implant anatomy?

- The junctional epithelium attaches to the tooth, with a gingival sulcus lined by sulcular and oral gingival epithelium

implant

Natural tooth anatomy or implant anatomy?

- There is a junctional epithelial attachment and a mucosal sulcus but lined with mucosal epithelium rather than gingival epithelium

True

T/F: In peri-implant health, the tissues are very similar to periodontal tissues

Deeper

Implants generally have a _________ probing depth than natural teeth

Shorter

Interproximal papillae of implants may be __________

- Absence of clinical signs of inflammation.

- Absence of bleeding and/or suppuration on gentle probing.

- No increase in probing depth compared to previous examinations.

- Absence of bone loss beyond crestal bone level changes resulting from initial bone remodeling

What does the diagnosis of peri-implant health require?

peri-implant health

What is the clinical periodontal diagnosis?

peri-implant health

What is the clinical periodontal diagnosis?

peri-implant health

What is the clinical periodontal diagnosis?

peri-implant health

What is the clinical periodontal diagnosis?

peri-implant health

What is the clinical periodontal diagnosis?

Observe for signs of redness, swelling, or other visible changes

What are visual inspections when detecting inflammation at implant site?

plastic

What type of probe is usually used for perio probing at implant sites to assess tissue response and pocket depths?

Digital palpation

Define the following:

Gently feel the tissue for changes in texture or tenderness

peri-implant mucositis

Define the following:

Reversible inflammation of soft tissues around a dental implant

BOP (Gentle probing - May also include erythema, swelling, suppuration)

What is the primary clinical sign of peri-implant mucositis?

peri-implant mucositis

What is the clinical periodontal diagnosis?

plaque accumulation

What is the main cause of peri-implant mucositis?

- Smoking

- Diabetes

- Radiation

What are three modifying factors of peri-implant mucositis?

False (Host response may vary between patients)

T/F: The host response to bacterial challenges is similar among patients

- Presence of bleeding and/or suppuration on gentle probing with or without increased probing depth compared to previous examinations.

- Absence of bone loss beyond crestal bone level changes resulting from initial bone remodeling

What is required for the diagnosis of peri-implant mucositis?

peri-implant mucositis

What is the clinical periodontal diagnosis?

peri-implant mucositis

What is the clinical periodontal diagnosis?

peri-implantitis

Define the following

A plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone

peri-implantitis

These are clinical characteristics of?

- Clinical signs of inflammation

- Bleeding on probing and/or suppuration

- Increased probing depths

- Possible recession of the mucosal margin

- Radiographic bone loss compared to previous examinations

probing depth

What correlates with bone loss, indicating disease severity of peri-implantitis?

False - Rate of bone loss progression may vary between patients

T/F: Patients all have similar rates of bone loss progress

peri-implantitis

What is the clinical periodontal diagnosis?

peri-implantitis

What is the clinical periodontal diagnosis?

peri-implantitis

What is the clinical periodontal diagnosis?

true

T/F: For peri-implantitis there is no specific or unique bacteria or proinflammatory cytokines

true

T/F: For peri-implantitis, onset may occur early in folow-up period and progression appears faster than periodontitis

Early detection and intervention

What is KEY when diagnosing peri-implantitis?

strong

Do the following major risk indicators for peri-implantitis have strong evidence, inconclusive evidence or limited evidence?

- History of severe periodontitis

- Poor plaque control

- Lack of regular maintenance care after implant therapy

inconclusive

Do the following major risk indicators for peri-implantitis have strong evidence, inconclusive evidence or limited evidence?

- Smoking

- Diabetes

limited

Do the following major risk indicators for peri-implantitis have strong evidence, inconclusive evidence or limited evidence?

- Submucosal cement post-restoration

- Implant positioning hindering oral hygiene

- Peri-implant keratinized mucosa

- Occlusal overload

- Titanium particles

- Bone compression necrosis

- Overheating

- Micromotion

- Biocorrosion

What are some factors requiring further research of indicators for peri-implantitis?

- Presence of bleeding and/or suppuration on gentle probing.

- Increased probing depth compared to previous examinations.

- Presence of bone loss beyond crestal bone level changes resulting from initial bone remodeling.

What is required for the diagnosis of peri-implantitis?

- BOP and/or suppuration on gentle probing

- Probing depth ≥ 6mm

- Bone levels ≥ 3mm apical of the most coronal portion of intraosseous part of implant

In the absence of previous exam data, diagnosis of peri-implantitis can be based on the combination of what three things?

≥ 6mm

What is the typical probing depth of the diagnosis of peri-implantitis?

Patient education

All of the following fall under what category of prevention and maintenance?

- Importance of oral hygiene for implant longevity

- Proper brushing and flossing techniques

- Use of interdental brushes and water flossers

Professional cleaning techniques

All of the following fall under what category of prevention and maintenance?

- Use of non-metal instruments to avoid implant surface damage

- Air-polishing devices with appropriate powders

- Ultrasonic devices with implant-safe tips

Importance of Regular Check-ups

All of the following fall under what category of prevention and maintenance?

- Recommended frequency of dental visits

- Early detection of potential issues

- Adjustment of maintenance protocol as needed