5 - Implantitis

Question 1

Define peri-implant health.

Answer 1

• absence of clinical signs of inflammation
• absence of bleeding/suppuration on gentle probing (single spot of bleeding allowed)
• no increase in pocket depth from previous exam (up to 5mm)
• absence of bone loss beyond crestal bone remodelling

Question 2

Describe the normal appearance of bone around an implant radiographically.

Answer 2

• threads still contained within bone
• 1-2mm bone loss around collar of implant

Question 3

Define peri-implant mucositis.

Answer 3

• presence of bleeding/suppuration on gentle probing with or without increased probing depth
• absence of bone loss beyond crestal bone remodelling

Question 4

How do you differentiate bleeding on probing in implants?

Answer 4

• health = single spot of blood
• mucositis = line of blood around margin, or more

Question 5

Define peri-implantitis.

Answer 5

Any of following
- increase probing depth to previous disease
- probing depth >/= 6mm
- presence of bone loss beyond crestal bone remodelling
- bone levels >/= 3mm apical to coronal portion of intra-osseous part of implant

Question 6

What is the prevalence of peri-implant disease?

Answer 6

• 43% have mucositis
• 22% have implantitis

Question 7

What are the main risk factors that predispose patients to peri-implant disease?

Answer 7

• history of severe periodontitis
• poor plaque control
• no regular supportive peri-implant care
• smoking
• diabetes

Question 8

What is the role of GDP in implants?

Answer 8

• patient preparation
• information resource
• referral
• ongoing care and maintenance

Question 9

What information do you require before referring a patient for implants?

Answer 9

• why does the patient require implants
• any disease present
• patients access

Question 10

How does a history of periodontitis impact implants?

Answer 10

• higher rate of peri-implant disease
• implant placement more complex
• co-morbidities present

Question 11

How should you assess an implant?

Answer 11

• look for inflammation or infection
• assess overal OH
• probe implant and 6 point chart around implant at every appointment
• radiograph regularly

Question 12

Define primordial prevention.

Answer 12

Prevention of risk factor development

Question 13

Define primary prevention.

Answer 13

Prevention of disease onset and risk factor control

Question 14

Define secondary prevention.

Answer 14

Prevention of disease recurrence

Question 15

Define tertiary prevention.

Answer 15

Prevention of disease complications

Question 16

Describe the OHI given to patients with implants.

Answer 16

• ID brushes or single tufted brushes are gold standard
• floss or superfloss not recommended as it can shred on exposed threads and implant in soft tissues