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Periodontology 1 > Final; Dental Implants Infections > Flashcards

Final; Dental Implants Infections Flashcards

(54 cards)

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1
Q

What is the pattern of early microbial colonization in regards to titanium implants and teeth

A

They follow the same pattern

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2
Q

What is the main difference between plaque build-up regarding implants and teeth

A

with increasing the duration of plaque build up (3 months) the duration of the peri-implant mucosa expands more and progresses further “apically
than in the case of the gingiva

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3
Q

What is the difference between peri-implantitis and periodontitis

A

peri-implantitis is a microbial heterogenous infection with predominantly gram-negative species and is less complex

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4
Q

True or False

the peri-implant micro biome differs significantly from the periodontal community in both health and disease

A

true!

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5
Q

What type of etiological factor is occlusal trauma regarding peri-implant disease

A

a PRIMARY etiological factor

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6
Q

This can create complications for peri-implant disease

A

bruxism

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7
Q

What are 4 possible risk factors for peri-implant disease

A

smoking
uncontrolled systemic disease (effect on healing)
radiation therapy
patients with a history of periodontitis

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8
Q

What are two etiological factors involved in tooth loss

A

deficiency in immune response

genetics

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9
Q

What is the difference between peri-implant mucositis and peri-implantitis

A

PIM - only at soft tissue level; like gingivitis

PI - bone loss around implant

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10
Q

What is the difference between early and late implant complications

A

early - before loading

late - after loading

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11
Q

What can cause an ailing implant

A

Peri-implantitis or Peri-implant mucositis

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12
Q

What can cause a failing implant

A

Peri-implantitis

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13
Q

What can cause a failed implant

A

Peri-implantitis with mobility and complete loss of osseointegration

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14
Q

This is the reversible inflammation of the mucosa surrounding the implant

A

peri-implant mucositis

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15
Q

What clinical manifestations are indicative of PIM

A
  • presence of bacterial plaque and calculus
  • edema, redness, and mucosal hyperplasia
  • bleeding on probing
  • exudate or pus formation on occasions
  • no radiological evidence of bone resorption
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16
Q

The peri-implant mucosa seems less effective than the gingiva in what

A

encapsulating plaque-assocaited lesions; thus, the existence of gingivitis is riskier for implants

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17
Q

This is an inflammatory reaction associated with loss of supporting bone around an implant in function

A

peri-implantitis

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18
Q

PI lesions are characterized by what

A

the presence of numerous neutrophils in the tissue surrounding the implant (not seen in periodontitis)

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19
Q

In PI, there is direct contact between what

A

plaque on the implant surface and the inflamed connective tissue (not seen in periodontitis)

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20
Q

PIM occurs in what percentage of patients

A

75%

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21
Q

What are the 6 clinical factors used to evaluate peri-implant health

A
  1. absence of motility
  2. radiographic examination
  3. absence of bone loss ≥0.2mm/year follow the first year
  4. absence of any pain, complaint, or infection
  5. functional and esthetic acceptance of implant
  6. a success rate of 94-98% following 5 years, and 90-94% following 10 years
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22
Q

What are the factors that play into the decision making in tooth extraction and implant placement

Study These Flashcards
A 
anatomy/bone quality
perio/restorative/endo status
systemic health
economics
compliance and motivation
23
Q

What are 5 diagnostic tools used regarding implants

Study These Flashcards
A 
probing of peri-implant mucosa
bleeding on probing
suppuration
radiographic interpretation
mobility
24
Q

T/F
There is direct contact between plaque on the implant surface and inflamed connective tissue in peri-implantitis patients.

25
Mobility of an implant shows what
lack of osseointegration, but check the abutment first
26
The number of implants each year placed are (rising/declining)
Rising each year - 43 million placed in 2012 alone
27
What are the 4 rules of successful implants?
1. Implant CAN'T move 2. NO radiolucency around the implant 3. NO pain or infection 4. Long term - No bone loss and proper function later in life
28
Does the size matter?
Well yes! it does. In healthy patients it isn't as big of a deal but in patients with Peri-implantitis it matters a great deal.
29
Is it better to place a mini implant on a patient with inadequate bone or to take the time and do a bone graft and put a larger implant?
Larger implant will be more secure if there is ever bone loss down the road.
30
If you have 6mm of bone buccal-lingual what size implant can you place?
4mm - you need 1mm in all directions surrounding the implant with sturdy bone
31
What amount of bone loss would you expect to see each year in an implant patient?
.2mm - The same as in non-implant patients
32
How early can an implant start failing?
As soon as it is placed?
33
What is a 1st stage implant?
The restoration is placed right away, there is no second stage surgery to uncover the implant
34
What is a 2nd stage implant?
The restoration goes on after tissue healing and you do a new incision to expose the implant subgingivally
35
If there is exudate and pus what does this mean?
Bleeding and pus is a failure of implant osseointegration
36
What is a primary failure to osseointegrate? | - What causes this? (4)
Immediate failure of implant - Too much torque or pressure was exerted - The bone was heated too high - Patient was on bisphosphonates - Or patient got an infection
37
What is a secondary failure? | - When would this occur?
The implant begins to osseointegrate with 2mm pockets at the follow up appointments but you see the patient at a later date (say a year) and it has 6mm pockets are present - This is peri-implantitis
38
If you have bone loss can your patient have peri-implant mucositis?
NO - Peri-implant mucositis is a precursor to implantitis which has bone loss
39
What percent of peri-implant mucositis progresses to implantitis?
90%
40
In studies of 6000 patients they found that implants placed _____mm or more apical to the CEJ of adjacent teeth got peri-implantitis
6mm or more
41
If the tooth next to the implant has gingivitis or perio is it at risk of peri-implantitis or no?
Yes
42
If you have a patient who comes in and they have gingivitis or plaque on their existing teeth is is advisable to start treatment for a graft or starting to place an implant?
NO
43
Peri-implantitis lesions are characterized by the presence of numerous ________ in the tissue surrounding the implant
Neutrophils
44
Is the bacteria found in patients with peri-implantitis the same or different than bacteria found in perio patients?
Different
45
Since bacteria is different in peri-implantitis patients than perio patients what does this mean for treatment?
A flap and full debridement is necessary | Anti-biotics for these patients will not work the same as perio patients
46
Occlusal trauma is a (primary / secondary) etiological factor for periodontal disease?
Secondary
47
Occlusal trauma is a (primary / secondary) etiological factor for peri-implantitis?
Primary
48
What is the ideal degree axis for an implant?
6 degrees or less from the axis
49
What is the max degree axis for an implant? (the most it can diverge from zero degrees)
20 degrees is the max
50
What are the classifications of peri-implantitis?
CLI - Slight horizontal bone loss with minimal peri-implant defects CLII - Moderate horizontal bone loss with isolated vertical defects CLIII - Moderate to advanced bone loss with broad circular bony defects CLIV - Advanced horizontal bone loss with circumferential vertical loss, as well as loss of the oral/vestibular bony wall
51
How to treat a CLI peri-implantitis cases
Surgical reduction of pocket depth, clean the implant
52
How to treat a CLII peri-implantitis cases
- Surgical reduction of pocket depth, Repositioning more apical, Performing implantoplasty - If ≥ 3 walls are affected restore using GTR technique - If 1-2 walls are affected osteoclasts or bone leveling
53
How to treat CLIII and CLIV peri-implantitis cases
- The presence of vertical defects almost always requires GTR techniques - Dr. Kumar says Explantation (Take that thing out)
54
What is the percentage of peri-implantitis reoccurrence?
100%

Periodontology 1 (29 decks)

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