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Clinical knowledge II > Implants > Flashcards

Implants Flashcards

1
Q

What are the two types of complications seen in implants?

A

Early implant failure.
Late implant failure.

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2
Q

What is early implant failure?

A

Failure of integration during the biological healing phase.

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3
Q

What is the early implant failure due to?

A

Poor surgical technique.
Inability to achieve primary fixation.
Implant loading.
Systemic conditions.

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4
Q

What are late biological failures due to?

A

Biological failures.
Mechanical failures.

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5
Q

What are the areas to focus on when maintaining implants?

A

Reduction of risk factors.
Patient education and motivation.
Screening
Instrumentation and intervention.

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6
Q

What are the local risk factors that affect implants?

A

Radiotherapy
Smoking
Poor bone quality
Periodontal disease
Occlusal trauma
Parafunctional habits
Periapical lesions in adjacent teeth.
Unrealistic patient expectations.
Poor soft tissue biotype.

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7
Q

What are the systemic risk factors that affect implants?

A

Uncontrolled diabetes.
Immunosuppression.
Medications (Bisphosphonates).

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8
Q

How can risk factors for peri-implant disease be reduced?

A

Patient factors
Prosthetic design
Soft tissue quality
Patient education
Implant design
Plaque presence

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9
Q

Why is smoking a contraindication to implant placement?

A

Due to the increased risk of peri-implant infection, crestal bone loss and poor wound healing.

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10
Q

What causes peri-implantitis?

A

An adherent layer of plaque on the implant is responsible for altering the biocompatibility of implant surfaces.

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11
Q

What OHI should be given to patients with implants?

A

Correct use of toothbrush.
ID cleaning is essential.
Sub-gingival cleaning with single tufted brush.

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12
Q

When can the cross-over floss technique be used?

A

In the aesthetic zone when the implant is placed in the ideal position.

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13
Q

What can a good flossing technique lead to with implants?

A

Good subgingival flossing will result in epithelialized sulcular tissue down to the implant neck.

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14
Q

When should the patients OH be reviewed?

A

2 weeks after placement.

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15
Q

What can poor cleaning technique lead to?

A

Self induced peri-implantitis from trauma.

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16
Q

When should radiographs be taken of implants?

A

Periapical radiographs should be taken: -
After placement.
At 1 year.
Bi-annually
Signs or symptoms.

17
Q

What amount of bone loss is acceptable around an implant?

A

<1.5mm in the first year.
0.2mm there after.

18
Q

What can be used to assess bone loss around implants?

A

The implant shoulder.
The distance between implant threads.
Baseline radiographs.

19
Q

What is biological width?

A

The dimension of soft tissue which is attached to the portion of the tooth to the crest of the alveolar bone.

20
Q

What is the biological width around an implant?

A

2-3mm

21
Q

What is the biological width of an implant made of?

A

2mm epithelial attachment.
1mm supra crestal connective tissue attachment.

22
Q

Why is the biological width important in implant placement?

A

It is important to the position of the restorative margins and impact on post surgical tissue.

23
Q

What can violations in biological width result in?

A

Gingival inflammation.
Gingival recession with bone loss.

24
Q

What is thin scalloped gingivae more at risk of?

A

Recession

25
Q

What is thin alveolar bone more at risk of?

A

Horizontal Bone loss

26
Q

What is thick alveolar bone more at risk of?

A

Vertical bone loss

27
Q

What is BoP an indicator of?

A

Peri-implant mucositis but it can be caused from excessive pressure.

28
Q

What is probing limited by?

A

Contour of prosthesis.
Depth of shoulder.
Design.

29
Q

Why should mobility be tested on implants?

A

It should be tested on free standing restorations by percussion as radiographs are not always diagnostic of a deterioration of oesso-integration.

30
Q

What is included in the supportive implant regime?

A

Exam 3-12 months.
BoP, PPD, plaque, suppuration and mobility.
Check crestal bone levels.
OHI
Stability of health conditions.
Check occlusal trauma.
Check removeable prosthesis.
Education.

31
Q

How would you instrument an implant?

A

Do not use steel instruments.
Biofilm therapy, air flow, piezo-electric, titanium probes and curettes.

32
Q

Why can peri-implantitis spread more rapidly?

A

There is not PDL attachment with implants.
The connective tissue is predominantly collagen which is similar to scar tissue.

Clinical knowledge II (18 decks)

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