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FP Ch. 9 Peri-Implants Health and Diseases (Tissues surrounding a Dental…
FP Ch. 9 Peri-Implants Health and Diseases
Dental Implant
non-biological/artificial device that is surgically inserted into the jawbone to replace a missing tooth
can also be used to provide support for a prosthetic denture
Implant Components
Implant body/implant fixture
portion of the implant system that is surgically placed into the alveolar bone
acts as the root of the implant restoration
usually threaded (like a screw) to provide a greater surface area for contact with alveolar bone
Abutment
titanium post that attaches to the implant body
protrudes partially or completely through the gingival tissue into the mouth
supports restorative prosthesis
biocompatible- doesn't get rejected by the body
allows tissue healing around the abutment
Prosthetic crown or Prosthesis
Peri-Implant tissues are hard and soft tissues that surround the dental implant
Implant to Epithelial Tissues Interface
epithelium adapts to abutment post - or to implant itself- creating biological seal
biological seal functions as a barrier between implant and oral cavity
Implant to Connective Tissue Interface
significantly different than CT around natural tooth
implant surface doesn't have cementum so the gingival fibers and the PDL cant insert into the titanium surface as they do in cementum of the natural tooth
Implant to bone Interface
Osseointigration
direct contact of living bone with the surface of the implant body
Tissues surrounding a Dental Implant
Junction Epithelium
attaches to the implant surface or abutment surface (biological seal)
Connect Tissue Fibers
run parallel to or encircle the implant and abutment surface
Periodontal Ligament
no PDL
Cementum
no Cementum
Alveolar bone
in direct contact with the implant surface
Peri-Implant Health
characterized by an absence of erythema, bleeding of probing, swelling, and suppuration
probe depths may be deeper at a healthy implant site compared to a healthy tooth site. May be due to the orientation of the CT fibers which offer less tissue resistance and probe penetration
Peri-implant Mucositis
also known as peri-implant gingivitis
plaque biofilm-induced inflammation of the soft tissues
Peri-impantitis
essentially chronic periodontitis that affects the soft tissue and hard tissues surrouding a functioning osseointegrated dental implant
characterized by plaque biofilm induced inflammation in the peri-implant mucosal tissues and progressive loss of supporting alveolar bone
Hard and Soft Tissue Deficiency
following tooth loss, the bone resorption will naturally take place
soft tissue recession may also occur
Peri-Implant Disease
Etiology
Bacterial Infection
Risk Factors
History of Periodontal Disease
Poor plaque biofilm control or lack of regular maintenance therapy
Smoking
Residual Cement
Biomechanical Overload
Detecting Failing Implant
Clinical signs of a Failing Implant
soft tissue indicators
presence or peri-implant pocket
BOP
suppuration from the pocket
Implant Mobility
best indicator for diagnosis of implant failure
Radiograohic Signs of a Failing Implant
vertical destruction of the crestal bone around the implant
wedge-shaped defects along the implant
Treatment Modalities for Failing Implants
nonsurgical periodontal instrumentation,use of antiseptics, local and/or systemic antibiotics, access flap surgery
initial Probing of the implant should be done one the final restoration has been installed
bleeding on probing is a good indicator of current tissue inflammation and should be recorded
maintenance of bone levels around dental implants is an importance criterion for determining treatment success