Archive for the ‘ Complications and Maintenance ’ Category

Health Status for Dental Implants

Health Status for Dental Implants -

Health Status for Dental Implants –

Health Scale for Dental Implants according to International Congress of Oral Implantologists

Implant Quality Scale Group Clinical Conditions
Success (optimum health) a) No pain or tenderness upon function.
b) 0 mobility
c) <2 mm radiographic bone loss from initial surgery.
d) no exudates history.
Satisfactory survival a) No pain on function.
b) 0 mobility.
c) 2-4 mm radigraphic bone loss.
d) No exudates history.
Compromised survival a) May have sensitivity.
b) No mobility.
c) Radiographic bone loss >4 mm (less than 1/2 of implant body)
d) Probing depth > 7 mm
e) May have exudates history.
Failure (clinical or absolute failure) Any of the following:
a) Pain on function.
b) Mobility.
c) Radiographic bone loss > 1/2 length of implant.
d) Uncontrolled exudate.
e) No longer in mouth.

International Congress of Oral Implantologists, Pisa, Italy Conference 2007

Loose / mobile dental implants

When the dentist is faced with a mobile dental implant, a complete examination of the dental implant and its components should be undertaken. Mobility could be caused at different levels as follows.

Mobility at the fixture level
It is usually a case of failing osseointegration. It is also possible (but less likely) that there’s a fracture of the implant fixture.

Mobility at the abutment level
Abutment could become mobile if the abutment screw is loosened.

Mobility at the crown level
The crown component (prosthetic component) could become loose if it is decemented or the retention screw becomes loose.

Parts of a Branemark Dental Implant

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Maintenance of Dental Implants

Proper hygiene is very important to minimize marginal bone loss. Plaque control should begin after the second surgery. It is tedious and requires considerable effort from both patient and the dentist.

Implant Brush is the most important tool for plaque control. Many implant brushes are available in a variety of sizes, shapes and textures.

Soft bristle implant brush

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Dental Implants Occlusal Overload

Studies have established that occlusal overload frequently led to marginal bone loss or de-osseointegration of effectively osseointegrated implants. The crestal bone around dental implants might be a fulcrum for lever action whenever a bending moment is used, recommending that implants may well be more prone to crestal bone loss by mechanical pressure.

Factors connected with elevated bending overload in dental implants:

• Prostheses based on a couple of implants in the posterior region

• Straight alignment of implants

• Significant deviation from the implant axis in the type of action

• High crown/implant ratio

• Excessive cantilever length (>15 mm within the mandible, >10-12 mm within the maxilla)

• Discrepancy in proportions between your occlusal table and implant mind

• Para-functional habits, heavy bite pressure and excessive premature contacts (>180 µm in monkey studies, >100 µm in scientific testing on people)

• Steep cusp inclination

• Poor bone strength and density/quality

• Insufficient quantity of implants
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Peri-implantitis is among the two primary causes of implant failure in later stages. A correlation between plaque accumulation and progressive bone loss around implants continues to be reported in experimental studies and studies. Tonetti and Schmid reported that peri-implant mucositis is really a reversible inflammatory lesion limited to periimplant mucosal tissue without bone loss. Periimplantitis however starts with bone loss around dental implants.

Clinical options that come with peri-implantitis were referred to by Mombelli as including radiographic proof of vertical destruction from the crestal bone, formationof a peri-implant pocket in colaboration with radiographic bone loss, bleeding after gentle probing, possibly with suppuration, mucosal swelling, redness with no discomfort typically.
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Q&A: Dental Implant Pain and Gum Disease

Question: Do implants get gum disease? Do dental implants give pain?

Answer: Yes. Dental implants can get gum disease and give pain. Gum disease results from local inflammation. Plaque accumulation and trauma can cause this inflammation. The plaque inflammatory responses can cause periimplantitis and bone resorption. Bone resorption can result from: Direct action of plaque products on progenitor cells to differentiate in osteoclasts. Plaque products act directly on bone through a non cellular mechanism. They can stimulate gingival cells, causing them to release mediators which in turn induce bone progenitor cells to differentiate into osteoclasts. Plaque products cause gingival cells to release agents that can act as cofactors in bone resoption.
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Dental Implant Maintenance

Poor oral hygiene is related to marginal bone loss. Proper hygiene is critical so the patient should understand the importance of plaque control. Dental implant maintenance is tedious and requires effort. The dentist should help evaluate devices which best suit the patient’s needs.

An implant brush is the most important tool for plaque control. A soft bristle brush type is effective for cleaning the abutment and prosthesis. It is used at the gingiva-abutment junction. Appropriate size of dental implant brush should be chosen to fit into the space between fully anchored denture and gingiva. The size should be comfortable for the patient.

Two filament dental implant brush with extra narrow brush head and flexible head

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