Lecture 5 02262024

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Questions and Answers

What is a common cause of denture-related problems?

Jaw misalignment

Gum disease

Alveolar ridge resorption (correct)

Tooth decay

What might need to be done for a patient with severe alveolar ridge resorption according to the text?

Undergo major surgery involving rib removal and mandible reconstruction (correct)

Receive dentures with better grip

Get immediate dental implants

Regular dental check-ups

How does peri-implantitis affect implant stability according to the text?

It increases implant stability

It has no impact on implant stability

It stabilizes the implant

It decreases implant stability over time (correct)

What type of implant restoration does the text suggest is not commonly performed?

Cement-retained implant crown Signup and view all the answers

For a patient with severe alveolar ridge resorption, why are implants not a likely solution according to the text?

The jaw bone cannot support implants due to significant resorption Signup and view all the answers

What is the primary purpose of using a titanium brush on a dental implant surface?

To remove any toxins or poisons on the implant surface Signup and view all the answers

What is a key challenge when treating peri-implantitis?

There is no consensus on the best treatment approach Signup and view all the answers

What is a key step that must be taken before attempting any bone grafting or restorative procedures for peri-implantitis?

Removing any toxins or poisons from the implant surface Signup and view all the answers

What does the text suggest about the effectiveness of different treatment approaches for peri-implantitis?

There is no clear consensus on which approach is most effective Signup and view all the answers

What is the significance of the statement in the text that 'None of it works 100%'?

There is no single treatment that can reliably resolve all peri-implantitis cases Signup and view all the answers

What is the consequence of exposing the implant surface to air for too long?

Decreased biocompatibility Signup and view all the answers

How long is the window of time between opening the sealed vial and inserting the implant into the osteotomy?

10 minutes Signup and view all the answers

What distinguishes the SLA Active implant surface from the SLA implant?

Faster healing time Signup and view all the answers

What is a common objective of modifying implant surfaces by different companies?

Improved stability Signup and view all the answers

Which factor contributes to the limited time available to work with the implant after opening the sealed vial?

Surface oxidation Signup and view all the answers

Which of the following is NOT a method mentioned for detoxifying the implant surface in cases of peri-implantitis?

Laser decontamination Signup and view all the answers

What is the primary reason for using a lot of water during the process of detoxifying the implant surface?

Both to prevent the generation of titanium particles and heat Signup and view all the answers

What is the primary cause of the need for detoxifying the implant surface?

Alveolar ridge resorption Signup and view all the answers

Which of the following substances is NOT mentioned in the text as a possible agent for detoxifying the implant surface?

Hydrogen peroxide Signup and view all the answers

Based on the information provided, what percentage of patients with Perry implant Titus are considered 'unfortunate'?

Both 6% and 36%, depending on how it is counted Signup and view all the answers

What should be the first question to consider when faced with an edentulous area or an area that will become edentulous?

Why not a dental implant? Signup and view all the answers

What is a major consideration when determining the suitability of placing a dental implant in an edentulous area according to the text?

The amount of available bone Signup and view all the answers

Which dental treatment option is suggested as being potentially unstable in the text?

Removable partial denture Signup and view all the answers

In the context provided, what is implied to be a potential consequence of leaving an edentulous area untreated?

Alveolar ridge resorption Signup and view all the answers

What type of denture was suggested as an option in the scenario described that involves extracting most of the teeth?

Implant-supported overdenture Signup and view all the answers

What is the primary purpose of using a titanium brush on the implant surface during treatment of peri-implantitis?

To remove granulation tissue around the implant Signup and view all the answers

Which of the following agents is NOT mentioned in the text for cleaning the implant surface after debridement?

Chlorhexidine Signup and view all the answers

What is the potential benefit of using minocycline during the surgical procedure?

To kill off any remaining bacteria on the implant surface Signup and view all the answers

What is the purpose of decorating (decortication) the buccal plate during the surgical procedure?

To create a bleeding surface for better graft integration Signup and view all the answers

What is the speaker's opinion regarding the use of a high-speed handpiece for implant surface debridement?

It should be avoided to prevent damage to the implant threads Signup and view all the answers

What was the primary concern that led the patient to seek a second opinion?

The patient was dissatisfied with the recommended treatment plan involving complete tooth extraction and denture placement. Signup and view all the answers

What was the alternative treatment approach recommended by the speaker?

Placing two implants with ball attachments to support a removable partial denture. Signup and view all the answers

Based on the information provided, what can be inferred about the patient's financial situation?

The patient had limited financial resources, necessitating a more cost-effective treatment approach. Signup and view all the answers

Which statement accurately reflects the speaker's perspective on the choice of attachment system used in the implant restoration?

The speaker acknowledged that different attachment systems could be used, but did not express a strong preference. Signup and view all the answers

Based on the information provided, what can be inferred about the speaker's area of expertise?

The speaker is an oral and maxillofacial surgeon focused on implant surgery. Signup and view all the answers

Based on the information provided, what can be inferred about the patient's remaining dentition?

The patient had partially edentulous maxillary and mandibular arches. Signup and view all the answers

Which statement accurately reflects the potential impact of alveolar ridge resorption on treatment planning?

Alveolar ridge resorption may necessitate additional procedures, such as bone grafting, before implant placement. Signup and view all the answers

What can be inferred about the potential risk of peri-implantitis in the patient's case?

The risk of peri-implantitis cannot be determined from the given information. Signup and view all the answers

Which statement accurately reflects the potential advantages of the implant-supported removable partial denture approach chosen for this patient?

It provides a more cost-effective solution compared to a conventional complete denture. Signup and view all the answers

What can be inferred about the potential need for future treatment or maintenance for this patient?

The patient will likely require regular maintenance and potential replacement of the implant-supported removable partial denture over time. Signup and view all the answers

Study Notes

Treatment Options for Edentulous Areas

The first question to consider when treating an edentulous area is why not a dental implant, considering factors such as medical history, bone amount, and other teeth.
Implants may be the best option depending on the circumstances, and it's essential to rule out implant placement before considering other alternatives.

Partial Dentures

A partial denture may be an option, but its stability may be questionable, especially if it relies on clasps.
Even with clasps, the stability of a partial denture may not be sufficient.

Implant-Supported Overdentures

An implant-supported overdenture is an option, involving extracting all remaining teeth except for the implants.
This option is not a natural tooth-supported overdenture.

Treatment of Peri-Implantitis

Peri-implantitis is a condition where bone loss occurs around a dental implant, and detoxifying the implant surface is necessary.
Methods for detoxifying the implant surface include:
- Plasti surgery: using a high-speed bar to remove roughened surfaces and exposed threads, while generating a lot of heat and titanium particles.
- Powder abrasion
- Ultrasonics
- Non-metal curates
- Citric acid
- Chlorhexidine
- EDTA
The effectiveness of these methods varies, and there is no clear evidence of which one is superior.

Restoration Options

The choice of restoration option can have consequences, and it's essential to consider these consequences.
Common causes of denture-related problems include alveolar ridge resorption, which can be difficult to treat.

Detoxifying the Implant Surface

Detoxifying the implant surface is crucial before placing a bone graft or treating the defect.
A titanium brush can be used to clean the implant surface, removing toxins and poisons.

Implant Surface Modification

Companies like Strom and Nobel Biocare are working on modifying implant surfaces to make them more biocompatible and effective.
These modifications can improve the stability of the implant, with some getting similar results in a shorter time.

Detoxification and Bone Grafting

Detoxifying the implant surface can be done using various methods, including titanium brushes, saline, tetracycline, and EDTA.
After detoxification, a bone graft can be placed to promote additional bone growth.

Real-World Case Study

A patient came in for a second opinion after being recommended to extract all their remaining teeth and get a denture.
The patient was given an alternative option of placing two implants, which didn't take long and provided a stable solution.

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Description

Explore the various treatment options mentioned in the literature for dental implantitis, including hydrogen peroxide, saline, tetracycline lasers, and titanium brushes. Understand the success rates and limitations of each method for treating peri-implantitis.