Peri-Implant Disease & Long-Term Maintenance Flashcards

What is the primary distinguishing feature that differentiates peri-implantitis from peri-implant mucositis?

Answer: Peri-implantitis involves bone loss beyond the initial remodeling, while peri-implant mucositis is limited to soft tissue inflammation

Peri-implant mucositis is a reversible inflammatory lesion confined to the soft tissues (analogous to gingivitis). Peri-implantitis is characterized by inflammation AND progressive bone loss beyond normal crestal remodeling, making it more serious and harder to reverse.

Which of the following is considered the most significant modifiable risk factor for developing peri-implantitis?

Answer: Poor oral hygiene and plaque accumulation

Poor oral hygiene leading to plaque biofilm accumulation is the primary modifiable risk factor for peri-implant disease, just as it is for periodontal disease. Smoking and a history of periodontitis are also significant risk factors, but oral hygiene is the most actionable.

When probing around a dental implant during a maintenance visit, which finding would most strongly suggest the presence of active peri-implantitis?

Answer: Probing depth of 6 mm with bleeding on probing and suppuration

A probing depth of 6 mm combined with bleeding on probing (BOP) and suppuration (pus) are hallmark clinical signs of active peri-implantitis. Bleeding and suppuration indicate active infection and inflammation, while increased probing depth suggests bone loss has occurred.

Which decontamination method is most commonly recommended for implant surface debridement during non-surgical treatment of peri-implant mucositis?

Answer: Titanium or carbon fiber curettes and air-polishing with glycine powder

Titanium or carbon fiber curettes and glycine powder air-polishing are recommended because they effectively remove biofilm without scratching the implant surface. Standard steel instruments and ultrasonic tips with metal tips can damage the titanium surface, creating roughness that promotes future bacterial adhesion.

What is the recommended minimum frequency for supportive implant therapy (maintenance recall) for a patient with a history of peri-implant mucositis who now has stable implants?

Answer: Every 3 to 4 months

Patients with a history of peri-implant disease are at elevated risk and typically require more frequent recall intervals of every 3–4 months to monitor for disease recurrence and reinforce home care. Annual or semi-annual intervals are insufficient for high-risk patients.

Radiographic bone loss is used to help diagnose peri-implantitis. Beyond normal initial crestal remodeling, what threshold of bone loss around an implant is generally considered indicative of peri-implantitis?

Answer: Greater than 2 mm of marginal bone loss after the first year of loading

The widely cited threshold for peri-implantitis diagnosis is marginal bone loss greater than 2 mm measured from the baseline radiograph taken at implant loading, combined with clinical signs of inflammation. Some initial bone remodeling (up to ~1–1.5 mm) in the first year is considered normal.