Dental Implants Complications & Maintenance 2 — Questions and Answers
Question 1: The recommended maintenance recall interval for implant patients after the first year of loading is typically:
- Every 5 years
- Annually only if asymptomatic
- Every 3–6 months depending on risk factors (Correct answer)
- Monthly for the first 10 years
Correct answer: Every 3–6 months depending on risk factors
Implant maintenance every 3–6 months allows early detection of peri-implant disease, mechanical complications, and ensures continued patient hygiene compliance.
Question 2: Which instrument is safest to use for calculus removal around titanium implants to avoid scratching the surface?
- Stainless steel curette
- Metal ultrasonic scaler tip
- Plastic, carbon fiber, or titanium-specific curettes (Correct answer)
- Diamond-coated burs
Correct answer: Plastic, carbon fiber, or titanium-specific curettes
Non-metallic or implant-specific instruments prevent scratching the titanium surface, which creates rough areas that increase bacterial adhesion and accelerate peri-implantitis.
Question 3: Implant fracture is most commonly associated with:
- Overheating during placement
- Small diameter implants under excessive occlusal load or in bruxers (Correct answer)
- Deep implant placement
- Using cemented vs. screw-retained crowns
Correct answer: Small diameter implants under excessive occlusal load or in bruxers
Narrow diameter implants subjected to heavy parafunctional forces or occlusal overload are at highest risk of fatigue fracture through the implant body.
Question 4: Retrograde peri-implantitis (implant periapical lesion) occurs when:
- Bone loss progresses apically from the crest
- Infection from the surgical site or residual pathology affects the periapical region of the implant (Correct answer)
- The crown is placed before osseointegration
- Abutment screws loosen repeatedly
Correct answer: Infection from the surgical site or residual pathology affects the periapical region of the implant
Retrograde peri-implantitis presents as a periapical lesion around an otherwise well-integrated implant, often from residual infection, overheated bone, or contamination during surgery.
Question 5: When peri-implantitis has caused significant bone loss, which treatment approach aims to regenerate lost bone?
- Implant removal immediately
- Surgical debridement with guided bone regeneration (resective or regenerative surgery) (Correct answer)
- Antibiotics alone without surgery
- Increasing the implant crown height
Correct answer: Surgical debridement with guided bone regeneration (resective or regenerative surgery)
Surgical access allows thorough decontamination of the implant surface followed by bone grafting and GBR to attempt to regenerate the lost supporting bone.
Question 6: Which radiographic finding specifically indicates active peri-implantitis progression rather than stable remodeling?
- Dense bone contact at all threads
- Serial radiographic comparison showing progressive crestal bone loss over time (Correct answer)
- Unchanged bone levels from initial placement
- Visible implant threads without shadows
Correct answer: Serial radiographic comparison showing progressive crestal bone loss over time
Progressive bone loss detected by comparing sequential radiographs is the hallmark of active peri-implantitis rather than the initial 1–2 mm remodeling expected after placement.
Dental Implants Complications & Maintenance 2
The recommended maintenance recall interval for implant patients after the first year of loading is typically: