Fast Facts: Perio Edition – Peri-Implant Soft and Hard Tissue Deficiencies Part 2

Fast Facts: Perio Edition Episode 76
 
[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
 
[Katrina Sanders, RDH]
Hello, and welcome to Fast Perio Edition. This week, we are continuing the conversation in unpacking what we know about the peri-implant soft and hard tissue deficiencies that will eventually lead to peri-implant failure. Remember, when we talk about peri-implant failure, it’s critical for us as clinicians to ensure that we are assessing potential challenges that could be in the soft or the hard tissues around a dental implant. And so it’s critical for us to look at things like a visual examination of the soft tissues around the implant to identify if there is some sort of an iatrogenic challenge. We also should be looking at probing the implant, palpating the implant to evaluate signs of peri-implant disease, as well as identifying the presence or hopefully absence of calculus, biofilm, or residue, evaluating for mobility or patient reported pain, and then, of course, looking at radiologic findings to evaluate optimal bone level.
 
Research now is telling us that dental implants have 80% less attachment apparatus around them when compared with teeth. And so this is why we start to see that simple signs of peri-implant disease early on could give us very critical pieces of information about down the road predicting if we will experience peri-implant failure.
 
Remember, dental implants fail at ten times the rate of natural teeth, particularly in patients who have already been treated due to chronic periodontitis. And remember, that’s going to be a vast majority of our patients who are going to be recipients of dental implants. So we do look at things like pocket formation, radiographic destruction, separation, inflammation, gingival, color changes, bleeding upon probing, or even things like poor oral hygiene, inadequate dental care, or challenges with regards to systemic health. One final piece that I will share before wrapping up today’s Fast Fact is in regards to residual cement. Oftentimes, hygienists especially predict that patients who are experiencing peri-implant failure are individuals in which they’ve had residual cement. And yes, we have found data points indicating that there really is no treatment that will remove all residual cement from implant surfaces. So the more that we can encourage our doctors to ensure that they are leaving behind a well cleansed opportunity, the better. Nevertheless, with the integration of screw retained dental implants, we are now beginning to find that one of the big challenges associated with peri-implant failure is either trapped floss or curls of plastic from our own instruments being utilized on the threads of a dental implant. So it’s important for us as clinicians to ensure we understand how to well-maintain a dental implant. Well, that’s all we have time for today. Join me next week as we talk about some of the strategies around optimal peri-implant maintenance.
 
This has been another episode of Fast Facts – Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
 
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts – Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We’ll see you next week for another Fast Fact!

Resources: ​​
Renvert, Stefan, G. Rutger Persson, Flavia Q. Pirih, and Paulo M. Camargo. “Peri‐implant health, peri‐implant mucositis, and peri‐implantitis: Case definitions and diagnostic considerations.” Journal of clinical periodontology 45 (2018): S278-S285.