Peri-implantitis is a pathological inflammatory condition affecting the tissues surrounding dental implants, characterized by inflammation of the peri-implant mucosa and progressive bone loss. It is caused by plaque accumulation on the implant surface. Risk factors include a history of periodontitis and smoking. Treatment involves non-surgical mechanical debridement using air abrasives or ultrasonic tips for mild cases. More severe cases may require surgical debridement and decontamination of the implant surface along with local or systemic antibiotics. Long-term maintenance therapy and adherence to the CIST protocol are important for managing peri-implantitis and ensuring the success of dental implants.
classification of periodontal diseasesneeti shinde
The document discusses the classification of periodontal diseases and the evolution of classification systems over time. It covers the need for classification, early systems from the 1870s-1920s based on clinical characteristics, the 1920s-1970s paradigm of classical pathology which distinguished inflammatory from non-inflammatory forms, and the current paradigm since the 1970s recognizing the infectious etiology. Key figures and their contributions to evolving understandings are mentioned, showing how newer ideas built upon older concepts as knowledge advanced.
This document provides information on antibiotics and analgesics used for periodontal diseases. It defines antibiotics as agents that destroy or inhibit the growth of microorganisms. Various antibiotics discussed that are used for periodontal diseases include tetracyclines, metronidazole, penicillins, cephalosporins, clindamycin, ciprofloxacin, and macrolides. It also discusses local delivery methods for antibiotics. Analgesics are defined as drugs that selectively relieve pain. The classes discussed include non-opioid types like aspirin, acetaminophen, ibuprofen and opioid types like morphine, codeine, synthetic opioids, and their mechanisms and side effects.
Periodontal Disease: A Possible Risk-Factor for Adverse Pregnancy OutcomeDr. Anuj S Parihar
Bacterial invasion in subgingival sites especially of gram-negative organisms are initiators for periodontal diseases. The periodontal pathogens with persistent inflammation lead to destruction of periodontium. In recent years, periodontal diseases have been associated with a number of systemic diseases such as rheumatoid arthritis, cardiovascular-disease, diabetes mellitus, chronic respiratory diseases and adverse pregnancy outcomes including pre-term low-birth weight (PLBW) and pre-eclampsia. The factors like low socio-economic status, mother’s age, race, multiple births, tobacco and drug-abuse may be found to increase risk of adverse
pregnancy outcome. However, the same are less correlated with PLBW cases. Even the invasion of both aerobic and anerobic may lead to inflammation of gastrointestinal tract and vagina hence contributing to PLBW. The biological mechanism involved between PLBW and Maternal periodontitis is the translocation of chemical mediators of inflammation. Pre-eclampsia is one of the commonest cause of both maternal and fetal morbidity as it is characterized by
hypertension and hyperprotenuria. Improving periodontal health before or during pregnancy may prevent or reduce the occurrences of these adverse pregnancy outcomes and, therefore, reduce the maternal and perinatal morbidity and mortality. Hence, this article is an attempt to review the relationship between periodontal condition and altered pregnancy outcome.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document discusses various periodontal regenerative procedures. It describes techniques such as bone grafting using autogenous bone or other bone substitutes to regenerate alveolar bone defects. Bone grafts can aid regeneration through osteogenesis, osteoinduction and osteoconduction. Autogenous bone is often considered the best option but alternatives include allografts and synthetic grafts when autogenous bone is not feasible. The ideal properties and use of various graft materials are also discussed.
Peri-implantitis is a pathological inflammatory condition affecting the tissues surrounding dental implants, characterized by inflammation of the peri-implant mucosa and progressive bone loss. It is caused by plaque accumulation on the implant surface. Risk factors include a history of periodontitis and smoking. Treatment involves non-surgical mechanical debridement using air abrasives or ultrasonic tips for mild cases. More severe cases may require surgical debridement and decontamination of the implant surface along with local or systemic antibiotics. Long-term maintenance therapy and adherence to the CIST protocol are important for managing peri-implantitis and ensuring the success of dental implants.
classification of periodontal diseasesneeti shinde
The document discusses the classification of periodontal diseases and the evolution of classification systems over time. It covers the need for classification, early systems from the 1870s-1920s based on clinical characteristics, the 1920s-1970s paradigm of classical pathology which distinguished inflammatory from non-inflammatory forms, and the current paradigm since the 1970s recognizing the infectious etiology. Key figures and their contributions to evolving understandings are mentioned, showing how newer ideas built upon older concepts as knowledge advanced.
This document provides information on antibiotics and analgesics used for periodontal diseases. It defines antibiotics as agents that destroy or inhibit the growth of microorganisms. Various antibiotics discussed that are used for periodontal diseases include tetracyclines, metronidazole, penicillins, cephalosporins, clindamycin, ciprofloxacin, and macrolides. It also discusses local delivery methods for antibiotics. Analgesics are defined as drugs that selectively relieve pain. The classes discussed include non-opioid types like aspirin, acetaminophen, ibuprofen and opioid types like morphine, codeine, synthetic opioids, and their mechanisms and side effects.
Periodontal Disease: A Possible Risk-Factor for Adverse Pregnancy OutcomeDr. Anuj S Parihar
Bacterial invasion in subgingival sites especially of gram-negative organisms are initiators for periodontal diseases. The periodontal pathogens with persistent inflammation lead to destruction of periodontium. In recent years, periodontal diseases have been associated with a number of systemic diseases such as rheumatoid arthritis, cardiovascular-disease, diabetes mellitus, chronic respiratory diseases and adverse pregnancy outcomes including pre-term low-birth weight (PLBW) and pre-eclampsia. The factors like low socio-economic status, mother’s age, race, multiple births, tobacco and drug-abuse may be found to increase risk of adverse
pregnancy outcome. However, the same are less correlated with PLBW cases. Even the invasion of both aerobic and anerobic may lead to inflammation of gastrointestinal tract and vagina hence contributing to PLBW. The biological mechanism involved between PLBW and Maternal periodontitis is the translocation of chemical mediators of inflammation. Pre-eclampsia is one of the commonest cause of both maternal and fetal morbidity as it is characterized by
hypertension and hyperprotenuria. Improving periodontal health before or during pregnancy may prevent or reduce the occurrences of these adverse pregnancy outcomes and, therefore, reduce the maternal and perinatal morbidity and mortality. Hence, this article is an attempt to review the relationship between periodontal condition and altered pregnancy outcome.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The document discusses various periodontal regenerative procedures. It describes techniques such as bone grafting using autogenous bone or other bone substitutes to regenerate alveolar bone defects. Bone grafts can aid regeneration through osteogenesis, osteoinduction and osteoconduction. Autogenous bone is often considered the best option but alternatives include allografts and synthetic grafts when autogenous bone is not feasible. The ideal properties and use of various graft materials are also discussed.
Aparelhos orais são usados para tratar apnéia do sono e ronco e devem ser usados todas as noites para ter efeito; os sintomas retornam quando o uso é descontinuado. Esses aparelhos posicionam a mandíbula para manter as vias aéreas superiores abertas durante o sono. O sucesso do tratamento depende de fatores anatômicos, fisiológicos e da adesão do paciente ao uso do aparelho.
The perioscope is a tiny camera that attaches to dental instruments allowing dentists and hygienists to visualize the subgingival root surfaces. It provides high magnification views of the root and pocket in real time on a monitor. This allows for more accurate diagnosis and complete removal of tartar and bacteria compared to traditional methods. The perioscope has increased the effectiveness of non-surgical treatments and improved outcomes for both non-surgical and surgical periodontal therapies.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
El documento trata sobre microbiología periimplantaria. Describe la detección de especies bacterianas como Porphyromonas gingivalis y Aggregatibacter actinomycetemcomitans en implantes dentales y tejidos periimplantarios. También describe las características de mucositis e periimplantitis, así como su tratamiento. Incluye tres casos clínicos de pacientes que recibieron tratamiento para infecciones periimplantarias.
The document summarizes the historical development of classifications for periodontal diseases from 1879 to the current 1999 classification system. Early classifications were based on clinical characteristics with little knowledge of etiology and pathogenesis. Later classifications incorporated knowledge of the role of bacteria, host response, and systemic factors. The current 1999 classification system aims to provide standardized terminology and was developed through international workshops. It classifies gingival diseases, chronic periodontitis, aggressive periodontitis, periodontitis associated with systemic diseases, and other conditions like necrotizing periodontal diseases.
This document discusses tissue engineering principles and their application to periodontal regeneration. It outlines that tissue engineering involves enhancing biologic processes or developing implantable products to modify deficient tissues. For periodontal regeneration specifically, the goal is to restore the original architecture and function of periodontal tissues affected by disease. Various techniques for periodontal regeneration are discussed, including guided tissue regeneration using membranes, root surface conditioning, and use of regenerative materials like ceramics, growth factors, and stem cells. Successful regeneration requires balancing cells, signaling molecules, and scaffolds in both in vitro and in vivo contexts.
The document discusses the history and biology of dental implants. It begins by describing how implants were first discovered in ancient Egypt and discusses various materials that were unsuccessfully used for implants over centuries. The modern history of implants began with the discovery of osseointegration between titanium implants and bone by Per-Inguar Branemark in the 1950s. The document then discusses the anatomy, biology, and function of peri-implant hard and soft tissues and the process of osseointegration between the implant and bone.
This document discusses the microbiology of periodontal diseases. It describes the typical microbiota found in healthy sites, gingivitis sites, and chronic or aggressive periodontitis sites. The microbiota shifts from mostly gram-positive facultative bacteria in health to include more gram-negative anaerobic bacteria in disease. Key pathogenic bacteria associated with periodontitis include Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia. These bacteria produce virulence factors like proteases, lipopolysaccharides, and leukotoxins that promote tissue destruction.
This document discusses the effects of various hormones from the endocrine system on the periodontium. It begins with an introduction to periodontitis and the role of the endocrine system. It then discusses the central endocrine glands of the hypothalamus and pituitary, as well as peripheral glands including the thyroid, parathyroid, pancreas, and adrenal glands. For each gland, it summarizes the hormones secreted and their effects on the periodontium, such as accelerated bone loss from hyperthyroidism, increased tooth loss with hyperparathyroidism, increased risk of periodontitis in diabetes, and reduced immune response from glucocorticoids. Sex steroid hormones from the ovaries and test
This document discusses orthodontic treatment planning and includes:
1) Concepts and goals of treatment planning as well as major issues like dental crowding, transverse maxillary deficiency, Class II and III problems.
2) Treatment possibilities for different orthodontic problems and how to reduce uncertainty.
3) A flow chart showing the treatment planning process from establishing a problem list and diagnosis to developing alternative treatment plans and getting patient input on the final plan.
Periodontal wound healing involves four overlapping phases - exudative, resorptive, proliferative, and regenerative. The proliferative phase includes re-epithelialization, fibroplasia, granulation tissue formation, collagen deposition, angiogenesis, and wound contraction. Growth factors play an important role in regulating periodontal wound healing. Healing after periodontal procedures like scaling and root planing, curettage, ultrasonic curettage, and gingivectomy depends on the extent of tissue disruption and follows a timeline of inflammatory response, epithelial migration, granulation tissue formation, collagen deposition and remodeling.
Desquamative gingivitis is a clinical manifestation characterized by erythema, desquamation and ulceration of the gingiva that can be indicative of an underlying condition. It is not a specific disease but rather a gingival response associated with various disorders. The document discusses the definition, pathogenesis, clinical presentation and diagnosis of desquamative gingivitis. It also describes three disorders that are commonly associated with desquamative gingivitis: lichen planus, bullous pemphigoid, and pemphigus.
The document discusses host modulation therapy for the treatment of periodontal disease. It defines key terms like host and modulation. It discusses how our understanding of periodontal disease progression has changed, recognizing that host response plays a major role in determining disease severity rather than just plaque levels. It describes how pharmacological agents can be used as adjuncts to conventional treatment to modulate the host response and reduce tissue destruction. Nonsteroidal anti-inflammatory drugs are provided as an example to inhibit prostaglandin formation and reduce bone loss, though long-term use can have side effects. The document outlines the role of arachidonic acid metabolites in pathogenesis and various studies investigating host modulation agents.
“Program on Ridge Split and Ridge Augmentation for Implant Placement”- Two lectures on “Concepts of Ridge Augmentation” and “Novel and Simpler Approaches to Ridge Augmentation”. Event organized by the Dental Experts and held at Paneenya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India on 18/11/2016.
Classification of periodontal diseases /certified fixed orthodontic courses ...Indian dental academy
This document discusses the classification of periodontal diseases. It outlines the need for classification to aid in diagnosis, treatment planning, and communication. It then details the historical evolution of classification systems from the 1870s to present day. Early systems were based on clinical characteristics, while later systems incorporated concepts of pathology and the infectious etiology of diseases. The current paradigm recognizes periodontitis as an inflammatory disease caused by bacterial plaque and host responses. Classification systems continue to be refined as understanding improves.
The role of NSAIDs in periodontal disease progressionHope Inegbenosun
This document discusses the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in periodontal disease progression. It outlines that periodontal disease results from the host inflammatory response to bacterial pathogens and involves the production of arachidonic acid metabolites like prostaglandin E2 (PGE2) that promote tissue destruction. NSAIDs inhibit the enzyme cyclooxygenase and thereby reduce PGE2 levels to decrease inflammation and bone resorption. Both animal and human studies show that systemic or local NSAID administration can suppress periodontal disease progression by limiting inflammation and PGE2 production.
The document summarizes the effects of various endocrine hormones on the periodontium. It discusses how hormones from the hypothalamus, pituitary gland, thyroid, adrenal glands, pancreas, parathyroid glands, and gonads can influence periodontal tissues and the progression of periodontal disease. Specific hormones like cortisol, sex hormones, insulin, and parathyroid hormone are associated with increased risk of periodontitis through impacts on inflammation, immune response, bone metabolism, and bacterial microbiota in the mouth. A better understanding of these endocrine influences could provide insights into risk factors and treatment approaches for periodontal disease.
This document discusses functionally generated path occlusion, which is a technique for developing occlusion without using an articulator. It involves having the patient move their jaw through various motions while wax is placed on their teeth, capturing the path of jaw movement. This wax tracing is then used to create a stone cast, called a functional core, which reproduces the jaw motion. This core can be mounted along with the dental casts to fabricate restorations that align with the patient's natural jaw function. The document outlines the specific steps for using this technique to develop occlusion for fixed dental prosthetics.
Aparelhos orais são usados para tratar apnéia do sono e ronco e devem ser usados todas as noites para ter efeito; os sintomas retornam quando o uso é descontinuado. Esses aparelhos posicionam a mandíbula para manter as vias aéreas superiores abertas durante o sono. O sucesso do tratamento depende de fatores anatômicos, fisiológicos e da adesão do paciente ao uso do aparelho.
The perioscope is a tiny camera that attaches to dental instruments allowing dentists and hygienists to visualize the subgingival root surfaces. It provides high magnification views of the root and pocket in real time on a monitor. This allows for more accurate diagnosis and complete removal of tartar and bacteria compared to traditional methods. The perioscope has increased the effectiveness of non-surgical treatments and improved outcomes for both non-surgical and surgical periodontal therapies.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
El documento trata sobre microbiología periimplantaria. Describe la detección de especies bacterianas como Porphyromonas gingivalis y Aggregatibacter actinomycetemcomitans en implantes dentales y tejidos periimplantarios. También describe las características de mucositis e periimplantitis, así como su tratamiento. Incluye tres casos clínicos de pacientes que recibieron tratamiento para infecciones periimplantarias.
The document summarizes the historical development of classifications for periodontal diseases from 1879 to the current 1999 classification system. Early classifications were based on clinical characteristics with little knowledge of etiology and pathogenesis. Later classifications incorporated knowledge of the role of bacteria, host response, and systemic factors. The current 1999 classification system aims to provide standardized terminology and was developed through international workshops. It classifies gingival diseases, chronic periodontitis, aggressive periodontitis, periodontitis associated with systemic diseases, and other conditions like necrotizing periodontal diseases.
This document discusses tissue engineering principles and their application to periodontal regeneration. It outlines that tissue engineering involves enhancing biologic processes or developing implantable products to modify deficient tissues. For periodontal regeneration specifically, the goal is to restore the original architecture and function of periodontal tissues affected by disease. Various techniques for periodontal regeneration are discussed, including guided tissue regeneration using membranes, root surface conditioning, and use of regenerative materials like ceramics, growth factors, and stem cells. Successful regeneration requires balancing cells, signaling molecules, and scaffolds in both in vitro and in vivo contexts.
The document discusses the history and biology of dental implants. It begins by describing how implants were first discovered in ancient Egypt and discusses various materials that were unsuccessfully used for implants over centuries. The modern history of implants began with the discovery of osseointegration between titanium implants and bone by Per-Inguar Branemark in the 1950s. The document then discusses the anatomy, biology, and function of peri-implant hard and soft tissues and the process of osseointegration between the implant and bone.
This document discusses the microbiology of periodontal diseases. It describes the typical microbiota found in healthy sites, gingivitis sites, and chronic or aggressive periodontitis sites. The microbiota shifts from mostly gram-positive facultative bacteria in health to include more gram-negative anaerobic bacteria in disease. Key pathogenic bacteria associated with periodontitis include Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia. These bacteria produce virulence factors like proteases, lipopolysaccharides, and leukotoxins that promote tissue destruction.
This document discusses the effects of various hormones from the endocrine system on the periodontium. It begins with an introduction to periodontitis and the role of the endocrine system. It then discusses the central endocrine glands of the hypothalamus and pituitary, as well as peripheral glands including the thyroid, parathyroid, pancreas, and adrenal glands. For each gland, it summarizes the hormones secreted and their effects on the periodontium, such as accelerated bone loss from hyperthyroidism, increased tooth loss with hyperparathyroidism, increased risk of periodontitis in diabetes, and reduced immune response from glucocorticoids. Sex steroid hormones from the ovaries and test
This document discusses orthodontic treatment planning and includes:
1) Concepts and goals of treatment planning as well as major issues like dental crowding, transverse maxillary deficiency, Class II and III problems.
2) Treatment possibilities for different orthodontic problems and how to reduce uncertainty.
3) A flow chart showing the treatment planning process from establishing a problem list and diagnosis to developing alternative treatment plans and getting patient input on the final plan.
Periodontal wound healing involves four overlapping phases - exudative, resorptive, proliferative, and regenerative. The proliferative phase includes re-epithelialization, fibroplasia, granulation tissue formation, collagen deposition, angiogenesis, and wound contraction. Growth factors play an important role in regulating periodontal wound healing. Healing after periodontal procedures like scaling and root planing, curettage, ultrasonic curettage, and gingivectomy depends on the extent of tissue disruption and follows a timeline of inflammatory response, epithelial migration, granulation tissue formation, collagen deposition and remodeling.
Desquamative gingivitis is a clinical manifestation characterized by erythema, desquamation and ulceration of the gingiva that can be indicative of an underlying condition. It is not a specific disease but rather a gingival response associated with various disorders. The document discusses the definition, pathogenesis, clinical presentation and diagnosis of desquamative gingivitis. It also describes three disorders that are commonly associated with desquamative gingivitis: lichen planus, bullous pemphigoid, and pemphigus.
The document discusses host modulation therapy for the treatment of periodontal disease. It defines key terms like host and modulation. It discusses how our understanding of periodontal disease progression has changed, recognizing that host response plays a major role in determining disease severity rather than just plaque levels. It describes how pharmacological agents can be used as adjuncts to conventional treatment to modulate the host response and reduce tissue destruction. Nonsteroidal anti-inflammatory drugs are provided as an example to inhibit prostaglandin formation and reduce bone loss, though long-term use can have side effects. The document outlines the role of arachidonic acid metabolites in pathogenesis and various studies investigating host modulation agents.
“Program on Ridge Split and Ridge Augmentation for Implant Placement”- Two lectures on “Concepts of Ridge Augmentation” and “Novel and Simpler Approaches to Ridge Augmentation”. Event organized by the Dental Experts and held at Paneenya Mahavidyalaya Institute of Dental Sciences, Hyderabad, India on 18/11/2016.
Classification of periodontal diseases /certified fixed orthodontic courses ...Indian dental academy
This document discusses the classification of periodontal diseases. It outlines the need for classification to aid in diagnosis, treatment planning, and communication. It then details the historical evolution of classification systems from the 1870s to present day. Early systems were based on clinical characteristics, while later systems incorporated concepts of pathology and the infectious etiology of diseases. The current paradigm recognizes periodontitis as an inflammatory disease caused by bacterial plaque and host responses. Classification systems continue to be refined as understanding improves.
The role of NSAIDs in periodontal disease progressionHope Inegbenosun
This document discusses the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in periodontal disease progression. It outlines that periodontal disease results from the host inflammatory response to bacterial pathogens and involves the production of arachidonic acid metabolites like prostaglandin E2 (PGE2) that promote tissue destruction. NSAIDs inhibit the enzyme cyclooxygenase and thereby reduce PGE2 levels to decrease inflammation and bone resorption. Both animal and human studies show that systemic or local NSAID administration can suppress periodontal disease progression by limiting inflammation and PGE2 production.
The document summarizes the effects of various endocrine hormones on the periodontium. It discusses how hormones from the hypothalamus, pituitary gland, thyroid, adrenal glands, pancreas, parathyroid glands, and gonads can influence periodontal tissues and the progression of periodontal disease. Specific hormones like cortisol, sex hormones, insulin, and parathyroid hormone are associated with increased risk of periodontitis through impacts on inflammation, immune response, bone metabolism, and bacterial microbiota in the mouth. A better understanding of these endocrine influences could provide insights into risk factors and treatment approaches for periodontal disease.
This document discusses functionally generated path occlusion, which is a technique for developing occlusion without using an articulator. It involves having the patient move their jaw through various motions while wax is placed on their teeth, capturing the path of jaw movement. This wax tracing is then used to create a stone cast, called a functional core, which reproduces the jaw motion. This core can be mounted along with the dental casts to fabricate restorations that align with the patient's natural jaw function. The document outlines the specific steps for using this technique to develop occlusion for fixed dental prosthetics.
Në këtë punim seminarik mund të gjeni se:
-çka janë malokluzionet (anomalitë ortodontike)?
-Cilët janë faktorët etiologjikë të këtyre anomalive ,si ndahen në grupe dhe poashtu do ketë shembuj për secilin prej tyre.
-Hipodoncioni,Hiperdoncioni,Mikrodoncioni,Makrodoncioni,Diastema Mediana,Ektopia,Rrotacioni,Infrapozicioni,Suprapozicioni,Transpozicioni,Kafshimi i hapur skeletal.
6. Dy entitete janë përshkruar
për sëmundjen peri-implatitis
Peri-implantit Mucositis:
është një manifestim klinik i karakterizuar nga shfaqja e
ndryshimeve inflamatore qe kufizohen tek mukoza(indet
e buta) të një implanti funksional,nuk ka humbjë
koçkorë. Nëse trajtohen siç duhet, ajo është një proces i
kthyeshëm.Është faza iniciale e një peri-implantiti të
vertet.
7. Dy entitete janë përshkruar
për sëmundjen peri-implatitis
Periimplantitis:
një manifestim klinik ku klinikisht dhe radiologjikisht është
evidente me humbjën e koçkës suportuese për
implantin, ndodh së bashku me një reaksion inflamatore
të mukozës periimplantare.
Është e rëndësishme të kuptojmë së peri-implantitis nuk
është një sinonim i "dështimit implantarë "osë " implant i
sëmurë ".
9. Mucositis Periimplantar
• Shenjat principale janë:
– Prezenca e pllakës
bakteriale dhe e kálkulave.
– Edema, shkuqja dhe
hiperplasia e mukozes.
– Gjakderdhje nga sondimi i
mukozes.
– Rrjdhja e eksudatit osë i
pusit nga (mikroabscese
gingivale).
– Ne radiografi nuk paraqet
mungëse osë reabsorbim
koçkorë.
11. Peri-implantitis
Shenjat klinike janë të një shkallë më të thellë të dëmtimit
sesa vetem në mukozen dhe karakterizohet nga:
1. Prania e pllakës bakteriale dhe e kalkulave.
2. Ënjtje dhe skuqje e indeve margjinale.
3. Hyperplasia mukozale në zonat ku nuk ka gingiva
shumë.
4. Gjakderdhje të lehtë dhe qelbi pas sondimit dhe / osë
prekjes duke ushtruar presion apiko-koronal.
12. Peri-implantitis
5. Rritja e thellësise së sondimit ne nivelin apikal.
6. Shkatërrimi i kockave vertikal në relacionin me xhepin
periimplantare.
7. Radiologjikisht kemi pranin e rezorbimit koçkorë.
8. Lëvizshmëri të implantit.
9. Ka dhimbje qe nuk është shumë e zakonshme, por
ndonjëherë ndodh..
16. Etio-patogjeneza e
peri-implantitis
• Morfologjia e indeve peri-implantare:
indet peri-implantare të shendetshem luajne një role të
madh si barriere biologjike kunder disa agjenteve qe
shkaktojne semundjen e peri-implantitis.
17. Etio-patogjeneza e
peri-implantitis
• Faktoret biomekanike :
si p.sh mbingarkesa okluzale mund të luajne një role të
rendesishem ne humbjen e implantit dhe kockes perreth
tij.Implantet të cilet vuajne nga humbja traumatike kanë
mikroflore subgingivale si tek semundjet periodontale
18. Etio-patogjeneza e
peri-implantitis
• Struktura e implantit:
Dizenjo e implantit është një faktor i rëndësishëm në
fillimin dhe zhvillimin e periimplantitis. Drejtimi jo i sakte i
komponentëve që përbëjnë një sistem implant- protezë
mund të nxisë mbajtjen e pllakës bakteriale, si dhe duke
bërë të mundur qe mikroorganizmatë të kalojë brenda
kufirit transepitelial.
19. Etio-patogjeneza e
peri-implantitis
• Infeksionet bakteriale:
luajne një role të rendesishem ne humbjen e implantit
dentare.Flora bakteriale qe shoqeron periodontitis dhe
peri-implantitis është e njejta.
Infeksioni mikrobial nga Gram negativet anaerob:
Prevotella intermedia, Porphyromonas gingivalis,
Actinobacillus actinomycetemcomitans, Bacterioides
forsythus, Treponema denticola, Prevotella nigrescens,
Peptostreptococcus micros dhe Fusobacterium
nucleatum .
20. Mikrobioza ne peri-implantitis
mucositis me osë pa higjene orale
implants teeth
plaque control cocci 71.4% 69.2%
motiles 2.1% 3.7%
spirochetes 1.4% 1.9%
no hygiene cocci 54.3% 47.3%
motiles 17.4% 19.2%
spirochetes 6.2% 7.8%
Pontoriero et al. Clin Oral Impl Res 1994: 5: 254-259.
21. Etio-patogjeneza e
peri-implantitis
• Stresi i tepruar mekanike.:
Një tjetër faktor që ndërhyn në etiopatogjenezen e
periimplantitis është stres i tepruar mekanike.
Procesi fillon me paraqitjen e mikrofraktures së kockave
perreth një implant të osteointegruar, si rezultat i të qenit
një subjekt i stresit axial osë lateral që kanë tepërt
ngarkese ,kapacitetin .
Në këto raste forcat shkaktojnë ne komponentet e protezes
(rrezine qeramike osë ne vidat transepitheliale ) osë tek
implantet frakturë, pa asnjë humbje të lartësise së
kockave osë osteointegrimit.
22. Stresi i tepert mekanike mund të shkaktohet nga:
1. Faktoret okluzal të protezes :parafunksione ,pjeserishte
bruksizmi
2. Nga lloji i trajtimit :ka shume implante osë pak implante
dhe keto implante kanë shperndarje të dobet të
ngarkeses.
3. Shkaktuar nga faktoret qe kanë lidhje me protezen :
efekti cantilevers ne protezat
23. Etio-patogjeneza e
peri-implantitis
• Semundjet sistemike p.sh. Diabeti mellitus
,osteoporoza,hemofilia,patologji të koagulimit etj.
• Faktore social si higjena orale jo adekuate,duhanpirja
dhe abuzimi me droga dhe ilace.
• Zakone para-funksionale si p.sh : bruksizmi
• Faktore iatrogjene si psh. Humbja e stabilitetit primare
dhe ngarkimi i parakohshem gjate periudhes së sherimit.
24. Faktorët riskantë për
peri-implantitis
• Historia e një periodontiti
• Duhanpirja
• Higjena e varfër orale
• Ekspozimet ndaj agjenteve të ndryshem
• Ekspozimi i sipërfaqeve të mbuluara(sipërfaqe të
ashpra)
• Xhepa të thella
• Ne rastet kur nuk kemi aksese për largimin e pllakës
bakteriale (urat ,protezat )
25. Diagnoza
Përdoren parametrat klinike si tek diagnoza e
periodontiteve.
• Klinika:
edema ,skuqja e indeve marginale peri-implantare
,prezenca e gurreve
,gjakderdhja(gingivorragjia).Ndryshimi i ngjyres ne indet
gingivare të keratinizuara osë ne mukozen orale
.Qelbezimi është një tregues i qarte i aktivitetit të
semundjes qe tregon nevojen per trajtim anti-infektive.
• .
26. Diagnoza
• Sondimi i sulkusit peri-implantare :
me një sonde plastike të drejte , me maji sferike.E cila
diagnostikon thellesine ,gjakrrjedhjen ,eksudacionin dhe
qelbezimin nga hapesira peri-implantare.
• Radiografia intraorale periapikale :
zbulon statusin e kockave peri-implantare dhe nivelin
marginal të kockes .Dmth shikojme zona me
radiotransparence ne radiografi
27. Diagnoza
• Lëvizshmëria e Implanti
shërben për të diagnostikuar në fazën e fundit të
osteointegrimit . Për interpretimin e lëvizshmërisë të ulet
, nevojtet një pajisje elektronike si periotest .
• Gjithashtu perdoren :
Kulturat bakteriale, hetimi i ADN-së, reagim zinxhir i
polimerazes (PCR), monoklonal enzimë dhe testet të
cilat janë përdorur për monitorimin e mikroflores
subgingival mund të ndihmojë për të përcaktuar një
rrezik për peri-implantitis
28. Diagnoza
• Metoda BANA((benzoyl-arginine-naphthylamide)
hydrolysis )
të tregon prezencen e enzimave trypsin qe prodhohen
nga specie patogjene si :Treponema denticola,
Bacterioides Forsythus dhe Porphyromonas gingivalis
• Regjistrimi i temperatures gingivale dhe i volumit të
fluidit peri-implantare.
32. Klasifikimi i peri-implantitis
Klasa 4
Humbje koçkorë horizontale e
avancuar me defekte vertikale
periferike të gjera si dhe humbje
koçkorë të mureve vestibulare
dhe atyre oral
33. Trajtimi i mucositis
Fazat e trajtimit:
Ne mucositis nuk kemi humbje të kockes.
1. Eliminimi i pllakes bakteriale dhe i gurreve
2. Kontrolli kimik i pllakes me ane të 0.12% chlorhexidine
aplikimi topikale cdo 8-12 ore per 15 dite..
3. Instruktimi i pacientit si të permiresoji higjenen orale.
34. Trajtimi i mucositis
4. Kontrolli dhe modifikimi i dizenjos së protezes nqs
nevojtet.
5. Kontrolli dhe eliminimi i streseve biomekanike të
protezes.
6. Kontrolli periodik tek dentisti ,kontrollet reduktohet nqs
verehet një permiresim dhe mirembajtja e saj
(higjenes).
35. Trajtimi i peri-implantitis
Faza e trajtimit:
Ne peri-implantitis kemi një humbje koçkorë .
Faza e pare e trajtimtit do jete njelloj si tek mucositis vetem
së do shtohet trajtimi me antibiotik dhe dekontaminimi i
kufijve protetik
36. Trajtimi i peri-implantitis
Faza e dyte
Nqs humbja e kockes vazhdon atehere do behet një
nderhyrje kirurgjikale per të hequr debritet ,indet e buta
të infektuara ,duhet të behet dekontaminimi
mikroimplantare i siperfaqeve dhe ne fund të behen
teknikat e regjenerimit koçkorë per të zevendesuar
kocken e humbur ,
GBR(Guided Bone Regeneration)
37. Trajtimi-Menaxhimi
Kur forcat biomekanike janë konsideruar si etiologjia
kryesore atëherë:
Faza e parë përfshin:
• Një analizë të arsyeshme të protezes, numrin dhe
pozicionin e implantit dhe një vlerësimit. Okluzale.
Baraspeshimi(ekuilibri) okluzale behet npm përmirësimit të
implantit:
Numri dhe pozicioni, dhe ndryshimet në dizanjon e protezes.
Mund të kontribuojë për të ndaluar progresionin e humbjes së
indeve peri-implantare.
38. Trajtimi-Menaxhimi
Faza e dytë përfshin :
një teknikë kirurgjikale me eliminimin e indeve të buta
nga xhepat e thella peri-implantare osë për rigjenerimin
e kockave perreth implantit.
39. Trajtimi-Menaxhimi
Kur faktori kryesor etiologjik është infeksioni bakterial;
Faza e parë përfshin:
• kontrollin e infeksionit akut dhe uljen e inflamacionit
. Kjo përfshin:
heqjen lokale e depozitat të pllakës me instrumenta plastike
(Implacare)
dhe lustrim i gjithë sipërfaqeve të arritshme,
Irrigimi subgingival i të gjithë xhepave peri-implant me 0.12%
chlorhexidine
terapi sistemike antimikrobiale për 10 ditë njëpasnjëshme
edukimi i pacientit per përmirësimin e higjienës orale derisa të kete
një shëndet peri-implantar nqs është krijuar kjo.
40. Trajtimi-Menaxhimi
• Faza e dyte
Kjo(faza e pare) mund të jetë e mjaftueshme për të
rivendosur shëndetin gingival, osë mund të kenë nevojë
dhe të pasohet nga një fazën e dytë kirurgjikale.