Start practicing

Implants · patient case with 2 questions

Inflammation around an established implant

Patient: Adult with an implant-supported restoration placed several years ago

Chief complaint: Bleeding and discomfort around the implant.

Background: Implant restored and functioning for several years.

Current findings: Bleeding on probing, deep peri-implant pocketing and radiographic bone loss around the fixture.

Question 1

How is established peri-implantitis with radiographic bone loss best managed?

  1. Chlorhexidine rinse alone
  2. Surgical debridement
  3. Scaling and root planing alone
  4. Immediate removal of the implant
Show answer and explanation

Correct answer: B. Surgical debridement

  • A. Chlorhexidine alone is adjunctive and cannot resolve established bone loss.
  • B. Once there is established bone loss, non-surgical measures alone rarely achieve resolution, because the roughened implant surface cannot be adequately decontaminated through a pocket. SURGICAL access permits direct debridement, surface decontamination and, where the defect morphology allows, regenerative grafting.
  • C. Non-surgical debridement is the correct treatment for PERI-IMPLANT MUCOSITIS — inflammation without bone loss — and is the reversible stage.
  • D. Explantation is the last resort, for implants with advanced bone loss and mobility.

Note: The source note reads: surgical debridement, unless the option explicitly pairs scaling and root planing WITH chlorhexidine. Distinguish mucositis (no bone loss, reversible, non-surgical) from peri-implantitis (bone loss, usually surgical).

Permanent page for this question

Question 2

What does routine maintenance of a screw-retained full-arch implant prosthesis require?

  1. No specific maintenance beyond ordinary brushing
  2. Maintenance of the abutments and the edentulous areas beneath the prosthesis
  3. Periodic tightening of the screws at every recall
  4. Removal of the prosthesis by the patient for daily cleaning
Show answer and explanation

Correct answer: B. Maintenance of the abutments and the edentulous areas beneath the prosthesis

  • A. These prostheses demand more maintenance than natural dentition, not less.
  • B. CORRECT. The critical maintenance task is access for cleaning beneath the prosthesis — around the abutments and across the edentulous ridge. This demands specific aids: superfloss, interdental brushes and irrigators, plus periodic professional removal of the prosthesis for thorough debridement.
  • C. Screws are torqued to the manufacturer's specification; routine retightening at every visit is not indicated and repeated cycling risks screw fatigue.
  • D. A screw-retained prosthesis is FIXED. Only the clinician removes it. Patient removal describes an overdenture.

Permanent page for this question

Practice patient cases Implants study notes