임플란트의 성공조건은 정확한 수술과정과 적절한 보철 수복 그리고 지속적인 환자 유지관리라 할 수 있다.

본 강의에서는 임플란트 환자의 유지 관리를 위해 전문가인 치과위생사에 의한 치태조절방법에 대해 알아보고자 한다.

전문가에 의한 치태 조절 방법

Assessments
․Bleeding on probing (BOP)
․Suppuration
․Probing depth (PPD)
․Radiographic bone loss
․Implant mobility

Bleeding on probing (BoP)
․light presure ? 0.25N
․BoP+ /
․BoP- / periodontal stability
․The diagnostic accuracy of BoPappears to be even better than that of BoP in periodontal examination (Luterbacher 2000)

Suppuration
․Contain a veriety of leukocytes
․Collagen is destroyed
․Tissue necrosis
․Pus formation
․Suppuration
․Fistula
․Active tissue destruction
․Need for anti-infective therapy

Probing depth
․Light probing force ? 0.2~0.3 N
․Epithelial attachment of the transmucosal tissue seal will be disrupted but will heal with in 5~7 days (Etter et al 2002)
․Barrier ep ? 2~3 mm
․At sites with peri-implantitis the probe will penetrate apical to the ep.

Radiographic interpretation
․Primary success criterion for different inplant system
․Less than 0.2 mm/yr. (Albreksson et al 1986)
․Longitudinal studies ? loss of alveolar bone may be almost absent
․Or minimal in well-maintained patients
․증상이 없으면 1년마다 엑스레이 검사

Mobility
․Lack of osseointegration
․Decisive in decision to remove the affected implant

Peri-implantitis
․Opportunistic infections
․If left untreated, progress deep into the supporting bone & lead to implant loss
․The tissue around implants be monitered at regular intervals to discover arising biological complications & to interfere with the disease process at an early stage.

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