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implant 2 > 2/20 - implant surgery > Flashcards

2/20 - implant surgery Flashcards

1
Q

medical history - does age matter

A

if amount of bone - is there no

but if person is growing!!! –> then this is something to consider

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2
Q

medical history to consider

A
  1. age
  2. immunosupression
    - active ones like on RA
  3. osteoporosis
    - not statistically significant
  4. diabetes
    - no statisticlly difference
  5. radiation
    - has an effect on success rate
  6. smoking
    - this is a big one – big risk factor for implant ffailure
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3
Q

medical history to consider

A
  1. age
  2. immunosupression
    - active ones like on RA
  3. osteoporosis
    - not statistically significant
  4. diabetes
    - no statisticlly difference
  5. radiation
    - has an effect on success rate
  6. smoking
    - this is a big one – big risk factor for implant ffailure
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4
Q

younger age with implant

A

no - dont do it

can become anklyosis and can sink in

esepecillay in the anterior maxillary region

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5
Q

implant surfaces with smoker and non smoker

A

smoker – decreased failure rate by using rough surfaced vs machine surfaces

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6
Q

anatomical location worse in smokers where

A

in maxilla

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7
Q

dose effect of smoking with implants

A

more than 10 years or more than 10 cigarettes a day

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8
Q

grafting in smokers

A

incidence in failure is higher risk

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9
Q

gingival biotype

A

thick or thin

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10
Q

thick bio-type

A

square teeth
contact point more apical
flat gingival architecture

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11
Q

thin bio-type

A

triangular or oval
contact point more coronal
scalloped gingval tissue
thin gingival tissue

also refelcts the bone underneath
- like thinner plates and fenestrations

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12
Q

interocclusal distance in cement retained / screw retained

A

posterior 7-8
anterior 9-10

screw retained minimum – 5-6

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13
Q

interocclusal for bar supported over denture

A

12 mm

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14
Q

room for hybrid - interocclusal space

A

15-18 mm

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15
Q

inter-occlusal space evaluation

A

have to do it on articulaotr to know dimensions

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16
Q

pattern of bone loss what is hard to build

A

hard to build bone verticall

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17
Q

pattern of bone loss dimensions

A

360 around
vertical 1.2-2
horizontal 1.34-1.4!!!!

circumferential - 360 degrees around the implant

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18
Q

dentla hisotry that is important

A

hx of periodonttiis - results in higher chances of peri implantitis and marginal bone loss is higher

if history of previous implant / grafting failure

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19
Q

dose effect of smoking that is important to consider

A

increased in more than 10 cigs a day or 10 + years of smoking

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20
Q

interocclusal space needed for cement retained in posteiro and anterio

A

posterior 7-8

anterior 9-10

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21
Q

interocclusal space needed for screw retained in posteiro and anterio

A

minimum is 5-6 mm

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22
Q

space needed for implant supported overdenture

A

12 mm

need to establish VDP - then mount and measure to soft tissue

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23
Q

bony anatomy of alveolar crest class I, II, III?

A

I - horizzontal loss = easiest to correct

class II - vetical harder

class III = both and hardest

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24
Q

implications of thicker gingival architecture

A

square teeth and contact point more apical

flatter gingival architecture with likely thick buccal plate and miniml fenestrations / dehiscence

25
implications of thinner gingival architecture
triangle teeth with contact more coronal scalloped gignival tissue - mroe likely to end up with recession and thinner buccal plate and more fenestrations / dihiscences
26
* magnification rate of PA? Pano? CBCT?
PA = 14% Pano =23.5% CBCT = 18% (least = ideal)
27
mental foramen? anterior loop?
anterior loop 28% on pano and 34% on CT scan 3mm from foramen and 2 mm anteior to it so 5 MM TOGETHER
28
distance to keep from IAN
2 mm
29
distnace to buccal plate? lingual? nasal cavity?
buccal = 2 mm lingual = mm nasal = 1 mm
30
Pattern of Bone Loss Around Implants
bio width - similar to this o 1.3-1.4mm horizontal o 1.2-2mm vertically o Circumferential around implant
31
less than 1 mm b/w implant and tooth what happens
more bone loss average of 2.2 mm vs 1.2 (normal average loss)
32
inter implant distance
• Horizontal loss is around 1.34 to 1.4mm in dimension • Average vertical bone loss in between two adjacent implants o Inter-implant distance <3mm  Vertical bone loss = 1.04mm o Inter-implant distance > 3mm  Vertical bone loss = 0.45mm
33
contraindiation for implant surgery?
ONLY THOSE WITH BISPHOSPHANATES FOR CANCER DIAGNOISS IS THE ONLY ABSOLUTE CONTRAINDICATION FOR IMPLANT PLACEMENT AS LONG AS CONDITION IS UNDER CONTROL osteoporosis, diabetes, radiation not contraindicated but MUST BE CONTROLLED
34
You get more remodeling and more resorption in the bone?
in a thin biotype in
35
interocclusal space needed for hybrid
15-18 mm
36
one of worst thing can do for esthetics
place the implant too buccal
37
use of antiobioics?
less failure rates if used PRE-OPERATIVELY
38
established principles for implant success
* Primary stability * Countersink below the crest of bone * LONG submerged healing period (3-6mo) * Maintenance of minimally loaded implant for 3-6mo
39
weaket point in stability vs time?
3 weeks out
40
stability vs time?
• With immediate implant, we have mechanical stability at first • Weakest point is 3 weeks out o Want to load implant immediately, or wait for healing o We are losing primary stability at this point and there is not a lot of osseointegration  OLD BONE = primary stability  NEW BONE = secondary stability
41
How important is surgical experience?
* <50 implants placed = 5.9% failure rate | * >50 implants placed = 2.4% failure rate
42
pre op abx
* Twice failure rate without * No abxs = 4% * Abx, any type and dose = 1.5% * Abx (AHA) = 1.4%
43
pre op CHX?
* No CHX = 8.7% infection * CHX = 4.1% infection * Infection = 12% fail * No infection = 2% failure
44
in order to reduce bone injury - maintain__
maintain as much vital bone in contract with implant by reducing thermal / mechanial trauma
45
do not exceed what torque
do not exceed 60 NCm torque -- increases microdamage to bone
46
drill speed at
800-1200 RPM with copious irrigation pre tap in dense bone use 35 NCM
47
temp which bone cell death could occur
40 C at 7 minutes and 1 minute at 47 celcius
48
pre op antibiotic
a. Amox 1-2g before, 500mg PO 3x/day for 10d | b. Clindamcyin 600mg before procedure then 3x/day for 10d (if cant take amox)
49
CHX rinse how long after
10 days also b4 too
50
implant mm from example
3. 5 4. 3 5. 0 6. 0
51
maxillary over dentures minimum of mandibular over denture miniimum of
4 implants mandibular = minimum of 2 implants
52
options after extraction of a tooth
immediate implant ridge preseration spontaneous healing
53
marginal section importance
critical for proper esthetics
54
spontaneous healing vvs bio oss
spontaneous heal lost 30% of surface area of the marginal portion vs bio oss collagen grafted sites gained 1.7% in surface area at the marginal portion
55
immediate implant placment does not what
placing an implant immediately following extraction does NOT maintain the original height and widdth of the socket which are always subject to remodeling
56
criteria to place immediate
* Intact buccal plate (thick is ideal) * No more than 3mm probing on facial * Ideal soft tissue
57
shape of defect
* Narrow is better! Healing comes from the side * Better access * V shaped defect, possible to place immediate implant with GBR  recession of 0.5mm or more, 8.3% change * U and UU shaped  NO immediate placement, 42.8% and 100% risk of recession >0.5mm
58
bone morphology for immediate placement
``` • Bone apical to root tip o Need to have enough initial stability or implant will fail o Want 4mm apical to implant • Palatal bone morphology • Implant shape o Tapered = more stability ```

implant 2 (11 decks)

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