2/6 Flashcards
B-L width relevance to implant diameter?
B-L width 2mm MORE than implant diameter
2 mm bone on either side of B and L
alveolar bone above IAN canal or below max sinus
10 mm
relation of ma centrals to incisive papilla?
mean distance b/w most ant. point of ma central incisors and posterior border od paapilla
12.454 mm
min and max implant diameter/
3 mm = min
7 mm = max
min and max implant length
min = 7 mm
max = 20 mm
extract tooth and wait 2 weeks called?
delayed immediate
closed trey impression basics
closed tray impression coping
material syringed
coping stays in mouth with closed tray
- then unscrew and put this into lab analog
need to know diameter of implant and brand
- lab analog needs to match
put back into the impression
closed or opern more accurate
open
positioning jig
needed when custom abutment comes back
- helps make sure abutment is in right orientation
wax on top when taking impression?
to make sure it is flush
tissue level in
straumann
what implant system to use?
• Published paper on safety and efficacy JOURNAL
o 5+ years, independent research
• Internationally available!
o Want to be able to accommodate patients who travel/move
• Established
• Has ALL components you need fixed remo, prefabricated abutments, screw retained, cement retained
crown to root that is too short
2:1 CR implant too short
one of first questions to ask when thinking about what system to use
○ You need to have research from an independent university research about safety and efficacy
○ Five years published
○ That is the only valid pulibilcation that you can accept
when topography is similar to bone?
it is easier for osseonitegration to happen
like acid etch
sand blasting
use of external hex
not anymore
popular systems
Nobel biocare, 3i, Zimmer, Straumann
● Nobel biocare had26% of market in 2002
● 3i
helaing abutment size
size of implant going to restore
trichannel is
nobel biocare
neck design
o Shape (parallel, taper, concaved taper)
o Length (0-3mm)
o Texture (machined, micro-groove, HA-coated)
Sand-blasting, like microscopic bombs
Acid etched topography becomes similar to bone
autografts
same person
examples
- ramus, chin, hip
angle of mandible - adds height and width
allografts
same species
- example = demineralized freeze / dried bone
xenograft
different species
- bovine mineral material like BioOss
alloplast
synthetic bone graftin materials
- tricalcium phosphate, HAP, coral
D1 BONE
MOST COMPACT
- not enough marrow to supprt implant
- 6% in anterior mandible
3% in posterior mandible
find d2 bone more
mandible
66% on anterior mandible and 50% on posterior mandible as compared to
25% on anterior maxilla and 10% on posterior maxilla
find d3 bone more where
on maxilla 65% on anterior maxilla
and 50% on posterior maxilla
as compared to
25% on anterior mandible and 46% on posterior mandible
d4 bone?
not dense enough
10% in anterior maxilla and 40% posterior maxilla
3% on anterior mandible and 1% on posterior mandible
we want what type of bone
2 and 3
find 2 more on mandble and 3 more on maxilla
lit review by goodman in terms of endo tx, extraction and implant crown, FPD, or extraction without tooth replacement
A systematic review by Goodacre was conducted to compare the outcomes of endodontic care and restoration compared to extraction and placement of implant supported crowns (ISC), fixed partial dentures(FPD), or extraction without tooth replacement. Success rates for ISCs were found to be higher than for RCTs and FPDs respectively.
study done regarding implants in cirriculum
more onvolvment in predoc = more involvment placing implants in clinical practice
things to consider in single tooth replacement
perio health
crown lengthening needed?
positin?
root length? - like canine - long root vs blunted root
cost of CLP and endo cast post core or implant
considr in mutli-rooted teeth
position crown lengthening? furcation involvment? - like where would you be after crown lengthening cost perio health
implant vs bridge consideration list!!!*
patient desire!
anatomical considerations
- nerve, root proximity, lack of bone
abutment distance
abutment conditions
- broken down adjacent teeth? or teeth with large fillings?
- could place an implant and two crown OR bridge
occlusion
cost
impression to lab for
positioning jig for abutments created
splinting - general
forces are divided between two implants
lateral forces are spread vs just going to one implant
3 implants next to each other? splint?
only time this would fail is if we ended up with a posterior cantilever
but other case - if one fails - we can take out bad implant and fill in with acrylic and use other two as support
longer 4 unit cantilever make sure have
parallel walls and a long bevel - wih mesial cantilever over posterior
need strong contact between cantilever and tooth
- prevent pocelain from fracturing
anterior case he showed us with missing incisor on mandibular anterior tx options
- ortho
- long span bridge
- maryland bridge
- three unit bridge
- implant
- removable
- root canal and post and core and corwn
• If you take a tooth out, you need to make sure there is something to keep the papilla
o Tissue follows bone and this will flatten out over time if there is nothing to hold this in place
