55. Soft tissue aesthetics and augmentation in implantology. Flashcards
1
Q
Esthetic importance of tissue biotype in implantology
A
- Type 1 Implant Placement=>flapless surgery w/ immediate provisionalization=>
- Good esthetic outcome.
- Type 2 Implant Placement=>Preferred in esthetic zone=>
- Reduces facial soft tissue recession compared to Type 1
2
Q
Bone volume decrease over time after tooth extraction
A
- Bone Loss After Extraction=>25% in first year
- 40-60% over first three years
3
Q
Important modifiable factors to consider for ridge augmentation
A
- Promoting Primary Wound Closure=>
- Tension-free primary soft tissue closure
- Augmenting soft tissues prior to bone augmentation
- Enhancing Cell Proliferation and Differentiation=>
- Blood, oxygen, and nutrients to tissues=>
- Marrow excellent source of osteogenic cells
- Protecting Initial Wound Stability=>
- Titanium-reinforced membranes=>
- space maintenance and proliferation of bone-forming cells
4
Q
How alveolar crest defects classified according to Seibert
A
- Class 1 Defects: In horizontal dimension
- Class 2 Defects: In vertical dimension
- Class 3 Defects: Both in vertical and horizontal dimensions
5
Q
How fresh extraction socket defects classified according to Hämmerle and Jung
A
- Class 1=> socket w/ intact bone walls
- Class 2=>socket w/ marginal dehiscence/fenestration of buccal bone wall
- Class 3=>socket w/ large dehiscence of the buccal bone wall
- One-step GBR=>Indicated for Class 1 and 2 defects
- Delayed Approach=> Indicated for large Class 3 defects
6
Q
Guided Tissue Regeneration (GTR)
A
- Regenerating periodontal structures lost due to periodontal disease=>
- Barrier membranes direct growth of new bone and periodontal ligament=>
- On root surface previously exposed due to disease
7
Q
Materials used for barrier membranes in GTR
A
- Non-absorbable materials=>
- Polytetrafluoroethylene (PTFE)
- Expanded polytetrafluoroethylene (e-PTFE)=>
- Often reinforced w/ titanium
- Perforated titanium foil
- Bioabsorbable materials=>
- Natural materials: Collagen membranes from porcine or bovine origin
- Synthetic materials=> Polylactic acid, copolymers of polylactic acid, polyglycolic acid, PEG
8
Q
Requirements for barrier membrane materials in GTR
A
- Biocompatibility=>No adverse tissue reactions
- Barrier function=>allowing passage of desirable gases and nutrients
- Tissue integration=>Should permit tissue growth into, but not through, membrane
- Maintain space for tissue ingrowth
- Easy to trim and place
9
Q
Characteristics of non-absorbable membranes
A
- Do not provoke tissue reactions
- Second surgical procedure for removal
- Porous and non-porous options=>titanium foil w/ specific thickness and perforations
10
Q
Characteristics and complications of bioabsorbable membranes
A
- More compatible than non-absorbable membranes
- Avoid need for second surgery to remove membrane
- Complications=>early degradation, epithelial downgrowth, premature loss of material
11
Q
Synthetic bioabsorbable membranes
A
- Polylactate acid and its copolymers
- Polyglycolic acid and its copolymers
- Polyglactin (Vicryl)
- PEG
12
Q
Natural bioabsorbable membranes
A
- Porcine origin=>Jason membrane and Collprotect membrane
- Bovine origin=>Geistlich Bio-Gide®
13
Q
Types of bone replacement grafts used in GTR
A
- Autologous grafts (autografts)=>patient’s own body
- Isografts=>genetically identical species
- Allografts=>different individuals of same species
- Xenografts=>different species
- Synthetic grafts (alloplasts)=> synthetic materials
- Composite grafts=>combination of different graft materials
14
Q
Autografts
A
- Same individual
- Osteogenic (4 weeks) osteoconductive and osteoinducive (2-4weeks) potential
- Extraoral=>
- Iliac crest, tibia, fibula, ribs
- Intraoral=>
- Chin, exostoses, torus
- Ramus, tuberosity
15
Q
Isografts
A
- Genetically identical species
