8/9 - Implant Fundamentals, Implant Components Flashcards
what is a prosthetic device made of alloplastic material(s) implanted into the oral tissues beneath the mucosal or/and periosteal layer, and on/or within bone to provide retention and support for a fixed or removable dental prosthesis
dental implant
what is the 2nd oldest discipline in dentistry after exodontia
implant dentistry
what are the different mechanisms of fixation
- mucosal insert
- eposteal
- transosteal
- endosteal
what method of fixation:
any metal form attached to tissue surface of removable dental prosthesis that mechanically engages undercuts of a surgically prepared MUCOSAL site
mucusol insert
what method of fixation:
any dental implant receives primary support by means of RESTING ON BONE
eposteal
what mechanism of fixation does a subperiosteal implant use
eposteal
what method of fixation:
dental implant PENETRATES BOTH CORTICAL PLATES and passes thru full thickness of alveolar bone
transosteal
what method of fixation:
device placed INTO ALVEOLAR and/or basal bone of mandible or maxilla and TRANSECTING ONLY 1 CORTICAL PLATE
endosteal
what method of fixation do needle implants use
endosteal
what method of fixation do plate form/blade implants use
endosteal
what method of fixation do root form implants use
endosteal
what are the type of implants used today? examples?
root form - basket type, cylinder type, and lew screw
presence of a layer intervening fibrous CT between dental implant and adjacent bone is indicative of what
failed osseointegration (creates a pseudo-ligament)
what is the goal when placing implants
direct contact between bone and implant
what materials are used in implants
- aluminum oxide
- vitreous carbon
- silver
- brass
- chromium cobalt
what is a term coined by Branemark
osseointegration
what is a direct attachment of osseous tissue to an inert, alloplastic material w/o intervening CT
osseointegration
what is the bone implant interface
- implant surface (titanium)
- GAG (w/ chondroitin sulfate)
- mineralized matrix (no cellular elements)
- unmineralized fibrous matrix (osteoblasts)
- mineralized bone
how is osseoinegration achieved via the Branemark Era in 1952?
- pure titanium fixture
- surgical sterility
- atraumatic bone prep
- intimate physical contact
- sequestration for sufficient time
what are the guidelines for successful implant dentistry per Toronto Conference 1982
biomaterials, implant design, biomechanical factors, surface characteristics, health and bone quality, and surgical technique
why is titanium the preffered implant material
- biocompatible
- mechanically compatible
- morphologically compatible
what are the biocompatible characteristics of titanium
- resistant to corrosion
- self-passivating
- bio-inert
what does it mean that titanium is self-passivating
titatnium oxide layer formed on surface when exposed to atmosphere. TiO2 strnogly adhered to titanium surface, attracts proteins from extracellular fluid
what does it mean that titanium is bioinert
non-toxic to cells and per-implant tissues
is titanium hypersensitivity common
no it’s rare
what type of hypersensitivity is a titanium rxn
type 4
is a titanium Type IV HS immediate or delayed
delayed (>2 days)
is titanium HS a cell-mediated response
YES
what does it mean for implant material to be mechanically compatible
shaped to accept and transfer load (maximize SA, initial mechanical stability, and attach prostheses/abutments)
what does it mean for implant to be morphologically compatible
implant surface is modified to INCREASE bone contact and INCREASE wettability
how does one increase wettability
decrease contact angle = degcreased surface tension
what is the texture of implant materials
average roughness. 10-50 microns
how are implant materials surface treated
sand-blasted, acid-etched, plasma spray, HAP
is it okay if the implant surface from sterile packaging touches prepared site?
NO
what is the antibiotic oral rinse: creighton protocol
0.12% CHX gluconate rinse for 5 minutes prior to surgery
AND
daily for 10 days following surfery
another name for CHX gluconate
Peridex
what do studies show about the antibiotic oral rinse? (%-wise)
significant reduction of infectious complications (4.1% vs. 8.7%)
what is the antibiotic prescription Creighton protocol
- for medically compromised pts
- require dental premedication
- augmentation procedures
what must be done for atraumatic surgery
- flap management
- limit bone heat
when managing flap, what do you do
- limit flap retraction (flap primary blood supply to cortical plate)
- optimize position of keratinized tissue
- tension free, water tight flap closure
what must you do to limit bone heat during surgery
copious irrigation, slow drill speed, sharp drills, sequential drill sizes, gentle pressure
what temp should you not heat bone? what happens?
do not heat > 10 degrees celsius. results in bone necrosis and implant failure
how to achieve intimate physical contact of implant
- minimize over-preparation of site
- limit gap between implant and bone
- achieve primary stability
what is the insertion torque used for primary stability
25 Ncm-45 Ncm (Astra)
what is primary stability developed by
- undersized osteotomy
- threaded fixture
- tapered implant fixture
what is developed by compressive preload
undersized osteotomy
what is developed by clamping preload
threaded fixture