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Oral Surgery 2 > Advanced Implant Surgery > Flashcards

Advanced Implant Surgery Flashcards

1
Q

minimum required distance between implant and buccal plate

A

1 mm

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2
Q

minimum required distance between implant and lingual plate

A

1 mm

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3
Q

minimum required distance between implant and maxillary sinus/nose

A

1 mm

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4
Q

minimum required distance between implant and incisive cancal

A

avoid midline maxilla

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5
Q

minimum required distance between implant and and inferior alveolar canal

A

2 mm from superior aspect of bony canal

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6
Q

minimum required distance between implant and mental nerve

A

5 mm from anterior or bony foramen

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7
Q

minimum required distance between implant and inferior border

A

1 mm

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8
Q

minimum required distance between implant and adjacent natural tooth

A

2 mm

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9
Q

minimum required distance between 2 implants (inter-implant distance)

A

3 mm between outer edge of implants

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10
Q

what leads to tissue loss?

A
  1. natural remodeling after tooth extraction
  2. traumatic tooth extraction
  3. congenitally missing teeth
  4. long-term wear of removable prostheses
  5. pneumatization of maxillary sinuses
  6. trauma
  7. resection of pathology
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11
Q

guided bone regeneration is a horizontal augmentation for what?

A

small, well-defined, concave defects

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12
Q

guided bone regeneration includes what?

A
  1. particulate graft

2. membrane

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13
Q

barrier in guided bone regeneration isolates what?

A

the defect from surrounding soft tissue

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14
Q

how does the barrier isolate the defect from surrounding soft tissue?

A
  1. exclusive migration of osteogenic cells

2. prevents fibroblast ingrowth

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15
Q

surgical technique for guided bone regeneration

A
  1. adequate flap
  2. prepare recipient site
  3. particulate graft material
  4. membrane
  5. tension-free primary closure
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16
Q

what is block grafting?

A

augment horizontal dimension of alveolus

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17
Q

harvested graft traditionally is shaped like what?

A

like a block

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18
Q

what type of graft is used in a block graft?

A

cortical +/- cancellous

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19
Q

block grafting maintains what?

A

space under soft tissue while remodeling

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20
Q

site is ready for implant placement in how many months are block grafting?

A

4-6 months

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21
Q

intraoral donor sites

A
  1. chin

2. ramus

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22
Q

limitations to intraoral donor sites

A
  1. limited quantity
  2. isolated defects of 1-2 cm in size
  3. no cancellous needed
  4. small but real risk of paresthesia
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23
Q

extraoral donor site

A

iliac crest

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24
Q

limitations to iliac crest as donor site

A
  1. large quantity of bone
  2. two surgeon “team” allows for harvest and site preparation simultaneously
  3. requires sterile field and anesthetic/surgical support that may limit venue and increase cost
  4. extraoral scar and site distant from oral cavity may not be well accepted by the patient
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25
Q

post-op care after bone grafting

A
  1. diet modification
  2. temporary prosthesis
  3. oral hygiene
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26
Q

patients who have undergo bone grafting can wear a temporary prosthesis that are what?

A
  1. non-load bearing

2. limit wear

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27
Q

why is vertical augmentation difficult to obtain?

A

due to pressure from soft tissue envelope or prosthesis

28
Q

concerns with vertical augmentation by grafting

A
  1. increased risk of graft/membrane exposure

2. inadequate adaptation and/or fixation of the bone graft to recipient bed

29
Q

T/F: there is a greater resorption rate with horizontal augmentation than vertical augmentation

A

FALSE, resorption rates greater with vertical than horizontal

30
Q

types of vertical augmentation

A
  1. distraction osteogenesis
  2. orthodontic eruption
  3. sinus augmentation
31
Q

distraction osteogenesis

A
  1. surgically lengthen bone
  2. controlled displacement of surgically created fractures
  3. new bone forms in gap
  4. soft tissue envelope expands
32
Q

advantages of alveolar distraction vs grafting

A
  1. minimal relapse
  2. bigger movements possible
  3. soft tissue brought with the bone
  4. low morbidity
33
Q

disadvantages of alveolar distraction vs grafting

A
  1. distractor arm

2. consolidation phase

34
Q

orthodontic eruption

A

orthodontically extract tooth over time instead of traditional extraction

35
Q

advantage of orthodontic eruption

A

bone comes with the tooth

36
Q

what does orthodontic eruption correct?

A
  1. vertical periodontal defects

2. uneven osseous/gingival levels

37
Q

what does orthodontic eruption require?

A

a “good root” with a non-restorable crown

38
Q

disadvantage of orthodontic eruption

A

time and cost

39
Q

sinus augmentation

A

elevate sinus membrane from the floor of the sinus and place bone graft material

40
Q

bone graft material will remodel in what after a sinus augmentation?

A

into load-bearing bone

41
Q

when is sinus augmentation indicated?

A

for inadequate vertical dimension

42
Q

what materials can be used for bone graft?

A
  1. autogenous
  2. allogeneic
  3. xenogeneic
  4. alloplastic
  5. bone morhogenic protein
43
Q

T/F: different bone graft materials have similar successes

44
Q

what is the advantage of an autograft vs allograft?

A

autograft - ready for placement in 4 months

allograft - ready for placement in 6-8 months

45
Q

bone morphogenic protein allows for quicker healing for faster placement of implant but what is the disadvantage?

46
Q

how is indirect sinus augmentation performed?

A

through implant osteotomy

47
Q

with an indirect sinus augmentation, you’re able to place an implant but needs what?

A

a few additional mm of bone

48
Q

augmentation yield from indirect sinus augmentation

A

4 mm of bone

49
Q

post-op sinus augmentation instructions

A
  1. sinus precautions
  2. abx
  3. nasal decongestant
  4. mucolytic
50
Q

case selection is critical in what?

A

immediate implant placement in the esthetic zone

51
Q

ideal case for immediate implant placement in esthetic zone

A
  1. healthy gingival collar
  2. thick biotype
  3. no active infection
  4. adequate bone for ideal placement and stability
52
Q

technique in immediate placement of implant in esthetic zone

A
  1. atraumatic extraction
  2. pilot hole drilled using restorative guide
  3. osteotomy created in palatal bone and 4 mm beyond apex
  4. bone augmentation in peri-implant defect
  5. collaplug
53
Q

when is a collaplug indicated for immediate implant placement in esthetic zone?

A

when tissue not advanced for primary closure

54
Q

bad cases for immediate implant placement in esthetic zone

A
  1. thin tissue biotype
  2. thin scalloped soft tissue
  3. thin facial plate
  4. inadequate facial bone height
  5. periodontal bone loss around natural tooth
55
Q

surgical error during immediate implant placement in esthetic zone

A
  1. traumatic extraction
  2. facial malposition of implant
  3. implant diameter too large for site
56
Q

what is considered atraumatic extraction?

A

sharp release of soft tissue and cannot have buccal plate coming off

57
Q

options for placing implants in posterior mandible

A
  1. shorter implants and over-engineer
  2. extract anterior teeth
  3. nerve reposition
  4. grafting
58
Q

what options do you have to give patients with vertical posterior bone loss and pneumatize sinuses, or if pt doesn’t desire or isn’t a candidate for sinus augmentation?

A

angled implants to avoid sinus

59
Q

advantage of angled implants

A

no sinus augmentation

60
Q

disadvantage of angled implants

A
  1. technique sensitive

2. long surgery

61
Q

why is the surgery to place angled implants long?

A
  1. difficult access
  2. general anesthesia
  3. coexisting medical comorbidities
62
Q

all-on-four

A

four implants

  1. 2 angled parallel to sinus wall
  2. 2 in anterior
63
Q

rigid frame of all-on-four allows what?

A

for off-axis loading of the angled implants

64
Q

advantages of all-on-four

A
  1. no sinus grafting
  2. fixed
  3. immediate loading
65
Q

disadvantage of all-on-four

A

none-on-three

Oral Surgery 2 (13 decks)

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