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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
post-op care after bone grafting
1. diet modification 2. temporary prosthesis 3. oral hygiene
26
patients who have undergo bone grafting can wear a temporary prosthesis that are what?
1. non-load bearing | 2. limit wear
27
why is vertical augmentation difficult to obtain?
due to pressure from soft tissue envelope or prosthesis
28
concerns with vertical augmentation by grafting
1. increased risk of graft/membrane exposure | 2. inadequate adaptation and/or fixation of the bone graft to recipient bed
29
T/F: there is a greater resorption rate with horizontal augmentation than vertical augmentation
FALSE, resorption rates greater with vertical than horizontal
30
types of vertical augmentation
1. distraction osteogenesis 2. orthodontic eruption 3. sinus augmentation
31
distraction osteogenesis
1. surgically lengthen bone 2. controlled displacement of surgically created fractures 3. new bone forms in gap 4. soft tissue envelope expands
32
advantages of alveolar distraction vs grafting
1. minimal relapse 2. bigger movements possible 3. soft tissue brought with the bone 4. low morbidity
33
disadvantages of alveolar distraction vs grafting
1. distractor arm | 2. consolidation phase
34
orthodontic eruption
orthodontically extract tooth over time instead of traditional extraction
35
advantage of orthodontic eruption
bone comes with the tooth
36
what does orthodontic eruption correct?
1. vertical periodontal defects | 2. uneven osseous/gingival levels
37
what does orthodontic eruption require?
a "good root" with a non-restorable crown
38
disadvantage of orthodontic eruption
time and cost
39
sinus augmentation
elevate sinus membrane from the floor of the sinus and place bone graft material
40
bone graft material will remodel in what after a sinus augmentation?
into load-bearing bone
41
when is sinus augmentation indicated?
for inadequate vertical dimension
42
what materials can be used for bone graft?
1. autogenous 2. allogeneic 3. xenogeneic 4. alloplastic 5. bone morhogenic protein
43
T/F: different bone graft materials have similar successes
true
44
what is the advantage of an autograft vs allograft?
autograft - ready for placement in 4 months allograft - ready for placement in 6-8 months
45
bone morphogenic protein allows for quicker healing for faster placement of implant but what is the disadvantage?
cost
46
how is indirect sinus augmentation performed?
through implant osteotomy
47
with an indirect sinus augmentation, you're able to place an implant but needs what?
a few additional mm of bone
48
augmentation yield from indirect sinus augmentation
4 mm of bone
49
post-op sinus augmentation instructions
1. sinus precautions 2. abx 3. nasal decongestant 4. mucolytic
50
case selection is critical in what?
immediate implant placement in the esthetic zone
51
ideal case for immediate implant placement in esthetic zone
1. healthy gingival collar 2. thick biotype 3. no active infection 4. adequate bone for ideal placement and stability
52
technique in immediate placement of implant in esthetic zone
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
when is a collaplug indicated for immediate implant placement in esthetic zone?
when tissue not advanced for primary closure
54
bad cases for immediate implant placement in esthetic zone
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
surgical error during immediate implant placement in esthetic zone
1. traumatic extraction 2. facial malposition of implant 3. implant diameter too large for site
56
what is considered atraumatic extraction?
sharp release of soft tissue and cannot have buccal plate coming off
57
options for placing implants in posterior mandible
1. shorter implants and over-engineer 2. extract anterior teeth 3. nerve reposition 4. grafting
58
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?
angled implants to avoid sinus
59
advantage of angled implants
no sinus augmentation
60
disadvantage of angled implants
1. technique sensitive | 2. long surgery
61
why is the surgery to place angled implants long?
1. difficult access 2. general anesthesia 3. coexisting medical comorbidities
62
all-on-four
four implants 1. 2 angled parallel to sinus wall 2. 2 in anterior
63
rigid frame of all-on-four allows what?
for off-axis loading of the angled implants
64
advantages of all-on-four
1. no sinus grafting 2. fixed 3. immediate loading
65
disadvantage of all-on-four
none-on-three

Oral Surgery 2 (13 decks)

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