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OS 4 > Advanced Surg: Implants > Flashcards

Advanced Surg: Implants Flashcards

1
Q

WHich directions does max resorb?

A

Up and in

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2
Q

Which direction does mand resorb?

A

Down and out

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3
Q

Bone type
* Almost entirely Compact bone
5months to integrate

A

Type I

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4
Q

Bone type
* Thin cortical bone + Low density trabecular bone
8 months to integrate

A

 Type IV

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5
Q

Bone type
* Thin cortical bone + Dense trabecular bone
6 months to integrate

A

 Type III

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6
Q

Bone type
* Thick cortical bone + Dense trabecular bone
4 months to integrate

A

 Type II

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7
Q
  • viable cells contribute to new bone formation
A

Osteogenesis

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8
Q
  • proteins, factors, hormones modulate host cells
A
  • Osteoinduction
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9
Q
  • matrix/scaffold onto which new bone can form
A
  • Osteoconduction
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10
Q

Same individual
* Gold standard : Osteogenic, osteoinductive, & osteoconductive
* Extra-oral vs. intra-oral donor sites
* Intra-membraneous vs. cartilaginous
* Block vs. particulate forms
* Cortical vs. Cancellous
Cortical: more bone morphogenic proteins (BMPs) & better structural
support
* Cancellous: more osteoblast precursor cells for greater osteogenic potential
* Healing time 3~7months
Disadvantage:
- Need for second operative site
- Insufficient amount of bone

A

Autogenous bone graft

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11
Q

Where are the two most common sites for bone graft harvesting intraorally?

A

Symphysis and Ascending Ramus

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12
Q
  • From other individuals of the same species
  • Cadavers
  • Tissue bank
  • Osteoinduction & osteoconduction
  • Types of Allografts
  • Freeze-dried bone allograft (FDBA): 6-15 months
  • Demineralized freeze-dried (DFDBA) 6 months
  • Irradiated bone (2.5 million rads)
    Advantages:
  • Ready availability
  • Eliminate second surgery
  • Reduced anesthesis & surgical time
  • Decrease blood loss
  • Fewer complication
    Disadvantages:
  • Associated with the use of
    tissues from another person
  • Immune responses
A

Allograft

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13
Q
  • Different species
  • Anorganic bone treated to remove its organic component
  • Highly osteoconductive
  • Rapid revitalized through new blood vessels
  • Slowly resorbing matrix structure (6 months ~)
A

Xenograft

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14
Q

Natural or Synthetic
* Mostly osteoconductive
* Variety of textures, sizes, and shapes
* Crystalline or amorphous
* Granular or molded
* Type of Alloplastic Bone Graft material
I. Ceramic : HA, TCP
II. Calcium Carbonate : Bio Coral
III. Biocompatible composite polymer
IV. Bioactive glass ceramic : Bio-glass

A

Alloplasts

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15
Q

 Polytetrafluoroethylene (e-PTFE, TR e-PTFE), or titanium mesh
* Titanium Reinforced PTFE Membranes (TR e-PTFE), Ti-Enforced microporous (ePTFE)
 Gold standard for GBR
 Optimal graft containment
 Disadvantage
- flap management
- 2nd surgical procedure to remove membrane

A

Nonresorbable barrier membranes

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16
Q

Are resorbable or non resorbable membranes more ideal for GBR?

A

Nonresorb

17
Q

ingrowth of
osteogenic cells
while preventing
migration of
unwanted cells

A

GBR

18
Q

What procedure should be done in the following situation?
* Less than 4 mm native maxillary alveolar bone

A

Lateral Window Sinus Lift procedure

19
Q

What procedure should be done in the following situation?
* More than 4mm native maxillary alveolar bone

A

Intracrestal Sinus Lift

20
Q

What type of tissue composes the Schniderian membrane?

A

Pseudostratified ciliated columnar epithelium

21
Q

How much sinus elevation can the Schniderian membrane support

A

4-8 mm

22
Q

ADVANTAGE
 Minimally Invasive
 Usually single surgery
 Little or no graft needed¹
 Less postoperative complication
 Septum Presence
DISADVANTAGE
 Lack of direct visual control
 Elevation height may be limited to 1-
2mm
 Uncertainty of microperforation of
Schneiderian membrane

A

Intracrestal Sinus Lift

23
Q

How much can you actually lift?

A

1-2 is safe
5mm can be done
5+ is pushing it

24
Q

If the ridge is less than ___ mm of vertical height, 85% perf rate

A

3mm

25
Q

What is the technique often used for intracrestal sinus lift?

A

Summers technique

26
Q

 Ridge Expansion Technique
 Longitudinal Osteotomy on Alveolar bone
 Lateral reposition of buccal cortex
 Resulted in ↑alveolar width
 Dental implant placed between buccal and lingual cortex
 Additional space filled with bone graft materials.
 More common performed on Maxilla > Mandible
 Thinner cortical plate
 Softer medullary bone

A

Ridge splitting

27
Q

What arch is ridge splittling more commonly performed on?

A

Max

28
Q

What is the most important factor for ridge splitting on mand?

A

Preserving vasculartiy

29
Q

What direction is an implant usually displaced in a ridge splitting procedure?

A

Facially

30
Q

What is the minimum alveolar thickness needed for ridge splitting to be done?

A

2-4 mm

31
Q

 Success rate of 90% or greater*
 Major bone grafting can have a failure
rate as high as 30%
 Immediate loading is not recommended
 Two-stage delayed loading protocol
needed

A

Grafting Treatment Planning

32
Q

What type of implant is used for pts who don’t want any grafting?

A

Zygomatic implants

33
Q

If bone is only present in zone 1 (anterior), what procedure can be done for implants?

A

Zygomatic implants

34
Q

If bone is only present in zone 1 (anterior) and zone 2 what procedure can be done for implants?

A

All on 4

35
Q

HOw long after placing zygomatic implants should the prosthesis be placed?

A

24-48 hours (immediate

36
Q

What is the minimum number of implants needed in addition to zygomatic implants in anterior?

A

at least 2 other implants

37
Q

How are zygomatic positioned intraorally?

A

Typically in pm region slightly more palatally placed

38
Q

Contraindications
 Acute sinus infection
 Maxillary or zygoma pathology
 Underlying uncontrolled systemic disease
 Relative contraindications
 chronic infectious sinusitis
 bisphosphonates
 smoking

A

Zygomatic implants

OS 4 (10 decks)

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