Assessment and Tx Plan Flashcards
What does current evidence suggest is the most appropriate choice for edentulous mandible?
Two-implant over denture is first choice
Why is two-implant over denture not overly popular?
Although first choice
Cost implant surgery
What are NHS indications for implant-retained over denture?
Instability despite well-adapted denture
Denture intolerance - gag reflex w/ reduced palatal coverage, ongoing pain
How to assess denture?
Examine in mouth: ridge adaptation, extension margins, occlusal stability, fit, OVD
What needs to be modified on denture if implant retained?
Thickness of acrylic between fitting surface and occlusal surface of teeth - need to be supportive
Minimum 8.5mm
What needs to be assessed in residual mandibular ridge?
Bucco-lingual width
Crestal contour
Mentalis insertion
Why is crestal contour important to assess?
if ridge isn’t flat - implant emergence won’t be correct
What is often seen in mentalis region?
Maintained bone - bone not resorbed due to mentalis muscle (canine-lateral region)
Issue with placing implants in mentalis region?
Cause implant to be too labial - encroach on muscle insertion may be outside fitting surface denture
Where expect to find mental foramen?
Between 4/5s general population
Expect to see apical 5s in Chinese subpopulation
Issue w/ mental nerve damage in edentulous mandible?
No teeth to reference against
What radiographs are advantageous in edentulous implant planning?
OPT - assess bone height and position mental nerve
CBCT - allows width and height to be assessed
What is a midline orientation marker?
Helps make implants parallel - compare position of drill
What is a locator abutment?
Allows denture to be clipped - protrudes into mouth few mm
What is used to protect acrylic from implants?
O-ring spacer
