Basic Surgical Protocols for Implant Placement

Question 1

there should be at least …. mm between 2 adjacent implants and at least … mm between an implant and adjacent tooth

Answer 1

3mm

2-3mm

Question 2

there should be at least … mm of interocclusal distance from the top (shoulder) of the implant to the occlusal surface of the opposing tooth

Answer 2

7mm

Question 3

when placed in mature bone, implants should have at least … of bone on all sides

Answer 3

1mm

Question 4

… implants are preferred in the posterior sextant

Answer 4

wider

Question 5

in general, … and … implants are needed in denser bone

Answer 5

fewer and shorter

Question 6

… and … implants are needed in patients who grind or clench their teeth

Answer 6

wider and longer

Question 7

what are the four placement types of implants (based on timing)

Answer 7

immediate
early
late
conventional

Question 8

… placement is when the implant is placed in a site where the soft tissue has healed and a mucosa is covering the socket entrance

Answer 8

early

Question 9

…. placement is when the implant is placed in an extraction site at which substantial amounts of new bone have formed in the socket

Answer 9

late

Question 10

… placement is when an implant is placed in a fully healed ridge

Answer 10

conventional

Question 11

advantages of immediate implant placement

Answer 11

less surgeries
less overall tx time
optimal use of existing bone

Question 12

disadvantages of immediate implant placement

Answer 12

site morphology may complicate it
tissue biotype may compromise outcome
potential lack of ker. mucosa for flap adapt.
adjunc. procedures may be needed
technique-sensitive procedure

Question 13

advantages of early placement

Answer 13

easier flap adaptation

allows resolution of local pathology

Question 14

disadvantages of early placement

Answer 14

site morphology may complicate it
longer tx time
varying amt of resorption at socket walls
adjunc procedures may be needed
technique-sensitive procedure

Question 15

late implant placement is usually at least … weeks out

Answer 15

16

Question 16

advantages of late placement

Answer 16

clinically healed ridge

mature soft tissues; easier flap management

Question 17

disadvantages of late placement

Answer 17

increased tx time

adjunc procedures may be needed

large variation in available bone (increased bone loss with longer waiting time)

Question 18

For immediate and early implant placement:
In sites where available bone height apical to the socket is less than …. it is frequently impossible to obtain primary impant stability

Answer 18

3 mm

Question 19

For immediate and early implant placement:

…. plays a major role in immediate and early implant placement indications

Answer 19

soft tissue biotype

Question 20

For immediate and early implant placement:

… out of 4 socket walls have to be intact w/ or w/o dehiscence or fenestration on buccal wall

Answer 20

3

Question 21

For conventional implant placement: the rate of new bone formation decreased after …. of healing

Answer 21

3-4 months

Question 22

4 preop procedures for implants

Answer 22

antibiotic prophylaxis (2gm amoxicillin)

NSAIDs

sedation (IV or oral)

CHX rinse 30 before

Question 23

apicocoronally, the implant shoulder should be placed … apical to CEJ of the adjacent teeth in patients w/o gingival recession

Answer 23

2 mm

Question 24

3 advantages of one-stage implant placement

Answer 24

no secondary surgery to uncover implant

better evaluation of wound healing

allows early temporization

Question 25

2 disadvantages of one-stage implant placement

Answer 25

exposure to oral cavity during osseointegration period

difficult to control loading especially with removable temporary restoration

Question 26

3 contraindications for 1 stage implant placement

Answer 26

primary implant stability is less than ideal

smokers

thin tissue biotype

Question 27

… implant placement is when the mucosal flap can be adapated to the neck (healing cap) of the implant

Answer 27

1 stage

Question 28

… implant placement is when the mucosal flap is sutured on top of implant (cover screw) obtaining primary wound closure

Answer 28

2 stage

Question 29

Pros of immediate/early implant placement with a single rooted tooth

Answer 29

single socket
easier extraction
adequate soft tissue
manageable gap
root length (shorter)

Question 30

Cons of immediate/early implant placement with a single rooted tooth

Answer 30

oval shape socket

rotated tooth

esthetic zone

anat. landmarks

root length (canines)

Question 31

Pros of immediate/early implant placement

Answer 31

intact large septum if roots were divergent

non-esthetic zone

Question 32

Cons of immediate/early placement for multi rooted teeth

Answer 32

more than one socket

lack of tissue adaptation

heavy occlusal forces

anat. landmarks