Biology of Dental Implants Flashcards
Natural Teeth
(3)
*Periodontal fibers aIach from
bone to root in mul2ple
direc2ons
*Periodontal Ligament act as
shock absorber
*Connec2ve 2ssue fibers aIach
to teeth
Dental Implants
(3)
- Direct bone to implant contact
(osseointegration) - Ankylosis
- Peri-implant fibers parallel cuff,
oriented longitudinal
Supracrestal tissue attachment
Biological Width
~2 mm
Implants
* Epithelial cells attached by
—
* Collagen fibers do not insert into
the implant but creates
hemidesmosomes
a cuff
around the implant
Difference in Blood Supply
(3)
- Blood supply by terminal
branches of large vessels
from periosteum. - More inflammatory response
than gingival Bssues - Fewer Capillaries
Teeth
Attachment
Orientation of collagen fibers
Source of blood supply
Biological width
Basal Lamina and hemidesmosomes
Perpendicular
Periosteum and PDL
~2
Implants
Attachment
Orientation of collagen fibers
Source of blood supply
Biological width
Basal Lamina and hemidesmosomes
Parallel
Periosteum
~3
Implants
JE Length — mm (depends on the implant
design).
PDs may very based on implant design (and brand)
1.3 to 1.8
Bone Remodeling: Physiologic
Once the implant is uncovered, vertical bone
loss of — mm is evidenced apical to
newly established implant-abutment
interface.
After one year of Loading, up to — mm of
bone loss is considered biologic bone
remodeling and WNL
1.5 to 2
2
Bone Remodeling: Pathologic
Baseline X-ray to evaluate progressive Bone Loss.
>= — after the first of function is pathologic
If you do not have a radiograph? PDs >= —
and BOP is pathologic
2mm
6mm
PERI IMPLANTITIS
“Is a pathological condition occurring in tissues around dental
implants, characterized by inflammation in the peri-implant mucosa
and progressive loss of supporting bone. Clinical sign of inflammation
is detected by —, while progressive bone loss is
identified on —”
bleeding on probings
radiographs
MESIO-DISTAL
* - at least — mm between teeth and implant
- — mm for papilla in anterior teeth
* - — mm between 2 adjacent implants
1.5
3-4
3
BUCCO-LINGUAL (anterior zone)
- As bone thickness approached — mm,
bone loss decreased significantly and some
evidence of bone gain was seen
1.8 - 2
BUCCO-LINGUAL (Posteriors)
non linear correlation between buccal ridge width and the resorption
*— threshold established to
account for non linearity . Significantly greater resorption when
the ridge width < —
* At least — buccal and lingual needed.
2 mm, 2 mm
1 mm
It is recommended to
place bone level implant —
subcrestally
Platform Switching
What is it?
Concept of placing an abutment of a
narrower diameter on the implant of a wider
diameter to preserve alveolar bone levels at
the crest of a dental implant
Platform Switching - Why?
It reduces peri-implant bone resorption at the one crest:
-ShiWs the inflammatory cell infiltrate inward and away from the adjacent crystal bone
-Maintains the supracrestal a^achment
-Increases distance of implant-abutment juncBon from the crystal bone
-limits possible interface of bone with micro-movements
skipped
The influence of Microgap at two-part
implants
(a)Modern endosseous two-piece implant design
comprising the implant and a screw-retained
abutment (Nobel Biocare).
(b) Modern one-piece implant with integral
abutment (Nobel Biocare).
The influence of Microgap at two-part
implants
* Inflammatory cell infiltrate was consistently present at the level of the interface between the two components, the bone crest was
consistently located — mm apical of the microgap.
* Inflammatory Infiltrate was due to
* Placement of —part implants at different levels in relation to the bone crest resulted in different amounts of bone loss.
1-1.5
bacterial contamination.
two
The — influences bone remodeling
Microgap
Keratinized Tissue and Implants
Implant sites with a band of — of KT were shown to be more prone to brushing discomfort, plaque accumulation, and peri-implant soft tissue inflammation when compared to implant sites with — of KT.
<2 mm
>2 mm
