Biology of Dental Implants

Question 1

Natural Teeth
(3)

Answer 1

*Periodontal fibers aIach from
bone to root in mul2ple
direc2ons
*Periodontal Ligament act as
shock absorber
*Connec2ve 2ssue fibers aIach
to teeth

Question 2

Dental Implants
(3)

Answer 2

• Direct bone to implant contact
  (osseointegration)
• Ankylosis
• Peri-implant fibers parallel cuff,
  oriented longitudinal

Question 3

Supracrestal tissue attachment
Biological Width

Answer 3

~2 mm

Question 4

Implants
* Epithelial cells attached by
—
* Collagen fibers do not insert into
the implant but creates

Answer 4

hemidesmosomes
a cuff
around the implant

Question 5

Difference in Blood Supply
(3)

Answer 5

• Blood supply by terminal
  branches of large vessels
  from periosteum.
• More inflammatory response
  than gingival Bssues
• Fewer Capillaries

Question 6

Teeth
Attachment
Orientation of collagen fibers
Source of blood supply
Biological width

Answer 6

Basal Lamina and hemidesmosomes
Perpendicular
Periosteum and PDL
~2

Question 7

Implants
Attachment
Orientation of collagen fibers
Source of blood supply
Biological width

Answer 7

Basal Lamina and hemidesmosomes
Parallel
Periosteum
~3

Question 8

Implants
JE Length — mm (depends on the implant
design).
PDs may very based on implant design (and brand)

Answer 8

1.3 to 1.8

Question 9

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

Answer 9

1.5 to 2
2

Question 10

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

Answer 10

2mm
6mm

Question 11

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 —”

Answer 11

bleeding on probings
radiographs

Question 12

MESIO-DISTAL
* - at least — mm between teeth and implant
- — mm for papilla in anterior teeth
* - — mm between 2 adjacent implants

Answer 12

1.5
3-4
3

Question 13

BUCCO-LINGUAL (anterior zone)
- As bone thickness approached — mm,
bone loss decreased significantly and some
evidence of bone gain was seen

Answer 13

1.8 - 2

Question 14

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.

Answer 14

2 mm, 2 mm
1 mm

Question 15

It is recommended to
place bone level implant —

Answer 15

subcrestally

Question 16

Platform Switching
What is it?

Answer 16

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

Question 17

Platform Switching - Why?

Answer 17

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

Question 18

skipped
The influence of Microgap at two-part
implants

Answer 18

(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).

Question 19

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.

Answer 19

1-1.5
bacterial contamination.
two

Question 20

The — influences bone remodeling

Answer 20

Microgap

Question 21

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.

Answer 21

<2 mm
>2 mm