Biology of Dental Implants Flashcards
How does the PDL work in natural teeth?
- Periodontal fibers attach from bone to root in multiple directions
- Periodontal Ligament act as shock absorber
- Connective tissue fibers attach to teeth
How is the dental implant attached since it is not the PDL?
- Direct bone to implant contact (osseointegration)
- Ankylosis
- Peri-implant fibers parallel cuff, oriented longitudinal
Supracrestal tissue (Biological Width) attachment length is…
~2 mm
Epithelial cells attached to implant by…
hemidesmosomes
Collagen fibers do not insert into the implant but creates a _____ around the implant
cuff
How is the implant blood supply different than natural teeth?
Implants have..
* Blood supply by terminal branches of large vessels from periosteum.
* More inflammatory response than gingival tissues
* Fewer Capillaries
Natural teeth have..
Attachment -
Orientation of collagen fibers -
Source of blood supply -
Biological width -
Attachment - Basal Lamina and hemidesmosomes
Orientation of collagen fibers - Perpendicular
Source of blood supply - Periosteum and PDL
Biological width - ~2
Implants have…
Attachment -
Orientation of collagen fibers -
Source of blood supply -
Biological width -
Attachment - Basal Lamina and hemidesmosomes
Orientation of collagen fibers - Parallel
Source of blood supply - Periosteum
Biological width - ~3
JE Length in implants is ___ mm (depends on the implant design).
1.3 to 1.8
PDs may very based on implant design (and brand)
**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
What is peri implantitis?
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 bleeding on probings, while progressive bone loss is identified on radiographs
How much bone is adequate on the mesio-distal of an implant?
- at least ____ mm between teeth and implant
- ____ mm for papilla in anterior teeth
- ____ mm between 2 adjacent implants
1.5
3-4
3
How much bone is adequate on the bucco-lingual (anterior zone) of an implant?
- As bone thickness approached ____ mm, bone loss decreased significantly and some evidence of bone gain was seen
1.8 - 2
How much bone is adequate on the bucco-lingual (posteriors) of an implant?
- 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 a bone level implant ______
subcrestally
What is platform switching?
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
Why is platform switching important?
It reduces peri-implant bone resorption at the one crest:
-Shifts the inflammatory cell infiltrate inward and away from the adjacent crystal bone
-Maintains the supracrestal attachment
-Increases distance of implant-abutment junction from the crystal bone
-limits possible interface of bone with micro-movements
Is it better to use 2-part implants or 1-piece?
2-piece is better!
(a) Modern endosseous two-piece implant design comprising the implant and a screw-retained abutment (better!!!)
(b) Modern one-piece implant with integral abutment
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 bacterial contamination
* Placement of two-part implants at different levels in relation to the bone crest resulted in different amounts of bone loss.
1-1.5
The ____ influences bone remodeling
Microgap
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
