Dr. Malek's lecture (all short ans. questions) Flashcards
Implant Success Criteria: Individual unattached implant that is _______ when tested clinically.
IMMOBILE (tested the same way as a normal tooth)
Implant Success Criteria: Radiograph that does not demonstrate evidence of periimplant ________.
radiolucency
Implant Success Criteria: Bone loss that is less than ___ mm annually after the implant’s first year of service.
0.2 mm annually
Implant Success Criteria: Individual implant performance that is characterized by an absence of persistent and/or irreversible signs and symptoms of ______, infections, necropathies, paresthesia, or violation of the mandibular _____.
pain…canal
Implant Success Criteria: A success rate of ___% at the end of a 5-year observation period
85%
Implant Success Criteria: ___% at the end of a 10-year observation as a minimum criterion for success.
80%
What is the main difference in biological attachment between a natural tooth and an implant?
the PDL…none on an implant
What is the main advantage of a bone level implant?
Esthetics-no metal color/control of emergence profile
What is the main disadvantage of a bone level abutment?
need a healing abutment for soft tissue managment
What is the main advantage of a tissue level abutment?
can do a 1 stage, soft tissue forms easier
How far do you want the end of your abutment to be from the adjacent CEJ again?
2-3mm
A ________ between your abutment and implant body can be the cause of bone loss
microgap
Perio Boards: Tell me how bone forms… What are the two ways?
1.Intramembranous 2. Endochondral
Perio Boards: Tell me how bone forms…What type of formation comes directly from Mesenchymal Connective Tissue
INTRAMEMBRANOUS
Perio Boards: Tell me how bone forms…Where are the 4 locations that Intramembranous bone formation are found?
1.MANDIBULO-CRANIOFACIAL COMPLEX 2.illium 3.clavical 4.scapula
Perio Boards: Tell me how bone forms…Which mechanism of bone formation is in intraoral bone augmentation?
INTRAMEMBRANOUS
Perio Boards: Tell me how bone forms…How does endochondrial bone formation work?
bone forms directly from pre-existing cartilage
What is the most common bone type for implant failure?
Type IV (thin cortical layer, low density trabecular)
Bone Biology: ________ bone-Poorly mineralized bone
Formed by multinucleated osteoclasts as they remove the blood clot or necrotic tissue immediately after implant placement
Osteoid bone
Bone Biology: ________ bone-Grows fast (100 μm per day)
Woven bone
Bone Biology: ________ bone-Random orientation of collagen fibrils….High cellularity…Limited mineralization
woven bone
Bone Biology: ________ bone-Poor biomechanics capacity……Grows by apposition or conduction using the implant as a scaffold
woven bone
Bone Biology: ________ bone-Forms 1-2 months under the effect of load
Lamellar bone
Bone Biology: ________ bone-Parallel collagen fibers…..grows slowly-a few microns per day
Lamellar bone
What is the most important factor when debating to use an immediate implant or not?
PRIMARY STABILITY
Principles of bone regeneration: #1 bone supply aka _________
angiogenesis
Principles of bone regeneration: Osteo_____ cell migration from defect periphery
GENIC
Principles of bone regeneration: Well-vascularized ________ tissue formation
granulation
Principles of bone regeneration: Biomechanically stable _______
scaffold
Principles of bone regeneration: _______ bone and bone apposition within the defect AND THEN _______ bone formation
woven THEN lamellar
Principles of bone regeneration: LETS GET IT! In a nutshell….WHAT ARE THE 6 steps of bone regeneration in progression?!?!
1.Angiogenesis 2.Osteogenic Cell Migration 3.Granulation Tissue 4.Scaffold 5.Woven bone 6.Lamellar bone
Review-Bone Grafting material properties: _______-Contain bone forming cells
osteoGENIC (autograft)
Review-Bone Grafting material properties: ________-Contain bone inducing substances
osteoINDUCTIVE (allograft)
Review-Bone Grafting material properties: ________-Serve as a scaffold for bone formation
osteoCONDUCTIVE (alloplastic/xenograft)
Review of the different bone grafting materials: _______-Self, osteogenic, osteoconductive, osteoinductive…very active so resorbs quickly, so place implant quickly!
Autograft
Review of the different bone grafting materials:_______-Members of the same species, genetically
dissimilar….no worries, pretty stable so you can leave plenty of time between graft and implant placement
Allograft
Review of the different bone grafting materials: ______-Another species, biocompatible, osteoconductive…pretty stable too, you can take your time to place an implant
Xenograft
Review of the different bone grafting materials: ______-Synthetic, osteoconductive only…“perioglass” essentially just a space filler..
Alloplast
Barrier membrane principles! _____ maintenance
space
Barrier membrane principles! Prevent ______ migration (___mm/day!)
epithelial…0.05mm/day!
Barrier membrane principles! Promote ingrowth of _______ cells
osteogenic
Barrier membrane principles! Protect _______ in defect
blood clot
What is the MAIN concept of a BARRIER MEMBRANE?!
CELL EXCLUSION!
**What is the GOLD STANDARD for barrier membranes?
e-PTFE (expanded POLY - TETRA - FLUORO - ETHYLENE)…aka “GORTEX”..NON-resorbable
Which membrane is utilized mainly for space maintenance only?
Titanium reinforced e-PTFE (expanded poly tetra fluoro ethelyne)
Out of the resorbable barrier membrane options, which one is more biocompatible?
“natural” barrier membrane-animal collagen origin, enzymatic degradation…..synthetic cause inflammatory response
Do resorbable barrier membranes maintain space?
No! No space maintenance!
Siebert Class I bone loss is _______ in nature
horizontal
Siebert Class II bone loss is _______ in nature
vertical
Siebert Class III bone loss is _______ in nature
Horizontal and Vertical
Which method of hard tissue grafting includes Regeneration of the supporting periodontal apparatus: cementum, periodontal ligament, alveolar bone
GTR…Guided Tissue Regeneration
Which method of hard tissue grafting includes bone formation only and in 1959 cell-occlusive membrane used for spinal fusion
GBR…Guided Bone Regeneration
What is the average amount of time after a bone graft before an implant is placed?
9 months
Which SOFT tissue graft is used to GAIN ROOT COVERAGE?
Sub-epithelial connective tissue graft (also increases Keritanized gingiva & attached tissue)
What are the two things that a free gingival graft accomplishes?
increases KG and increases attached tissue (DOES NOT GAIN ROOT COVERAGE!!)
Final Comments on implants: _____-_____ COMMUNICATION!!!!
Peril-Pros COMMUNICATION!!!
