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Intro to IMPLANTS > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Initial definition of osseointegration?

A

“Direct structural and funcitonal connection between ordered, living bone and the surface of a load-carrying implant”

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2
Q

Later definition of osseointegration

A

“Process in which clinically asymptomatic rigid fixation of alloplastic materials is achieved and maintained in bone during functional loading”

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3
Q

On what level of magnification is osseointegration defined?

A

Light microscope

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4
Q

When was titanium originally used?

A

1950, titanium chambers embedded into soft tissue of ears of rabbits

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5
Q

When were implants first study for osseointegration?

A

1952

Branemark implanted titanium in rabbit femur

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6
Q

When were guidelines put in place for implants?

A

1982 - toronto

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7
Q

What Med history factors effect implant survival?

A

Smoking and radiation

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8
Q

Are implants contraindicated with smokers? What are the rates of success?

A

No
Smokers: 89%
Non Smokers: 96-98%

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9
Q

What pretx records are required for implants?

A
  1. Pano radiographs
  2. PA of edentulous area to be restored
  3. Implant Diagnostic Checklist
  4. Mounted dx cast and wax up
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10
Q

Diagnostic checklist

A
  1. Edentulous space to be restored
  2. Edentulous ridge
  3. Soft Tissue
  4. Occlusion
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11
Q

Edentulous space

A

MD width at least 6.5mm, ideally 7mm for single tooth
Double for two teeth
BL width - molar area at least 7mm
Height - PA radiograph is necessary
Max post/man ant = at least 10mm
Man post = at least 12 mm above IAN
Interocclusal space = at least 5mm from ridge crest to opposing dentition

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12
Q

Soft tissue

A

Thin biotype - difficult to manage esthetics

Thick biotype - predictable esthetics

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13
Q

Occlusion

A

Anterior guidance
Parafunction
Inter-arch relationship

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14
Q

TX planning options

A
  1. Nothing
  2. RPD
  3. FPD
  4. Implant Crown (IC)
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15
Q

Advantages of Implant Crowns

A
  1. Conservative
  2. Improved Hygiene
  3. Esthetics
  4. Maintains Bone
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16
Q

Disadvantages of IC

A
  1. May require additional surgery - graft/sinus lift
  2. Long tx time
  3. Expensive
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17
Q

Contraindications of implant tx

A
  1. Inadequate bone height and width

2. Presence of bone loss around adjacent teeth (anterior esthetics compromised)

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18
Q

Most common complication of implant restoration

A

Abutment screw loosening - easily managed

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19
Q

What has the highest survival rate in terms of prosthesis

A

Single tooth replacement with implants - 97%

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20
Q

Edentulous arch tx options

A
  1. Nothing
  2. Immediate denture
  3. Complete Denture
  4. Implant Overdenture
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21
Q

How many edentulous pt have implants?

A

1-5%

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22
Q

First choice tx for edentulous mandible

A

2-implant overdenture

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23
Q

What is the braenmark definition of osseointegration

A

Direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant

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24
Q

What percentage of osseointegration takes place?

25
Implant success critieria
1. No mobility 2. No peri-implant radiolucency 3. Vertical bone loss
26
Predictors of implant success
1. Implant material biocompatability 2. Implant design and surface 3. Bone quality and quantity 4. Implant placement and restoration technique
27
Implant materials and advantageous properties
* Titanium 1. Biocompatability 2. High Strength 3. Cost effective
28
Primary Stability
Implant macrostructure - length/ diameter/ threads/ microgrooves
29
Secondary stability
Surface roughness/ texture
30
How do aggressive threads impact stability?
Increase it upon placement | Increase surface area once integrated
31
What happens with primary and secondary stability over time?
Decrease in primary stability and increase in secondary stability between 2-4 weeks after implant placement
32
Tapered implants
1. Better primary stability 2. mimics root anatomy 3. Immediately after extraction or in healed sites 4. Limited buccal plate thickness 5. Limited inter-dental root space 6. Sinus floor infracture cases
33
Implant diameter is based on
1. Available bone width 2. Size of tooth replaced 3. restoration contours (emergence profile) 4. Occlusal load
34
How does implant diameter effect surface area
1. Increase implant diameter from 4 to 5mm increases SA by 25%
35
How to select diamter?
Implant diameter should be within 1mm of the diameter of the restoration at CEJ
36
Length dependent on..
Available bone Anatomy Longer implants = more SA for osseointegration Immediate implant cases, primary stability is achieved by engaging apical 1/3rd of the socket
37
Thread and monogrove features
Guide implant placement - active thread Mechanical interlocking Increases SA for greater BIC (bone to implant contact)
38
How can implant surface topography be modified
1. Acid etch 2. Blasted surface 3. Acid etched and blasted surface 4. Oxidiezed surface 5. Titanium plasma spray
39
Can you have too rough of surface?
Yes, calculus becomes difficult to remove once attached if too rough of surface - perimplantitis
40
D1 Description and Location
Dense cortical bone | Anterior mandible
41
D2 Description and Location
Porus cortical and coarse trabecular bone Ant and Post man Post max
42
D3 Description and Location
Porus cortical (thin) and fine trabecular bone Ant and Post Max Post Man
43
D4 Description and Location
Fine trabecular | Post Max
44
Stress
Magnitude of force/functional area over which it is applied
45
Strain
Changed in length of a material/original length
46
Bone density of Load transfer
Greater stress = greater strain Excessive stress at B-I = crestal bone loss Bone density is directly related to bone strength
47
Greater bone density offers:
Greater BIC Better stress distribution BIC: Cortical bone (D1) > Trabecular bone (D4) Greater implant surface area is required to obtain similar amount of BIC in soft bone -Bone density down = need to increase implant surface area
48
How to determine bone density?
CT Scan Tactile sensation during surgery *PA and pans NOT useful
49
What is the imaging method of choice for gaining bone info?
CBCT
50
How to reduce stress on less denser bone (D3, D4 bone)
1. Reduce cantilever forces on the prostheses 2. Reduce the amount of load - narrow occlusal table 3. Occlusal force directed along the long axis of the tooth
51
What tx modifications can accomodate for variations in bone density
1. Reduce force of the prosthesis 2. Increasing load bearing area 4. Improving the design and surface
52
How to reduce the stress in implant prostheses
First - decide type of prosthesis - fixed or removable prosthesis Second - eval the amount of force that the implant restoration needs to withstand Third - determine bone density at the implant site Fourth - decide implant position and number
53
Restorative dentists prescribe...
Implant brand, size (diameter/length) and location (depth and orientation) of implant placement that is most favorable for long term success of implant prosthesis
54
What is important for optimal support and stability of hard and soft tissue?
Correct 3D Implant positioning
55
CB
Crest of Bone
56
CP
Contact Point
57
What happens when CP-CB = 5mm or less
Papilla present almost 100% of the time
58
What happens when CP-CB = 6mm?
Papilla present 56% of the time
59
What happens when CP-CB > 7mm?
Papilla present 25% or less

Intro to IMPLANTS (2 decks)

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