Exam 1 Material Flashcards

1
Q

What are the three major groups of implants?

A

1.Sub-periosteal 2.Transosteal 3.Endosteal (3a. Palate form 3b. Root form)

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2
Q

Who discovered osseointegration? What material did he use?

A

Bran-e-mark…titanium

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3
Q

Titanium is resistant to corrosion and spontaneously forms a coating of ________, which is stable, biologically inert and promotes the deposition of a mineralized bone matrix on its surface.

A

titanium dioxide

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4
Q

Achieving osseointegration! Avoid: Over _________ of the site–gap between the bone and the surface of the implant is too large

A

preparation

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5
Q

Achieving osseointegration! Avoid: Overheating the site KEEP BELOW ___ DEGREES CELSIUS!

A

BELOW 47 DEGREES CELSIUS

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6
Q

Achieving osseointegration! Avoid: Micro motion of the implant during the _______ phase

A

healing

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7
Q

Achieving osseointegration! Avoid: _________ of the implant surface prior to placement

A

Contamination

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8
Q

Achieving osseointegration! Avoid: this came up 1 million times today- AVOID LESS THAN __ mm of healthy bone on the buccal and lingual

A

1 mm

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9
Q

How long do you need to have an implant heal before restoration on the MAXILLA?

A

6 months

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10
Q

How long do you need to have an implant heal before restoration on the MANDIBLE?

A

4 months

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11
Q

After healing- signs of success…Fixture is clinically stable -NO _______

A

mobility

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12
Q

After healing- signs of success… No peri-implant _________

A

radiolucency

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13
Q

After healing- signs of success… No ____, infection or other pathology in the hard or soft tissue

A

PAIN

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14
Q

After healing- signs of success…**Mean marginal bone loss is LESS THAN ___mm in total after ___ years OR vertical bone loss was LESS THAN ___mm annually following the implant 1st year of service.

A

Less than 1.5mm after 3 years…..0.2 mm

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15
Q

Success rate by location- Maxillary Posterior

A

90% (worst-1.less dense bone 2.higher forces from proximity to TMJ)

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16
Q

Success rate by location-mandibular posterior

A

96%

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17
Q

Success rate by location-maxillary anterior

A

95%

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18
Q

Success rate by location- mandibular anterior

A

100% HOLY SMOKES!

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19
Q

Bone quantity- _____ implants have a higher failure rate

A

shorter

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20
Q

Bone quality-Poor quality bone type ___ has a higher failure rate

A

Type IV (least DENSE)

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21
Q

What type of bone is best to place an implant?

A

Type II (like half trabecular bone and half cortical bone)

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22
Q

Implants placed in the anterior mandible : excellent ________ because the cortical bone is thick and the trabecular bone is very dense

A

ANCHORAGE

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23
Q

Implants placed in the ________ : less effective anchorage because the cortical bone is thin and the trabecular bone is not very dense.

A

posterior maxilla

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24
Q

Indications for implants: Inability to wear ______ or complete denture

A

RPD

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25
Q

Indications for implants: Need for long span ____ with questionable prognosis

A

FPD

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26
Q

Indications for implants: _______ tooth loss that will require preparation of minimally restored teeth for FPD

A

Single

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27
Q

What is the largest contraindication to implant placement?

A

uncontrolled diabetes

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28
Q

How long should you wait post radiation therapy before placing an implant?

A

6 months

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29
Q

Bone loves a ______ surface and soft tissue loves a ______ surface.

A

bone=rough….soft tissue = smooth

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30
Q

Cool- some of the initial titanium ______ spray surfaces were excessively rough and giant cells and macrophages were seen phagocytizing portions of the surface.

A

plasma

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31
Q

MP-1 HA Coating is a type of implant coating containing highly ______ hydroxyapatite

A

crystalline

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32
Q

What is the newest type of osseointegrating finish on the implant that Zimmer and Straumann use (and ASDOH uses)?

A

Trabecular metal

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33
Q

Trabecular Metal Material is made of _______, element number 73 in the periodic table. It is a highly biocompatible and corrosion- resistant metal

A

tantalum

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34
Q

Most studies indicate that the bone appositional index (amount of bone contact with the surface of the implant) achieved is greater with ______ surfaces as compared to _______ surfaces

A

ROUGH vs machined

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35
Q

The bioreactive surface of HydroxylApatite Coatings leads to more rapid osseointegration. At _______ following placement the bone appositional index is close to 70% for HA coated implants compared to 30-50% for original titanium surfaces (machined and TPS)!!!

A

6 WEEKS!!

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36
Q

This analysis revealed that 95.2% of machined Ti threaded implants and 97.92% of HA-coated threaded implants were successful, while ____% of HA-coated cylindric implants experienced less than 2 mm of bone loss (P

A

99%!!!….5 years

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37
Q

****Avoid the use of implants less than ___ mm in length and ___mm in diameter when restoring POSTERIOR quadrants.

A

10mm in length…..4mm in diameter

38
Q

With a narrow diameter implant what type of effect can wreak havoc on the success of your implant?

A

cantilever effect

39
Q

Cantilever forces lead to ________ and overload the bone anchoring the implant.

A

screw loosening

40
Q

We can eliminate the cantilever effect by using ______ diameter and ______ implants…

A

wide…multiple

41
Q

If small diameter implant (

A
42
Q

AGAIN, We need at least ___mm of bone thickness on Buccal and lingual side of the implant

A

1mm

43
Q

What type of titanium is the Branemark system? Which is WEAKER: Pure titanium or titanium alloy?

A

Pure Titanium……Pure titanium is WEAKER than titanium alloy!

44
Q

What was the method used for making 3 consecutive implants stronger with pure titanium? (no longer used)

A

staggered pattern

45
Q

What is more susceptible to failure: straight or angled?

A

Angled is more susceptible to failure

46
Q

Several studies showed that 􏰂______ loading concentrated clinically significant stresses around the neck and at the tip of the implant

A

Off-axial

47
Q

Another common theme: implants should be placed so that occlusal loads can be directed _______ in the POSTERIOR quadrants.

A

axially

48
Q

In the _____ region, anatomic necessity precludes implant placement perpendicular to the occlusal plane.

A

ANTERIOR

49
Q

In the anterior, we don’t have to place the angle of the implant axial because forces to incise food are ____ the amount of the posterior.

A

1/4

50
Q

implant overload is rarely seen in the ______ regions.

A

Anterior

51
Q

What are the 2 dimensions of cantilevers?

A

B/L and M/D

52
Q

If the OCCLUSAL tables are too _____, B and L cantilever forces lead to these 3 things:

A

WIDE…..1.Prosthesis failure 2.Screw failures 3.Implant overload and bone loss

53
Q

AVOID B and L cantilevers by ________ the occlusal table on the posterior teeth.

A

NARROWING

54
Q

Strategies to avoid implant overload (posterior): Place implants _________ to the occlusal plane

A

perpendicular

55
Q

Strategies to avoid implant overload (posterior): Place implants in proper tooth _______

A

positions

56
Q

Strategies to avoid implant overload (posterior): When in doubt, always add the _______

A

third implant

57
Q

Strategies to avoid implant overload (posterior): AVOID the use of ________

A

cantilevers

58
Q

Strategies to avoid implant overload (posterior): Control the _______ factors (cusp angles, width of the occlusal table)

A

occlusal

59
Q

Strategies to avoid implant overload (posterior): Avoid use of _____ implants (less than ___ mm)

A

short….10mm

60
Q

Rule of thumb:

A
61
Q

Rule of thumb: > ___mm of bone - 2 implants to replace 3 teeth

A

> 13mm of bone

62
Q

What is the main issue with external hex design?

A

abutment screw loosening

63
Q

The internal hex connection virtually ELIMINATES rotational _______ and micro-movement

A

TIPPING

64
Q

Posterior : splint in the posterior regions thanks to improved anti-________ features may make non- splinted posterior restorations more routine.

A

anti-rotational

65
Q

Can you connect a natural tooth to an implant? Why?

A

HELL NAW! “bening load” of the fixed tooth

66
Q

What do we use to check occlusion with an implant prosthesis?

A

SHIM STOCK-we want a lighter contact. When pt bites down hard should hold the stock, when pt closes normally stock should drag out

67
Q

Where do you place centric contacts over a implant prosthesis?

A

OVER the screw access hole

68
Q

Is it ok to have working and balancing contacts on an implant crown?

A

NO, eliminate working and balancing contacts

69
Q

What is a really bad contraindication that requires an occlusal guard?

A

fracturing of natural teeth! not good for implants!

70
Q

For profile and lip support what type of denture is best?

A

an overdenture

71
Q

***What type of restoration works best for 8-9mm of space from the crest for the ridge to the incised edge?

A

PFM or regular type crown

72
Q

***What type of restoration works best for 15–20mm of space from the crest for the ridge to the incised edge?

A

A hybrid or fixed denture

73
Q

What is more esthetically challenging? A high smile line or a low smile line?

A

high is more challenging

74
Q

What is the ideal thickness of keratinized tissue over the implant area?

A

3-4mm

75
Q

Can we work with unattached mucosa?

A

Yep, attached is preferable but we can work with unattached

76
Q

Distance from crest of ridge to occlusal plane: _______: 8-10 mm

A

overdenture

77
Q

Fixed complete denture (hybrid prosthesis): ___-___ mm

A

15-20 mm

78
Q

Posterior single crown or fixed partial denture: Minimum ___ mm

A

5mm

79
Q

Anterior single crown: Space between opposing tooth & implant abutment should be adequate for the type of restoration being fabricated. Minimum ___ mm for metal ceramic crown or all ceramic crown.

A

1mm

80
Q

A minimum of ___ MIO should be available for instrument access

A

35

81
Q

**What is the MINIMUM implant to tooth distance?

A

1.5mm to 2mm

82
Q

**What is the MINIMUM implant to implant distance?

A

3mm

83
Q

*****What is the MINIMUM distance between and implant and the mental foramen?

A

5mm

84
Q

For mandibular fixed detachable prosthesis (hybrid) the inter-foraminal distance should be adequate to place __-__ implants

A

4-5 implants

85
Q

Usually not a problem as the average inter-foraminal distance is about ___ mm

A

47 mm

86
Q

What yields better esthetics? flat, thick gingiva or scalloped gingiva?

A

flat, thick gingiva

87
Q

For proper inter-dental papilla in the anterior- how much room do you need from crest of the bone to the contact point?

A

5mm

88
Q

There should be at least ___mm space between the implant surface and adjacent tooth to maintain the inter-proximal bone.

A

1.5mm

89
Q

Anterior implant: __mm lingual to the final facial surface for build up of porcelain and __-__mm placement of the implant apical to the CEJ of the final crown

A

2mm…..2-3mm

90
Q

QUIT SMOKING! ______ before and _____ after

A

1 week before….8 weeks after placement