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Implant > Factors Effect > Flashcards

Factors Effect Flashcards

1
Q

What are the factors effects implant osseointegration ?

A

1- implant material ( Ti gold standard )
2- implant finish
3- status of the bone
4- implant loading condition
5- surgical techniques
6- Macro and micro design of implant

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2
Q

What is Osseointegration ?

A

Direct interaction between implant and bone at microscopic level
Asymptomatic rigid fixation of alloplastic material during function

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3
Q

What is the type of stability in primary and secondary ?

A

Primary : pure mechanical ( micro motion lead to failure )
Secondary : is the long term success , biochemical ( after healing of bone ) and depends on the degree of bone formation

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4
Q

Deferences between bone remodeling and modeling :

A

Remodeling : replace old bone with new bone ( Slow / same shape ) , Decrease primary increase secondary
Modeling : changing the shape/size of bone as response to force or stress ( fast / different shape )
Repair : physiological process were body facilitate repair of bone fracture
Bone regeneration : development of new bone in deficient sites with using surgical protocols ( osteogenesis, osteoinduction, and osteoconduction )

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5
Q

What are the components of osteogenesis,
osteoinduction, and osteoconduction ?

A

Bone graft + osteoblasts = OSTEOGENESIS
Bone graft + angiogenesis = OSTEOCONDUCTION
Bone graft + growth factors = OSTEOINDUCTION

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6
Q

Implant with Higher survival rate sites to lower survival rate and why :

A
  • Anterior mandibular teeth ( 100 % ) thick outer cortical bone
  • Anterior maxillary teeth ( 94 % )
  • Posterior mandibular teeth ( 92% ) neurovascular bundle’s
  • Posterior maxillary teeth ( Nasal floor and maxillary sinus )
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7
Q

What imagine modality to see bone density?

A

CBCT

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8
Q

Alveolar bone proper “Cortical bone” other names ?

A
  • Lamina dura ( RO lining )
  • cribriform plate ( because of blood vessels )
  • bundle bone ( because of pdl fibers )
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9
Q

Deference between cortical and cancellous bone ?

A
  • Cortical bone Microscopic structure is osteon and it’s organized and surrounds blood vessels
  • cancellous bone microscopic structure is trabeculae and it’s unorganized and surrounds blood vessels
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10
Q

Osseointegration Prerequisites ?

A

• Precise fit
• Primary stability ( Achieved in surgery place and torque measurement )
• Bioinert No - tissue reation )
• Bioactive ( + favorable tissue reaction )

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11
Q

Osseointegration Process :

A

0 day ( 2 hours ) : production of Coagulum
4 weeks : New trabecular bone
6 weeks : Dense trabecular bone
12 weeks : New mature bone

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12
Q

BIC is what ?

A

Bone to implant contact and measures degree pf ossteointegration

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13
Q

Most common incision

A

Creatal incision ( should be beveled and suitable for submerged and non submerged )

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14
Q

In case of bone grafting what incision should we use ?

A

Vertical releasing incision

( should be beveled 45- 60 degree to the center of the flap not the IDP and not of middle of facial surface )
( Should extend beyond the muccogingival line and AVOID it in palatal/ lingual ( thicker fibers )

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15
Q

In implant osteotomy what is the benefit of placing surgical guide template ?

A

Directs the angulation of the implant

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16
Q

What torque and speed we use in implant osteotomy ?

A

Low speed (1500 - 2000 rpm ) , High torque , copious irrigation ,

17
Q

Generic drilling sequence ?

A
  • blade no 12
  • Pilot drill ( low speed diamond with taper end ) ( 1.5-2 mm hight ) drill into center by 7-9 mm
  • position verification ( must take PA with it to asses position and angulation ) ( maximum speed 800 rpm )
  • 2nd Twist drill ( re assess the position and angulation) ( 2.5 mm in width ) ( maximum speed 800 rpm )
  • final shaping drill ( widen the osteotomy to implant diameter )
  • Taper drill or thread former ( only for thicker bone ) less than 30 rpm
  • implant insertion 45 Ncm by hand piece or hand ratchet then take PA

Sequence change according to the implant and bone ( soft or hard ).

18
Q

Methods of measuring implant stability( primary ) include :

A
  • Percussion testing
  • Insertion torque (IT) by a machine that determine the stability of the implant, it gives readings: 15,25,30,35
  • Reverse torque test
19
Q

1 stage vs 2 stage approach ?

A

1-stage approach (non submerged):

  • Healing Abutment
  • one surgical intervention.
  • shortens treatment times.
  • Partially edentulous patients

2-stage (submerged) :

  • cover scrow
  • when primary stability not obtained and GTR
  • when expected that removable temporary prostheses could transmit excessive forces
  • fully edentulous patients.
20
Q

When to remove sutures?

A

After 7-10 days ( should use CHX 0, 12 % )

21
Q

What is the most common suturing material ?

A

Non absorbable like :
silk use for flap because it’s cheaper
Nylon

22
Q

Absorbable material for sutauing used for what?

A

Extraction & Bone graft ( we use figure of 8 for it )

23
Q

Most commonly used suturing technique?

A

Simple interrupted

24
Q

When late complications aries and what is it ?

A

After 3 months

  • Implant mucositis : inflammation of soft tissue
  • Perimplantitis: inflam. of the bone cause bone loss
  • Implant fracture
25
Q

When immature collagen start to form?

A

After 2 weeks

26
Q

Implant loading condition :

A

Immediate : 48 hours
Early : 48 hours to 3 months
Conventional : 3-6 months
Delayed : 6-12 months

27
Q

In the case of inadequate primary stability :

A

May select to increase the diameter of the implant being placed and/or avoid immediate loading.

28
Q

Aim of dental implant design?

A

1- Maximise osseointegration: Maximise cell activity and bone apposition at the bone-to-implant contact (BIC)
2- Maintenance: Balance between Biological vs biomechanical factors

29
Q

Most commimgly used and more successful material?

A

CPTi

30
Q

Titanium (Ti) and its alloys are commonly used materials dental implants due to :

A

their mechanical and chemical properties.
• high strength to weight ratio
• high yield and fatigue strength
• relatively low modulus counteracting the effects of stress shielding.

31
Q

Benefits of passive titanium oxide (TiO2) passive film at the surface and where it found?

A

In Tiatinum and it’s alloy and it’s biocompatible ( react with water ion and serum protein ) to resists corrosion .

32
Q

Dose old age effect implant survival ?

A

No , Older the patient more successful the implant

33
Q

Does diabetes effect implant ?

A

Yes , chronic Hyperglycemia increase inflamation to the site of implant will cause bone loss and implant failure
AGEs ( Advanced glycation end product effect wound healing )

34
Q

Does CVD ( HTN ) effects implant survival ?

A

No , but effect bleeding >2.5 and ischemia

35
Q

Dose osteoporosis effect implant survival ?

A
  • Oral and Low dose IV of BP / low risk of MRONJ
  • IV BP / High risk of MRONJ ( Absoulte contraindication )
36
Q

How soft tissue effect implant ?

A
  • Increase keratinized tissue will increase esthetic and hygiene and patient comfort /decrease reccesion
  • THICK biotype is better
37
Q

Best types of cortical bone ?

A

II / III

38
Q

Treatment options for post extraction ?

A
  • 0 : immediate/ same day
  • 4-8 weeks : early , soft tissue healing
  • 12-16 weeks : partial bone healing
  • > 6 months : complete bone healing

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