Final; Dental Implants in Health Flashcards
This is the direct attachment or connection of vital osseous tissue to the surface of an implant, without intervening connective tissue; physical binding
osseointegration
This is the clinical term to define osseointegration
rigid fixation
True or False
Implants can be 100% integrated into bone
False, 100% bone connection does not exist, approx. 60% bone to implant contact
What are the steps in placing an implant
- incision
- mucoperiosteal flap elevation
- preparation of a bed of the cortical and spongy bone (osteotomy)
- insertion of the titanium device
There is this type of displacement of bone tissues at the tight contact at the cortical bone level regarding initial implant stability
lateral
What is the ultimate goal of the implant regarding the bone
for it to become anchylotic with the bone; establish a mucosal attachment
- You can always add bone onto the rest of the implant if you need to if it is stable in 3 walls
What is the process of bone healing at 24 hours
- resorption of cortical bone
- woven bone formation
- blood clot formation
- proliferation of vascular structures into newly forming granulation tissues
What is the process of bone healing at 1 week
- reparative macrophage and undifferentiated mesenchymal cells
- modeling at the apical trabecular region and at the furcation sites of a screw shaped implant
What is the process of bone healing at 2 weeks
new bone formation can be detected at the “furcation sites” of a screw shaped implant
What is the process of bone healing at up to 6 weeks
callus formation and lamellar compaction within woven bone
True or False
During bone healing, there is a temporary decrease in implant stability
True
This is the distance that can be filled with new bone between the implant and the remaining host bone
“jumping distance”
What is the ideal tolerable bone “jumping distance”
20-40μm
When is a good time for dental implant loading
accepted healing period for osseointegration is 6 months for maxilla and 3 months for mandible
What are the 4 types of implant loading
- immediate loading (same day)
- early loading (weeks)
- late loading (months)
- progressive bone loading (something new every week)
What is good/poor bone quality
- you want a MIX of cortical and trabecular, cortical gives you the stability, while trabecular gives you the blood supply
- Too much cortical = not enough blood
- Too much trabecular = not enough stability
This increases surface area, and bone response is stronger to surfaces with irregularity values
porosity
An implant should be surrounded with a minimum of how much alveolar bone thickness
1mm
What are the minimum ridges of bone thickness between implant/implant and implant/tooth
implant/implant - 3mm
implant/tooth - 4mm
The coronal part of an implant should be places approx. how many mm apical to the adjacent CEF
5mm
Obtaining this between implants and teeth is critical
maximum parallelism
Implants do not have this, which means they cannot tolerate horizontal forces
PDL
An implant can be places at a maximum of this angle
20 degrees
What are the two parts of transmucosal attachment
- barrier epithelium (2mm)
- zone of connective tissue (1-1.5mm)
The collagen fiber bundles are in which direction corresponding to the implant surface
parallel
The zone that is adjacent to the implant surface is rich from what and poor from what?
rich from fibroblast, but poor from blood vessels
The zone that is in lateral direction and continuous with the first zone has fewer fibroblasts but is rich in what
collagen fibers and blood vessels
The blood supply is coming from which blood vessels
supraperiosteal
What is the difference between one and two stage implant placement
two stage = submerged tech.
one stage = non-submerged tech.
This is the same that exists between implant and abutment
microgap; generally located at the alveolar crest
Where does the biologic width on an implant exist
around unloaded and loaded non submerged one part titanium implants; approximately 3mm
What are the 6 parameters used to evaluate peri-implant health
1; absence of mobility
2; radiographic examination
3; absence of bone loss ≥2mm/year following the first year
4; absence of any pain, complaint, or infection
5; functional and esthetic acceptance of implant
6; success rate of 94-98% following 5 years and 90-94% following 10 years
What are the three techniques to evaluate dental implants
peri-implant probing
existence of mobility
radiographic examination
This of an object is strongly correlated to the boundary constrains of the structure
resonance frequency analysis (RFA)
the higher the # the better stability
is keratinized tissue or attached gingiva required around dental implants
yes, especially in partially edentulous
What is the success rate for implants placed at grafted sites
about the same - stability
With an implant there is no _____ ______ attachment
Soft tissue
With implants what seals the implant post to the bone?
Mucosal seal
What is stronger a soft tissue attachment or mucosal seal?
soft tissue attachment (found in natural teeth)
How much mobility is acceptable with an implant?
ZERO
What is rigid fixation?
Osseointegration
Why does 100% bone connection not exist?
There are small non-binding pocket areas along the surface of the implant
New implants differ from older implants how? Some older styles are still used today.
Older implants - smooth
Newer implants - roughened surfaces - screw design
Why would we pick a roughened implant design over a smooth?
For additional surface area binding
When would you expect to see the temporary decrease in stability of the implant improve?
After 6 week plateau
When is a good time for dental implant loading? Maxilla and Mandible?
Maxilla = 6 months (thinner cortical bone) Mandible = 3 months (thicker cortical bone)
What is the worst type of bone quality for implants? What is best?
Type IV bone, then Type I
Best is between Types II and III
What type of implant is most used today in the US?
Titanium (covered with titanium dioxide)
