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implant 2 > fliecher > Flashcards

fliecher Flashcards

1
Q

clinical manifestations of ridge resorption

A 
headaches 
improper speech
diet
painful oral sores 
fracture
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2
Q

physiologic impact of edentulism

A

frustration
depression
isolation
embaressment

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3
Q

as the bone loss progresses

- actions and consequences

A

additional denture adhesive is used

relining material

reshaping of dentures

multiple sets

complete loss of denture function

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4
Q

a common cause of denture related problems

A

alveolar ridge resorption

 This is something that is completely avoidable today
• Yet, we still see patients that are completely edentulous in one or both arches
• We need to do a better job at explaining to our patients about the benefits of implants

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5
Q

total implant procedures per year in the USA

A

has increased exponentially each year

graph showed from 2011 - to 2021

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6
Q

o How would you treat this case if you didn’t have implants?

A
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7
Q

tx changes early on with implants

A

implants with ball clasps

- make a partial denture now with less material and it can be completely retentive and functional for the patient

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8
Q

Ball attachments

A

utalized to retain the denture

- will prevent resorption in area that they are placed

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9
Q

branemark implant

A

titanium and cylindrical

- screw shaped

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10
Q

supporting structure in tooth

A

periodontium

  • alveolar bone
  • PDL
  • gingiva
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11
Q

supporting structure in implant

A

peri-implant tissue

  • osseointegrated bone
  • NO pdl
  • gingiva
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12
Q

supporting structures (mucosal seal forms)

A

free gingival margin
gingival sulcus
free gingival groove

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13
Q

maxillary implants success rates in function from 1-4 years?

5-10 years?

A

1-4 = 95%

5-10 = 81%

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14
Q

mandibular implants success rates in function from 1-4 years?

5-10 years?

A

1-4 = 99%

5-10 = 91%

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15
Q

implant success based on

A 
biocompatibilit 
bomechanics 
surgical protocol
prosthetic protocol
orla hygeine
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16
Q

broad breakdown of patient selection

A

medical eval
dental eval
psychological evaluation

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17
Q

medical eval

A

rule out disease

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18
Q

dental evaluation

A 
cariies exam
perio disease eval
OHI eval 
bone level
- quality 
- quantity
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19
Q

psychological eval

A

realisitic expectation

full understanding of procedures and complications

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20
Q

what to use to measure for adequate bone

A

pano / periapical rx

  • clinical
  • CBCT scan –tremendous amount of information and all of the information that we’re going to need, as far as the amount of bone that’s available

height width depth

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21
Q

tx plan decisions

A 
type of implant 
design of prosthesis 
diagnosis 
extractions 
tissue augmentation
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22
Q

as little as ___ for healing after implant

A

6 weeks

23
Q
  • How important is the recall appointment to the long-term success of the dental implant and restoration, what is done during the appointment?
  • Implant Recall Appointment
A 
o	Assessment and documentation
	Radiographic exam
	Mobility evaluation
	Osseointegration test?
	Soft tissue examination
o	Disease control instructions 
o	Scaling and prophylaxis
24
Q

assess what at recall at site

A 
	Soft Tissue Examination
•	Color
•	Texture
•	Shape
•	Bleeding
•	Exudate
•	Keratinization
25
Q

probe implant?

A

yes - cant just tell by x-rays alone - have to look clinically
but NO metal ; use plastic or titanium instruments

Implants that get probed have no lower success rate, long-term, than implants that don’t

26
Q

after healing how do we know when an implant is ready to be restored?

A

different stability test

  • percussion
  • torque and tactile
  • resonance frequency analysis (RFA)
27
Q

T/F size of osteomty slightly smaller than implant

A

true – helps with mechanical retention and stability

28
Q

when does primary stability decrease?

A

around 2-3 weeks
have a decrease
- trauma from the surgery is causing initial bone to be lost on a microscopic level
• At the same time, get secondary stability increasing and bone placement at a much faster rate
• New bone formation takes place at a faster rate
• Also depends on the surface treatment of the implant itself

29
Q

SLA active

A

getting stability sooner - but end result is same with same stability just occuring sooner with this

QUICKER RATE – and if quicker - less liklihood of problems occuring

30
Q

reverse torque test

A

o Spin the implant into place clockwise
o After a period of time, will put a driver on the implant and will try to unscrew it
o If osseointegrated, won’t move
o If it isn’t, it will spin and come out
o Putting strain on the implant and may have osseointegration and cause it to lose it by doing the test
o For a long time, only test we had available

31
Q

resonance frequency analysis (RFA)
basics?
include ISQ

A

uses a tuning fork

the stiffer the interface b/w the bone and implant - the higher the frequency

ISQ – implant stability quotient - has a NON-LINEAR correlation to micro stability – the scale is 1-100 ISQ

32
Q

the more stable the implant the ISQ is

A

the higher frequency the ISQ quotient is

33
Q

ISQ has a strong correlation to ?

measures?

A

micro mobility

RFA measures ressistance to lateral micro mobility

34
Q

torque measures

A

resistance to shear forces

35
Q

by measuring on two diff occasions?

A

you can verify not only the intial mechanical stability - but also determine the degree of osseointegration

36
Q

insertion torque?

what influences it?

A

measures the rotational friction together with the force required to cut the bone

diameter of the implant will influence the torque

37
Q

collar effect?

A

o Peak torque can give high values due to the “collar effect” when the implant collar is seated in cortical bone

38
Q

ISQ graph and important marks

A

 Micromobility decreases approximately 50% between 60 to 70 ISQ
• Between 60 and 70, have stability of a dental implant that can be restored

more reliable test than torque test

39
Q

Stability Development Over Time

A

o As a result of osseointegration, initial mechanical stability is supplemented, and/or replaced by biological stability, and the final stability level for an implant is the sum of the two
o Stability does not generally remain constant after implant placement. For example, there is likely to be an initial decrease in stability, followed by an increase as the implant becomes biologically stable

40
Q

low stability
medium
high?
in terms of ISQ

A

low is 60 and below
medium is 60-70

high is 70 and above

If we look at ISQ on day we place it and then 6-8 weeks later and assess the differences, get a pretty good idea of whether or not the implant has a high level of stability

41
Q

o Implant failure will appear radiographically as

A

vertical bone loss

radiolucency around implant

42
Q

what largely determines the patients potential abiblity to maintain home care

A

the design

43
Q

prophy procedure

A

home care

  • begins at first consultation
  • stress professional monitring
  • review homecare routine

tissue conditions peri- implant

stability
bone level (rx)
deposit removal
recall intervention

44
Q

ultrasonics on implants?

A

o Conclusions: all ultrasonic scaling caused the production of titanium particles and caused damage to the SLA coating of the implant. Ultrasonic scalers should be used with great caution
 He doesn’t like to use ultrasonics on implants
• Not a whole lot of evidence out there
 Shows that pieces of the metal are coming off
 No clear cut evidence that ultrasonics shouldn’t be used around a dental implant

45
Q

cement on an implant is

A

a contributing factor to peri-implantitis and mucositis

46
Q

if cement on implant can see this on radiograph

A

no - not all the time

have to raise a flap

47
Q

dynamic 3D navigation and robotic assisted surgery

A

new techniques and no surgical guide used

48
Q

dynamic 3D navigation

A

o No surgical guide used
o Shows your handpiece on the screen, live, so you can see exactly where your handpiece is
o Need to keep the bur cool to not cause the bone to necrose
 With a surgical guide, the water is being blocked and the tip of the bur isn’t reached by the water
o Problem: surgeon isn’t looking at the patient, looking at the computer screen

49
Q

robotic assisted surgey

A

o Advantage of this over 3d navigation
 With 3d navigation, will get visual and audible cues, but nothing that will stop you from doing it incorrectly
 This, will not allow you to go in at the wrong angle  physically stop you
 You still use the pedal, but the position in space is done by the robotic arm
 If patient moves, it moves in real time  no lag
o The issue: robotic arm is sensitive and finicky
 Takes a while to be comfortable with it

50
Q

basic of delayed implant placement

A

with soft tissue healing and only partial hard tissue / bone healing

51
Q

immediate placement advantages

A

1 surgical procedure

reduced over all tx time

these are both potential advantages

52
Q

immediate placement disadvantages

A

morphology of socket may lead to compromised implant positino

morphology of socket can compromise intital implant stabilit

lack of soft tissue volume for primar closure

increased risk of recession

complexitiy of procedure increases

53
Q

flapless in immediate?

A

yeah maybe cause youll have the extraction socket to guide you
- up to individual

54
Q

images needed for immediate

A

pano
periapical
CBCT

implant 2 (11 decks)

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