Hermann and Tarnow Flashcards
Hermann looked at?
Crestal bone levels
Tarnow looked at?
inter-implant distances
consequence of loosing peak of bone if implants placed too close together? loss of interdental bone will result in..?
with loss of the inter-dental bone height/ crest you get an esthetic problem as well recession and loss of the gingiva/ papilla inter-proximally
POOR ESTHETICS
minimum distance needed when placing adjacent implants? what does this prevent?
3mm he is saying it will prevent the loss of the CREST OF BONE INBETWEEN
*NOT SAYING IT WILL PREVENT BONE LOSS FROM OCCURING
Major assumption Tarnow made? relationship to the Hermann study?
that bone loss is inevitable – meaning it will always happen
Hermann said you can avoid bone loss depending on the type
schematic of hermann design
- extracted
- implants 6 weeks later
- abutment placed 3 weeks after that
- sacrifice and looked at histologically
which implant showed no bone loss?
Type A – tissue level implant as it is significantly above the crest of bone
what guarantees bone loss will occur?
if the interface is at the crest of bone or submerged apical to the crest of bone
why did Tarnow always see bone loss?
Because he put every implant AT THE CREST OF BONE – so if place it at the crest of bone you are guaranteeing bone loss to occur
what does submerged mean?
when placing the implant you put the soft tissue back over it and had primary closure
original branemark said you got bone loss when?
not at the time of placing the implant but subsequent to the screwing in of the abutment
so when patient came back to put the abutment on - the crest of bone was at the same level then when you took radiogrpah of the abutment you ALWAYS had bone loss after a period of time
Hermann’s conclusions
the location of the abutment interface relative to the implant is crucial whether or not you will have bone loss in the future or not and also the location of the roughened surface or polished collar
if you have polished collar it should always be where?
coronal to the bone because it can lead to bone loss
Hermann assumptions
canine model translates to the human model
do the studies compliment eachother?
that you will get bone loss ineviteably if you use the certain design
implications of Tarnow study
If using implant like tarnow used – expect bone loss and expect to lose the peak of bone between as well if place them closer than 3mm
if placing a supra-crestal implant what are we most concerned with?
what surface is that is supra-crestal
implications of sub crestal and at the crest for implants
will get bone loss
if supra crestal surface is roughneded what are the implications
potential for plaque build up
platform switching use?
general
try to combat the problem that we see with implant placements like Tarnows
brings interface FURTHER AWAY from the EDGE OF THE IMPLANT IN A HORIZONTAL DIRECTION
which direction is being manipulated in platform switching
HORIZONTAL
brings interface FURTHER AWAY from the EDGE OF THE IMPLANT IN A HORIZONTAL DIRECTION
solutions for limiting bone loss (2 we discussed)
- interface between abutment and implant more coronal
2. platform switching
describe the platform switching **
method used to preserve alveolar bone levels around dental implants
placing screwed or friction fit restorative abutments of NARROWER DIAMETER in implants of wider diameter
platform matching and implications
when the implant and abutment interface is matched in a horizontal direction so it lines up – results in more bone loss
if platform switch and place at crest of bone?
likley no bone loss
location of polished collar
coronal to crest always - so when place the abutment it sits above crest of bone and then no bone loss
alveolar ridge resoprtion occurs a lot of times from what?
denture wearing related problems
require a complete denture what should always be recommended?
implant supported dentures – as we see a lot of ridge resorption with denture wearing
PREVENTING THE ADDITIONAL RESORPTION OF THE RIDGE FROM WEARING A DENTURE
