implant

Question 1

minimum bone distance for buccal plate, lingual plate, nasal floor, interplant, IAN, mental foramen, implant and natural dentition

Answer 1

• Buccal plate – 0.5 mm •
Lingual plate – 1.0 mm
• Nasal floor – 1.0 mm
• Inter-implant distance – 3.0 mm - blue book agrees
• Inferior alveolar canal – 2.0 mm
• Mental foramen – 5.0 mm, due to anterior loop - commonly accepted
• Space between implant and natural tooth – 1.5 mm (some say 2mm) blue book is 1.5 mm

Question 2

Integration times anterior and posterior maxilla and mandible, and grafted bone

Answer 2

Anterior Mandible – 3 months
• Posterior Mandible – 4 months
• Anterior Maxilla – 4-6 months
• Posterior Maxilla – 6 months
• Grafted bone – 4-6 months

Question 3

immediate load needs to torque to

Answer 3

35 ncm

Question 4

AP spread should be

Answer 4

cantilever to last tooth should < 2 times AP spread,

Question 5

Anterior esthetics – distance below CEJ of adjacent tooth

Answer 5

3mm

Question 6

Interdental papilla – distance from contact point to crestal bone - how likely there will be papilla presennt

Answer 6

• < 5mm papilla present 100 % (98% in blue book)
• 6 mm papilla present 56 % - same
• > 7 mm papilla present 27 % - same

Question 7

kg tissue grafting - when can you do it and what are your options

Answer 7

may be done prior to bone grafting,
non- submerged implant placement or
at 2nd stage

• Subepithlial connective tissue graft
• Palatal roll
• Free gingival graft

Question 8

Edentulous cases and height required per arch

Answer 8

locator: 9 mm
bar: 12 mm
crown and bridge: 5 mm (like regular teeth)
Hybrid: 15 mm

Question 9

causes of peri-implantitis, including the bacteria

Answer 9

• Mechanical overload/bruxism
• Biologic - similar bacteria to periodontal disease - gm negative anerobic (p gingivalis, prevotella intermedia)

Question 10

treatment for peri-implantitis

Answer 10

plastic scalers, citric acid (not sure on the percentage), and other decontaminants….

Question 11

anterior hip graft - soundbite, important anatomy etc (will do later)

Answer 11

to be filled in

Question 12

posterior hip graft (fill in later)

Answer 12

will do later

Question 13

how many mm of anterior posterior resorption in edentulous maxilla may indicate needing support with a denture with a flange

Answer 13

10-11mm - or lack of lip support when dentures are out
from bageri case based review.

Question 14

what angulation do implants have to be parallel for locators

Answer 14

15 degrees? need to look up, but can do a bar if not parallel enough with custom abutments?

Question 15

what are the types of bone? what is the classification system called
this also corresponds with hounsfield units found on page 73 of blue book

Answer 15

Misch bone density classification, modified from torabinejad et al
d1 - dense cortical bone - found in anterior mandible
d2 - thick cortical and course trabecular found in anterior mandible, posterior mandible, and anterior maxilla
d3 - thin cortical with dense trabecular - round in the anterior Maxillofacial, posterior maxilla and posterior mandible
d4 - find trabecular, thin cortical - posterior maxilla

Question 16

cement height vs screw retained height

Answer 16

blue book - not sure if this is right.
5 mm for cement
8 mm for screw retained

Question 17

what will happen if implants put in a growing child -

Answer 17

appositional growth of bone - the implants will end up more palatal/lingual

Question 18

after an implant is osseointegrated what are highmedium and low stability isq

Answer 18

High stability - 70 isq
medium between 60-69
low is below 60
implant stability quotient - not sure how it gets these numbers - some sort of radio frequency??,

Question 19

loading protocols - immediate, early and conventional time periods

Answer 19

immediate - up to 7 days after implant placement
early - 6 weeks to 12 weeks after implant placement
conventional - mandible 3 months, maxilla is 4-6 months .

Question 20

classification of edentulous maxilla and mandible

Answer 20

cawed Howell - the amount of alveolus vs basilar bone, height and width remaining
1
2 - most of the width and height still present (Immediately post extraction)
3
4 - knife edge, less height
5 - decreasing height
6 - decreasing height

also there is a bedrossian classification that is used for implants - this is zone 1 - anterior (K9-k9), zone 2 middle (premolars?) and zone 3 is posterior (molars)