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Oral Surgery > Implant Complications > Flashcards

Implant Complications Flashcards

1
Q

definition of primary osseointegration

A

mechanical engagement of an implant with the surrounding bone after implant insertion

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2
Q

definition of secondary osseointegration

A

wheras bone regeneration and remodeling offers secondary oseointegration

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3
Q

poor initial stability - referencing bone quantity

A

bone quantity!

- the more bone thats present at an implant site, the better the possibility for success

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4
Q

poor initial stability - referencing bone quality

A

relates to the bone DENSITY
- type i – considered the least vasuclar and most homogenous (stronger cortical bone)

type IV – thin cortex and low density trabeculae

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5
Q

type 1, II, III, and IV bone quality

A

relates to density

I – least vascular and most homogenou

II- combination of cortical bone with a marrow cavity

III- predominantly composed of trabecular bone

IV- thin cortex and low density trabeculae

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6
Q

poor initial stability - referencing implant site (poor situation examples)

A

examples
- posterior maxilla with type IV bone

less than 1 mm buccal/lingual/ palatal to the implant width

anterior maxilla concavity

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7
Q

poor initial stability - referencing implant diameter

A

wider - usually more stable

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8
Q

ISQ scale?

A

ISQ has a non-linear correlation to micro mobility

micro mobility decreases >50% from 60-70 (stability is better closer to 70 +)

low stability i less than 60

higher is greater than 70

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9
Q

use of undersized drilling?

A

weak evidence that could enhance the primary implant stability in sites of poor bone density

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10
Q

osteotome technique affect?

A

weak evidence that in poor bone density could enhance the primary stability

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11
Q

flapless affect?

A

there is weak evidence suggesting that could enhance the primary stability

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12
Q

effect of surgical techniwue on the initial stability

A

poor / weak evidence when used undersized drilling, osteotome technique, or flapless technique

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13
Q

likely causes of implant exposure

A

thin cortical plate

un-even crestal ridge

too large implant

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14
Q

higher chance of implant fracture with?

A

AT THE TIME OF ONSERTION

small diameter nobel biocare trilobed have a higher incidence

more common area – anteiror mandible

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15
Q

causes of implant fracture during functino?

A
  1. inadequate fit of the superstructure
  2. material or design defect
  3. long-term metal fatigue
  4. occlusion, parafunctinoal habits
  5. location
  6. diameter
  7. bone resorption around the implant
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16
Q

general % of implant fracture

A

0.16-1.5%

17
Q

main reasons (over arching) that an implant would fracture

A
  1. design and manufacturing defects
  2. non passive fit of the prosthetic framework
  3. physiologic or biomechanical overload
  4. others – localization
    galvanic activity
    iatrogenic implant placement of manipulation
18
Q

implication of implant diameter

A

narrow platform – lower ISQ’s (less stable)

narrow platform – lower ISQ’s

regular and wide showed higher ISQ’s but no significant difference between the two

19
Q

implication of implant length

A

13 mm and 10 mm when compared — in D1 bone – ISQ significantly higher for longer implant length

implants of 13 mm in length – ISQ value were higher in D3 bone than 10 mm

regular platform of 13 mm significantly higher ISQ values compared to 10 mm

20
Q

over-arching themes to poor initial stability

A
  1. over size drilling
  2. under length drilling
  3. perforating cortical plate
  4. changing implant drilling direction
  5. wrong implant drilling system
21
Q

initial stability in D1 bone vs D3

A

will always be different
D1 – higher

also drops off when using narrow platform

22
Q

nerve injury prevelence in implant placement

A

0-11%

- referring to the inferior alveolar nerve

23
Q

inferior alveilar nerve injury with implant placement

A

usually a reslt of poor planning

swelling may have been present around the nerve

poor surgical technique

retraction (like retractor placed against the nerve in mandibular pre-molar region) around mental nerve

with the use of CBCT – incidence of nerve injury should be decreased to a minimm

24
Q

incidence of oro-antral communicatoin

A

11-56%

25
Q

risk factors of oro-antral communication

A

thickness (thinness of sinus membrane)

presence of septa

sinus width – angle of medial and lateral walls at the crest

26
Q

signficance between the membrane thickness and membrane perforation with oro-antral communicaton

A

the perforation rate was 41% when membrane thickness was LESS THAN 1.5 MM

perforation rate was 16.6% when membrane thickness i equal or greater than 1.5 mm

27
Q

1.5 mm of membrane thickness?

A

PERFORATION RATE INCREASED RISK

41% VS 16.6%
BELOW AND ABOVE / EQUAL TO 1.5

28
Q

oro-antral communication most commonly seen?

A

most common in first molar area

within the sinus area we see prevelance of
middle at 41%
posterior at 35%
anterior at 24%

29
Q

orientation of sinus septum? / oro-antral communication link

A

medial-lateral orientation – HIGHER ON MEDIAL than lateral

30
Q

panorex with oro-antral communication?

A

can cause up to 21% false diagnosis

31
Q

sinus membrane perforation occurence can increase with?

A

in cases with SINUS SEPTUM there is a higher incidence of perforation

lower incidence if use two window technique

lower incidence with ultra-sonic

32
Q

late complications - general

A

occur AFTER osseointeration

33
Q

implant survival

A

exhibit characteristics that MAY lead to failure

34
Q

implant failure

A

implant has LOST osseointegration

35
Q

failing implant

A

has NOT FULFILLED the predetermine success criteria

36
Q

peri-implantatis

A

LATE COMPLICATION (after osseointegration)

micro-organisms most commonly associated with implant failure are SPIROCHETES AND MOBILE FORMS OF GRAM-NEGATIVE ANAEROBES

  • bone loss
  • implant mobility
37
Q

treatment of peri-implantitis

A

local debridement

surface decontamination

anti-infective therapy

surgical technique

removal

38
Q

incidence of implant fracture

A

2.3%

related to

  • improper treatment planning
  • bruxism
  • bone lost

Oral Surgery (26 decks)

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