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Patient Care 3 > Implant lecture > Flashcards

Implant lecture Flashcards

1
Q

what are the basic parts of the implant

A
  • implant body
  • abutment
  • crown
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2
Q

why do we use titanium in implants

A
  • excellent biocompatibility
  • low weight/high strength
  • excellent corrosion resistance
  • contains a titacium oxide layer that promotes adhesion of osteogenic cells
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3
Q

what is bone level

A

the interface of implant and abutment is at the bone

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4
Q

what is tissue level

A

the interface of the implant and abutment is at the tissue

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5
Q

what are the pros and cons of bone level

A
  • better esthetics, no metal collar
    -can achieve primary closure if needed
  • microenvironment allows bacteria to be present at bone level
  • less cleansable
  • harder to see residual cement
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6
Q

what are the pros and cons of tissue level

A
  • collar creates a biologic width
  • bacteria is at tissue level, away from the bone
  • metal collar may show through
  • more cleansabke
  • easier to see residual cement
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7
Q

what are the types of prostheses

A
  • single crowns
  • FPDs
  • implant supported RPDs
  • overdnetures
  • hybrid dentures
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8
Q

what is implant retained prostheses

A

removable

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9
Q

what is implant supported s=prostheses

A

fixed

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10
Q

what is osseointegration

A

a stable implant relies on direct structural and functional connection between vital bone and the surface of an implant

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11
Q

what are the factors that determine successfull osseointegration

A
  • biocompatibility of the implant surface
  • macro and microscopic nature of the implant surface
  • status of the implant sute (non infected bone, bone quality)
  • surgical technique
  • undisturbed healing
  • long term loading and prosthetic design
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12
Q

what are the patient factors that affect the implant success

A
  • diabetes (controlled vs uncontrolled)
  • osteoporosis and bisphosphonate use (not a contraindication though)
  • smoking
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13
Q

how does smoking affect implants

A
  • increased failure of dental implants
  • 84% vs 98%
  • depends on use - heavy or light
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14
Q

what is osseointegration clinically

A
  • immobile
  • clear sound to precussion
  • no pain or infectino
  • no paresthesia
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15
Q

what is osseointegration radiographically

A
  • no radiolucent peri-implant space
    -minimal bone loss- <1 mm remodeling, <0.1mm/year after the first year
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16
Q

what is contact osteogenesis

A

bone first forms on the implant surface
- bone formation progresses from implant surface to existing bone
- rough surface implants

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17
Q

what is distance osteogenesis

A
  • bone forms on the surface of the existing bone
  • bone formation progresses from the existing bone to implant surface
  • smooth or machined surface implants
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18
Q

what are the implant placement timing

A
  • immediate: at the time of extraction
  • delayed: 6-10 weeks after extraction
  • late: 6 months or more after extraction
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19
Q

describe the bone density and quality of Type D1, D2, D3 and D4

A
  • D1: homogenous compact bone
  • D2: thick layer of compact bone around a core of dense trabecular bone
  • D3: thin layer of compact bone around dense trabecular bone
  • D4: thin layer of cortical bone around a core of low density trabecular bone
20
Q

which implant timing has the lowest success rate

A

immediate

21
Q

what are the differences between periodontium of a tooth to a dental implant

A
  • less vascularity
  • no PDL
  • fewer gingival fibers
  • collagen fibers parallel the implant
22
Q

what does connective tissue do around an implant

A
  • circular fibers form a cuff around the implant
  • forms a hemodesmosome attachment to the implant and abutment
  • forms a soft tissue seal
23
Q

describe the buccal surface of peri implant mucosa

A
  • 3-4mm high on average
  • core of connective tissue ( primarily collagen fibers, low cellular content)
  • orthokeratinized epithelium
24
Q

describe the inner surface of peri implant mucosa

A
  • thin barrier epithelium
  • like JE
  • connective tissue adhesion
25
Q

what are the vascular differences between real tooth and PDL

A
  • no vascular supply from PDL
  • sources: alveolar bone (supraperiosteal vessels) , connective tissue
26
Q

what does less vascular supply mean about immune system

A

less vascular supply less immune system regulation

27
Q

what are the supracrestal attachment for implants and teeth

A
  • implants: 3-4 mm. 1 mm epithelium, 2mm CT
  • teeth: 2 mm, 0.97mm epithelium , 1.07mm CT
28
Q

what are some other differences for teeth and implants

A
  • teeth: 2.5mm PD, 1.1mm buccal mucosa thickness, taller papilla height, more papilla fill
  • implant: 2.9mm PD, 2.0mm buccal mucosa thickness, shorter papilla height, less papilla fill
29
Q

what are the types of implant faillures and describe each

A
  • surgical: lack of osseointegration, improper placement, infection
  • mechanical: screw lossening, abutment fracture, implant fracture
  • esthetic: metal collar show through, smile line concerns, long crowns
  • biological: peri- implant mucositis and peri implantitis
30
Q

what are the parameters for peri implant health

A
  • free of inflammation: no BOP, no suppuration, no erythema or edema
  • stable probing depths
  • no radiographic bone loss
31
Q

what are the symptoms of peri implant mucositis

A
  • signs of inflammation such as BOP, erythema and edema
  • no radiographic bone loss
32
Q

is per implant mucositis reversible

A

yes if etiology is controlled

33
Q

what is the etiology of peri implant mucositis

A

plaque biofilm

34
Q

what is the prevalence of peri implant mucositis

A

43%

35
Q

what are the symptoms for peri implantitis

A
  • signs of inflammation such as BOP, erythema, edema, and suppuration
  • radiographic bone loss
  • increased probing depth compared to time of restoration
36
Q

what is the etiology of peri implantitis

A

plaque biofilm

37
Q

what are the risk factors for peri implantitis

A

history of periodontitis, poor plaque control, no regular maintenance care after placement
- data not conclusive for smoking and diabetes

38
Q

what is the prevalence for peri implantitis

A

22%

39
Q

what is the difference between peri mucositis and peri implantitis

A

peri implantits involves bone loss

40
Q

what if you have no previous radiographs or history

A

radiographic bone loss > or equal to 3mm
- probing depths > or equal to 6mm
- diagnostic for peri implantntis

41
Q

describe the remodeling phase

A
  • 0.9-1.6mm bone loss in the frist year after placement
  • 0.1mm bone loss per year
  • clinically acceptable
  • not seen as much with platform switched implants
42
Q

what is the importance of keratinized mucosa

A

keratinized tissue may improve patient comfort and benefit oral hygiene and plaque removal

43
Q

what are the major risk factors for peri implantitis

A
  • poor plaque control
  • lack of regular maintenance after placement
44
Q

how long to restore dental implants

A

12-16 weeks

45
Q

what is the maintenance schedule for implants

A

every 3 months
- move to 6 months is OH is stable
- based on risk factors and OH

46
Q

what are the treatment options for peri implant complication

A
  • refer to specialist
  • nonsurgical therapy - debridement
  • surgical therapy: open flap debridement, osseous recontouring, bone grafting/guided tissue regeneration
  • explantation/removal of implant
47
Q
A

Patient Care 3 (22 decks)

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