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Year 2 Integrated theory > Implant or the natural tooth > Flashcards

Implant or the natural tooth Flashcards

1
Q

Recognise that implants are like the tooth in that they are susceptible to becoming diseased by stating implant related diseases

A
  • Peri- implant health
  • Per-implant mucositis
  • Peri- implantitis
  • Peri- implant soft and hard tissue deficiencies
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2
Q

State some common systems of implants

A
  • Branemark: most scientifically documented implant system in the world, concept of osseointegration
  • Straumann: implant design and implant surface modifications (plasma sprayed cylinders and screws for one stage surgery)
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3
Q

State the parts of the implant

A
  • Suprastructure: Fixed-crown (cement -retained or screw-retained), attachment retained restorations (denture)
  • Abutment/ tissue extension
  • Implant body
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4
Q

Describe the implant body based on the following descriptor:
Function

A
  • Inserted into jaw bone

* Serves as the anchor for where the abutment is placed

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5
Q

Describe the implant body based on the following descriptor:
Composition

A
  • Made from commercially pure titanium which is strong and biocompatible
  • Can be ceramic (Zirconia)
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6
Q

Describe the implant body based on the following descriptor:
Surface texture

A
  • Surface texture is moderately rough. This helps increase surface area and osteointegration potential
  • Its surface can be modified to attract cells to facilitate osseointegration (via acid etching and sand blasting), nano- modification (where the implant is impregnated with healing cells)
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7
Q

Describe the implant body based on the following descriptor:
Measurement of implant success

A
  • Has threads which “osseointegrate” into bone
  • The distance between two threads is 1mm
  • When 5mm of threads are not in contact with bone, the implant is not successful
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8
Q

Describe the implant abutment based on the following descriptor:
Function

A
  • Provides support for crown or bridge
  • Interface between crown and implant
  • After surgery, it allows tissue healing and creates a biological seal
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9
Q

Describe the implant abutment based on the following descriptor:
Materials used

A
  • Can be made of titanium

* For aesthetics, a zirconia aesthetic abutment can be used

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10
Q

Describe the implant abutment based on the following descriptor:
The four different types of abutments

A
  1. Abutment as a support for a crown
  2. Abutment as a retentive anchor for dentures: Ball anchor
  3. Abutment as a retentive anchor for dentures: Magnetic
  4. Abutment as a retentive anchor for dentures: bar retainers
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11
Q

List indications for implants

A
  • To treat edentulous patients (single or more missing teeth)
  • Retain lower dentures (retain full denture)
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12
Q

Describe the process of fixing an implant, with the two types of surgical stages that can be used

A
  1. An incision in made in the mucosa and the bone is exposed
  2. A series of drills are use to prepare the bone for the implant. A saline water drip is attached to the drill to firstly prevent overheating of the bone and secondly, help maintain a sterile environment
  3. The implant is installed (never touched with fingers for sterility)

A) 2 stage surgery: the implant is submerged with soft tissue (gum is sutured). After healing (4-6 months), the implant is exposed and the abutment is placed in
OR
B) 1 stage surgery: After implant is inserted, the healing abutment is placed right after. This special abutment helps healing with soft tissue

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13
Q

List the predictive factors that influence implant SUCCESS:
Bone type

Oral hygiene level

Amount of post operative recalls

Implant length

Clinicians expertise

Patient age

Level of bone volume

Placement site

Other

A

Bone type
• Bone type I and II

Oral hygiene level
• Very good

Amount of post operative recalls
• Frequent

Implant length:
• >8 mm

Clinicians expertise:
• High

Patient age:
• Under 60

Level of bone volume:
• High

Placement site:
• Mandibular (more successful)

Other:
• Single tooth implant

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14
Q

List predictive factors that influence implant FAILURE:
Bone type

Oral hygiene level

Amount of post operative recalls

Implant length

Clinicians expertise

Patient age

Level of bone volume

Placement site

Other

A

Bone type:
• Bone type III and IV

Oral hygiene level:
• Poor

Amount of post operative recalls:
• Little

Implant length:
• <7mm

Clinicians expertise:
• Inexperienced

Patient age:
• Over 60

Level of bone volume:
• Low

Placement site:
• Maxillary placement (esp posterior)

Other:
• Bruxism and other parafunctional habits
• Systemic diseases e.g. Lupus and HIV
• Smoker
• Chronic periodontitis
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15
Q

Describe the histological features of an implant tooth
PDL

Cementum

Amount of cells

Orientation of gingival fibres

Composition of tissue

A

PDL:
• Absent

Cementum:
• Absent

Amount of cells:
• Very few

Orientation of gingival fibres:
• Parallel orientation, they do not attach to the abutment/ implant surface

Composition of tissue:
• Fibrous, (scar tissue)

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16
Q

Discuss the four characteristics of successful osseointegration

A
  • No mobility
  • Absence of inflammation around implant tissue
  • No pain or discomfort
  • No increased bone loss or radiolucency
17
Q

Briefly define contact and distance osseointegration

A
  • Contact osseointegration: New bone forms first on the implant surface, where cells colonise the bone before the matrix is laid down
  • Distance osseointegration: New bone is formed on the surface of old bone and then grows towards the implant surface

These both happen concurrently

18
Q

List three factors that affect osseointegration

  • Implant related
  • Operator related
  • Patient related
A

Implant related:
• Material
• Macro design
• Micro-surface topography

Operator related
• Level of experience

Patient related:
• Quality and quantity of bone
• Systemic diseases (severe osteoporosis, uncontrolled diabetes mellitus)

19
Q

Analyse what affects the depth of the mucosal tunnel provided by peri- implant tissue

A

• The mucosal tunnel functions similar to a sulcus. Its depth is variable

It can be affected by:
• Thickness and height of soft issue
• Depth of implant (sometimes the implant is pushed all the way in to hide its metallic component)
• Implant neck design

20
Q

Analyse the implant to epithelial tissue interface and compare this to the natural tooth

A
  • This is the biological union of the epithelial cells to the implant surface (very similar to natural tooth)
  • Like a natural tooth, a sulcus lined by sulcular epithelium surrounds the abutment/implant body
21
Q

Analyse the implant to connective tissue interface, and compare this to the natural tooth

A
  • Connective tissues around an implant are oriented parallel to the implant OR encircle the implant
  • Unlike the natural tooth where these fibres are oriented in many different directions.
  • The fibres do not attach to the abutment
  • There are less blood vessels and fibroblasts in the connective tissue than in normal teeth

Year 2 Integrated theory (15 decks)

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