Implant Planning and Placement Flashcards
what is osseointegration
direct functional and structural connection between load bearing dental implants and living bone
what is primary osseointegration
implant anchored in bone due to frictional forces provided between osteotomy and dental implant design features
what is secondary osseointegration
functional connection between bone and implant
living bone grows onto surface of implant
what is the healing process after implant insertion
granulation tissue in wound
immature woven bone
mature lamellar bone
what is the supra-crestal tissue like with an implant in it
more collagen
less fibroblasts
collagen fibres orientate parallel to implant crown
what is the sub-crestal tissue like with an implant in it
implant anchored to bone by direct functional contact
no physiologic adaption present
rigid connection
what materials can be used for implants
titanium
titanium zirconium
ceramic
when would you use a bone level implant
in aesthetics
when would you use tapered implants
increased stability in immediate placement
root convergence apically
what would dictate the length and diameter of implant use
site
indication
local anatomy
what are the different surface treatments for implants
sand blasting
acid etch
plasma spray
what is the purpose of implants
replace missing teeth with aesthetic, functional and predictable restoration
what is assessed prior to extraction of a tooth for dental implant placement
prosthetic value of tooth
periodontal status
endodontic status
what medications may compromise implant survival
SSRIs
PPIs
bisphosphonates
steroids
what medical conditions can compromise implant success
radiotherapy
poorly controlled diabetes
CVS disease
what are the implications of smoking with implants
increased failure and peri-implantitis
affects vascularity, fibroblasts, PMN function
why do you need to wait for skeletal maturity to place an implant
relative infra-occlusion
suboptimal aesthetics
occlusal disharmony
implant fenestration
what is a high smile line
> 2mm ST show
what is a medium smile line
<2mm ST show
what is a low smile line
lip covers >25% of teeth
what is examined extra-orally
skeletal relationship
incisal cants
gingival cants
width of aesthetic zone
what if the favourable gingival biotype
thick low scalloped
what determines the presence of papilla
bone crest to contact point distance
what is the favourable bone crest to contact point distance
<5mm
what would restorations on the adjacent teeth mean for implants survival
risk of recession
suboptimal aesthetics
what happens if you have a wide edentulous span
lots of space to fill
what are the disadvantages of having a narrow edentulous span
damage to adjacent teeth
necrosis of bone
effect on ST aesthetics
what is the relevant maxillary anatomy
maxillary sinus
nasal floor
naso-palatine canal
infra-orbital nerve
what is the mandibular relevant anatomy
IAN canal
mental foramen
incisive canal
lingual perforating vessels
submandibular fossa
what does implant positioning depend on
implant system
gingival margin
local anatomy
prosthetic plan
what is the minimum mesio-distal distance for implants
1.5mm
why do implants need to be spaced a set distance from neighbouring teeth
lowers risk of damage to adjacent teeth
lowers risk of bone necrosis and ST defects
what is the bucco-palatal distance for an implant
> 1mm bone labially
2mm HT/ST labial to implant
what are the aids to planning used
study models
diagnostic wax up
surgical template
essex
clinical photographs
CBCT
surgical guide
what is analogue planning
diagnostic wax up combined with CBCT
what is digital planning
modern software used prosthetically and surgically to plan placement
