Implant Position - Surgical Considerations

Question 1

process (6)

Answer 1

diagnostic wax up
radiographic guide
CBCT
implant planning
surgical guide
implant surgery

Question 2

Anterior region
* – mm buccal bone
* – mm apical to CEJ of adjacent
tooth
* – mm from adjacent roots

Answer 2

2
3-4
1.5-2

Question 3

Posterior region
* – mm buccal bone
* – mm apical to CEJ of adjacent
tooth
* – mm from adjacent roots

Answer 3

1
1.5-3
3-4

Question 4

In teeth:
a. When the measurement from the dental contact
point to the crest of bone was 5 mm or less, the
papilla was present –% of the time.
b. When the distance was 6 mm, the papilla was
present –% of the time.
c. When the distance was 7 mm or more, the
papilla was present –% of the time or less.

Answer 4

98
56
27

Question 5

The mean height of the papillary tissue
between two adjacent implants is

Answer 5

3.4mm(2 to 4mm)

Question 6

1. The level of interproximal papilla of the
   implant is independent of the

Answer 6

proximal bone
level next to the implant.

Question 7

2. The level of interproximal papilla of the
   implant is related to the

Answer 7

interproximal bone
level next of the adjacent teeth.

Question 8

3. Greater peri-implant mucosal dimensions
   were noted in the presence of

Answer 8

thick peri-
implant biotype vs thin

Question 9

Danger Zones
Maxillary sinus:
(3)

Answer 9

• pneumatization
• septum
• sinusitis

Question 10

Danger Zones
Mandible:
(2)

Answer 10

• Inferior alveolar nerve
• Lingual concavity perforation and
  sublingual artery hemorrage

Question 11

• Minimum — of bone required
  between the apical end of an
  implant and neurovascular
  structures

Answer 11

2mm

Question 12

Focus question: Is the width of KM <2mm around functionally
loaded-implants detrimental for peri-implant health?
CONCLUSION
(3)

Answer 12

• Results showed that GI, PI, and mPI were significantly higher in KMW group <2mm.
• PD was not significantly different between the two KMW groups.
• Reduced KMW around implants appears to be associated with clinical parameters
  indicative of inflammation and poor OH

Question 13

TYPE I

Answer 13

IMMEDIATE
implant is placed immediately following tooth extraction

Question 14

TYPE II

Answer 14

4-8 WEEKS
implant is placed in a site where soft tissues have healed and mucosa is covering the socket entrance

Question 15

TYPE III

Answer 15

12-16 WEEKS
implant is placed in a site where substantial amounts of new bone has formed in the socket

Question 16

TYPE IV

Answer 16

> 16 WEEKS
implant is placed in a fully healed ridge

Question 17

Type 1
Very difficult procedure. Requires a —
* Implant is stabilized mainly in the
— region.
* Mainly done when — of
extraction socket are maintained.
* Great for maintaining — for anterior teeth

Answer 17

very skillful and experienced surgeon.
apical
all 4 walls
papilla height

Question 18

Type 2
Similar to immediate loading,
except:
(2)

Answer 18

• Allows more soft tissue to
  cover extraction site and is
  easier to close wound.
• Does not preserve as much
  papilla height.

Question 19

Type 3
Allows more — to be formed
inside extraction socket giving
the implant better —.
* If bone substitutes are used,
needs to be of

Answer 19

bone, stability
fast resorption
to allow new bone formation
within the 12-16 weeks.

Question 20

Type 4
When extensive — is
needed to compensate for
missing bone.
* If bone substitutes are used,
needs to be of — resorption
or mixed to allow new bone
formation without resorbing
too quickly.
* Most of the time needs at least
—

Answer 20

grafting
slow
6 months

Question 21

Class I

Answer 21

Buccolingual loss of
tissue with normal
height in the apico-
coronal direction

Question 22

Class II

Answer 22

Apico-coronal loss of
tissue with normal ridge
width in bucco-lingual
direction

Question 23

Class III

Answer 23

Combination of
buccolingual and apico-
coronal loss of tissue
resulting in loss of normal
height and width

Question 24

Implant Surgery: Free-Hand
Surgeon Provides: (2)
Guide Provides: NA

Answer 24

Position
Depth
Angulation

Question 25

Implant Surgery: Partially Guided
Surgeon Provides: (1)
Guide Provides: (1)

Answer 25

Depth
Angulation

Postion
Angulation

Question 26

Implant Surgery: Fully Guided
Surgeon Provides: NA
Guide Provides: (2)

Answer 26

Position
Depth
Angulation

Question 27

Free-Hand
(5)

Answer 27

• Increased surgical
  freedom and flexibility.
• Increased surgical site
  visibility.
• Increased implant
  positioning error.
• Increased risk of affecting
  critical anatomical
  structures.
• Increased risk of
  complications

Question 28

Partially Guided
(5)

Answer 28

• Moderate implant
  positioning error.
• Increased surgical
  freedom and flexibility.
• Increased surgical site
  visibility.
• Increased risk of affecting
  critical anatomical
  structures.
• Increased risk of
  complications

Question 29

Fully Guided
(9)

Answer 29

• Minimal implant
  positioning error.
• Minimal risk of affecting
  critical anatomical
  structures.
• Allows for more
  prosthodontically driven
  implant placement and
  increased parallelism
  between implants.
• Decreased risk of
  complications.
• Decreased surgical
  freedom and flexibility.
• Decreased surgical site
  visibility.
• Software based
  pre-surgical implant
  planning required.
• Any assessment error
  during the planning
  phase will be transferred
  to the surgical phase:
  accurate planning is
  crucial.
• Added financial cost of
  guide