Implant Position - Surgical Considerations Flashcards
process (6)
diagnostic wax up
radiographic guide
CBCT
implant planning
surgical guide
implant surgery
Anterior region
* – mm buccal bone
* – mm apical to CEJ of adjacent
tooth
* – mm from adjacent roots
2
3-4
1.5-2
Posterior region
* – mm buccal bone
* – mm apical to CEJ of adjacent
tooth
* – mm from adjacent roots
1
1.5-3
3-4
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.
98
56
27
The mean height of the papillary tissue
between two adjacent implants is
3.4mm(2 to 4mm)
- The level of interproximal papilla of the
implant is independent of the
proximal bone
level next to the implant.
- The level of interproximal papilla of the
implant is related to the
interproximal bone
level next of the adjacent teeth.
- Greater peri-implant mucosal dimensions
were noted in the presence of
thick peri-
implant biotype vs thin
Danger Zones
Maxillary sinus:
(3)
- pneumatization
- septum
- sinusitis
Danger Zones
Mandible:
(2)
- Inferior alveolar nerve
- Lingual concavity perforation and
sublingual artery hemorrage
- Minimum — of bone required
between the apical end of an
implant and neurovascular
structures
2mm
Focus question: Is the width of KM <2mm around functionally
loaded-implants detrimental for peri-implant health?
CONCLUSION
(3)
- 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
TYPE I
IMMEDIATE
implant is placed immediately following tooth extraction
TYPE II
4-8 WEEKS
implant is placed in a site where soft tissues have healed and mucosa is covering the socket entrance
TYPE III
12-16 WEEKS
implant is placed in a site where substantial amounts of new bone has formed in the socket
TYPE IV
> 16 WEEKS
implant is placed in a fully healed ridge
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
very skillful and experienced surgeon.
apical
all 4 walls
papilla height
Type 2
Similar to immediate loading,
except:
(2)
- Allows more soft tissue to
cover extraction site and is
easier to close wound. - Does not preserve as much
papilla height.
Type 3
Allows more — to be formed
inside extraction socket giving
the implant better —.
* If bone substitutes are used,
needs to be of
bone, stability
fast resorption
to allow new bone formation
within the 12-16 weeks.
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
—
grafting
slow
6 months
Class I
Buccolingual loss of
tissue with normal
height in the apico-
coronal direction
Class II
Apico-coronal loss of
tissue with normal ridge
width in bucco-lingual
direction
Class III
Combination of
buccolingual and apico-
coronal loss of tissue
resulting in loss of normal
height and width
Implant Surgery: Free-Hand
Surgeon Provides: (2)
Guide Provides: NA
Position
Depth
Angulation
Implant Surgery: Partially Guided
Surgeon Provides: (1)
Guide Provides: (1)
Depth
Angulation
Postion
Angulation
Implant Surgery: Fully Guided
Surgeon Provides: NA
Guide Provides: (2)
Position
Depth
Angulation
Free-Hand
(5)
- Increased surgical
freedom and flexibility. - Increased surgical site
visibility. - Increased implant
positioning error. - Increased risk of affecting
critical anatomical
structures. - Increased risk of
complications
Partially Guided
(5)
- Moderate implant
positioning error. - Increased surgical
freedom and flexibility. - Increased surgical site
visibility. - Increased risk of affecting
critical anatomical
structures. - Increased risk of
complications
Fully Guided
(9)
- 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
