Implant prosthodontics

Question 1

If a patient arrives with an implant what do you need to know

Answer 1

1. Name and make of The implant
2. Implant diameter and width
3. Connection type

Question 2

Name some different manufactories that make dental implants

Answer 2

1. Nobel biocare
2. Straumann
3. XiVE
4. Ankylos
5. Astra tech dental
6. Mini Dental Implants

Question 3

How big is an implant usually

Answer 3

Between 3.0-6.0mm in width

Question 4

Do we need to know the length of the implant before applying prosthesis

Answer 4

Yes so that we can assess how much load the implant can bear

Question 5

What do we mean by connection type of the implant

Answer 5

The shape of the architecture of thread of the implant

Question 6

List the components that make up a dental implant

Answer 6

1. Cover screw
2. Healing abutment
3. Screwdriver
4. Torque wrenches
5. Impression copings
6. Abutments

Question 7

What is a cover screw

Answer 7

A small component that fits on top of the head into the internal connection

Question 8

When is a cover screw used

Answer 8

In a two stage implant procedure

Question 9

What is a two stage implant procedure

Answer 9

Where the gums are stitched to bury the implant completely at a time of placement

Question 10

Why do we use a cover screw

Answer 10

Often used when implant stability is not great at primary placement and you want to leave the implant undisturbed for a few weeks to months

Question 11

Why do we leave an implant after placement for a few weeks

Answer 11

To allow osseointegration

Question 12

What is a healing abutment

Answer 12

A tall cover screw that fixes to gum to allow you to obtain access to the implant in order to do your impression or any other stages that may be necessary

Question 13

How do we use which height and width healing abutment to use

Answer 13

It depends on tissue thickness and emergence desired

Question 14

Why do we use torque wrenches

Answer 14

To ensure that the screws are tightened to the correct torque

Question 15

what can over torquing lead to

Answer 15

Screw fractures

Question 16

What can under torquing lead to

Answer 16

Loosening of the prosthesis

Question 17

How much do we need to torque screws

Answer 17

Depends on the screw and manufacture but usually between 15-60 NCm

Question 18

What are impression copings

Answer 18

They are really tall healing abutments

Question 19

why do we use impression copings

Answer 19

They are designed to record the position of an implant in an impression

Question 20

How do we use impression copings

Answer 20

We screw them into an implant before an impression is taken

Question 21

What is an abutment

Answer 21

The component sometimes needs to connect an implant to the final crown or bridge

Question 22

What are abutments made of

Answer 22

Usually titanium or high strength ceramics

Question 23

When are abutments usually used

Answer 23

When the angulation of an implant is unfavourable or when implants are divergent

Question 24

How can we take impression of in implant

Answer 24

1. Close tray technique

2. Open tray technique

Question 25

How do we take a close tray impression

Answer 25

1. Remove healing abutment
2. Screw impression coping
3. Squeeze light bodied silicone onto the impression coping
4. Load impression tray with heavy body silicone
5. Take impression
6. Unscrew impression coping
7. screw impression coping ono the impression tray

Question 26

Once we have take a close tray impression what do we do

Answer 26

We screw a titanium steel component called the implant replica to the impression coping

Question 27

Why do we add implant replicas to our impression

Answer 27

Allows the technician to cast a model that can mimic the gingiva

Question 28

What is a key difference between open and closed tray impression s

Answer 28

Open tray impressions use A special tray with small holes to take the impression

Question 29

How do we take an open tray impression

Answer 29

1. Remove healing abutment
2. Screw impression coping
3. Squeeze light bodied silicone onto the impression coping
4. Place heavily bodied silicone onto special tray with holes for the healing abutment
5. Take impression
6. Unscrew healing abutment prior to removal of special tray from mouth
7. Remove the impression tray and healing abutment with one go

Question 30

What is the benefit of removing the impression tray with the healing abutment in one go

Answer 30

Increases accuracy

Question 31

Name the two different ways we can add crowns onto our implant

Answer 31

1. Screw retained

2. Cemented

Question 32

What is a screw retained crown

Answer 32

A crown with a small hole on the occlusal table

This small hole permits the crown to be screwed directly onto the implant

Question 33

How do we seal the occlusal Hoel in a screw retained crown

Answer 33

Use a small amount of cotton roll and then composite

Question 34

What are the advantages of screw retained crown

Answer 34

Permits retrievability making it easier to remove the crown in the future if needed

Question 35

When might a screw retained bridge or crown not be possible

Answer 35

When the angulation of the implant is unfavourable

Question 36

What is an implant retained crown

Answer 36

Temporary cement is used to cement the crown onto the implant

Question 37

What can go wrong when placing implants

Answer 37

1. Sublingual haematoma

2. Implant lodged into maxillary sinus

Question 38

What causes a sublingual haematoma

Answer 38

When an implant is placed in the mandibular anterior region and perforate the lingual bony plate at the floor of the mouth