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Oral Surgery Module 8 > Implant Surgery > Flashcards

Implant Surgery Flashcards

1
Q

Name the 2 types of implant?

A

Tissue level - 1 stage surgical technique
Bone level - 2 stage surgical

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2
Q

What type of implant is the Straumann?

A

Bone level - no metal collar, more aesthetic cases

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3
Q

What does FEV stand for and what does it mean?

A

Finite element analysis
transfer of load to surrounding bone tested by mathematical model analysis.

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4
Q

what 4 factors can affect implant design?

A

Implant body shape (tapered)
Implant collar shape
Threads – shape, pitch, height (triangular compacting)
Grooves

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5
Q

why is the quantity and quality of bone important in implant design?

A

as we want to avoid stress of the bone around the neck of the implant leading to bone loss

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6
Q

what is the (long!) name of the commercially pure titanium?

How many grades are there?
What do the grades depend on?

A

titanium-6-aluminium-4-vanadium (Ti6Al4V) (Ti alloy)

4 grades
Amount of carbon and iron.

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7
Q

what is the properties of titanium-6-aluminium-4-vanadium (Ti6Al4V) (Ti alloy)?

A

very high-mechanical strength
reduces the titanium heat conduction and doubles resistance to corrosion
Better fracture resistance

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8
Q

what is roxolid?

A

15%zirconium
85% titanium

Higher tensile strength than titanium
Preserves bone
Greater flexibility with smaller implants

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9
Q

What material of implant are used today?
and name some properties?

A

pure ceramic
High-performance zirconia ceramic with higher fatigue strength than grade 4 titanium implants

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10
Q

what is the success rates of a zirconia implant?

A

excellent clinical performance with 97.5 % survival and success rates after three years.

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11
Q

what different forces are placed on an implant?

A

Compressive, tensile, shear forces

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12
Q

how much vertical force can be placed on a molar region and incisor region?

A

380-880N molar
less than 220N incisor

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13
Q

why is the lateral shearing forces so much less? What is the approximate force?

A

implants don’t deal with tensile forces
approx 20N
can only cantilever 1 unit

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14
Q

what is the crown: implant ratio

A

1:7

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15
Q

name 2 main reasons why implants may fail?

A

Biological factors – overloading, bruxism, bone insufficient quantity, less vascularity.

Mechanical factors – breakage of abutments, screw breakage, implant breakage.

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16
Q

what are the 4 different timings for implant placement?

A

Immediate – take tooth out and insert into socket same time. Good bone volume.

Immediate delayed – early soft tissue healing 4-8 weeks – then place implant in, may need bone grafting.

Delayed – partial bone healing – 3-4 months – better primary stability.

Elective – full bone healing > 4 months – edentulous arches. May have had full clearance long time ago.

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17
Q

what are the 4 types of bone

A

1 - most cortical bone
2 - cortical and some rabecular
3 - more trabecular
4 - nearly fully trabecular

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18
Q

do types 1 and 2 bone need threading?

A

yes - lots of cortical bone

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19
Q

do types 3 and 4 bone need threading?

A

No - can be easily compressed due to trabecular bone

20
Q

Name 10 surgical technique tips for Straumann implants?

A
  • Atraumatic soft tissue handling
  • Serial round burs to flatten the implant sites
  • Surgical stent for ideal position
  • Always use cool saline irrigation for drills(<40oC), never room temp!
  • Pilot drill to depth 500-800 rpm – 6mm to check alignment before you then drill down to 10-12mm length of implant.
  • Twist drills to depth and width at slow speed
  • Profile drills to create coronal flare
  • Hand placed implant with copious irrigation
    all threads within bone
  • Suture soft tissues
21
Q

What are the different colours in the Straumann implant kit?

A
  • Blue = rose head burs to prepare bone
  • Blue drill = pilot drills 2.2mm wide
  • Yellow = narrow platform implants, upto 2.8mm
  • Red = standard upto 3.5
  • Green = large 4.2mm
  • Taps are to tap thread.
  • Carrier used to pick up implant
  • Closure screw stops material growing down inside of implant.
22
Q

Is an implant hydrophobic or hydrophilic?

A

Implant comes in capsule surrounded with saline, nothing can be touched to oxidised surface only saline or blood no saliva!! Hydrophilic alloy!

22
Q

what are the measurements of the depth gauges on the drill?

A

Depth gauges on drill = 6,8, 10,12, 14-16mm (rare to go this far!)

22
Q

what screw is used for tissue implant?

A

healling screw

23
Q

what is used to place a straumann implant?

A

torque rench

24
Q

what screw is used for a bone implant?

A

closed screw

25
Q

for tissue level implants, how long is the healing abutment left in place?

A

2-3 months

26
Q

for bone level implants, how long is the healing abutment left in place?

A

2 stage - after 2 months, implant is exposed and taller healing abutment is placed.

26
Q

what sutures may we use for implant?

A

resorbable

27
Q

what xray would you take for angulation + how long after placement?
what is the follow up?

A

PA 1 week after
2yr follow up to look for crestal bone loss

28
Q

what is a common sign from implants?

A

black triangle - loss of papilla

28
Q

what is important in implant planning for aesthetics?

A

smile line

28
Q

Name the 5 most common complications of implants?

A
  • Wound breakdown – overtightened sutures, tissue necrosis.
  • Infection – antiseptic mouthwash, only evidence of single dose 2g oral amoxicillin1hr before, none to prevent infection afterwards.
  • Early loss - uncommon
  • Mucositis – poor OH, lack of keratinised mucosa, is reversible! Inflammation!
  • Peri-implantitis – non reversible! Bone loss around implant. Once threads are exposed surface isn’t smooth but easily harbours bacteria.
28
Q

according to Buser et al and Cochran et al, what are the 4 criteria for success of implants?

A
  1. absence of clinically detectable implant mobility
  2. absence of pain or any subjective sensation
  3. absence of recurrent peri-implant infection
  4. absence of continuous radiolucency around the implant at the 12-week time point
29
Q

what is the 8 + 10 year success of implants?

A

“the 8-year cumulative survival and success rates resulted in 96.7% and 93.3%, respectively.”

“the 10-year cumulative survival and success rates were 99.2% and 96.4%, respectively.”

30
Q

what is the success of implants according to the meta analysis (2019 Long term survival)?

A

greater than 93%

31
Q

what constitutes implant failure?

A

uncommon
early - maybe failure to osseointegrate, implant is lost.
late - mobile, no osseointegrate or peri implant bone loss.

32
Q

what is acceptable peri implant bone loss?

A

some will occur in the first year:
greater than 1.0 mm in the first year
no greater than 0.2 mm a year after.

33
Q

treatment for wound dihiscence?

A

CHX gel 2 xday

34
Q

polyp around implants?

A

surgical removal and OHI

35
Q

How much bone width is the minimum required to place a standard dental implant?

A

7mm

36
Q

what is the width of standard implant?

A

4.4mm

37
Q

What is the minimum distance between teeth that is sufficient to place a dental implant

A

7mm

38
Q

When placing an immediate delayed implant, how many weeks do you wait after the tooth is extracted?

A

4-8 weeks soft tissue healing

39
Q

When doing surgery for dental implants which of the following has the greatest impact on the outcome of surgery?

A

Using refrigerated saline to irrigate the drill –greatest impact too success is bone healing, don’t want to heat bone beyond 40 degrees.

40
Q

When would you use tissue level implants rather than bone level implants?

A

When planning for a denture

Oral Surgery Module 8 (4 decks)

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