Implant roughness Unit of measure Average roughness Techniques to create roughness

Implant roughness Sa value = Unit of measure 1-2 Sa = Average roughness Techniques to create roughness Additive = plasma spray Subtractive = Blast or Etch

Implant space requirements Root Other implant buccal/lingual plate Gingival margin for good emergence profile Esthetic zone buccal plate Alveolar nerve Mental foramen

Implant space requirements 1.5mm Root 3mm Other implant 1mm buccal/lingual plate 3mm inferior to Gingival margin for good emergence profile 2mm from buccal plate in Esthetic zone 2mm Alveolar nerve 5mm anterior Mental foramen

Implantology Flashcards by Levi Zarbano

Where is most mechanical stress on implant? Why does this matter?

Crestal 5mm

Width more important than length to minimize stress

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Components of Ti allow

90% Ti

6% Aluminum

4% Vanadium

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Implant roughness

Unit of measure
Average roughness
Techniques to create roughness

Implant roughness

Sa value = Unit of measure
1-2 Sa = Average roughness
Techniques to create roughness
- Additive = plasma spray
- Subtractive = Blast or Etch

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Given same length and diameter, which has greater surface area?

Straight or Tapered wall implant

Fine pitch or Course pitch

Straight has greater surface area

Fine pitch has greater surface area (more threads)

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Restorative distance (crestal bone to occlusal plane)

Min-Max for screw retained

Min-Max for cement retained

Does depth of implant placement affect this?

Restorative distance (crestal bone to occlusal plane)

6-12mm for screw retained

8-12mm for cement retained

Depth of implant placement: sort of matters. If subcrestal there is more room for abutment pieces, porcelain thickness. However, if bony crest to occlusal plan is >12mm than teeth will still look too long and require pink porcelain. And if less than 6mm tooth will look stubby, even if implant deeply subcrestal.

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Implant space requirements

Root
Other implant
buccal/lingual plate
Gingival margin for good emergence profile
Esthetic zone buccal plate
Alveolar nerve
Mental foramen

Implant space requirements

1.5mm Root
3mm Other implant
1mm buccal/lingual plate
3mm inferior to Gingival margin for good emergence profile
2mm from buccal plate in Esthetic zone
2mm Alveolar nerve
5mm anterior Mental foramen

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Which bone type is mostly cortical bone?

Type 1

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Which bone type is best for implant placement?

Type 2

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Is magnification in Panorex increased or decreased

Increased

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Implant success

Defined as:

Implant success

Defined as:

Restorable
<0.2mm bone per year after 1st year of function
No mobility, radiolucency, symptoms

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What temperature causes osseus thermal necrosis

47 celsius

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Minimum diameter of keratinized tissue around implant

2mm

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Incision design for 2nd stage

>5mm keratinized buccal
4-5mm
2-4mm

Incision design for 2nd stage

>5mm keratinized buccal = Crestal and papilla sparing
4-5mm = Crestal, papilla sparing, reverse cutback
2-4mm = Crestal, papilla sparing, anterolateral advancement

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Which arch has higher failure rate for over denture?

Maxilla

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Vertical space for ovedenture

Vertical space for ceramometal

Vertical space for hybrid

Vertical space for ovedenture = 12mm

Vertical space for ceramometal = 8mm

Vertical space for hybrid = 15mm

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All on four and zygomatic implants can only be used with which prothesis

Hybrid

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Indications for coronally positioned semilunar flap

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Where is restorative emergence of zygomatic in relation to original teeth?

Palatal to palatal cusp of premolar

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Insertion torque for immediate temporization of implant

30-35ncm

When can free gingival graft be placed in relation to implant placement?

Any of three times

Original implant placement if non-submerged
At time of stage II
Anytime after definitive restoration

Harvest site for free gingival graft

How to prevent neurovascular injury

Smooth area of palate in anterior to 1st molar

How is recepient site prepared for free gingival graft?

Split thickness so graft is secured to periosteal bed

Which has greater shrinkage at gingival graft site

Free gingival graft (Autograft) or Allograft (acellular dermis)

Acellular dermis.

Timing of subepithelial connective tissue graft

Harvest site

Subepithelial connective tissue graft

Timing: completed prior to stage II or done at implant placement if nonsubmerged

Harvested: premolar area 3mm apical to gingival margin. Split thickness leaving behind palatal epithelium

Palatal roll technique Timing Harvest site

Palatal roll technique Timing: only at stage II Harvest site: subepithelial adjacent palatal tissue

Pedicled palatal flap Flap classification type Timing

Random pattern flap Periosteum/connective tissue Timing: Done simultaneously with bone graft for large volume alveolar grafts

Match indication with soft tissue procedure Epithelialized free graft (auto/allograft), subepithelial free graft, palatal roll, pedicled palatal flap * Deficient width of connective tissue around implant * Deficient thickness of connective tissue around implant * Metal show through gingiva * Large composite defect

* Deficient width of connective tissue around implant = epithelialized graft * Deficient thickness of connective tissue around implant = subepithelial free graft, palatal roll * Metal show through gingiva subepithelial free graft, palatal roll * Large composite defect = pedicled palatal flap

What type of cells are acted on with osteoinduction

Mesenchymal stem cells

Allograft and xenograft Osteoconductive, osteoinductive, or both

Osteoconductive only. Matrix for host cells

Describe triangle of tissue engineering

Source of cells Signal Scaffold

BMP * Osteoinductive or Osteoconductive * Belongs to which mesenchymal lineage * What is source of BMP * How long should BMP graft heal prior to implant placement

BMP * Osteoinductive * Lineage: Transforming Growth Factor (TGF) * Source: Recombinant human * 4-6 months of healing

Minimal ridge width for ridge split technique

minimum 3mm

Distraction osteogenesis for ridge augmentation Latency time Distraction rate Consolidation duration

Distraction osteogenesis for ridge augmentation Latency time = 5-7 days Distraction rate = 1mm/day Consolidation duration = 2-3 months

Which dimension of alveolus is most affected in first 6 months after tooth extraction

Buccal lingual 50% reduction in 6 months

Sequence of socket healing with/without graft Name of stage and duration

Clot with fibrin network = day 1-3 Granulation tissue at crest with provisional matrix = formed by day 7 Epithelial cover and woven bone = month 1 Mature lamellar bone = month 2

Ideal bone graft for socket preservation Source of bone Particle size What is FDA approve and can be used to obtain osteoinduction

Ideal bone graft for socket preservation Allograft or Xenograft 250-1000micrometer What is FDA approve and can be used to obtain osteoinduction = BMP

Volume of maxillary sinus in average adult Sinus dimensions Thickness of sinus membrane

Volume = 14ml Sinus dimensions = W2.5cm, H3.75cm, D3cm Thickness of sinus membrane = 0.1-0.5mm

Alveolar bone thickness for immediate implant placement with sinus lift

3mm

Max elevation of sinus membrane with internal/Summer technique Uses osteotomes

2mm

Most common surgical complications Incidence%

Bleeding 25% Nerve disturbance 7% Mandible fx 0.3%

Implant failure risk factors List 6 with incidence %

• Risk factors (failure rate) – Radiation therapy (maxilla 25%, mandible 6%) – Maxillary overdentures (19%) – Type 4 bone (16%) – Smoking (11%) – Implants shorter than 10 mm (10%) – Diabetic patients (9%)

Abutment screw loosening incidence % More common in single crown, multi-unit PFD, or overdentures

Abutment screw loosening (8%) caused by excursive forces – Single crowns \> multiple-unit "xed prosthesis \> overdentures

Peri-implantitis Present in what % of osseointegrated implants Normal implant probing depth Normal bone loss rate Etiologies x5 Implicated bacteria group

Peri-implantitis 10% osseointegrated implants \<=5mm normal implant probing depth 1.5mm during first year, them 0.2mm per year afterwards Etiologies x5 * cement * mechanical (occlusal trauma) * Bacteria gram-negative anaerobes * Patient factors: smoking, diabetes, periodontitis * Surgical factors: bone overheating, poor primary stability, dehiscence Implicated bacteria group

initial perimplantitis management

Remove etiology * eliminate overload * control infection

Management of persistent periimplantitis 3 steps

1. Surgical exposure and debridement * Remove granulation tissue 2. Surface decontamination * Remove biofilm * Agents: Saline, abrasive pumice, citric acid, chlorhexidine, hydrogen peroxide, tetracycline, lasers 3. Guided bone regeneration * Fill osseous defect and eliminate probing depth