implantology Flashcards
Dental implant
An artificial tooth root placed in the jaw to hold a replacement tooth or bridge
components of implants
- Crown: extra-gingival
- Abutment: transmucosal
- Implant Body: endosseous portion
implant levels
Bone level vs Tissue level
Bone Level Implants
* Connect at?
* Allows?
* which zone?
* Allows what # stages?
- Connect at bone
- Allows customized and angled abutments
- Esthetic zone
- Allows two-stage implant surgery
Tissue Level Implants
* Connect at?
* shaping soft tissue?
* staged surgery?
- Connect at soft tissue level
- Smooth neck shapes the soft tissue
- One-stage implant surgery
shapes of implants
cylindrical and tapered
cylindrical shaped implants
- Increased Surface Area
- Greater Force Transfer
- Most Common Design
conical shaped implants
- Complex osteotomy sites
- Root proximity
- Bone concavity
platform widths
std btwn 3.5-4.5mm
microgap
- Inflammatory cell infiltrate was consistently present at the level of the interface between the two components, the bone crest was consistently located 1-1.5 mm
apical of the microgap. - Inflammatory Infiltrate was due to bacterial contamination
platform switching
Platform switching is the concept of placing an narrower abutment on the wider implant to preserve
alveolar bone levels at the crest of a dental implant
how does platform switiching work
It reduces per-implant bone resorption at the bone crest and maintains the supracrestal attachment
* Increases distance of implant-abutment junction from the crestal bone
* Limits possible interface of bone with micro-movements
* Shifts the inflammatory cell infiltrate inward and away from the adjacent crestal bone
surface properties of implants
why would these be used?
Surface characteristic and roughness
Surface chemistry and surface free energy (SFE)
Enhance cell adhesion to get better osseointegration
ways to alter surface roughness
Roughness (Macro & Micro):
* Texture
* Machined
Substractive:
* Sandblast
* Acid-etch
Additive:
* Oxidation
* Coating
Smooth vs Rough Surfaces
moderately rough surfasces provided best osseointegration
issues with increasing roughness
the rougher the implant, the higher its’ Sa value
(in um), the easier for bacterial adhesion, the less efficacy of biofilm treatments
does microbial colonization always occur on implants based on roughness?
Microbial adhesion can occur on any implant surface,
regardless of the degree of surface roughness
Surface Chemistry And Surface Free Energy (SFE)
- SFE is the interaction between the force of cohesion and the force of the adhesion that determines whether or not wetting occurs.
testing SFE
- Sessile drop technique
- Different material, implant design with characteristics contribute to the SFE and cell/ bacterial adhesion.
factors of cell and bac adhesion to implant
definition of successful implants
A successful implant must present no mobility, no peri-implant radiolucency, bone loss less than 0.2 mm per year after the first year of loading, and no persistent pain, discomfort or infection
Landmarks to consider during implant placement
- Inferior Alveolar Canal/Mental Foramen
- Incisive Foramen
- Maxillary Sinus/Nasal Cavity
- Lingual undercut
Inferior Alveolar Canal And Mental Foramen implamnt recomendations
Premolar and molar areas of the mandible
A loop of the nerve can be found to extend mesially.
Safety zone of 3mm from the mental foramen and
2mm from the IAN is recommended.
best way to detect IAN/ mental foramen
CT, worst is PA
Incisive Canal implant considerations
Size and location are Important, may even graft canal for more bone
Maxillary Sinus/Nasal Cavity for implants
direct vs indirect lifting
Sinus augmentation may be needed
Direct sinus lifting: less than 4mm residual bone height
Indirect sinus lifting: more than 4mm residual bone heigh
Lingual Undercut and implants
- Perforating the lingual plate during preparation of the implant site can result in extensive and even life threatening bleeding.
- Proper planning and considering reflect a lingual flap to visualize the ridge
osseointegration
A direct functional and structural connection
between living bone and the implant surface
requirements of successful osseointegration
The stability of the bone at the time of implant
placement is critical to the successful osseointegration
Quantity: related to the degree of bone loss or bone resorption present
* Quality: related to the degree of bone density present
classes of bone quantitiy for implants