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Module 8 > Implantology > Flashcards

Implantology Flashcards

1
Q

what % of adults in uk are edentulous?

A

6%

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2
Q

what % of adults in uk have had a tooth removed?

A

74%

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3
Q

what is the definition of an implant?

A

a prosthetic device of alloplastic material implanted into the oral tissues beneath the mucosa and/or periosteal alter and/or within the bone to provide retention and support for a fixed or removable prosthesis

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4
Q

What are the indications for implants?

A

replace single tooth, multiple teeth, full arches
well motivated compliant pts
well maintained dentition
systemically well
non-smoker
no bruxism/parafunctional habits

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5
Q

what are the advantages of implants?

A

function
aesthetics
quality of life

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6
Q

what are contraindications for implants?

A

age
medical health

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7
Q

what medical issues contraindicate implants?

A

poorly controlled diabetes (hba1c > 8)
bisphosphonate tx
psychiatric and mental health issues
blood disorders
immunodeficiency
poor dental health

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8
Q

Who can get implants on NHS?

A
  1. Congenital, inherited conditions that have led to missing or malformed teeth
  2. Trauma
  3. H&N cancer or non-malignant pathology
  4. Congenital or acquired conditions with extra-oral defects
  5. Edentulous pts when repeated conventional denture failure
  6. Severe oral mucosal disorders and severe xerostomia
  7. No suitable existing teeth that can be used for anchorage to facilitate ortho tx
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9
Q

Name 4 implant brands

A

Straumann
Hoissen
Nobel biocare
Dentsply Sirona

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10
Q

What are the 3 parts of an implant?

A

Crown
Abutment
Implant post/screw

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11
Q

What are the requirements of an implant?

A

Safety
Compatibility (biological, biomechanical and morphological)
MRI safe and image compatibility

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12
Q

What is osseointegration?

A

A direct structural and functional connection between ordered living bone and the surface of a load-carrying implant

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13
Q

What host factors affect osseointegration?

A

Bone density
Bone volume and bone implant surface area
Parafunctional habits

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14
Q

What implant factors affect osseointegration?

A

Implant macro design
Chemical composition and biocompatibility
Surface treatment and coatings
Implants tilting, prosthetic passive fit, cantilever, crown height, occlusal table, loading time

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15
Q

What factors will improve osseointegration?

A

Surface chemical composition, biocompatibility, high corrosion resistance
Hydrophilicity
Roughness (macro, micro, nano-sized topologies) - titanium plasma spaying, grit blasting, acid etching, anodiation, calcium phosphate coating

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16
Q

What are the advantages of surface modification?

A

Greater amounts of bone-to-implant contact more rapid integration with bone tissue higher removal torque values

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17
Q

What are the 2 metals used in implantology and why are these used?

A

Titanium and zirconium
They do not inhibit the growth of osteoblasts

18
Q

what anatomical features would be taken into consideration when planning implants?

A

bone - volume horizontally/veritcally
soft tissue - keratinized mucosa, soft tissue quality/thickness/biotype
site - proximity to vital anatomical structures
adjacent teeth - papillae, recession, interproximal attatchment
aesthetic risk assessment - facial support, labial support, upper lip length, buccal corridor, smile line

19
Q

what is the issue with keratinised mucosa and implants?

A

absence of adequate amount of keratinised mucosa is associated with higher plaque accumulation and gingival inflammation

20
Q

how is bone quality classified?

A

class i - anterior part of mandible mainly cortical bone, very dense - good primary stability
class ii - more trabecular bone - still good primary stability
class iii - even more trabecular bone
class iv - nearly exclusively trabecular bone

21
Q

what happens if there is instability when implant fitted?

A

causes fibrous encapsulation = failure

22
Q

what imaging would be taken before implants?

A

photographs
- document resting lip line and smiling lip line
- position of midlines
- occlusion
radiographs:
- PA
- DPT
- CBCT

23
Q

what can you use clinically to locate the mental foramen?

A

nabers probe

24
Q

what is the minimal distance the implant should be placed from adjacent tooth?

A

1.5mm

25
Q

what is the minimal distance the implant should be placed from adjacent implants?

A

3mm

26
Q

what can be done to change bone levels for implants?

A

recontouring - knife-edge ridges, mandibular tori, undercutes
onlay grafts, inter-positional grafts, PRF sticky bone
sinus lift techniques

27
Q

what is finite element analysis? (FEV)

A

transfer of load to surrounding bone tested by a mathematical model analysis, to avoid stress of the bone around the neck of the implant leading to bone loss

28
Q

what is FEV affected by?

A

implant body shape (tapered)
implant collar shape
threads - shape, pitch, height
grooves

29
Q

what is the main Ti alloy used for implants?

A

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

30
Q

What does the addition of aluminium and valadium do to titanium?

A

lowers heat conduction by 50%
doubles resistance to corrosion
better fracture resistance

31
Q

what is roxolid?

A

15% zirconium
85% titanium

32
Q

what are the good properties of roxolid?

A

higher tensile strength than titanium
preserves bone
greater flexibility with smaller implants

33
Q

what are the positives of pure ceramic implants?

A

high-performance zirconia ceramic (Y-TZP) has higher fatigue strength than grade 4 Ti implants
97.5% survival and success rates after 3 years

34
Q

what are the vertical forces on implants?

A

380-880N molars
<220N incisors

35
Q

what is the crown to implant ratio?

A

1.7

36
Q

what are the lateral/shearing forces on implants?

A

20N

37
Q

what are the timings for implant surgery?

A

immediate
immediate delayed - early soft tissue healing (4-8 weeks)
delayed - partial bone healing (3-4 months)
elective - full bone healing >4months

38
Q

how long after placement will restorative team commence tx with tissue level implants?

A

2-3 months

39
Q

how long after placement will restorative team commence tx with bone level implants?

A

2 months after implant is exposed and a taller healing abutment placed

40
Q

name 5 complications of implants

A

wound breakdown
infection
early loss
mucositis
peri-implantitis

Module 8 (7 decks)

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