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ABOMS (Johnston) > Implantology > Flashcards

Implantology Flashcards

1
Q

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

A

Crestal 5mm

Width more important than length to minimize stress

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2
Q

Components of Ti allow

A

90% Ti

6% Aluminum

4% Vanadium

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3
Q

Implant roughness

  • Unit of measure
  • Average roughness
  • Techniques to create roughness
A

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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4
Q

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

Straight or Tapered wall implant

Fine pitch or Course pitch

A

Straight has greater surface area

Fine pitch has greater surface area (more threads)

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5
Q

Restorative distance (crestal bone to occlusal plane)

Min-Max for screw retained

Min-Max for cement retained

Does depth of implant placement affect this?

A

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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6
Q

Implant space requirements

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

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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7
Q

Which bone type is mostly cortical bone?

A

Type 1

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8
Q

Which bone type is best for implant placement?

A

Type 2

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9
Q

Is magnification in Panorex increased or decreased

A

Increased

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10
Q

Implant success

Defined as:

A

Implant success

Defined as:

  • Restorable
  • <0.2mm bone per year after 1st year of function
  • No mobility, radiolucency, symptoms
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11
Q

What temperature causes osseus thermal necrosis

A

47 celsius

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12
Q

Minimum diameter of keratinized tissue around implant

A

2mm

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13
Q

Incision design for 2nd stage

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

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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14
Q

Which arch has higher failure rate for over denture?

A

Maxilla

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15
Q

Vertical space for ovedenture

Vertical space for ceramometal

Vertical space for hybrid

A

Vertical space for ovedenture = 12mm

Vertical space for ceramometal = 8mm

Vertical space for hybrid = 15mm

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16
Q

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

A

Hybrid

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17
Q

Indications for coronally positioned semilunar flap

A
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18
Q

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

A

Palatal to palatal cusp of premolar

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19
Q

Insertion torque for immediate temporization of implant

A

30-35ncm

20
Q

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

A

Any of three times

  1. Original implant placement if non-submerged
  2. At time of stage II
  3. Anytime after definitive restoration
21
Q

Harvest site for free gingival graft

How to prevent neurovascular injury

A

Smooth area of palate in anterior to 1st molar

22
Q

How is recepient site prepared for free gingival graft?

A

Split thickness so graft is secured to periosteal bed

23
Q

Which has greater shrinkage at gingival graft site

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

A

Acellular dermis.

24
Q

Timing of subepithelial connective tissue graft

Harvest site

A

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

25
Q

Palatal roll technique

Timing

Harvest site

A

Palatal roll technique

Timing: only at stage II

Harvest site: subepithelial adjacent palatal tissue

26
Q

Pedicled palatal flap

Flap classification type

Timing

A

Random pattern flap

Periosteum/connective tissue

Timing: Done simultaneously with bone graft for large volume alveolar grafts

27
Q

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
A
  • 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
28
Q

What type of cells are acted on with osteoinduction

A

Mesenchymal stem cells

29
Q

Allograft and xenograft

Osteoconductive, osteoinductive, or both

A

Osteoconductive only. Matrix for host cells

30
Q

Describe triangle of tissue engineering

A

Source of cells

Signal

Scaffold

31
Q

BMP

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

BMP

  • Osteoinductive
  • Lineage: Transforming Growth Factor (TGF)
  • Source: Recombinant human
  • 4-6 months of healing
32
Q

Minimal ridge width for ridge split technique

A

minimum 3mm

33
Q

Distraction osteogenesis for ridge augmentation

Latency time

Distraction rate

Consolidation duration

A

Distraction osteogenesis for ridge augmentation

Latency time = 5-7 days

Distraction rate = 1mm/day

Consolidation duration = 2-3 months

34
Q

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

A

Buccal lingual 50% reduction in 6 months

35
Q

Sequence of socket healing with/without graft

Name of stage and duration

A

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

36
Q

Ideal bone graft for socket preservation

Source of bone

Particle size

What is FDA approve and can be used to obtain osteoinduction

A

Ideal bone graft for socket preservation

Allograft or Xenograft

250-1000micrometer

What is FDA approve and can be used to obtain osteoinduction = BMP

37
Q

Volume of maxillary sinus in average adult

Sinus dimensions

Thickness of sinus membrane

A

Volume = 14ml

Sinus dimensions = W2.5cm, H3.75cm, D3cm

Thickness of sinus membrane = 0.1-0.5mm

38
Q

Alveolar bone thickness for immediate implant placement with sinus lift

A

3mm

39
Q

Max elevation of sinus membrane with internal/Summer technique

Uses osteotomes

A

2mm

40
Q

Most common surgical complications

Incidence%

A

Bleeding 25%

Nerve disturbance 7%

Mandible fx 0.3%

41
Q

Implant failure risk factors

List 6 with incidence %

A

• 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%)

42
Q

Abutment screw loosening incidence %

More common in single crown, multi-unit PFD, or overdentures

A

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

43
Q

Peri-implantitis

Present in what % of osseointegrated implants

Normal implant probing depth

Normal bone loss rate

Etiologies x5

Implicated bacteria group

A

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

44
Q

initial perimplantitis management

A

Remove etiology

  • eliminate overload
  • control infection
45
Q

Management of persistent periimplantitis

3 steps

A
  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

ABOMS (Johnston) (8 decks)

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