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OS > Implants > Flashcards

Implants Flashcards

1
Q

Characteristics of ideal tooth replacement

A 
Firm, 
does not destroy adjacent tooth 
preserve alveolar bone 
senate, 
easy to clean
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2
Q

What are mucosal inserts

A

Buttons in mucosa alone holding dentures in place. Not firm

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3
Q

Endodontic stabilizer

A

Historically, through apex of tooth into bone cause difficulty extracting

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4
Q

What is suprapeniostal implant

A

Raise flap and take impression and place cobalt chrome

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5
Q

Blade implant

A

Hard to retrieve

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6
Q

Trans mandibular implant

A

Difficult to retrieve

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7
Q

Definition of dental implant

A

Permucosal device
Bio compatible and biofunctional.
Placed within mucosa or on or within bone
Associated w oral cavity
To provide support forfixed or removable prosthesis

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8
Q

Definition of osteo integration

A

Time - dependent healing process
Finically asymptomatic rigid fixation
Of aloplastic materials
Is achieved and maintained in bone during loading

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9
Q

How are root form implants classified

A

By shape: cylindrical/tapered
Threaded/non-threaded (press fit)
Surface finish: polished/treated (acid etched, sand blasted)
Material: conventionally pure titanium, titanium alloy is stronger

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10
Q

Parts of implants

A

Implant body fixture
Abutment
Prosthetic

Vs

Single piece: harder to manage when fails

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11
Q

Surgical procedure of implants placement

A

Delayed loading

  1. Initial surgery
  2. Ossointegration period
  3. Abutment connection
  4. Final prosthetic restoration

If you need bone graft, wanna place safe

Immediate loading (for aesthetic zone)

temp crown on top of abutment

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12
Q

What happens when its not osseointegration but fibrous integration

A

Implant moves, poor long term success

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13
Q

Factors affecting success of osteo integration

A

Biocompatibility of material: commercially pure titanium, titanium alloy, zirconium, HA

Implant adaptation to prepared site

Atraumatic surgery: minimal tissue violence,

Undisturbed healing process

Successful implants have unbroken perimucosal seal between soft Tissue and implant abutment surface

Just long junctional epithelium,no PDL no sharpie fibres

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14
Q

Implant surface design

A

Pitch: threads per unit length
Increased pitch and depth allows for more contact area
Moderately rough surface with 1.5 micron improve contact area between bone and implant surface

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15
Q

Types of bone quality

A

Quality 1: homogenous compact bone, anterior lower jaw, less blood supply than rest of types, 5 months of OI, very dense that when you drill bone will over heat

Quality 2: thick layer of cortical bone surrounding dense trabecular, posterior lower jaw, 4 months of OI, bestest bone

Quality 3: thin cortical bone surrounding dense trabecular, in anterior upper jaw, 6 months OI

Quality 4: very think cortical bone w Low density trabecular bone, posterior upper jaw, 8 months OI

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16
Q

Surgical protocol

A

Atraumatic surgery: minimal tissue violence,
sharp instruments,
careful cooling (bone temp below 45 degrees),
use graded series of drills (tiny to big),
intermittent drilling,
moderate insertion torque cos strong torque result in stress and resorption

17
Q

Biomechanics

A

Force and magnitude, fixed prosthesis more force, implant designs (distribute stress)

18
Q

Complications of surgery

A

Failure of osteointegration: depends on location and bone quality

IDN posterior to mental foramen: required CBCT, DPT has magnification, take informed consent

Infection: peri-implantitis, active infection site, exposure of rough surface to oral fluids, manage with antibiotic therapy

Maxillary sinus: penetration usually not problem tight fit no communication, need to do sinus lift

Biological: lingual pouch, hit a vessel excessive bleeding

Aesthetic failure: if patient think ugly then is failure alr, lack of labial bone, inability to shade match, loss of papilla, recession

Fracture: excessive insertion torque, excessive cantilever, poor selection and design

Insertion wrong angulation: remove or bury, off axis loading, injury to adjacent teeth, unrestorability

19
Q

Factors affecting survival: patient

A

Local: bone quality, bone quantity, periodontal health, anatomical structures, soft tissues

Systemic: immune suppression- diabetes, allotransplantation, poor healing, infection, drug exposure to bisphosphonates, previous radiotherapy

Habits: smokers, brutish, grinding, occupation, age (alveolarbone grows until 18, so later your bone grows over your implant gg)

20
Q

Bone grafting types

A

Osteogenic: presence of viable osteoblasts and osteocytes in graft with direct healing and formation of new bone and blood vessels (autogenous marrrow)

Osteoconductive: inorganic material only, conducts path for osteoclasts to resort hydroxyapatite crystals and osteoblast from host bed to form new osteons (animal/cadevar)

Osteoinductive: organic portions of bone induces formation of new osteoblasts from osteoprogenitor cells (autogenous)

Autogenous, allogenous (human), xenogenous (animal), alloplastic (synthetic)
Must all be fixated in place if not disrupt angionenesis

21
Q

What’s the easiest implant

A

Single tooth, adequate bone, space, soft tissue: upper premolar

22
Q

What are some osteoactive agents

A

Osteoactive agents help support formation

Osteoinducers: rh BMP
Osteopromoters- TGF beta, PDGF, IGF, PRP (from blood into rich plasma)
Stem cells and tissue engineering, you need screws or titanium mesh

23
Q

Where to take bone

A

Adjacent bone is best
Bone from drills
Mandibular Ramus, menton (incisive nerve), Coronoid
Maxillary tuberosity

Femur

24
Q

New materials for bone graft

A

Regenerative material: PCL (poly caprolactone )
Sugars- heparin sulfate
MSC (mesenchymal stem cell derived) exosomes
Tissue engineered scaffolds

25
Q

What are some newer advances in implantology

A

Computer aided surgery
Regenerative implants
Tissue engineering

OS (8 decks)

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