implants Flashcards

Question

mandible anatomy to be aware of

Answer 1

IDC mental foramen incisive canal linugal perforating vessels submandibular fossa

Answer 2

from finish to start e.g. have final planned prosthesis and then work out how to get there

Answer 3

minimum 1.5mm lower risk of damage to adj teeth, bone necrosis and soft tissue defects | if 2 implants side by side - need 3mm between them (2 biologic widths)

Answer 4

minimum 1.5mm lower risk of damage to adj teeth, bone necrosis and soft tissue defects | if 2 implants side by side - need 3mm between them (2 biologic widths)

Answer 5

aim for >1mm bone labially or >2mm hard tissue/soft tissue labial to implant also factor in if cement or screw retained final restoration

Answer 6

* Dehiscence * Fenestration * Inadequate contour

Answer 7

planned relatative to the proposed gingival margin vary if tissue or bone level implant

Answer 8

ITI’s classification system SAC: Straightforward, Advanced, Complex.(international team for implantology)

Answer 9

1. immediate implant placement 2. early implant placement with soft-tissue healing (4-6weeks) 3. early implant placment with partial bone healing (12-16weeks) 4. late implant placment in healed sites (6months+)

Answer 10

Study models * Mounted? Diagnostic wax up Surgical template Essex (provisional) Clinical photographs CBCT Surgical Guide (stent)

Answer 11

Removable prosthesis * Stud, bar, magnet retained Fixed prosthesis * (single or multi unit or full arch) * Screw retained, cement retained

Answer 12

open tray closed tray

Answer 13

Components * Impression Post, guide screw Benefits * Color-coded components corresponds to prosthetic connection * High precision impression * Clear-cut tactile response for accurate positioning * Guide screw can be tightened by hand or with the SCS screwdriver

Answer 14

concept of snapped impression cap Components: * Cap (Polymer), Post, Screw Benefits * Color-coded components corresponds to prosthetic connection * No additional preparation of tray * High precision impression * Clear-cut tactile response for accurate positioning

Answer 15

Gap of <5mm interproximally will be entirely filled by soft tissue (to alveolar crest) Gap of >5mm = black triangles and recession likely

Answer 16

Post-extraction defects Trauma Hypodontia Periodontal disease Thin biotype

Answer 17

* Bone volume and morphology * Space dimensions * 3D implant position * Biotype * OPERATOR SKILL AND EXPERIENCE There are biological limits to what can be achieved. | tissues the issue, bone sets the tone

Answer 18

* Bone volume and morphology * Space dimensions * 3D implant position * Biotype * OPERATOR SKILL AND EXPERIENCE There are biological limits to what can be achieved. | tissues the issue, bone sets the tone

Answer 19

Peri-implant disease is a collective term for the inflammatory reaction of tissues surrounding osseointegrated Implants, encompassing two main entities; * Peri- Implant Mucositis and Peri-Implantitis. A cause effect relationship has been demonstrated between Dental plaque and Peri-Implant disease. Like teeth implants are susceptible to bacterial plaque and calculus formation leading to an inflammatory response in the Peri-implant tissues * tissues can also become inflamed in response to the presence of a foreign body, such as excess residual cement.

Answer 20

no tissue surrounding implants are not connected to implant surface in the same way as those surrounding teeth and are less resistance to probing in combination with the anatomical position of the implant in relation to the bone and soft tissues, may potentially lead to deeper probing depths and bleeding in healthy sites

Answer 21

baseline bleeding =inflammation

Answer 22

* Signs of chronic inflammation colour, texture of gingival tissues * Bleeding on gentle probing * Probing depths * Suppuration * Mobility * Radiographic bone loss | do at regular intervals

Answer 23

* Access for oral hygiene * Poor oral hygiene * Smoking * History of Perio disease * Poorly controlled Diabetes * Occlusal Forces

Answer 24

Regular, routine, holistic, care of the patient before and after implants Patient preparation * Clinical preparation * Emotional preparation Information resource * About the technical aspects – explain in pt terms (similar to putting in shelves – wall plug is screw implant, prosthesis is the shelf; almost always involves surgery) * Where to go and who to see – reliant on your trust of contact Making the referral After care and ongoing maintenance

Answer 25

Dental Implants Oral Health Foundation; Association of Dental Implantology

Answer 26

Anticipation –tell the pt good as pt unaware they are usually more angry Clinical * Surgical - Problems in planning; Problems in placement (E.g. Graft failure, Bur not cooled, Angle wrong) * Restorative - Problems with the restoration – seal not correct (fluid out around restoration or nose); Problems with its function – rocking overdenture Biological * Peri implant mucositis * Peri implantitis Administrative * Patient not happy with the outcome * Patient didn’t know what they were letting themselves in for * Getting lost in a complex system Know what they communication is like before referring to them There pt management expertise

Answer 27

* Cracking porcelain * Staining comp or acrylic * Mobility - refer away to get tighten * Check margins - cement retain or leakage

Answer 28

Usually on day of placement - baseline * Remodelling of bone in 1st year at margin - normal Another at 1 year post loading - new baseline (compare to this from then on) Then retake when suspect change - recession, BOP, pus, inflammation See them at least once yearly - high risk maybe more

Answer 29

Bleeding, pus and inflammation in soft tissues Not related to probing depth around the implant All implants lose some bone after loading, this should stabilise and not be progressive Threads all still covered = No bone loss; But inflammation present NO BONE LOSS

Answer 30

Bone loss associated with the implant (threads uncovered) Ensure restoration not taking lots of occlusal load - inc chance of bone loss May be bleeding and/ or pus on probing May be painful Check the loading May be asymptomatic * If you don’t look you don’t see

Answer 31

What is the problem? * Is it a surgical, restorative, biological or maintenance issue? * Whose problem is it? - skill set and responsibility * What was the patient’s contract with the placing/restoring team? – maintenance; guarantee period Can you take over? Maintain almost like a tooth if superficial inflammation, OH/PMPR/review * Peri implant mucositis - OHI and clean like perio * Safer with airflow (airabrasive device), When loose bone - refer to someone may need alteration to emergence profile if plaque trap - refer What do you say to the patient? * Be honest with them - sorry there is an issue with this implant and I’m going to refer you back to get care for it

Answer 32

ADI; A Dentist’s Guide to Implantology 2012 SDCEP Guidelines for the Prevention and Treatment of Periodontal Diseases in Primary Care 2014, (being re-written) British Society of Periodontology; Young Practitioners guide to Periodontology (currently being re-written)