Implants Flashcards
What patient factors must be considered to enhance the functional and esthetic outcomes of immediate implants?
health of the patient
History to tooth failure
Esthetic evaluation
Periodontal biotype
What surgical factors must be considered to enhance the functional and esthetic outcomes of immediate implants?
Operator experience
Minimizing trauma during extraction
Removal of residual infection
Ability to achieve primary stability
Describe Immediate loading
Prosthesis connected to dental implant within 1 week after placement
-Restores immediate function to the patient
-Restores esthetics
-Preserves soft tissue architecture
-Dependent on initial stability of the implant
Describe Early loading
Prosthesis connected to dental implant between 1 week and 2 months after placement
-Patient does not have to deal with missing tooth for prolonged period of time
-Allows the clinician time to fabricate a restoration based on an impression/index performed at time of surgery
-Reduces the number of procedures performed on the patient in one session-reduced morbidity
Describe coventional loading
Prosthesis connected to dental implant >2 months after implant placement
-Osseointegration of implant is confirmed before restoration is placed
-Long history of success, predictable outcomes
How does immediate loading of a single implant affect implant survival rate, and marginal bone loss?
There is no significant difference for survival rate and marginal bone loss.
Survival rate
Immediate load: 96.8%
Conventional 97.9%
(1 year)
Marginal bone loss
Immediate load: 1.31mm
Conventional: 1.01mm
(5 years)
How does immediate loading of a single implant affect soft tissues surrounding the loaded implant, esthetics, and patient satisfaction?
Soft tissue - No significant differences
(mean recession almost identical)
Esthetics - no significant differences
(same Pink Esthetic and white esthetic score)
Patient satisfaction - no significant difference
What is the clinical performance and significance of complications and failures, when providing implant –supported reconstructions with either screw or cement retention?
There are no significant differences between the survival rates and failure rates of cement or screw retained abutments.
Possible complications for screw may include porcelain chipping at access hole.
Possible complication for cement may include excess cement causing biological complications
In what restorative situations may screw retained implant restorations be the treatment of choice and under what situations might cement retained implant restorations be the treatment of choice?
Screw retained:
-When retrievability is desirable
-When margins are submucosal (greater than 1.5 mm increases difficulty of removing cement) when the implant can be placed appropriately/prostheticaly driven
Cement retained:
-Esthetics
-Margins are supragingival
-When intact occlusal surface is desirable
inflammatory tissue pathology resulting from plaque accumulation and bacterial infiltration around implants
Peri-implant mucositis
Condition of inflamed peri-implant soft tissues, bone loss, and increased probing depth combined with exudation.
Peri-implantitis
Risk factors for Perio implant infections
- History of periodontitis
- Smoking
- Diabetes
What 4 elements of therapy have shown beneficial results in the treatment of peri-implantitis, based on systematic reviews?
- Oral hygiene instruction
- Non surgical debridement
- Smoking cessation
- Surgical therapy
4 Pre-op conditions are associated with peri-implant mucositis/peri-implantitis?
-Remaining periodontally involved teeth
-High plaque scores and biofilm
-History of smoking
-Poor oral hygiene recall
4 Post-op conditions are associated with peri-implant mucositis/peri-implantitis?
-Presence of active periodontitis
-Keratinized tissue band around the implant of 1mm or less
-Lack of structured oral hygiene recall program (spt)
-Smoking
Based on the best available evidence, does supportive periodontal therapy affect peri-mucositis/peri-implantitis, and how?
Yes, it does affect peri-mucositis and peri-implantitis, supported by the following evidence:
-High long-term survival and success rates of dental implants can be achieved in partially and completely edentulous patients adhering to regular SPT.
-SPT is associated with reduction in the incidence of peri-implant mucositits/peri-implantitis
-Patients with a history of periodontitis have a higher risk of peri-implant mucositis/peri-implantitis
-Active periodontal disease should be resolved prior to implant placement