Implants Flashcards
What is the early tissue response to implants?
- Initial implant wound
- Following days: blood clot followed by granulation tissue and then vascular invasion
1 week: osteoclasts invasion
2 weeks: early woven bone
4 weeks: 1st phase of true integration
4 months: fully matured remodelling
How can the surface of the implants be altered?
Grit blasting blasting and etching etched HAP coated Oxidised surfaces Titanium plasma sprayed surface
What is the purpose of altering the implant surface?
Provides better initial stability in bone
greater contact area for integrration
surface that retained better blood clot
stiumulation of bone healing process
What are the structural types of implants?
Isotropic and Anisotropic
What are isotropic implants surfaces?
surface structure without a dominating direction
What are anisotropic surfaces?
processes which involve turning and milling to produce a distinct pattern
what radiographic views are taken for implants?
primary and secondary views
What are primary views?
Intra oral
Panoramic
What are the secondary views?
CT scan
Allow segmental measuring jaws
identifies structure eg nerve
How can we asses the bone?
Quality and Quantity
How can we assess bone quality?
Type 1, 2, 3, 4,
Type 1: Almost entire jaw comprimises homogenous cortical bone
Type 2: a thick layer of cortical bone surrounds a core of trabecula bone
type 3: a thin layer of cortical bone surrounds a core of dense trabecular bone of good strength
type 4: a thin layer of cortical bone surrounds a core of low density trabecular bone
What are the different bone quantities?
A: most alveolar ridge is present
B: moderate resorption is present
C: Advanced resoprtion has occurred and basal bone remains
D: minimal to moderate resoprtion of basal bone occurred
E: extreme resoprtion of basal bone occurred
What is bone height ?
distance from a bone level where the width is sufficient to a limiting anatomical structure
How is bone height best measured?
tomograms
What is guided tissue regeneration?
Place barrier membrane
Space can only be invaded by bone cells and creates new bone
What materials can be used for GTR?
PTFE
Gortex
Collagen
and can be draped and pinned
When would a sinus lift be performed?
insufficient bone
pneumatised sinus
How can you perform a sinus lift?
internal lift
lateral lift
How can the ridge be aurgmented?
autogenous
allograft
Xenograft
What is an autegnous graft?
graft which is harvsted from else where in the body
What is an allograft?
graft fro another pateint eg mineralised freeze dried
What is a xenograft?
harvested from another species
WHAT ARE THE sites avaible for autogenous grafts?
Locally: from within the implant prepartion site
from mandib ramus, or symphysis
Distant: from tibia, ilial crest, vascularised free flaps
What are the advnatges of block bone grafts?
Good incoporation
less volume loss
shorter healing timebetter bone qiality
