Implants Flashcards
What are the risk factors for implants?
Age Dental anxiety Medical disorders Psychological Smoking Local surgical condition Local pathology eg Parafunction, bone quality
What are the options for missing teeth?
Removable Fixed prosthesis resin bonded Fixed pros conventional Implant Auto transplant Stem cell
What is osseointegration?
Direct structural and functional connection between living bone and implant surface
What are the thre types of oral implants?
Trans osseous
Sub periosteal
Endosseous
What are the Endosseous implants?
Blade
Root form
Cylindrical
Mini transitional implants
What are trans osseous implants?
Plate and ion system which penetrate through the mandible and secured in place with bolts and screws
What are thr problems with trans osseous implants?
Very traumatic Only used in mandible Requires EO and IO incison Needs a GA Was mainly for dentures
No longer used
What are subperiosteal implants?
Not anchored in bone rather ride on the bone
Used in edentulous as well as partially dentate in upper and lower jaws
Where are the best results for the subperiosteal implant?
Lower edentulous
What is the problem with subperiosteal implants?
Infection can spread easily and wipe out bone
No longer used
What are Endosseous implants?
Placed surgically into bone
When are the blade implants used?
Rarely now
Used to be used where ridge was very thin or certain anatomical structures prevent conventional implants being made
When are the root Endosseous implants used?
Root form
Popular for immediate placement into xla socket
T/F root from implants are easier to accommodate between teeth?
T
Theoretically
What is the mostly widely used design of implant?
Cylindrical Endosseous implant
Following the work of branmakr
When are mini or transitional implants used?
To stabilise and retain removable prosthesis
One piece design with a simple o ring connector in denture
What are thr sucks rates for implants?
5yr vs 10yr
Trans: 95% vs 87%
Blades: 49-75% vs 50%
Subperiosteal : 95% vs 65-78%
Endosseous: 98% vs 96-98%
What are the designs of the endoessous implants?
Cylindrical Stepped Threaded and stepped Parallel threads Tapered thread
What is the diameter of the root form implants?
Mini: 4.5
What are the components of an implant?
Implant/fixture
Crown
TMA/Abutment/collar
What materials are used for implants?
Titanium
Zirconia
T/F there is contact between the implant and patient?
F
Contact due to oxide layer
How does the oxide layer form on the implant?
Within 1ms oxide layer forms on the surface of the implant and become 3-5nm thick
What are sleeper implants?
When you put more implants in than you ended but not done any more
What is the narrowest width you can place an implant?
5.5mm
How much space do you need between two implants?
7mm
What are the contra indications to implants?
Age Smoking Radiotherapy Surgical experience Overloading Poor bone Grafts Medication
What are the early complications arising from implant placement?
Oedema Bleeding Heamatoma Implant loss Nerve damage Infectin
What are the medium term complications arising from implants ?
Abutment screw fracture
Prosthesis fracture
Framework bar misfit
What are the late complication arising from implant placement?
Soft tissue recession overgrowth
Bone loss
Peri implantitis
Aesthetics
What are the fixed implant abutment options?
Screw retained
Cement retained
What is torque?
The force acting in rotation
Why do peri implant inflam diseases arise?
The surface of the implant is inevitably going to be colonised by plaque
What are the two types of per implant inflam diseases?
Peri implant mucositis
Peri implantitis
What is peri implant mucositis?
Reversible inflam lesion affecting peri implant soft tissues
What is peri implant mucositis analogous to?
Gingivitis
T/F thre is bone loss in peri implant mucositis?
F
What variant has been found of the peri implant mucositis?
Necrotising variant seen in smokers and immunocomprimised
T/F peri implant mucositis can also be hyperplastic?
T
How do you mange peri implant mucositis?
OHI
How many implants and people will be affected by per implant mucositis?
50% of implants over 9 yrs
80% of patients
What is peri implantitis?
Inflammatory disease which also affects the bone
BOP maybe out and marginal bone loss
How much bone loss is needed to be classified as peri implantitis?
More than 1.8mm within first year
What is the difference between peri implantitis and periodontitis?
Implants not teeth Lack of innervation Lack of pdl Decreased vascularity of oeri implant connective tissue Lack of true soft tissue attchmemt
How common is peri implantitis?
12-43% of implants over 9 yrs
28-56% patients
What are the risk factors for peri implant disease?
OH
Perio
Smoking
What is the association between perio implant disease and perio?
Increaed prevalence of peri implantitis in ppl with history of perio
T/F perio disease is a contraindications to implants?
F
History or perio disease not but perio Should he stabilised
How do you diagnose peri implant disease?
Probing
Radiographs
How should you probe implants?
Probe four sites with light force
Need to be careful since if inflamed then can penetrate to bone
Measure one month after placement the annually
T/F there is a link that indicates probing depth is linked with potential for peri implant disease?
F
When should you take xrays?
Long cone PARALELLING Baseline 6months 12 months 2-3 yr intervals
But maybe more frequent if peri imaplmt disease
What machines can you use to help diagnose peri implant disease?
Perio test: measure damping capacity, lack of sensitivity
Osstel: measures effective change in height of implant above bone and stability of implant
How do you manage peri implant mucositis ?
OHI Non surgical debridement Antimicrobial mouth rinse CHX and listering Air power polishing
What type of hand instruments should you use for peri implant disease?
Not steel since scratches surface
Plastic, graphite, titanium instrument
These have limited effect on implant itself but more useful on abutment
What is air powered polishing?
Little surface alterations
Good at reducing biofilm but not calculus
How do you manage peri implantitis?
Mild cases( bone loss of less than 2mm) same as mucositis but consider antibiotics
If BOP and or PUSS refer
Surgical approach when depth greater than 2mm
Consider regenerative treatment in long term
