Implants

Question 0

What are the risk factors for implants?

Answer 0

Age 
Dental anxiety
Medical disorders
Psychological 
Smoking
Local surgical condition
Local pathology eg Parafunction, bone quality

Question 1

What are the options for missing teeth?

Answer 1

Removable 
Fixed prosthesis resin bonded
Fixed pros conventional
Implant 
Auto transplant 
Stem cell

Question 2

What is osseointegration?

Answer 2

Direct structural and functional connection between living bone and implant surface

Question 3

What are the thre types of oral implants?

Answer 3

Trans osseous
Sub periosteal
Endosseous

Question 4

What are the Endosseous implants?

Answer 4

Blade
Root form
Cylindrical
Mini transitional implants

Question 5

What are trans osseous implants?

Answer 5

Plate and ion system which penetrate through the mandible and secured in place with bolts and screws

Question 6

What are thr problems with trans osseous implants?

Answer 6

Very traumatic 
Only used in mandible 
Requires EO and IO incison 
Needs a GA
Was mainly for dentures 

No longer used

Question 7

What are subperiosteal implants?

Answer 7

Not anchored in bone rather ride on the bone

Used in edentulous as well as partially dentate in upper and lower jaws

Question 8

Where are the best results for the subperiosteal implant?

Answer 8

Lower edentulous

Question 9

What is the problem with subperiosteal implants?

Answer 9

Infection can spread easily and wipe out bone

No longer used

Question 10

What are Endosseous implants?

Answer 10

Placed surgically into bone

Question 11

When are the blade implants used?

Answer 11

Rarely now

Used to be used where ridge was very thin or certain anatomical structures prevent conventional implants being made

Question 12

When are the root Endosseous implants used?

Answer 12

Root form

Popular for immediate placement into xla socket

Question 13

T/F root from implants are easier to accommodate between teeth?

Answer 13

T

Theoretically

Question 14

What is the mostly widely used design of implant?

Answer 14

Cylindrical Endosseous implant

Following the work of branmakr

Question 15

When are mini or transitional implants used?

Answer 15

To stabilise and retain removable prosthesis

One piece design with a simple o ring connector in denture

Question 16

What are thr sucks rates for implants?

Answer 16

5yr vs 10yr

Trans: 95% vs 87%
Blades: 49-75% vs 50%
Subperiosteal : 95% vs 65-78%
Endosseous: 98% vs 96-98%

Question 17

What are the designs of the endoessous implants?

Answer 17

Cylindrical
Stepped
Threaded and stepped
Parallel threads
Tapered thread

Question 18

What is the diameter of the root form implants?

Answer 18

Mini: 4.5

Question 19

What are the components of an implant?

Answer 19

Implant/fixture
Crown
TMA/Abutment/collar

Question 20

What materials are used for implants?

Answer 20

Titanium

Zirconia

Question 21

T/F there is contact between the implant and patient?

Answer 21

F

Contact due to oxide layer

Question 22

How does the oxide layer form on the implant?

Answer 22

Within 1ms oxide layer forms on the surface of the implant and become 3-5nm thick

Question 23

What are sleeper implants?

Answer 23

When you put more implants in than you ended but not done any more

Question 24

What is the narrowest width you can place an implant?

Answer 24

5.5mm

Question 25

How much space do you need between two implants?

Answer 25

7mm

Question 26

What are the contra indications to implants?

Answer 26

``` Age Smoking Radiotherapy Surgical experience Overloading Poor bone Grafts Medication ```

Question 27

What are the early complications arising from implant placement?

Answer 27

``` Oedema Bleeding Heamatoma Implant loss Nerve damage Infectin ```

Question 28

What are the medium term complications arising from implants ?

Answer 28

Abutment screw fracture Prosthesis fracture Framework bar misfit

Question 29

What are the late complication arising from implant placement?

Answer 29

Soft tissue recession overgrowth Bone loss Peri implantitis Aesthetics

Question 30

What are the fixed implant abutment options?

Answer 30

Screw retained | Cement retained

Question 31

What is torque?

Answer 31

The force acting in rotation

Question 32

Why do peri implant inflam diseases arise?

Answer 32

The surface of the implant is inevitably going to be colonised by plaque

Question 33

What are the two types of per implant inflam diseases?

Answer 33

Peri implant mucositis | Peri implantitis

Question 34

What is peri implant mucositis?

Answer 34

Reversible inflam lesion affecting peri implant soft tissues

Question 35

What is peri implant mucositis analogous to?

Answer 35

Gingivitis

Question 36

T/F thre is bone loss in peri implant mucositis?

Answer 36

F

Question 37

What variant has been found of the peri implant mucositis?

Answer 37

Necrotising variant seen in smokers and immunocomprimised

Question 38

T/F peri implant mucositis can also be hyperplastic?

Answer 38

T

Question 39

How do you mange peri implant mucositis?

Answer 39

OHI

Question 40

How many implants and people will be affected by per implant mucositis?

Answer 40

50% of implants over 9 yrs | 80% of patients

Question 41

What is peri implantitis?

Answer 41

Inflammatory disease which also affects the bone | BOP maybe out and marginal bone loss

Question 42

How much bone loss is needed to be classified as peri implantitis?

Answer 42

More than 1.8mm within first year

Question 43

What is the difference between peri implantitis and periodontitis?

Answer 43

``` Implants not teeth Lack of innervation Lack of pdl Decreased vascularity of oeri implant connective tissue Lack of true soft tissue attchmemt ```

Question 44

How common is peri implantitis?

Answer 44

12-43% of implants over 9 yrs | 28-56% patients

Question 45

What are the risk factors for peri implant disease?

Answer 45

OH Perio Smoking

Question 46

What is the association between perio implant disease and perio?

Answer 46

Increaed prevalence of peri implantitis in ppl with history of perio

Question 47

T/F perio disease is a contraindications to implants?

Answer 47

F | History or perio disease not but perio Should he stabilised

Question 48

How do you diagnose peri implant disease?

Answer 48

Probing | Radiographs

Question 49

How should you probe implants?

Answer 49

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

Question 50

T/F there is a link that indicates probing depth is linked with potential for peri implant disease?

Answer 50

F

Question 51

When should you take xrays?

Answer 51

``` Long cone PARALELLING Baseline 6months 12 months 2-3 yr intervals ``` But maybe more frequent if peri imaplmt disease

Question 52

What machines can you use to help diagnose peri implant disease?

Answer 52

Perio test: measure damping capacity, lack of sensitivity | Osstel: measures effective change in height of implant above bone and stability of implant

Question 53

How do you manage peri implant mucositis ?

Answer 53

``` OHI Non surgical debridement Antimicrobial mouth rinse CHX and listering Air power polishing ```

Question 54

What type of hand instruments should you use for peri implant disease?

Answer 54

Not steel since scratches surface Plastic, graphite, titanium instrument These have limited effect on implant itself but more useful on abutment

Question 55

What is air powered polishing?

Answer 55

Little surface alterations | Good at reducing biofilm but not calculus

Question 56

How do you manage peri implantitis?

Answer 56

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