Implants

Question 1

osseointegration

Answer 1

direct contact between living bone and a functionally loaded dental implant surface without interposed soft tissue at the light microscope level

Question 2

what is the clinical manifestation of osseointegration?

Answer 2

absence of mobility

Question 3

sinus augmentation (sinus lift)

Answer 3

surgical approach commonly used for the rehabilitation of the posterior edentulous maxilla with dental implants when there is insufficient bone height

Question 4

indirect sinus lift (osteotome technique)

Answer 4

sinus grafting technique whereby the maxillary sinus floor is carefully infractured and the Schneiderian membrane is elevated through an osteotomy prepared and extended in the ridge with an osteotome

Question 5

direct sinus lift (lateral window technique)

Answer 5

creation of access to max sinus through its lateral wall

Question 6

the access to max sinus with direct sinus lift is used to elevate what?

Answer 6

Schneiderian membrane for the placement of graft material in inferior part of sinus space

Question 7

≥10 mm from crest of ridge to floor of sinus

Answer 7

conventional implant procedure

Question 8

6-9 mm from crest of ridge to floor of sinus

Answer 8

osteotome technique with sinus membrane displacement (during implant site preparation) and bone graft in combo with immediate implant placement

Question 9

4-5 mm from crest of ridge to floor of sinus

Answer 9

lateral approach to sinus involving flap (Caldwell-Luc) with bone graft, with immediate or delayed implant placement

Question 10

1-3 mm from crest of ridge to floor of sinus

Answer 10

lateral sinus approach with bone grafting material and delayed implant placement

Question 11

hybrid implants

Answer 11

an implant prosthesis made by attaching denture teeth with heat-polymerized acrylic resin to cast metal substructure that is connected to several implants

Question 12

biointegration (osseointegration)

Answer 12

bonding of living bone to the surface of an implant (ankylosis) which is independent of any mechanical interlocking mechanism

Question 13

jaw shape-bone resorption patterns

Answer 13

1. most of alveolar ridge is present
2. moderate residual ridge resorption has occurred
3. advanced residual rdige resorption and only basal bone remains
4. some resorption of basal bone has started
5. extreme resorption of basal bone has taken place

Question 14

bone quality

Answer 14

1. homogenous compact bone
2. thick layer of compact bone surrounds a core of dense trabecular bone
3. thin cortical bone with dense trabecular bone of favorable strength
4. thin layer of cortical bone with low density trabecular bone

Question 15

peri-implant mucositis

Answer 15

reversible inflammatory rxn of mucosa that surrounds an osseointegrated implant with no bone loss

Question 16

peri-implantitis

Answer 16

inflammatory process affecting the hard and soft tissues around an implant that has results in

1. PD >5mm with BoP (suppuration)
2. progressive bone loss (greater than 0.2 mm/year after the first year it is loaded)

Question 17

ailing implant

Answer 17

general term for implant affected by peri-implant mucositis, without bone loss

Question 18

failing implant

Answer 18

general term for implant that is progressively losing its supporting bone anchorage (may exhibit increased PD, purulence, but is still clinically stable)

Question 19

failed implant

Answer 19

dental implant that is mobile (has not achieved or has lost osseointegration) or that is symptomatic in spite of osseointegration

Question 20

criteria for implant success

Answer 20

1. immobile
2. no peri-implant radiolucency
3. <0.2mm bone loss after the 1st year of loading
4. no pain, infection, neuropathies, paresthesia
5. minimum 85% success at 5 years and minimum 80% success at 10 years

Question 21

how is alveolar ridge deficiencies classified?

Answer 21

via Seibert classification

Question 22

Seibert classification

Answer 22

system of 2 categories used to describe the form of a residual alveolar ridge

Question 23

class 1 alveolar ridge defect

Answer 23

loss of tissue width in facial-lingual or buccal-lingual direction but there is adequate ridge height

Question 24

class 2 alveolar ridge defect

Answer 24

loss of ridge height but there is adequate ridge width

Question 25

class 3 alveolar ridge defect

Answer 25

loss of both ridge height and width

Question 26

guided bone regeneration

Answer 26

surgical technique that increases and augments alveo.lar bone volume in areas designated for future implant placement or around previously placed implants

Question 27

concept of guided bone regeneration

Answer 27

barrier to create a space into which cells originating from bone tissue can grow without migration or interference by faster proliferating cells of the flap connective or epithelium

Question 28

what is considered the be the gold-standard material for bone grafting techniques?

Answer 28

autogenous bone

Question 29

examples of bone necrosis

Answer 29

1. bisphosphonate-related osteonecrosis of the jaw (BRONJ) 2. osteoradionecrosis 3. sequestration

Question 30

bisphosphonate-related osteonecrosis of the jaw (BRONJ)

Answer 30

complication characterized by exposed necrotic bone in maxillofacial region that does not heal within eight weeks after diagnosis and proper care, in a patient under current or previous bisphosphonate tx for osteoporosis and hwo has not received radiation in the head and neck area

Question 31

risk factors for bisphosphonate-related osteonecrosis of the jaw (BRONJ)

Answer 31

1. route of administration (IV vs oral) 2. duration of therapy 3. type of bisphosphonate

Question 32

osteoradionecrosis

Answer 32

death of most or all of bone cells due to irradiation

Question 33

sequetration

Answer 33

necrotic bone that becomes separated from surrounding healthy bone and forms a sequestrum ...is a complication (sequela) of osteomyelitis and bisphosphonate-related osteonecrosis of the jaw (BRONJ)

Question 34

sequestrum

Answer 34

island of non-vital bone that is separated from native healthy bone

Question 35

sequestrectomy

Answer 35

removal of sequestrum by surgical means

Question 36

one-stage surgery for implant placement

Answer 36

surgical protocol consisting of placing an endosseous root-form dental implant in bone and leaving it in contact with the oral environment during the healing process

Question 37

two-stage surgery for implant placement

Answer 37

surgical procedure consisting of exposure of a submerged dental implant platform to the oral environment by the connection of an abutment which extrudes through the soft tissues

Question 38

immediate implant placement

Answer 38

placement of dental implant at the time of tooth extraction into extraction socket

Question 39

socket preservation

Answer 39

augmentation of residual alveolar socket at time of tooth extraction ...also known as socket augmentation and ridge preservation

Question 40

rationale for socket preservation

Answer 40

an attempt to reduce dimensional changes of ridge, promote bone formation, minimize horizontal ridge resorption, and ultimately reduce or eliminate the need for further ridge augmentation

Question 41

osseointegrated implants are ankylosed to surrounding bone without PDL which provides what?

Answer 41

mechanoreceptors shock-absorbing fxn and adaptation through remodeling

Question 42

what is the most commonly used implant?

Answer 42

threaded root-form

Question 43

common implant diameters

Answer 43

range from 3.3 to 5.0 mm

Question 44

common lengths of implants

Answer 44

7-15 mm

Question 45

piezoelectric bone surgery

Answer 45

surgical technique using an ultrasonica device operating at a modulated frequency that is designed to cut or grind bone but not damage adjacent soft tissues

Question 46

anatomic considerations for implant in maxilla

Answer 46

1. max sinus 2. nasopalatine canal 3. floor of nose and nasal spine 4. greater palatine and pterygoid vessels

Question 47

anatomic considerations for implant in mandible

Answer 47

1. sublingual vessels 2. mental n 3. inferior alveolar n 4. incisive branch of inferior alveolar n 5. genial tubercles

Question 48

in order to avoid the inferior alveolar n and mental foramen, how much space should be left to safely place an implant in the mandible?

Answer 48

2 mm between implant and coronal aspect of nerve

Question 49

the heat generated during drilling site for implant placement must be less than what?

Answer 49

47 Celcius

Question 50

what happens if the heat generated during drilling site for implant placement exceeds 47 degree Celcius?

Answer 50

irreversible necrosis of bone tissue after preparation of implant site

Question 51

conditions that mandate implant removal?

Answer 51

1. persistent pain on palpation, percussion or fxn 2. horizontal and/or vertical mobility 3. uncontrolled progressive bone loss 4. uncontrolled purulent exudate 5. more than 50% bone loss around implant

Question 52

criteria for a successful outcome with implant placement

Answer 52

1. implant is immobile and fxning 2. no radiographic evidence of radiolucency 3. vertical bone loss is less than 0.2 mm annually following the implant's first year of service 4. implant has an absence of persistent and/or irreversible signs of periimplantitis or pain 5. patient and clinician are satisfied with treatment outcomes

Question 53

connection between natural teeth and bone

Answer 53

bone, PDL, cementum with PDL insertion into bone and cementum

Question 54

connection between implants and bone

Answer 54

osseointegration (bone grows to implant with ankylosis and no PDL)

Question 55

junctional epithelium (epithelial attachment) of natural teeth

Answer 55

hemidesmosomes and basal lamina (basement membrane)

Question 56

junctional epithelium (epithelial attachment) of implants

Answer 56

hemidesmosomes and basal lamina

Question 57

connective tissue attachment (suprcrestal attached tissues) of natural teeth

Answer 57

collagen bundles (many groups) inserting into cementum

Question 58

connective tissue attachment (suprcrestal attached tissues) of implants

Answer 58

no attachment of collagen to implant surface

Question 59

probing depths in health of natural teeth

Answer 59

up to 3 mm

Question 60

probing depths in health of implants

Answer 60

varies (up to 5 mm depending on implant placement and abutment length)