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Implants - ABGD - Oral Boards > Implants - ABGD - Oral Boards > Flashcards

Implants - ABGD - Oral Boards Flashcards

1
Q

What is some Rationale for Implant Assistance?

A
  • Aging population with various presentations of edentulism: single tooth to full arch
  • Bone/soft tissue loss with tooth loss
  • Diminished dental and facial esthetics
  • Decreased functional performance
  • Negative experience wiht traditional revmovable prosthetic options
  • Psychological aspects of tooth loss
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2
Q

What is the “Stress Treatment Theorem”?

A
  • “Weak links” exist in bone-implant-prosthesis system
  • Various factors stress weaker links and may lead to diminished system survival
  • Diagnosis: Assess stress factors in system
  • Tx Plan: Engineer mechanisms to protect overall system from identified stresses
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3
Q

What is a Biomechanical reason of implant failure?

A

Early Loading

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4
Q

What is a Biomechanical reason for surgical failure?

A

Micromovement

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5
Q

What is a Biomechanical reason for healing failure?

A

Occlusal Trauma - Micro vs Macro overloading

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6
Q

What is a Biomechanical reason for failure after Crestal Bone Loss?

A

Bone Biomechanics - Density

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7
Q

What is a Biomechanical reason for failure from Periosteal Reflection?

A

Cellular Biomechanics - Remodeling

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8
Q

What are 3 additional Biological reasons that fall under the category of Stress Tx Theorem Complications?

A
  • Osteotomy
  • Bacterial
  • Microgap
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9
Q

What are some Stress Treatment Theorem Complications in regards to materials?

A
  • Screw Loosening
  • Component Fracture
  • Implant Body Fracture
  • Acrylic/Porcelain Fracture
  • Framework Fracture
  • Denture Tooth Fracture
  • Acrylic Base Fracture
  • Opposing Restoration Fracture
  • Attachment Wear and Loss
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10
Q

What should you always do when treatment planning an edentulous space?

A

Begin with the end in mind

  • Continuum of impplant assited options and complexity
  • Single tooth to complete reconstruction
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11
Q

What drives prosthesis design?

A
  • Esthetics
  • Phonetics
  • Functional occlusion and guidance
  • CR
  • Vertical Dimension
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12
Q

An appropriately positioned implants is utilized for…

A
  • Support
  • Stability
  • Retention
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13
Q

What are your treatment options for a single tooth Fixed Prosthesis?

A
  • Replaces anatomic crown (crown only)
  • Replaces crown and portion of root
  • Replaces crown, root, gingiva
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14
Q

What are your 2 options for a Removable Implant Supported Prosthesis?

A
  • Removable completely supported by implants
  • Removable supported by implants and soft tissue
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15
Q

What forces are you concerned about when treatment planning implants?

A
  • Overall Forces
  • Lateral Forces
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16
Q

What is a treatment planning challenge for implants in regards to implants?

A

Enginner prosthesis to decrease anticiapted forces

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17
Q

What are some force mamangement issues you should be concerned with when treatment planning implants?

A
  • Parafunction (Bruxism, clenching, tongue thrust)
  • Crown Heigh Space
  • Maasticatory Dynamics
  • Arch Position
  • Nature of Opposing Arch
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18
Q

How do you define the CHS in the Posterior?

A

Occlusal plane to the crest of bone

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19
Q

How do you define CHS for the anterior?

A

Incisal edge to the crest of bone

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20
Q
A
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21
Q

What are your thoughts if you have too little or too much CHS?

A
  • Increase Biomechanical Complications
  • Increase Stress
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22
Q

What is the CHS for Fixed Posterior/Anterior Implants?

A

8-12 mm

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23
Q

What is the CHS for Removable with a bar options?

A

> or equal to 12 mm

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24
Q

What is the CHS for “Hybrids”?

A

> or equal to 15 mm

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25
Q

What does CHS help dictate?

A

Material and Structural Requirements

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26
Q

What are some patient fators in regards to force management?

A

Masticatory Dynamics

  • Age
  • Sex
  • Skeletal positions associated with increase forces
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27
Q

What are some Arch Position considerations related to patient factors in force managment?

A
  • Molar positions incrased force
  • Increased lateral forces with guidance teeth
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28
Q

What are some considerations regarding the Opposing arch related to Force Managment/Patient Factors?

A

Opposing Arch

  • Implant fixed restoration to implant fixed = most forces (4x natural)
  • Opposing natural dentition-greater forces with additional teeth
  • Partial denture - intermediate forces
  • CD - dinished forces
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29
Q

What are the 4 general guidelines for key implant positions?

A
  1. Each arch has 5 segments to guide implant position
  2. Terminal abutments (FDP) are key positions
  3. No more than (2) two adjacent premolar pontics
  4. Canine and 1st molar implants sites are key positions
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30
Q

What do the numbers in this picture represent?

A

Key implant support in each covered segment

31
Q

What implant guideline is this picture demonstrating?

A

Terminal abutments are key positions

32
Q

What imlpant guideline is this picture demonstrating?

A
  • No more than (2) two adjacent premolar-sized pontics
33
Q

What are some considerations in this picture regarding M/D space, laws, etc.?

A
  • 7-8 M-D Pontic
  • Law of Beams
  • Connector Thickness
34
Q

What implant guideline is this picture illustrating?

A

Canine and 1st Molar implant sites are key positions

35
Q

What are some general recomendations regarding Cantilevers?

A
  • Recommendation: do not use
  • Place second implant
36
Q

What are some factors to consider if you do place an Implant Cantilever?

A
  • 4-6 implant splint with 1.5 X A-P spread
  • Max Lateral Incisor with no guidance
37
Q

How man mm between 2 implants?

A

3 mm

38
Q

How many mm between tooth/root and imlant?

A

1.5 mm

39
Q

What are some benefits to Splinting together implants?

A
  • Increases support
  • A-P spread for lateral forces management
  • Decrease cement failure
  • Distributes/decrease prosthesis stress
  • Decrease scew loosening, material fatigue/failure
40
Q

What are some ways you can manage Increased CHS Situations?

A

Strategies to Decrease Forces…

  • Shorten cantilever
  • Minimize B/L offsets
  • Increase # implants
  • Increase dimaeter
  • Splinting
  • Removable Restoration
  • HNG
41
Q

What are some considerations when dealing with decreased CHS situations?

A
  • Insufficient space for restoration components, prosthesis retention
  • Prosthetic material structural durability compromised
  • Absolute minimum dependent on brand
  • All-in-one restoration/metal occlusal/occlusal near screw head
42
Q

Is it a good idea to connect teeth to implants?

A

Not Recommended

  • Can be done
  • Risk tooth intrusion
43
Q

What are some numerical differences in Implant/Tooth mobility in regards to vertical and lateral forces?

A
  • Implant: 2-3 um vertical, 12 um laterally
  • Tooth: 28 um vertical, 58-108 um laterally
44
Q

If you are going to splint an implant to a tooth, what are some splinting guidelines?

A

Splinting to Tooth Guidelines

  • Tooth has no mobility
  • Tooth has favorable support/crn form
  • Final occlusal on tooth/prosthesis occlusal slight vertical contact
  • No lateral forces on prosthesis
45
Q

Are non-rigid connectors a good idea?

A
  • Increase tooth instrusion/movement risk
  • Not recommended
  • Tooth Implant Tooth FPD
46
Q

What are some reasons to strive for Single Tooth Implants?

A
  • Most predictable method for single tooth replacement
  • Adjacent teeth have higher success rates (lower endo, lower perio, lower tooth and porcelain fractures)
  • Maintains bone
  • Easier hygiene
47
Q

What are contraindications for implants?

A
  • Decrase bone volvume
  • Poor candidate for grafting
  • Decrease or Increase Restorative Space (8-12)
  • Time of treatment
48
Q

What factors influence Implant Selection?

A
  • Based upon root anatomy at 2-4 mm apical to labial CEJ
  • Anticipate favorable emergence profile
  • Provide bone support for soft tissue
49
Q

Where does the idealized implant diameter approximate?

A

Approximates the natural tooth at current bone level

50
Q

For proper emergence profile from gingival margin to underlying bone you should have how many mm?

A

3 mm

51
Q

How many mm from the contact to the crest be according to Tarnow in order to avoid black triangles?

A

5 mm

Slide says 4 - 6 mm

52
Q
A
53
Q

How much bone would you like Facial to Implants?

A

1.5 - 2.0 mm

54
Q

If you have some Adjacent Implants - what are some considerations when placing them in the esthetic zone?

How are apart should adjacent implants be?

A
  • Smaller diameter implants in esthetic zone - 3 mm between
55
Q

What is this?

A

Fixed detachable “Hybrid”

56
Q

What is this?

A

Root Supported Overdenture

57
Q

What is this?

A

Implant Supported

58
Q

What is this?

A

Tissue Supported

59
Q

What are some advantages of Implant Assisted Over-Dentures?

A
  • Minimum anterior bone loss
  • Improved facial esthetics
  • Decreased soft tissue abrasions
  • Improved stability, retention, support
  • Improved occlusion, chewing efficiency (20%) and force
  • Improved speech
  • Reduced prosthesis size: gagging
  • Maxillofacial applications
  • Improve access for hygiene
  • Decreased cost
  • Reduced stress
60
Q

What are some Implant Overdenture Advantages vs Fixed Pros?

A
  • Fewer implants
  • Improved esthetics
  • Soft tissue replacement, color
  • CHS
  • Reduced stress
  • Lower cost
  • Transitional device
61
Q

What are thoughts of OD vs. Fixed?

A
  • Psychological need for fixed restoraiton
  • Long term Maintenance/Greater expense for resilient attachments/relines/new prosthesis and professional care
  • Continued posterior bone loss
  • Food impaction
  • Movement
62
Q

How much restorative space do you need for implant overdenture?

A

12 mm

63
Q

How much space do you need for an overdenture with a bar?

A

> 15 mm

64
Q

How much CHS do you need for a Fixed Detachable (Hybrid)?

A

> 18 mm

65
Q

What are some Tx Planning considerations for Overdentures in regards to anatomy?

A
  • Max Sinus/Post bone volume
  • Premaxilla Form
  • A-P spread
  • Catilever-Biomechanical disadvantage
  • Max Bone quality
  • Man posterior bone avilability
66
Q

If tx planning an implant supported man denture, how many implants are you thinking?

A

2-6 implants

  • Defined by…
  • Prosthesis
  • Site Position
  • Bony Anatomy
67
Q

What is the minimum amount of implants for man denture?

A

2 Implants Minimum

68
Q

Where would you place 2 anterior mandibular implants?

A

Position more anterior to minimize fulcrum/rotation

69
Q

What is the first implant supported maxillary denture design?

A

4 - 6 Splinted Implants Minimum

  • Must have A-P spread
  • 3 Minimum in premaxilla (canines key position)
  • Tissue support utilized
70
Q

What is the second design for implant supported maxillary denture?

A

7 - 10 Splinted Implants Minimum

  • Bar/Attachment Supported
  • Key Positions: Canine, 1st Molars
71
Q

In Implant Supported Dentures, what dicates post cantiliver?

A

A-P Spread

72
Q

What are some guidelines for cantilever length?

A
  • 2 - 3 premolars
  • < 20 mm if 5-6 implants used
  • < 15 mm if 4 implants used
73
Q

How do you figure out your A-P spread for Fixed-Detachable Denture?

A

A-P Spread Based

  • 1.5 X A-P Spread
  • 15-20/minimum 10 mm A-P spread
  • Maximum implants, maximum spread

Implants - ABGD - Oral Boards (1 decks)

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