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Implant > Implants In The Esthetic Zone > Flashcards

Implants In The Esthetic Zone Flashcards

1
Q

No difference in survival rate of implants with regards to their anatomical location

A

Eckert and wollen

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2
Q

Henry and colleagues : multicenter study - success rate of ____ in anterior maxillary. However esthetic failure rate _____ in these areas

A

96%
9%

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3
Q

What do you need to understand when placing an implant in an esthetic zone

A

Biological principles
Anatomic principles
Surgical principles
Prosthetic principles

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4
Q

It has been suggested that implants should be placed only after the age of __ in females and ___ in males to avoid problems caused by further skeletal growth

A

15
18

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5
Q

_____ last to grow
______ skeletally mature faster than _____

A

Premaxilla
Females
Males

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6
Q

What does some evidence show with continuous vertical growth of the maxilla?

A

Continuous growth after age 18 - issue not totally resolved

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7
Q

What is necessary to evaluate growth plate fusion ?

A

Wrist x ray
Lateral cephalometric radiograph

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8
Q

Mandible

Pattern of bone growth may bring about _____ positioning of the implant in case it is placed _____
Increase in mandibular length is limited to the ______ _____ _____ to accommodate the permanent molars

A

Lingual
Early
Primary second molars

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9
Q

What is the most ideal anatomical lip line

A

Low

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10
Q

Alveolar ridge

A

Adequate width

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11
Q

Status of mucosa

A

Loss of architecture of gingival and its papilla due to loss of tooth — can lead to black triangle

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12
Q

What type of soft tissue is more prone to recession ?

A

Thin and scalloped gingival margin (compared to thick and flat gingival phenotype)

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13
Q

Soft tissue thickness (phenotype)

A

Thick is more ideal !

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14
Q

Keratinized tissue

A

Minimum of 2mm KT required for implant and or tooth

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15
Q

Mucogingival junction symmetry

A

Esthetics

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16
Q

Presence/absence of papilla/black triangle

A

Tissue shaping with provisionals

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17
Q

Which garber class is more ideal

A

Garber class I

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18
Q

Favorable horizontal and vertical levels of both soft tissue and bone are present

A

Garber class I

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19
Q

No vertical bone loss and slight 1-2 mm horizontal bone deficiency

A

Garber class 2

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20
Q

No vertical bone loss and horizontal bone loss greater than class II (2mm)

A

Garber class 3

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21
Q

No vertical bone loss but significant horizontal loss
Crater defect/depression

A

Garber class 4

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22
Q

Sites with extensive apicocoronal (vertical) bone loss present
A significant challenge to the surgeon

A

Garber class 5

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23
Q

4 main factors directly affect the esthetic outcome of implant supported restorations

A

Implant placement
Soft tissue management
Bone grafting considerations
Prosthetic considerations

24
Q

Flap design for surgery

A

Conservative
Flap should be jagged
Only when necessary - can destroy blood supply

25
Q

Implant placement

A

Implant position
Implant size

26
Q

Too buccal position

A

Dehiscence and gingival recession

27
Q

Too palatal position

A

Improper restoration, not hygienic, not ethic

28
Q

Where must the centerline of the implant be located

A

At or near the center of the tooth it replaces
Buccal aspect of implant platform just touches imaginary line that touches the incisal edges of the adjacent teeth

29
Q

Patients presenting with a thin gingival bio type

A

Palatoversion is desirable
Prevents showing of metal collar

30
Q

Distance between implant-tooth

A

1.5 mm at least

31
Q

Distance between implant -implant

A

3 mm at least

32
Q

___ mm inter implant distance prevents overlap of horizontal bone loss (saucerization) between implants (maintains papilla)

A

3

33
Q

In the case of max central incisor site, may be desirable to place the implant slightly to the _____ to mimic the natural asymmetry of the gingival contour often seen in these teeth

A

Distal

34
Q

Most apical point of clinical crown. Generally distal. Lateral - exception and are in the center

A

Gingival zenith

35
Q

Ideal apico-coronal position

A

3-4 mm apical to adjacent CEJ
Use gingival margin in case of recession
Allows for running room for emergence profile - easier to clean

36
Q

What does implant size selection depend on

A

Dimension of the edentulous crest
Proximity of adjacent roots
Final restoration - molar vs mand central incisor, canine, max central incisors
Maintain at least 3 mm inter implant distance at the crest

37
Q

Distance between the underlying interproximal alveolar crest heigh on the adjacent natural teeth and the final prosthetic contact point dictates the presence or absence of _______ ________

A

Interdental papilla

38
Q

If the distance is more than _____, the complete papilla formation will be compromised. Often leads to _____ ____

A

5 mm
Black triangle

39
Q

Average height interdental papilla between adjacent implants

A

3.4 mm

40
Q

What can papillary height be influenced by

A

Spacing between implants
Placement of the contact point

41
Q

Type 1 - immediate

A

Immediately after ext

42
Q

Type 2- early

A

4-8 weeks later (soft tissue healed)

43
Q

Type 3 - early delayed

A

12-16 weeks later (bone formation in clinical and Radiographic evaluation)

44
Q

Type 4 - delayed

A

More than 16 weeks

45
Q

Following tooth removal, a considerable amount of ____ _____ takes place in both ____-_____ or ______-_____ dimensions

A

Ridge collapse
Buccal -lingual
Apical-coronal

46
Q

An average of ____ - _____ original height and width is expected to be lost after tooth ext with the greatest loss happening within the first ____ years

A

1/3rd
1/5th
2

47
Q

Width loss without ridge preservation

A

30-35%

48
Q

Width loss with ridge preservation is

A

15%

49
Q

Buccal bone in esthetic zone is primarily made of ____ _____ ____. Function is to attach ____ _____. Following ext , most buccal bone is ____

A

Cortical bundle bone
PDL fibers
Lost

50
Q

As the bone thickness in buccal are approached ____ to ____, bone loss decreased significantly, and some evidence of bone ____ was seen

A

1.8
2 mm
Gain

51
Q

Implant angulation

A

Mimic adjacent teeth

52
Q

Poor angulation can

A

Alter screw access hole - post = central fossa, ant = cingulum
Poor esthetic result
Difficult home care
Undesirable cantilevers

53
Q

Optimal esthetic result is achieved only with ideal ____ _____ placement

A

3D implant

54
Q

4 positional parameters contribute to the success of the restoration

A

Buccolingual
Mesiodistal
Apicocoronal position relative to implant platform
Angulation of implant

55
Q

Prosthetic design factors

A

Cement vs screw retained

Implant (10 decks)

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