Implants - Lecture 4: Radiologic Assessment Options Flashcards
What are the 3 things imaging helps with pre-operatively?
Assessment
Design
Planning
What part of pre-operative?
Acquisition and display
Site assessment, limiting anatomy & pathology
Assessment
What part of pre-operative?
Prosthetic and surgical integration
Implant selection and prosthetic design
Design
What part of pre-operative?
Radiographic and clinical integration
Translation of plan to clinical environment
Planning
How much bone volume does an implant need in the anterior and posterior?
Anterior = 2mm
Posterior = 1.5mm
(on each side of the implant)
What are the 3 most important things to assess when “planning”?
- Bone volume
- Bone quality
- Pathology
What is the best and worst quality of bone?
Best = Type 2
Worst = Type 4 (thin cortical plate, sparse trabeculae)
What vital structures encroach on the residual alveolar ridge for the maxilla?
Sinus
Nasopalatine canal
What vital structures encroach on the residual alveolar ridge for the mandible?
Mental foramen
IAN canal
What are the 4 prosthetic space requirements to consider when looking at “design”?
Inter-coronal space
Oro-facial space
Inter-radicular space
Inter-occlusal space
Allow for soft tissue, abutment, metal, restorative material, +/- cement
Fixed inter-occlusal space
How much fixed inter-occlusal space is needed for the anterior and posterior?
Anterior = 10-12 mm
Posterior = 8-9 mm
Allow for soft tissue and adequate abutment/prosthetic thickness
Removable inter-occlusal space
How much removable inter-occlusal space is needed for the bar and attachment?
Bar = ≥ 15 mm (ideal is 15-17 mm)
Attachment = ≥ 7mm (ideal is 10-12 mm)
Used to assist in the preparation for and
the placement of implants. It dictates drilling position and angulation
Surgical guide
What are the 3 things imaging helps with peri-operatively?
Guided implant placement
Calibrated measurements
Single site implant placement
What are the 5 things imaging helps with post-operatively?
Monitor osseointegration
Immediate or delayed review of implant position
Establish osseointegration failure
Bone augmentation prior to implant retrieval
Graft success
What are you looking for when monitoring osseointegration?
Bone-to-implant surface
Marginal bone level stability
What are the 4 criteria for radiographic success of an implant?
Subjective (pt satisfaction)
Prosthetic
Peri-implant soft tissue
Implant (absence of pain, mobility, infection, radiographic)
What are the crestal bone loss measurements when determining if an implant was successful at 1 year and beyond?
At 1 year: < 1.5 mm crestal bone loss
After 1 year: < 0.2 mm annual crestal bone loss
What X-Ray system has the highest resolution of all modalities?
Digital intraoral
