Implants - Lecture 9: Implants in the Esthetic Zone Flashcards
Contrary to missing a posterior tooth, most patients have an ____________ response regarding a maxillary anterior missing tooth
emotional
What is one of the simplest procedures in implant surgery and prosthetics?
Posterior single tooth implant
What is one of the most difficult procedures in implant surgery and prosthetics?
Maxillary anterior single tooth implant
Why do esthetics matter?
Impact on pt satisfaction + quality of life
Role in social + professional interactions
Higher expectations for natural-looking restorations
What is the critical anatomy?
Alveolar bone dimensions/quality
Nasopalatine canal
Gingival biotype
Attempting to place implants in cases with a large ______________ __________ leads to penetration into the canal and a soft tissue interface
nasopalatine canal
Which gingival biotype?
More resistant to shrinkage/recession
Thick gingival biotype
Which gingival biotype?
Periodontal pocket after bone loss
Thick gingival biotype
Which gingival biotype?
More prone to shrinkage after extraction
Thin gingival biotype
Which gingival biotype?
More difficult to augment after extraction
Thin gingival biotype
What are the 3 parts of comprehensive assessment?
Clinical exam
Radiographic analysis
Digital planning
Which part of comprehensive assessment?
Involves smile line and lip dynamics
Clinical exam
Smile line and lip dynamics are important to evaluate when observing the ____________ region
cervical
Clinical results of what 4 things are much less demanding?
Emergence contours
Interdental papilla presence
Shade
Contour
Which part of comprehensive assessment?
CBCT scans for bone assessment
Radiographic analysis
Which part of comprehensive assessment?
CAD/CAM integration
Digital planning
What are the 3 principles of smile design?
Proportion + symmetry
Tooth form, size, shade
Pt’s facial features
Which principle of smile design?
Influence on interproximal contact area and gingival embrasure
Tooth form, size, shade
Which tooth shape is most favorable? Why?
Square
Bc the contact is further apical
Which tooth shape is less predictable? Why?
Triangular
Bc the contact is more incisal
The distance between the underlying interproximal alveolar crest height on the adjacent natural teeth and the final prosthetic contact point dictates the presence or absence of ______________ ______________
interdental papilla
If this distance is more than ____ mm, the complete papilla formation will be compromised, creating a ____________ _____________
5 mm; black triangle
What are 4 anatomical challenges?
Natural tooth size vs implant diameter
Compromised bone height
Compromised mesiodistal space
Compromised faciopalatal width
There are challenges in restoring ______________ esthetics with round-diameter implants
cervical
The reason it is important to evaluate the amount of bone available is because it influences the ________ tissue drape, implant _______ and ___________, and the final esthetic outcome
soft; size; position
Ideally, we want midcrestal bone to be ______ mm below the CEJ
2-3 mm
Ideally, we want interproximal bone to be scalloped ______ mm more _________ than midcrestal
3 mm; incisal
When there is a compromised faciopalatal width, the bone width loss is primarily from the _________ region
facial
When is necessary to restore ridge anatomy when there is compromised faciopalatal width?
Bone graft
Available bone should be at least _____ mm greater than the implant diameter
3 mm
Implants should be:
______ mm below the free gingival margin
______ mm from adjacent teeth
______ mm from buccal bone
______ mm from lingual bone
3 mm; 1.5 mm; 2 mm; 1 mm
What happens if an implant is too buccal?
Dehiscence
Gingival recession
What happens if an implant is too palatal?
Improper restoration
Not hygienic
Not esthetic
What are the risks of too much facial angulation?
Esthetic + functional complications
What are the risks of too much cingulum angulation?
Plaque control is difficult
Challenges with screw retained crowns + facial ridge lap
The implant must be positioned in such a way that the ________ aspect of the implant platform just touches an imaginary line that touches the
________ edges of the adjacent teeth
buccal; incisal
What are 3 common esthetic complications?
Soft tissue recession/loss of papilla
Malposition affecting the smile line
Peri-implantitis
