Implants Patient Assessment

Question 1

what are the patient related factors?

Answer 1

oral hygiene, compliance

Question 2

what are the patient medical factors?

Answer 2

medical fitness, medication, radiation treatment, growth

Question 3

what are the site related factors?

Answer 3

periodontal status, access, pathology near implant site, previous surgeries at the site

Question 4

what are the urgical complexity?

Answer 4

timing of implant placement
simultaneous or staged grafting procedures number if implants

Question 5

what is the tool used for planning?

Answer 5

international team for implantology tool
ITI

Question 6

what anatomical factors are important?

Answer 6

bone
soft tissue
site
adjacent teeth
aesthetic risk assessment

Question 7

how much bone is required horizontally?

Answer 7

7mm

Question 8

how much bone is required vertically?

Answer 8

8-10mm

Question 9

what tissue type is best?

Answer 9

thick keratinised biotype

Question 10

what width of keratinised tissue is associated with lower alveolar bone loss and improved soft tissue health?

Answer 10

greater than 2mm

Question 11

less keratinised tissue is associated with?

Answer 11

higher plaque and gingival inflammation levels

Question 12

what diseases can thin biotypes lead to?

Answer 12

May lead to peri mucositis - peri implantitis + bone loss.

Question 13

what can happen if recession causes metal collar to show?

Answer 13

easily harbors bacteria as rough impant coated surface - leads to recession of gingiva and threads –> peri implantitis.

Question 14

what happens to bone when you lose teeth?

Answer 14

flattens and nothing to support tip of the papilla.

Question 15

what 4 main anatomical factors in bone need to be considered?

Answer 15

shape - knife edge ridge, undercut
maxilary antrum
IDC + mental foramen
feeder blood vessel

Question 16

how many classifications of bone are there?

Answer 16

4

Question 17

describe classification 1 of bone?

Answer 17

found anterior part of mandible
mostly cortical bone
primary stability + less mobility of implant

Question 18

describe classification 2 of bone?

Answer 18

mix of cortical and trabecular bone
primary stability + less mobility of implant

Question 19

describe classification 3 of bone?

Answer 19

more trabecular bone, less stable

Question 20

describe classification 4 of bone?

Answer 20

most trabecular bone
found in maxilla
least stable

Question 21

how many weeks required for class III and class IV bone stability?

Answer 21

12 weeks

Question 22

how many weeks required for class I and class II bone stability?

Answer 22

6 weeks

Question 23

what radiograph is gold standard

Answer 23

CBCT

Question 24

why take radiographs

Answer 24

assess bone, quality of adjacent teeth and position of IAN canal and antrum.

Question 25

what is the safety zone?

Answer 25

takes into account that the coronal aspect of the mental foramen is 2 mm above the inferior alveolar/mental nerve.

Question 26

what distance is required from implant shoulder - adjacent tooth?

Answer 26

A minimal distance of 1.5 mm from the implant shoulder to the adjacent tooth at bone level (mesial and distal) is required.

Question 27

what distance is required from implant shoulder - adjacent implant shoulder or the centre of each implant?

Answer 27

A minimal distance of 3 mm between two adjacent implant shoulders (mesiodistal) is required or 7 mm between the centre of each implant

Question 28

what may need recontouring?

Answer 28

knife edge ridges
mandibular tori
undercuts

Question 29

what can be done if large bone volume is lacking?

Answer 29

onlay grafts
inter-positional grafts – make space between palatal shelf or buccal shelf.
Plasma Rich Fibrin sticky bone

Question 30

what can be done if there is a large sinus?

Answer 30

sinus lift

Question 31

can we refer pt for implants if there is active disease?

Answer 31

no - does not fit the guidelines

Question 32

if pt has old dentures and wants implants, what would you do?

Answer 32

Need to make dentures first then maybe refer pt for implants if she does not get on well with them

Question 33

would trauma that occured 20yrs ago enable NHS implant referral?

Answer 33

no - trauma not significant

Question 34

what is an absolute contraindication for dental implants on NHS?

Answer 34

SMOKING

Question 35

How often would pt’s with xerostomia need implant cleaning?

Answer 35

every 3 months