Implants Patient Assessment Flashcards
what are the patient related factors?
oral hygiene, compliance
what are the patient medical factors?
medical fitness, medication, radiation treatment, growth
what are the site related factors?
periodontal status, access, pathology near implant site, previous surgeries at the site
what are the urgical complexity?
timing of implant placement
simultaneous or staged grafting procedures number if implants
what is the tool used for planning?
international team for implantology tool
ITI
what anatomical factors are important?
bone
soft tissue
site
adjacent teeth
aesthetic risk assessment
how much bone is required horizontally?
7mm
how much bone is required vertically?
8-10mm
what tissue type is best?
thick keratinised biotype
what width of keratinised tissue is associated with lower alveolar bone loss and improved soft tissue health?
greater than 2mm
less keratinised tissue is associated with?
higher plaque and gingival inflammation levels
what diseases can thin biotypes lead to?
May lead to peri mucositis - peri implantitis + bone loss.
what can happen if recession causes metal collar to show?
easily harbors bacteria as rough impant coated surface - leads to recession of gingiva and threads –> peri implantitis.
what happens to bone when you lose teeth?
flattens and nothing to support tip of the papilla.
what 4 main anatomical factors in bone need to be considered?
shape - knife edge ridge, undercut
maxilary antrum
IDC + mental foramen
feeder blood vessel
how many classifications of bone are there?
4
describe classification 1 of bone?
found anterior part of mandible
mostly cortical bone
primary stability + less mobility of implant
describe classification 2 of bone?
mix of cortical and trabecular bone
primary stability + less mobility of implant
describe classification 3 of bone?
more trabecular bone, less stable
describe classification 4 of bone?
most trabecular bone
found in maxilla
least stable
how many weeks required for class III and class IV bone stability?
12 weeks
how many weeks required for class I and class II bone stability?
6 weeks
what radiograph is gold standard
CBCT
why take radiographs
assess bone, quality of adjacent teeth and position of IAN canal and antrum.
what is the safety zone?
takes into account that the coronal aspect of the mental foramen is 2 mm above the inferior alveolar/mental nerve.
what distance is required from implant shoulder - adjacent tooth?
A minimal distance of 1.5 mm from the implant shoulder to the adjacent tooth at bone level (mesial and distal) is required.
what distance is required from implant shoulder - adjacent implant shoulder or the centre of each implant?
A minimal distance of 3 mm between two adjacent implant shoulders (mesiodistal) is required or 7 mm between the centre of each implant
what may need recontouring?
knife edge ridges
mandibular tori
undercuts
what can be done if large bone volume is lacking?
onlay grafts
inter-positional grafts – make space between palatal shelf or buccal shelf.
Plasma Rich Fibrin sticky bone
what can be done if there is a large sinus?
sinus lift
can we refer pt for implants if there is active disease?
no - does not fit the guidelines
if pt has old dentures and wants implants, what would you do?
Need to make dentures first then maybe refer pt for implants if she does not get on well with them
would trauma that occured 20yrs ago enable NHS implant referral?
no - trauma not significant
what is an absolute contraindication for dental implants on NHS?
SMOKING
How often would pt’s with xerostomia need implant cleaning?
every 3 months
