Implants_7th May_8am Flashcards
What is one stage and two stage implant surgery?
One stage is used with abutment screws (screw is visibly sticking out of gingiva)–>thus no need to do another surgery to re-expose
Two stage is used with cover screws (screw is buried under gingiva which is stitched up over the top), thus a second surgery is required to re-expose it (done in anterior region for aesthetics)
What do you have to consider in terms of implant diameter?
-Have to have bone all around implant to facilitate osteo integration
If there is only a thin amount of bone around base of sinus, what are the options to avoid piercing sinus?
- Shorter implant
- Sinus lift + bone augmentation
- Onlay/inlay graft
In which area do you never put implants and why?
Lower 6’s, this is where inferior alveolar nerve starts to curve.
Symphysis area: You will fracture the jaw
What is the minimum number of implants that you can do (and still make it worthwhile)?
If absolute worst 2 implants lower, 4 upper
More ideally 4 lower, 6 upper as better stability
Define osteointegration
Direction functional and structural connection between living bone and load bearing carrying implant, seem to have junctional epithelium
What is the difference periodontally between implant and natural tooth? What implications does this have?
Natural tooth has periodontal ligament, implant does not, works via osteointegration instead, therefore there is no feeling in the implant. Thus, advisable to put it against opposing arch natural tooth to get some feeling
Is a rough implant better or a smooth implant, why?
Rough: better osteointegration, allows shorter implants
T/F Denser bone causes better osteointegration
T (better to place implant into type i or type ii bone)
What should you consider when assessing your patient for suitability for implants?
MHx (undisturbed wound healing, jaw growth completed before implant insertion unless for special reasons e.g. ortho otherwise will cause infra-occlusion)
What are some factors you have to consider that may disturb wound healing?
- Diabetes
- Heavy smoking (>10)
- Radiotherapy patient (irradiated bone may cause vascular fibrosis and thrombosis)–>waiting time after therapy recommended
- Bleeding disorders (haemorrhage or drug induced anticoagulants)
What are some temporary contraindications to implant therapy?
- Insufficient bone volume
- Untreated periodontitis (infection will just result in peri-implantitis)
- Residual root (source of infecdtion)
- Local infection
What are some local risk factors for implant failure?
Erosive and bulbous disease: (autoimmune disease)
Xerostomia
Bruxism
What should you inform your patient for consent?
Treatment alternatives
Risks: damage to adjacent structures, immediate or post op complications (soft tissue diheisences, peri implantitis, fracture of implant)
Long term prognosis
Cost
*Implant treatment is lengthy and needs ongoing commitment
What radiographs should you always take for implants?
OPG (can show tilting of roots which may resorb if you put an implant through them)
