intro Flashcards
- Approximately —-% of adults aged 20 to 64 have no teeth and almost ___% of seniors (above the age of 65) have no remaining teeth.
- Approximately 5% of adults aged 20 to 64 have no teeth and almost 30% of seniors (above the age of 65) have no remaining teeth.
The leading causes for teeth loss are:
The leading causes for teeth loss are caries and periodontal disease.
- Approximately ____% of US adults aged 20-64 had dental caries in 2011-2012, ____% of
which suffered from untreated dental caries.
- Approximately 91% of US adults aged 20-64 had dental caries in 2011-2012, 26% of
which suffered from untreated dental caries.
- Periodontal disease affects —-% of the population between 35-44 years of age and —–% of people over 65 years of age.
- Periodontal disease affects 75% of the population between 35-44
years of age and 95% of people over 65 years of age.
- ____ million Americans are missing at least one tooth, and more than ____ million are currently edentulous, _____ of which in both arches (ACP).
- 120 million Americans are missing at least one tooth, and more than 36
million are currently edentulous, 2/3 of which in both arches (ACP).
success % of implants
95
CD % function restored
30
RPD %function restored
60
Fixed Dental Prostheses (Crowns
and Bridges) % function restored
100% of lost function restored
* Can be tooth or implant supported
Dental Implant
“A prosthetic device or alloplastic material implanted into the oral tissues beneath the mucosal and/or periosteal layer, and/or within the bone to provide retention and support for a fixed or removable dental prosthesis.”
Implant Categories
- Eposteal: on/around the bone
- Transosteal: through the bone
- Endosteal: in the bone
- ■EPOSTEAL - Subperiosteal
■TRANSOSTEAL-Transmandibular
■ENDOSTEAL - Blade and Root Form
subperiosteal implants
metal? supported by? cost? survival? indication? bone?
■Vitallium metal
■Denture is implant supported /expensive
■Survival rate 85% Ten years (Harvard Consensus)
■Indicated for atrophic edentulous mandible.
■Bone resorption leads to mobility infection and loss
transosteal implants
metal?
success?
indicated?
supported by?
requires?
■Titanium metal
■91% Success rate at fifteen years (excellent)
■Only indicated for the edentulous mandible
■Denture is tissue supported
Requires one surgery usually in the hospital.
External incision / approach.
Excellent for the atrophic mandible where root form implants would weaken the jaw.
Complex surgical procedure therefore not widely used.
Restricted to the anterior mandible. (post=IA nn)
transmandibular implants
■% success rate
■used for?
■indication?
■metal?
■Reversible?
■97% success rate
■used for Implant supported denture
■Used in severe atrophic mandibles <10mm
■Gold Alloy, not titanium
■Reversible – can be removed due to design of screws and degree of integration, but not easy process
endosteal implant types
blade implants
metal?
best for?
% survival?
when ceased?
■Titanium metal
■One stage/best for partially edentulous mandibles
■75% five year survival
■Most widely used until 1980
blade implants failures/drawbacks
■Early failures due to heat at preparation and immediate loading
■Drawbacks: Difficult to prepare a precision slot and if it fails, a large section of bone is involved
blade implant
root form implants
success?
indicated?
uses?
■Success rate greater than 90%
■Indicated for partially and fully edentulous cases/any area of the mouth (versatility)
■Multiple uses: overdenture, hybrid, crown and
bridge, ortho anchorage…
root form implants
■ metal(s)?
■ stage approach?
■In office?
■types?
■implant surface types?
■Titanium or an alloy of titanium-aluminum-vanadium metal(s)
■1 or 2 stage approach
■In office procedure
■Screws/Cylinders
■Machined or rough (to increase surface area for integration)
super implants
zygomatic and pterygoid
no need for bone grafting
osseointegration
Brånemark introduced the term osseointegration and defined it
as “a direct structural and functional connection between
ordered, living bone and the surface of a load-carrying implant.”
why use Ti?
■Not recognized as a foreign object by the body
■Less host rejection than other metals/alloys
■Medicine also recognized utilization in joint replacements
and heart valves
impants vs teeth
- Important distinction from
natural dentition - Implants are not teeth and
there is extensive evidence
that they behave differently
implants and dx
Not susceptible to the same disease processes that
affect our dentate patients.
Teeth:
*Caries
*Periodontal disease
Implants:
*Peri-implantitis (bone)
*Peri-mucositis (soft-tissue)
possible implant designs
mainly use two piece due to tx felibility
tissue vs bone level implants
most today are?
tissue level: screw portion in bone and small collar above bone
bone level: only present in bone, none present in soft tissue
most today are bone level, more flexibility
implant platforms
internal vs external hexes
location male and female parts differ
single implant survival rate
94-98
failure % relative to placement of restoration (before vs after placement)
~55-60% of failures occur prior to the placement of the restoration
~40-45% occur after the restoration placement
failure % after placement
time frames
- 57% of the failures occurred in 1st year
- 34% of the failures occurred in the 2nd year
- 9% of the failures occurred in the 3rd year
- 0% after?
bone loss with implants
- Average of 1mm during 1st year
- Average of 0.1 mm each year after
soft tissues with implants
mostly occurs when?
1mm of soft-tissue recession can generally be expected during the first year.
Most of this occurs within the first three months following abutment connection surgery.
