Intro to Implant Dentistry Flashcards
% US pop 18yo+ fully dentate;
30%
Functional dentition:
21+ natural teeth
% of US pop 21+ w functional dentition:
71.7%
% of US pop 50+ w functional dentition:
42.4%
State w lowest rate of edentulism:
hawaii (16%)
State with highest rate of edentulism:
Kentucky (44%)
Most commonly missing tooth type:
molars
In which arch is reer-end edentulism more common:
mandible
1 out of __ in US pop have removable prosth:
5
% of US pop missing at least 1 tooth:
70%
2 main issues with free-end edentulism:
lack of stability, poor masticatin
Edentulism is __ times more common in which arch?
35, maxilla
% of US pop edentulous in 1 arch:
7%
% of US pop totally edentulous:
10.5%
2 primary reasons for tooth loss:
caries, pdd
Benefits of implants;
bone preservation/ regeneration, functional benefits, comforting benefits, pt satisfaction and quality of ife, esthetics, preservation of the biological env
Why does bone need stimulation:
to maintain form and density
% initial bone loss w placement of implant:
25%
Implants can be splinted via:
ridges
How to preserve bone height and width most effectively:
immediate implant placement
TF? Implant fixed dentures can not preserve bone.
F. and regeneration for some
If pt has this disease you can’t do implant.
patient has severe, uncontrolled diabetes, bridge avg life is 10-15y max
Why is age such an important factor to consider when deciding whether to recommend RPD for a pt?
an RPD will wear on a tooth over time and will eventually need replacing, each time you prep more tooth structure
Could a person theoretically change Bone type in a region of the mouth by exerting more masticatory force in that area?
ask check
Better option for person w sever bone loss?
implants, a very large denture may break the jaw
Max biting force implant overdenture vs. implants:
75N to 132 N
IOD sf:
implant overdenture
TF? Implants improve digestion over complete dentures
T
Max biting force Implant Fixed Complete Denture vs. implants:
250N vs. 132N
Benefit of implant over prosth:
less pain, less instability, most pts think operation is comfortable
Esthetic benefit of implants over dentures:
teeth better positioning, enhanced facial esthetics, better color matching
Appearance due to loss of VD:
prognathic
Esthetics consequences of edentulism:
prognathic appearance, thinning of the lips (esp max), dec facial ht, dec horizontal labial angle, loss of tone in muscles o facial expression
This allows for us to create proper lip height and lip protrusion even if there is a lot of bone loss:
bar connecting the series of implants that is higher than the most coronal portion of the implant
Preservation benefits of implants:
adjacent teeth are not prepped, less likely to cause caries, higher level of perio health, better gingival appearance and health
Potential issue w placing a conventional FPD in the esthetic zone:
margins may show w recession
This must be done first to place an implant if a tooth has never erupted:
bone grafting, or possibly do both at the same time
Skinny implant diameter:
33/3.5, ideal for 24/25
Placement of #3 implant
just below sinus
Implants are made of:
alloplastic material(s)
Diameter of mini implants:
2.3 and below
mini implant placement:
through soft tissue, above or 3,4,5,mm
Tissue level implant: (check)
screw portion buried in bone, part flares out at level of mucosa, glossy and polished, stays at mucosal height, does not protrude into oral cavity
Thin layer covering the bone:
periosteum
implant that gets primary support by resting on bone:
eposteal
implant in alveolar and/or basal bone and transecting only 1 cortical plate:
endosteal
implant that penetrates both cortical plats and passes through the full thickness of the alveolar bone
transosteal/ transmandibular
most commonly used type of implant:
endosteal
Eposteal, aka:
subperiosteal
Transosteal, aka:
transmandibular
2 types of endosteal implants:
plate form (blade implants), root form (root shaped)
Implants used primarily for edentulous arch:
eposteal, transosteal
Type of implant that looks like a cork-screw in bone:
endosteal root form
Type of implant that has a long span, horizontally positioned RGO metal piece:
endosteal blade implant
Are endosteal blade implants an option for a person w severe bone loss?
yes
Location of implant on weblike full coverage maxillary RGO structure:
bw periosteum and bone, submaxillary implant
submaxillary implant:
bw periosteum and bone
To identify transosteal:
implant protrudes below the mandible
Transosteal transect both ot these part of the bone:
coronal and apical cortical plates (check)
Osseous integration depends on:
quality of the bone
Define osseointegration:
bone to implant w/o CT bw
sits between bone and periosteum (makes new bone w osteoblasts), so there will be a thin layer of bone above the implant:
eposteal
TF? Root form endosteal implant will lead to oseointegration.
T
Implants req these 2 things for osseointegration anchorage and retention:
mechanical retention, bioactive retention
This provides bioactive retention:
hydroxyapetite, bond directly to bone
Provides mechanical retention:
metallic substrate (Ti or alloy) w UC’s like vents, slots, dimples, screws in direct contact w bone and no chemical bonding
How to get 100% bone contact in implant interface:
impossible
TF? Successful implant requires CT bw bone/implant interface.
F!!!
__mm of bone undergoes necrosis after implant placement.
1mm
What type of bone undergoes necrosis after implant placement
cortical bone, spongy bone aroundt he cortical bone
How long does it take or bone to start growing after implant?
right away
Cause of initial bone loss with implant placement:
drilling, thermal and mechanical trauma
Fibrous integration leads to:
failure of implant
2 major causes of implant failure:
bac bw implant and bone, implant too small
SIze of hole in relation to size of implant:
smaller, usually 0.5mm, mechanical retention is our first
How to prevent bac:
OHI for implant
periodontitis of an implant:
Perimplantitis, leads to implant failure
What happens to hematoma that forms bw bone/ implant interface?
transformed to new bone through calous formation
Damaged bone undergoes these 3 processes;
revascularization, demineralization, reminarlization
Remodeling of bone begins when:
loading begins
Non-mineralized CT of implant failure is a kind of:
pseudoarthrosis that forms in border zone of implant
Durability phase, aka:
loading period
Strength phase, aka:
healing period
Stabilization phase, aka:
placement
drilling into bone is called:
osteotomy
osseointegration process takes:
allow 2-3mo
There is a high level of bone maturation during htis phase:
Loading period/ durability phase
These form and adhere to the implant surface during the stabiliazation phase:
subendosteal and subperiostical calluses
When is weak woven bone formed:
6wks
Cells that replace non-vital bone with lamellar, weight bearing bone:
osteoclasts
TF? Assuming implant continued success, a pt will remain in the durability phase for life.
T (check)
All screw shaped implants are:
root form (check)
Found at the Interface of healthy bone and titanium implants
titanium oxide
Cells in bone that face the titanium interface:
osteocytes
Mucoperiosteal-Implant interface:
implants establishes CT seal
What does the mucoperiosteal-Implant interface prevent?
the ingress of oral toxins and bacteria, initial tissue inflammation around site
The mucoperiosteal-Implant interface, an epi seal, is similar to:
gingival tissues and has a a sulcus
Tissue type of the mucoperiosteal-Implant interface:
non-keratinized, 3-4mm deep
thin biotype mucusa
1-2mm sulcus
thick biotype mucosa:
3-4 mm sulcus
When drilling in bone, always use this type of irrigation:
sterile saline
Causes of failure:
premature loading, apical migration of JE to interface, placed w too much pressure, overheating, loose
Healing time for Man implant
ait 3 mo
Healing time for maxillary anterior implant
softer bone, 4mo
check
Healing time for maxillary posterior
6mo (check)
RPM to use for final phase of implant placement:
15-30 RPM
If the implant moves more than __um, it was probably due to premature loading
28
RPM for drill in anterior mandible:
1000 RPM
Mean % implant loss in Type 1-3 bone:
4%
Mean % implant loss in Type 4 bone:
16%, posterior maxilla
What does the screw screw into:
abutments
what is on the onther side of the screw than the abutment:
crown
What fits intot he implant?
abutmante
What does the inside of the implant look like?
post inside is hollow with thread
Amt o clearance needed for clearance from the occlusal plane for the implant crown:
2mm
of surgical stages for a tapered wall implant:
2
of surgical stages for a straight walled implant
1
List the surgical stages for tapered walled implant:
cover screw, then healing abutment
Cork screw and healing abutment:
Healing abutment in implant, similar diameter of implant, suture flap around abutment, will see emergence profile and embrasure spaces with 1st stage
Type of implant we use:
internal Hex, abutment in implant
Types of hex:
internal, external
Types of abutments:
engaging, non-engaging
Type of abutment required for single teeth:
engaging, does not allow for rotational movement
When to use non-engaging abutment:
when position does not need to be completely fixed
What is engaged when we say engaging abutment:
the hex
Go with this type of implant if implant is placed in the wrong direction:
non engaging, gives you freer range of motion
Types of abutments:
standard, fixed, angled, tapered, nonsegmented or UCLA
What type of abutment is the standard?
screw-retained crown
What type of abutment is the fixed?
cemented crown
What type of abutment is the angled?
cement or screw-retained crown
What type of abutment is the tapered:
screw-retained crown
What type of abutment is the nonsegmented or UCLA:
screw
inclination of a tooth that can be fixed with a non-engaging abutment:
30’ (check)
1 reason why %#8 and 9 are so hard to restore;
must preserve incisal papilla, black triangle, won’t grow back
MD dimesion requred to restore 8:
6-7mm
How to visuallze needed angulation of teeth:
whte stripe material on wax up to do RG template, appears RGO, take cephalometric
Color of surgical template:
clear
What is the surgical guide?
Clear rg guide w a hole in the occlusal surface to direct surgeon
Endoseos implant materials;
titanum, HA (tribasic calcium phosphate), glass ceramic
subperiosteal implant material:
Co-Cr-Mo
Brittle endoseous material:
glass sercamis
Material that can be used for implants:
ti, Co-Cr-Mo, HA (Tribasic calcium phosphate), glass ceramic, zirconium, polymeric materials
Adv of Ti as implant material;
biocompatible, corrosion resistant, light weight, low density, low modulus, high tensile strength
If a metal is corrosion resistant it will form:
oxide layer (check) Ti, does
CPT sf:
commercially pure titanium
Grades of CPT:
1-4
What is the difference in grades of Ti?
ultimate tensile strength and amt of oxygen and iron
WHich has higher tensile strength, CPT or CP4 ot Ti-6AL-4V?
Ti (240MPa, 550MPa, 930 MPa)
