Introduction to implant dentistry

Question 1

How many people in the US have full dentition?

Answer 1

only 30% of US population of 18+ year olds have full dentition (Does not include third molars)

Question 2

What is the accounts as functional dentition?

percentage of 20 year plus? 50 plus? What state has highest rate of edentulism which state has the lowest?

Answer 2

Presence of 21 or more natural teeth has been used as an international marker for a functional dentition

Eat, speak, socialize without disease discomfort or embarrassment

20 years and older – 71.7%

50 and older -42.4%

Hawaii – lowest rate of edentulism (16%)

Kentucky –Highest rate of edentulism (44%

Question 3

What are th most common missing teeth? Free end edentulism is more common in maxillary or mandibular? Whats the population of people that have a removable prosthesis?

Answer 3

Most common missing teeth: molars

Mandibular free end edentulism is greater than maxilla-the mandibular most posterior teeth are missing- cantilever. 35 times more frequent than maxilla

1/5 of the US population have a removable prosthesis

70% of the US population is missing at least 1 tooth

Question 4

What are the primary reasons of tooth loss?

Answer 4

• Carries

- Periodontal disease

Question 5

What are the 6 benefits of implant dentistry?

Answer 5

Bone preservation/regeneration 
Functional benefits
Comfort benefits
Patient satisfaction and QOL
Esthetics
Preservation of the biologic environment (adjacent teeth not prepared)

Question 6

How do implants work to preserve the bone?

Answer 6

Bone requires to be stimulated in order to maintain or regenerate.
Implants help preserve bone height and but when no teeth are present bone is lost. immediate placement of implants will present the bone height and width. Implant fixed complete dentures preseverve bone for some and regenerate bone for others.

Question 7

What are the functional benefits of implants?

Answer 7

Fewer problems, chewing, eating, kissing, speaking

• Increase biting force
• decrease chewing time and stroke

Question 8

What are the difference between bite forces between Implant fixed complete dentures vs complete dentures?

Answer 8

IFCD (250N) CD only 80N of bite force

Question 9

What are the comfort benefits of implants?

Answer 9

less pain and more stable.

Question 10

How does it affect patient overall health?

Answer 10

Significant attitude improvement

• Better psychological benefits
• More comfortable smiling
• Less oral anxiety

Question 11

What are the esthetics benefits of implants?

Answer 11

• teeth can be better positioned
• better facial esthetics
• Color match is also better

Question 12

How do implants dentistry preserve the biological enviroment of the oral cavity?

Answer 12

• saves the adjacent teeth from being prepared or putting too much pressure on them
• Usually better periodontal health
• gingiva looks better and healthier

Question 13

What is an implant?

Answer 13

A device made of a alloplastic materials

• implanted beneath the mucosal or periosteal layer within the oral tissue
• provides retention, support for fixed or RDP by being placed, on or withing the bone

Question 14

What are the classification of implants? how are they classified?

Answer 14

• Implants are classified on the type of anchor component in relation to bone.There are 4 types:
• Eposteal (Subperiosteal implants)
• Endosteal ( Transmandibular) ( plate form aka blade implants)
• Endosteal root form (State of the art)
• Transosteal

Question 15

What is an eposteal implant?

Answer 15

Device placed rests upon th ebone under the periosteom

Question 16

What is an Endosteal implant?

Answer 16

Device placed in the alveolar or basal bone transects only 1 cortical plate

Question 17

What is transosteal implant?

Answer 17

The device will penetrate the cortical plate and passes through the full thickness of the bone. (transmandibular)

Question 18

What is osteointegration?

Answer 18

attachment of osseous tissue to alloplastic material without innervation.
-Depends significantly on the quality of the bone

Question 19

Whats the different ways of integrating implants?

Answer 19

Osseointegration and biointegration

Question 20

What does it mean by biointegrating an implant?

Answer 20

to have bioactive features such as hydroxyapatite on the outside making it bond better.

Question 21

what is the mechanism for oseointegration?

Answer 21

never 100% bone implant contact.

• a small amount of bone goes through necrosis after implant
• Interface of bone and implant begin to develop then
• if implant is lose then its failed and there is no oseointegration

Question 22

What are the steps of interface development?

Answer 22

• Stabilization phase
• Strength phase
• Durability phase

Question 23

What is the stabilization phase?

Answer 23

-weak woven bone formed within 6 weeks to adhere implant surface

Question 24

What is the strength phase?

Answer 24

replacement of weak no vital bone with strong lamellar bone

Question 25

What is the durability phase?

Answer 25

extensive remodelling occurs. strength is enhanced for the patient as time goes by

Question 26

What is the mucoperiosteal interface?

Answer 26

• Implants establishing CT seal to prevent the ingress of oral toxins and bacteria
• critical to educate patients about how to keep implants clean to avoid bacteria accumlating

Question 27

What are the causes of osseointegration failure?

Answer 27

• Pre mature loading so usually have to wait 3-6 months.
• too much occlusal load
• too much pressure when placing implant
• too much heat will cook the bone so gotta go on low rpms
• Loose fitting of implant

Question 28

What are the different bone types?

Answer 28

Posterior mand- type 2

Anterior mand- type 1

Anterior max- type 3

Posterior max-type 4 (balsa wood)

Question 29

What are the effects of bone quality on implant failure and longevitiy?

Answer 29

only 113/3192 implants failed in bones types I-III (4%)
-160/1009 of implants in type IV bones lost (16%)
More likely to faile in type IV bone

Question 30

What are the parts of an implant?

Answer 30

-Crown
-Screw
-Abutment
-Implant
The diameter of the implant is most important depending on the tooth you’re replacing

Question 31

What are the surgical stages?

Answer 31

two stages! inicial incision, move gum and osteotomy -length (same as implant but slightly narrower diameter. . cover the screw and close flap wait 6 month open it and place healing abutment and then expose again and place the implant when ready

Question 32

The one stage surgical method

Answer 32

Incision, move gums, osteotomy prep, place implant and no neeed for second surgery

Question 33

Whats the difference between externa and internal Hex?

Answer 33

Most modern ones/better results from internal hex

We use internal hex- abutment sits inside the implant

Question 34

What are th differences between engaging or none engaging abutments?

Answer 34

For single teeth it must be an engaging abutment

Engaging abutment: only goes in one position, doesn’t allow for the implant to rotate

Nonengaging: if you place something that’s not parallel (non parallel abutments)

No hex, more rounded, seats completely

Not an absolute fixed position, used for bridges

Question 35

Whats the minimal distance between two implants?

Answer 35

3 mm between two implants and 1.5 between implant and tooth !!!!!

Question 36

Why is a surgical template or radigoraphic template important?

Answer 36

Allow surgeon to place implant where you want

determine bone location and dimension