Introduction to implant dentistry Flashcards
Lecture one
How many people in the US have full dentition?
only 30% of US population of 18+ year olds have full dentition (Does not include third molars)
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?
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%
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?
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
What are the primary reasons of tooth loss?
- Carries
- Periodontal disease
What are the 6 benefits of implant dentistry?
Bone preservation/regeneration Functional benefits Comfort benefits Patient satisfaction and QOL Esthetics Preservation of the biologic environment (adjacent teeth not prepared)
How do implants work to preserve the bone?
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.
What are the functional benefits of implants?
Fewer problems, chewing, eating, kissing, speaking
- Increase biting force
- decrease chewing time and stroke
What are the difference between bite forces between Implant fixed complete dentures vs complete dentures?
IFCD (250N) CD only 80N of bite force
What are the comfort benefits of implants?
less pain and more stable.
How does it affect patient overall health?
Significant attitude improvement
- Better psychological benefits
- More comfortable smiling
- Less oral anxiety
What are the esthetics benefits of implants?
- teeth can be better positioned
- better facial esthetics
- Color match is also better
How do implants dentistry preserve the biological enviroment of the oral cavity?
- saves the adjacent teeth from being prepared or putting too much pressure on them
- Usually better periodontal health
- gingiva looks better and healthier
What is an implant?
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
What are the classification of implants? how are they classified?
- 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
What is an eposteal implant?
Device placed rests upon th ebone under the periosteom
What is an Endosteal implant?
Device placed in the alveolar or basal bone transects only 1 cortical plate
What is transosteal implant?
The device will penetrate the cortical plate and passes through the full thickness of the bone. (transmandibular)
What is osteointegration?
attachment of osseous tissue to alloplastic material without innervation.
-Depends significantly on the quality of the bone
Whats the different ways of integrating implants?
Osseointegration and biointegration
What does it mean by biointegrating an implant?
to have bioactive features such as hydroxyapatite on the outside making it bond better.
what is the mechanism for oseointegration?
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
What are the steps of interface development?
- Stabilization phase
- Strength phase
- Durability phase
What is the stabilization phase?
-weak woven bone formed within 6 weeks to adhere implant surface
What is the strength phase?
replacement of weak no vital bone with strong lamellar bone
What is the durability phase?
extensive remodelling occurs. strength is enhanced for the patient as time goes by
What is the mucoperiosteal interface?
- 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
What are the causes of osseointegration failure?
- 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
What are the different bone types?
Posterior mand- type 2
Anterior mand- type 1
Anterior max- type 3
Posterior max-type 4 (balsa wood)
What are the effects of bone quality on implant failure and longevitiy?
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
What are the parts of an implant?
-Crown
-Screw
-Abutment
-Implant
The diameter of the implant is most important depending on the tooth you’re replacing
What are the surgical stages?
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
The one stage surgical method
Incision, move gums, osteotomy prep, place implant and no neeed for second surgery
Whats the difference between externa and internal Hex?
Most modern ones/better results from internal hex
We use internal hex- abutment sits inside the implant
What are th differences between engaging or none engaging abutments?
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
Whats the minimal distance between two implants?
3 mm between two implants and 1.5 between implant and tooth !!!!!
Why is a surgical template or radigoraphic template important?
Allow surgeon to place implant where you want
determine bone location and dimension
