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implant 2 > jacobson - last one > Flashcards

jacobson - last one Flashcards

1
Q

why CBCT?!

A

so many reasons

Like anterior loo 
●	Is instead of the mental foramen turning out 
●	It just like turns in on intself
You could have double mental foremant 
●	And theres like two 
The nerve can go through the roots 
Impacted wisdom teeth 
●	Can be hugging the inferior alveolar nerve 
●	So thir dmolar removal you need it 
Sinus septae
●	Like oyu can have it neraby 
Superficial IAN 
●	If its like right on the ridge
●	You will have major ain 
●	Whenever you touch the gingiva

You can have impacted teth
● And you will have a better idea of where the impacted teeth are
● You can find where nerves are in the jaw
● Like you can map where the impacted teeth

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2
Q

anterior loop

A

with mental foramen
- can seem like theres 2

can like turn out
CBCT can show you this

so want to stay within 5mm
2 mm anterior
3 mm above

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3
Q

superficial IAN?

A

like can come up closer to the tooth

poses complication

need CBCT

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4
Q 
study with complications
#1?
A

complications due to extractions
TOTAL CASES = 63

INFECTIONS 
severed lingual nerve 
IAN nerve 
sinus perforation 
fractured mandible 
TMJ injuries 
extraction of wrong teeth
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5
Q 
study with complications
#2?
A

endodontic procedures
total cases = 41

infections 
instruments broken 
nerve damage 
sinus stuff 
etc
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6
Q 
study with complications
#3? ***
A

dental implant surgery
25 cases

unrestorable implants placed 
implants interferring with nerves 
implant  loss
post op infection 
fracture jaw
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7
Q

third most common alleged negligence involved?

A

dental implant surgery

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8
Q

4 complication

A

complications due to crown and bridge treatment
universal lack of treatment planning in these cases

20 total cases

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9
Q

5 complication

A

alleged negligence was failure to diagnose or treat perio disease in a timely fashion
- x rays were not taken and perio probing not recorrded

19 cases

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10
Q

important component of the informed consent

A

that the patient understands that no tx is also an option

but this document basically spells out everything that the patient needs to know

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11
Q

informed consent say no method to

A

My doctor has explained that there is no method to accurately predict the gum and the bone healing capabilities in each patient following the placement of the implant.

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12
Q

refund in informed consent?

A

no

Replacement will be made at fee for costs or replacement components only. There will be no refund in the case of failure

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13
Q

if fails within first year?

A

consent says will look at it

- re- evaluate and maybe do it for free

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14
Q

witness on informed consent

A

yes

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15
Q

T/F never attach to the natural tooth

A

true

one implant one tooth

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16
Q

single standing implant no shorter than?

A

10 mm

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17
Q

minimum of ___ of bone around the implant

A

minimum 1 mm of bone around the implant

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18
Q

diameter f implant?

A

should be close to diameter of the tooth being replaced

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19
Q

what makes a cement retained retrievable

A

add the retrievable knob and cement with temporary cement

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20
Q

breakdown of complete dentures

A

bars

studs

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21
Q

abutment selection

A

posterior - not as important but in the anteior - becomes v important in terms of esthetics

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22
Q

color of abutment??

A

color of abutment has no effect on color of all ceramic crown is the ceramic is at least 1.6 mm thick

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23
Q

cement / screw crown

A

yes an option for single tooth replacement

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24
Q

T/F splinted can be screw retained and cement retained

A

true

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25
Q

hybrids are always

A

screw retained

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26
Q

implant abutments for fixed restorations

A

custom made

pre fab
- can be angulated or non angulated
or non prepable or prepable

one piece implants

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27
Q

custom made abutments?

A

UCLA

CAD-CAM

can be metal or porcelain?

28
Q

CAD CAM use?

A

custom made abutments this way

29
Q

crown materials

A

PFM vs lithium disilicate vs zirconia

30
Q

abutment material (main ones)

A

titanium vs zirconia

he said he perfers titanium

31
Q

the color of ___ restoration is not affected by the abutment color if there is ___ thickness

A

● COLOR O ABUTMENT HAS NO EFFECT ON COLOR OF ALL CERAMIC CROWN S
● IF THE CERAMIC IS AT LEAST 1.6MM THICK

if EMPRESS – no effect if 1.5 mm

32
Q

which abutments are stronger

A

titanium abutments > than ceramic abutments

33
Q

__ could lead to substantial strength degradation and reduced reliability of prefac zirconia

A

grinding

34
Q

fracture strenghts of metal cermic crowns on cemented titanium abutments vs ceramic crowns cemented on milled abutments?

A

fracture strengths are higher regardless of loading direction

35
Q

indication for implant over denture

A

these are removable prosthesis (bar or stud retained)

  • sever ridge resorption
  • knife edge ridge
  • palatal defect
  • severly atrophic maxillae
  • financial limitations
36
Q

breakdown ofimplant supported restorations for completely edentulous

A

fixed

  1. metal ceramic implant supported FPD
    - cement retained
    - screw retained
  2. fixed complete denture = HYBRID

REMOVABLE

  1. implant overdenture
    - bar retained
    - stud attachment
37
Q

advantages of implant overdentures

A

hygeine access (number 1 benefit)

lip and facial support

ease of repair

economics

38
Q

contraindications to implant overdentures

A

patient is comfortable with complete dentures and has no complaints

residual ridge is not adequate for the standard placement of implants

general health conditions do not allow a minor surgical intervention

theray with immunoscompromised , long standing intake of corticosteroids

metabolic disease not under control

39
Q

first disadvantage of implant over dentures

A

having to take it out all the time

pschological 
more post insertion maintenance 
- attachments
- denture base 
- artificial teeth

Overdenture needs more post insertion maintaince:
The attachment might loss its retention or becomes losse or get fracture
The denture base will need to reline and repair with time
And the denture teeth will wear down or pump out with the time and will need to be changed

40
Q

implant over dentures advantages over fixed prosthesis

A 
fewer implants 
improved esthetics
soft tissue considerations 
less costly 
transitional prosthesis
41
Q

fixed denture prosthesis needs transitional?

A

yes

42
Q

design principles for implant supported over denture depends on what 4 factors

A
  1. number of implants
  2. type of support
  3. distribution of implants
  4. attachment system
43
Q

7 year survival of implant overdenture with 2 vs 4 implants on maxilla

A

76 % vs 99.3% when used 2 vs 4 respectively

44
Q

breakdown of attachment system

which to use?

A

bar
- most retentive with least mechanical complications

stud
- intermediate retention but more mechanical complications

magnets
- lowest retentino and limited denture stability

45
Q

breakdown of stud attachment

A

ball attachment

  • there are ball attachment which the male part is on the implant
  • the male part is on the implant and the retention comes from the o-ring

locator
-which the female in screw on the implant

46
Q

retention comes from where on the ball attachment

A

under the stud attachments

comes from the o - ring

the male part is on the implant

47
Q

locators

A

part of the stud attachment options

The Locator attachment features a denture component with a skirt that easily locates the
mating implant abutment. This self-aligning feature of the attachment aids the patient
in seating their prosthesis in a similar manner as a guide plane created by a milled bar

48
Q

OT bar falls under the

A

bar clip attachments

OT bar is basically U shaped

49
Q

hader bar details

A

Hader clips come in different retention. the clip damage is usually found in this type. It is because there is a little ledge coming out from the housing, everytime pt put in and take out the denture, this ledge can be distorted easily. Finally it will break.

50
Q

bar or stud depends on?

how?

A

SPACE available

- need to do a space assessment to know which type of attachment we can do

51
Q

space assessment

A

The way how we do the space assessment is by doing a teeth set-up, as regular steps of making a complete denture, then we dewax them, and see how much space we have from the mucosa to the occlusal/incisal surface of the teeth

52
Q

space needed for stud

A

8-10 mm

from the mucosa to the occlusal table

53
Q

space needed for bar attachment

A

14-16 mm

54
Q

mechanical problems associated with verdentures

A

loss of screws

breakage

accelerated wear of acrlyic resin artifical teeth

55
Q
  • Goodacre in 2003 did a study for evaluating the mechanical implant complication / failure and what he found is that
A

loss of retention / adjustment = 30%

denture relines = 19%

overdenture clip and attachment fracture which was = 17%

56
Q

goodcare also found main problems with implant loss?

A

maxillary over denture had highest amount of implant loss at 19% vs
mandibular at 4%

57
Q

2010 did a study to evaluated the effects of implant design and attachment type on marginal bone loss in implant-supported overdentures, and they stated that

A

no difference in marginal bone loss around implants retaining / supporting mandibular OVERDENTURES relative to implant type or attachment designs

58
Q

advantages of fixed complete dentures

A

more efficient / improved function

more psychologically acceptable

less potential for sore spots

MAINTENANCE OF ALVEOLAR BONE

less prosthetic maintenance

not subject to mishandling

59
Q

disadvantages of fixed complete dentures

A

cost
more implants
may have esthetics and phonetics problems
more difficult to clean for the maxilla

60
Q

contraindications for fixed complete dentures

A

off ridge relation

esthetic concerns

phonetic concerns

hygeine considerations

cost

61
Q

fixed complete dentures require how many implants in maxilla

A

6
The reason for placing more implants in the maxilla is related to the challenges that can be encountered due to bone resorption patterns in the edentulous maxilla, it is more likely that the implants will not be located directly beneath the prosthetic teeth or they will be facially inclined, thereby placing unfavorable forces on the implants

62
Q

fixed complete dentures require how many implants in mandible?
mental foramina?

A

5

It has been determined that up to 4-5 implants can be placed between the two mental foramina since the mean circumferential distance between these 2 landmarks is 47 millimeters. According to Pokorny and others.

63
Q

number or distribution is more important in the mandible for imlpants

A

DISTRIBUTION

64
Q

A-P spread on maxilla for fixed compelte denture

A

10 mm

Antero-posterior spread is the distance between the center of the most anterior implants and line drown through the center of the two most posterior implants. To ensure the mechanical integrity of the final prosthesis, the A-P spread should be at least 10mm, For the maxilla, a cantilever of 10 mm (the dimension of the mandibular bicuspids) is possible .

65
Q

mandibular implant distance

A

14-16 mm from center to center

66
Q

case planning

A

diagnostic wax up

surgical template

CT scan

surgical phase

prosthetic phase

67
Q

most common complications associated with implant fixed complete dentures

A
  1. max implant loss 10%
  2. prosthesis screw loosening 8%
  3. gingival inflammatin / proliferation
  4. implant dehiscence prior to surgical uncovery 6%
  5. metal framework fracture 6%

implant 2 (11 decks)

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