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xD2 Implantology > Midterm Review > Flashcards

Midterm Review Flashcards

1
Q

What is the implant component that lies between the implant and the crown?

A

Abutment

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2
Q

What is the screw that clamps the abutment onto the implant?

A

Abutment screw

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3
Q

What are flat small implants that are inserted into a cut in the bone?

A

Blade implants

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4
Q

What is a software associated radiographic technique that produces an exact cross-sectional view of the mandible or maxilla?

A

Computed tomography (CT)

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5
Q

What is the CT scanner that uses a cone-shaped radiographic source and a large detector to produce a 3-D radiographic image?

A

Cone beam CT

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6
Q

What is the screw that blocks the implant entrance during the healing period after surgery?

A

Cover screw

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7
Q

What is the distance between the implant platform and the edges of the extraction socket. Used as a reference for feasibility of immediate implant placement?

A

Critical Space

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8
Q

What is the subgingival change in shape of the abutment and/or the crown, between the implant platform and its emergence from gingival tissues?

A

Emergence profile

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9
Q

What is an implant-to-abutment attachment that sits on top of the implant platform. Common shape is external hexagon?

A

External Connection

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10
Q

What is a temporary abutment that is used in place of a cover screw after an implant has been inserted and removed before the restoration is placed?

A

Healing abutment

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11
Q

What is an arbitrary scale of values assigned to various radiopaque densities when using computed tomography?

A

Hounsfield numbers

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12
Q

What is technique in which implants are restored/loaded at the time of implant placement?

A

Immediate loading

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13
Q

What is a titanium device placed in bone that replaces the root of a tooth and enables the attachment of a prosthesis?

A

Implant

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14
Q

What is an implant-to-abutment attachment placed inside the implant body, found in internal friction systems?

A

Internal connection

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15
Q

What is a system where abutments are retained by friction against the inner walls of the implant?

A

Internal friction system

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16
Q

What is the term for Irreversible microscopic changes in the metal of implants and components when an excessive force applied; often leads to fracture?

A

Mechanical fatigue

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17
Q

What are Implants that are exposed to oral cavity on day of placement?

A

One Stage Implants

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18
Q

What is the term for attachment of bone to the surface of an implant?

A

Osseointegration

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19
Q

What the name of the procedure by which the sinus floor is elevtted via the osteotomy prior to implant placement?

A

The Osteotome technique

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20
Q

What is progressive bone loss and inflammatory tissue pathology that results from plaque accumulation and bacterial infiltration around implants?

A

Peri-implantitis

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21
Q

What is a reversible condition characterized by gingival inflammation around implants without evidence of bone resorption?

A

Mucositis

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22
Q

What are flat, mesh-like implants that lie on the osseous surface?

A

Periosteal implants

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23
Q

What is a clinical procedure in which soft tissue is measured at several locations of an edentulous ridge in order to estimate the width of underlying bone architecture?

A

Ridge mapping

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24
Q

What is the term for cylinder or screw-shaped implants that are also the most common implants used today?

A

Root form implants

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25
Q

What is an acrylic appliance used during surgery that indicates where the ideal implant placements must be for restorative purposes?

A

Surgical guide

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26
Q

What is a lightweight, soft, noncorroding metal used to make implants?

A

Titanium

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27
Q

What are Implants that are covered by the gingival immediately after placement and that require a second surgery to uncover them?

A

Two-stage implants

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28
Q

What are implants a replacement for?

A

Tooth roots

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29
Q

What does titanium do when exposed to oxygen and what is its purpose?

A

Forms titanium dioxide (natural ceramic coating) enables bone cells to attach

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30
Q

Do bone cells react better to rough or smooth titanium surfaces?

A

rough

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31
Q

What are 3 ways to roughen titanium surface of implants?

A
  1. Mechanical (blasting)
  2. Chemical (acids)
  3. Combo mechanical/chemical
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32
Q

Is roughening done the entire length of the implant and why?

A

No the area near the implant head left smooth to decrease bacterial attachment.

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33
Q

What is another method to enhance bone healing?

A

Hydroxyapatite coating

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34
Q

What are 2 reasons for the thread shape and pitch on the implant?

A
  1. Transfer biting force to surrounding bone

2. Enhance placement and stability

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35
Q

Is osseointegration a clinical or histological observation?

A

histological

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36
Q

Is the osseointegration of the implant and bone continuous along the implant?

A

Not continuous. Only 40-50% implant surface in contact with bone

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37
Q

When does osseointegration begin?

A

At time of implant placement

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38
Q

What forms between the bone and the implant w/in the first few minutes of implant placement?

A

blood clot

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39
Q

What attaches to the implant after the surgical trauma has caused surface bone cells to die and inflammation to take place?

A

fibrous mesh attaches

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40
Q

Describe the sequence of events leading to osseointegration and their time frame.

A

Necrosis – time of placement
Inflammation – within days
Osteoid Matrix formation – 2-3 wks Maturation – 6 -12 wks

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41
Q

Does osseointegration stop after 6-12 weeks or continue for the life of the implant?

A

matures for life of implant

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42
Q

Does the implant surface undergo changes as does the bone around it?

A

es, the ceramic oxide layer thickens over time

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43
Q

Do all implant types require abutments?

A

No, some have the crown screw directly into the implant

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44
Q

With external connection root form implants, how high does the attachment rise above the implant

A

Approximately 1 mm

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45
Q

Can two stage implants be exposed to the oral environment on the day of placement like a one stage implant?

A

yes, but covered with a healing abutment

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46
Q

in blade implants and periosteal implants (mesh like frame that overlays buccal-lingual), is the abutment separate of inseparable from the implant itself?

A

Insperable

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47
Q

Where is force predominantly dissipated in the implant?

A

at the neck

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48
Q

What is the benefit of an implant with respect to bone?

A

constant remodeling around implant preserves bone volume

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49
Q

What is a clamping force that the screw applies between the two parts of the implant

A

preload

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50
Q

What term refers to implants that are still in the mouth at the time of examination, regardless of the state of the prosthesis or patient satisfaction?

A

survival

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51
Q

What term refers to implants that are not only in the mouth, but are also functional and satisfactory?

A

success

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52
Q

What is more frequent with smoking and implants?

A

Peri-implantitis

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53
Q

What type of diabetes contraindicates implant placement?

A

Uncontrolled

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54
Q

What should be considered with implant placement in a controlled diabetic at time of implant placement?

A

Antibiotic therapy

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55
Q

Does osteoporosis appear to influence implant success rates?

A

No

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56
Q

With respect to age, what should be considered for implant treatment planning?

A

If patient is young, you should consider whether they are done growing.

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57
Q

How will an implant act in a person still growing?

A

Like an ankylosed tooth

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58
Q

Why are implants good for a person who has undergone head and neck radiation?

A

If xerostomic, pt’s mucosa does not react well to removable prosthesis, so implants avoid the mucosal pressure

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59
Q

What is the necessary interarch distance in the posterior required to build a fixed implant-supported prosthesis

A

7mm

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60
Q

What is the necessary interarch distance in the anterior required to build a fixed implant-supported prosthesis?

A

8-10mm

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61
Q

What is the total distance between adjacent teeth required for single-tooth implants?

A

7mm from CEJ to CEJ

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62
Q

What is the manual formula for determining 7 mm bone requirement between adjacent teeth in single-tooth implants?

A

1 mm bone M & D, PDL is 0.5mm, 4 mm diameter implant 4mm + (2 x 1mm) + (2 x 0.5mm) = 7mm

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63
Q

What amount of bone is required buccal and lingual for implant?

A

1mm B, 1 mm L 4 mm implant + 1mm B + 1 mm L = 6 mm bone width

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64
Q

Where is bone usually narrower, at the crest or the base, and which is most critical?

A

narrower at crest, crestal bone width is most critical

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65
Q

What Periapical radiograph technique best minimizes distortion?

A

Paralleling technique

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66
Q

For what are panoramic radiographs utilized?

A
  1. Estimate bone quality
  2. Estimate bone quantity
  3. Presence of anatomic limitation (e.g IAN, sinus)
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67
Q

What is prevalent on a panoramic?

A

Distortion

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68
Q

If doing an overlay on a distorted panoramic, should you round up to the next ratio overlay or round down?

A

Round up, allows for a more conservative plan

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69
Q

What are the Hounsfeld numbers used in CT for water, trabecular bone, cortical bone respectively?

A

Water = 0
Trabecular bone = 200
Cortical bone = 1000

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70
Q

Hounsfeld numbers are an indication of what?

A

Bone density

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71
Q

What is the main shortcoming of Conebeam CT?

A

bone density (Hounsfield units) is not as reliable as conventional CT

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72
Q

What is an acrylic appliance worn by the patient that is used to visualize diagnostic teeth or markers on a radiograph, and that can be modified to a surgical guide?

A

radiographic template

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73
Q

A radiographic template utilized for computed tomography called _________ and what is the acrylic mixed with to be radiopaque?

A

Scannographic template

Barium sulfate

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74
Q

Bone quality Class I/D1 describes what type of bone?

A

Compact/ thick cortical bone

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75
Q

Bone quality Class II/D2 describes what type of bone?

A

Thick cortical bone surrounds trabecular bone

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76
Q

Bone quality Class III/D3 describes what type of bone?

A

Thin cortical bone surrounds highly trabecular bone

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77
Q

Bone quality Class IV/D4 describes what type of bone?

A

Thin cortical bone and spongy core

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78
Q

What is the only way to get a subjective analysis of bone quality?

A

CT scan with Hounsfeld units

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79
Q

Is bone quality directly correlated to implant success?

A

Not directly, but it does play a role

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80
Q

Which bone quality class is hardest to prep surgically due to poor blood supply?

A

C1/D1

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81
Q

Which bone quality class has been associated with higher implant loss?

A

CIV/D4

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82
Q

What is a system for classifying bone volume?

A

A to D. A is most intact edentulous architecture and D is most atrophic

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83
Q

What guides implant length selection?

A

bone availability (measure from crest to vital structure)

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84
Q

For posterior mandibular osteotomy, how far is it recommended to stay away from IAN?

A

2mm

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85
Q

What is the distance required between the edges of 2 adjacent implants?

A

3mm

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86
Q

What is the distance required between the edge of an implant and the adjacent tooth?

A

1.5mm

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87
Q

For posterior teeth implants, where should the long axis emerge through?

A

Center of occlusal surface

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88
Q

For anterior teeth implants, where should the long axis emerge through?

A

Cingula

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89
Q

What must be completed before implant treatment planning begins?

A

initial disease control phase

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90
Q

Should implants be connected to natural teeth?

A

It should be avoided

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91
Q

If a cantilever is to be used, should it be used for short or long spans?

A

No. Only to be used for short spans.

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92
Q

How far should the cantilever extend distally?

A

no further than 1.5 distal to the A-P Spread

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93
Q

What is the A-P Spread?

A

The mesiodistal distance between the most forward and the most posterior implant

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94
Q

If a narrow arch decreases the number of implants anterior, thereby decreasing the overall A-P spread, should a cantilever be considered, or is a removable appliance indicated?

A

removable appliance indicated

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95
Q

If considering a splinted implant for a removable prosthesis, what is the consideration and space required?

A

Splint requires more material. Require +12mm

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96
Q

When is bone grafting necessary?

A

When bone width or height is inadequate for receiving an implant

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97
Q

Which is more successful: width bone augmentation or height bone augmentation?

A

Width augmentation

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98
Q

What is the amximum amount of bone height that can be gained with bone graft?

A

2mm

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99
Q

What are the origins of the various bone grafts?

A

Autogenous (self: hip, chin)
Allografts (freeze dried bone)
Xenografts (bovine origin)
Biomaterials

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100
Q

What is the ideal waiting period after tooth extraction before implant placement?

A

8 weeks

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101
Q

If doing a two-stage implant, how long after uncovering should you wait before final restoration of the implant?

A

6 weeks

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102
Q

Can implant placement and bone grafting be done at the same time?

A

Yes, if there is primary stability and minimal grafting required

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103
Q

What is required for primary stability to place an implant immediately after extraction?

A

Must engage 5 mm or more bone, either apically or horizontally

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104
Q

What is the critical space in the extraction socket?

A

Distance between implant platform and edges of extraction socket. Should be <2mm

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105
Q

Which is usually a better candidate for immediate implant placement after extraction: anterior or posterior?

A

Anterior teeth because diameter of implant is close to CEJ diameter of extracted tooth

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106
Q

Why are posterior extractions not a good candidate for immediate implant placement?

A

Posterior teeth have wider diameter than implant so socket exceeds critical space of <2mm

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107
Q

Implants are most often made of what material?

A

Titanium

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108
Q

Why is a rough implant surface desirable?

A

Ossification is improved around a rough implant.

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109
Q

What percentage of contact between bone and implant is necessary for osseointegration?

A

40-70%

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110
Q

What is the first event after implant placement in the process of osteointegration?

A

Formation of a blood clot

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111
Q

What results from excessive force on implant crowns?

A

fatigue of implant components, leading to fracture

112
Q

What is preload?

A

tension placed by screws to protect implant components from displacing forces

113
Q

True or false: Plaque and calculus accumulate on implants similar to the way they accumulate on teeth

A

True

114
Q

Connective tissue fibers around the implant neck are parallel or perpendicular to the implant?

A

Paralell to implant surface

115
Q

Does peri-implantitis spread rapidly to bone?

A

Yes

116
Q

What is the term for when an implant is still present in a patient’s mouth after a period of time?

A

Survival

117
Q

What is the Minimum interarch space for a fixed implant- supported prosthesis?

A

7mm

118
Q

What does ridge mapping measure?

A

soft tissue thickness clinically to deduce bone width

119
Q

With respect to implants, what are panoramic radiographs used for?

A

Ruling out bony pathologies and estimating bone availability

120
Q

What is the most precise radiographic technique?

A

Computed tomography

121
Q

Does cone beam CT use more or less radiation than conventional CT?

A

Less radiation than conventional CT

122
Q

What are Hounsfield numbers?

A

Arbitrary numbers set for tissue density on computed tomographs

123
Q

What are radiographic templates used for?

A

Used to visualize diagnostic teeth

124
Q

What is a scannographic template?

A

An aide to visualized diagnostic teeth on a computed tomography image

125
Q

Which bone is the densest: D1 or D4?

A

D1

126
Q

What amount of bone is required buccal and lingual when selecting and implant?

A

1 mm bone buccal and lingual of implant

127
Q

What is an advantage of screw-retained prostheses?

A

Ease of retrieval

128
Q

What is an advantage of cemented prostheses?

A

Ease of fabrication

129
Q

Should connecting implants and teeth be avoided at all costs, or avoided but can be performed?

A

Should be avoided whenever possible, but can be performed with careful consideration

130
Q

Distal cantilevers should be avoided whenever possible, but if must be used, they should be limited to what type of span ?

A

Short spans

131
Q

What is immediate implant placement?

A

placement of an implant at the time of tooth extraction

132
Q

What is immediate loading?

A

placement of a restoration at the time of implant placement

133
Q

Should provisional restorations rest on bone grafts or newly placed implants?

A

No

134
Q

Does bone grafting work best to augment ridge height or ridge width?

A

Ridge width

135
Q

Should gingival grafts be performed prior to fabricating final restoration or after the final restoration is delivered?

A

prior to fabricating final restoration

136
Q

What is the implant with the longest period of clinical trial?

A

Subperiosteal (doesn’t integrate into bone)

137
Q

Who is the father of modern implantology?

A

Per-Ingvar Branemark

138
Q

What are 4 keys to osseointegration?

A
  1. Atraumatic surgery
  2. 1mm bone, B & L at crest
  3. No micromovement
  4. Adequate healing time
139
Q

What temperature must not be exceeded during implant site preparation to make the surgery atraumatic and avoid bone necrosis?

A

47 Degrees Celsius

140
Q

If there is movement in the implant, what integration will there be: fibro-osseous or osseointegration?

A

Fibro-osseous/unacceptable

141
Q

What are 5 criteria for implant success?

A
  1. Immobile
  2. Less than 0.1mm bone loss annually (used to be 0.2mm/annually)
  3. No pain, infection, neuropathies, paresthesia, or IAN violation
  4. No x ray evidence of peri-implant radiolucency
  5. 85% still in 10 yrs = success
142
Q

What type of titanium does the ITI-implant system use and what kind of implant placement does it utilize?

A
  1. Commercially pure titanium
  2. Single stage transcended through gingival into oral
    cavity
143
Q

How is ITI different from Branemark?

A

Branemark said implant should be two stage and level with bone

144
Q

What type of titanium and what type of implant placement is the Core Vent system?

A

titanium-6 aluminum-4 vandium alloy 2 stage

145
Q

How is Core-Vent different from Branemark?

A

Does not use commercially pure titanium

146
Q

If patient needs ortho, should it be done before or after implant placement?

A

Before; implants do not move

147
Q

What is the titanium type and implant placement for the Integral-Calcitek implant system?

A

Hydroxyapatite coated bullet form

Tapped into hole

148
Q

Are parts interchangeable between implant systems?

A

No

149
Q

What are 3 basic components of dental implant?

A

Implant body Abutment

Retaining screw

150
Q

What are the different types and coatings for titanium?

A
  1. CP (commercially pure) titanium
  2. Titanium alloy (Ti6Al4V)
  3. Titanium plasma sprayed (TPS)
  4. Hydroxyapatite coated (HA)
  5. Microtextured Combination (micro-textured and HA)
151
Q

What are 3 terms describing implant/bone interface?

A
  1. Fibro-osseointegration
  2. Osseointegration
  3. Biointegreation
152
Q

What is the advantage of microtextured titanium?

A

Uniform 1-2 micron surface roughness gives 44% more surface area than mechanical titanium

153
Q

Where is Type I bone found?

A

Anterior mandible

154
Q

Where is Type II bone found?

A

Posterior mandible

155
Q

Where is Type III bone found?

A

Anterior maxilla

156
Q

Where is Type IV bone found?

A

Posterior maxilla

157
Q

Where do implants work better, maxilla or mandible?

A

Mandible

158
Q

Which bone type osseointegrates fastest even though it has the lowest blood supply?

A

Type 1

159
Q

Why is Type 1 bone the best for implants?

A

Because majority of implant is in thick cortical

160
Q

Why is a tapered implant good to use in type 4 bone?

A

It compresses that bone increasing the mechanical retention

161
Q

Which place is most difficult for implant placement and why?

A

Posterior. Greatest force, least space, poorest bone quality, anatomic structures (IAN, Max Sinus)

162
Q

How do natural tooth biomechanics dissipate lateral occlusal forces?

A

By the PDL

163
Q

How do Ideal implant biomechanics direct occlusal forces?

A

Along vertical axis of implant, dissipate periapically

164
Q

Where are lateral occlusal forces concentrated in an implant?

A

At crest of ridge on abutment screw

165
Q

What is the main difference between a “failing” implant and an “ailing” one?

A

“Ailing” implant still has some osseointegration

166
Q

How far can a cantilever be placed?

A

1.5 times the A-P spread

167
Q

What does a cantilever do with forces?

A

Increased force at crest and on abutment screw

168
Q

How do you place three or more implants in a row?

A

Offset to give a tripod effect

169
Q

All torque is measured in what units?

A

Newton centimeters

170
Q

What is the max angle on an angle abutment that has been found to not significantly effect occlusal loading?

A

30 deg

171
Q

What diameter should be chosen for the implant?

A

What is the largest diameter that leaves 1mm bone B & L and allows for coronal anatomy?

172
Q

What is the problem with long implants?

A
  1. Lots of heat generated at most apical portion

2. Longer implants have higher failure rate

173
Q

What is the ideal implant length?

A

11-13 mm

174
Q

What is the maximum crown to implant ratio?

A

1:1

175
Q

What are 2 contraindications for a long implant in posterior mandible?

A
  1. Retromylohyoid line (thin)

2. IAN

176
Q

What is the minimum amount of space between edge of implant and adjacent tooth?

A

1.5 mm

177
Q

What is the minimum amount of space between edges of adjacent implants?

A

3mm

178
Q

What type of occlusion is desirable on implants?

A

light centric and no lateral contacts

179
Q

What are the surgical steps for implant placement?

A 
Reflect flap 
Twist drill 1.5mm
Direction indicator 
Tapered drill 3.5 mm 
Direction indicator 
Tapered drill 4.3 mm 
Implant placement
180
Q

Who steers the multidisciplinary implant case?

A

Restorative dentist

181
Q

What are the 5 roles of implant surgeon?

A
  1. Initiate or assist treatment planning
  2. Perform site preparation surgery
  3. Perform fixture placement surgery
  4. Assist with impression and temporization 5. Treat ailing & failing implants
182
Q

What are 7 relative systemic health contraindications for implant surgery?

A
  1. Uncontrolled diabetes
  2. Severe immunodeficiency
  3. Uncontrolled vascular disease
  4. Heavy smoking
  5. Alcoholism
  6. Post-irradiated jaws
  7. Bisphosphonates (Fosamax)
183
Q

What are 3 spaces to evaluate clinically before implant?

A
  1. Mesial-Distal
  2. Buccal-Lingual
  3. Interarch (w/ teeth in MIP)
184
Q

Minimum B-L width and what makes up the number?

A

8-9mm

3.75 to 4.3 mm implant + 1 mm bone B + 1mm bone Lingual + 1 mm soft tissue B + 1 mm soft tissue lingual

185
Q

Which crown type requires less interarch space?

A

Screw retained

186
Q

What is the minimum interarch space and numbers that make it up?

A

7.0 mm 5.0mm abutment + 2.0mm crown thickness

187
Q

If the patients have all the available spaces, what space can still contraindicate implant placement?

A

Patient cannot open enough for implant surgical hardware

188
Q

What is the minimum distance required for surgical hardware?

A

35mm

189
Q

What does a periapical radiograph show for implant planning?

A

periodontal status Periapical status
Root alignment
Mesio-distal space

190
Q

What are 3 major things seen on Panoramic for Implant planning?

A

Bone volume
Bone morphology
Anatomical concerns

191
Q

What anatomic structures should you be concerned with for implant planning that can be assessed radiographically?

A

Nasal floor
Maxillary sinus
Mandibular canal
Mental foramen

192
Q

What is the distortion on a PA radiograph?

A

0-10%

193
Q

What is the distortion on a Panoramic radiograph?

A

25-30%

194
Q

What should be done when treatment planning an implant in the vicinity of the mental foramen?

A

Add a few mm anterior to allow for the nerve loop

195
Q

CT scan gives what information?

A

Anatomic info and bone density

196
Q

In what areas is a rectangular platform implant used?

A 
Maxillary central incisor 
Maxillary canines 
Maxillary premolars 
Mandibular canine 
Mandibular premolars 
Some molars
197
Q

what is the diameter or regular platform implants?

A

4.0-4.5 mm

198
Q

Wide platform implants used in what areas?

A

Molars

199
Q

What is the diameter of wide platform implants?

A

5.0-6.0 mm

200
Q

Narrow platform used in what areas?

A

Maxillary lateral incisors
Mandibular incisors
Some premolars

201
Q

What is the diameter of narrow platform implants?

A

3.0-3.5 mm

202
Q

When determining placement angle for implant, what should be drawn on casts?

A

Adjacent tooth roots

203
Q

What are 3 considerations for fixture position?

A

Apical enough for emergence profile
Slightly palatal for gingival bulk
More than 1.5-2.0 mm from adjacent roots

204
Q

What are 2 things tapered implants do?

A
  1. Allow missing adjacent roots

2. Wider portions compress bone to make it more dense

205
Q

How long after atraumatic extraction to wait if doing delayed fixture placement?

A

4-6 months (during the Q and A session before the test, he said more like 3-4 months)

206
Q

What are 3 criteria for immediate implant placement after extraction?

A
  1. Absence of infection
  2. Sufficient residual socket walls
  3. Adequate bone for primary stabilization (lateral and apical)
207
Q

What is another term for “socket preservation”?

A

GBR = guided bone regeneration

208
Q

What can a majority of implant “misadventures” be attributed to?

A

A lack of attention to detail in diagnosis and treatment planning phase

209
Q

What are 4 general steps in implant treatment?

A
  1. Patient selection
  2. Diagnosis and treatment planning
  3. Informed consent
  4. Dental implant treatment
210
Q

What is a risk associated with Fosamax (bisphosphonate)?

A

Bisphosphonate-related oseonecrosis of the Jaws (BRONJ)

211
Q

What bisphosphonate user can be a candidate for implant surgery?

A

Asymptomatic patient on oral bisphosphonates for less than 3 years

212
Q

What should be done if pt is asymptomatic bisphosphonate user for more than 3 years?

A

Coordinate with prescribing doctor to take a 3 month drug holiday prior to surgery

213
Q

When should the bisphosphonate drug holiday end after implant placement?

A

After osseous healing has occurred

214
Q

What blood test and its readings can be done to determine osteonecrosis risk in a more than three year oral bisphosphonate user?

A

CTx (C-terminal telopeptide)

150 pg/ml = Minimal risk

215
Q

On a drug holiday, how much will the pg/ml increase per month of the drug holiday?

A

25 pg/ml for each month (the desire is to get them to >150 pg/ml)

216
Q

What are 2 major factors that most frequently determine whether or not a patient will receive dental implants?

A
  1. Desire

2. Dollars

217
Q

What are 6 things to eval in dentate patient clinical exam for implant treatment planning?

A
  1. Overall dentition and periodontium
  2. Tooth/teeth to be replaced
  3. Status of adjacent teeth
  4. Occlusion/interarch space
  5. Bruxism/habits
  6. Alveolar Ridge
218
Q

True or false: you should connect natural teeth with implant supported restorations.

A

False

219
Q

What items should be covered by informed consent?

A
  1. Treatment alternatives
  2. Not a magic cure, not 100%
  3. No guarantees, requires maintenance
  4. Can still get peri-implantitis
  5. Surgery risks
  6. Final Treatment may differ
220
Q

What are 5 factors to consider when deciding between root canal therapy or implant or another treatment?

A
  1. Patient desires and needs
  2. Strategic Value of tooth
  3. Periodontal support
  4. Condition of remaining tooth structure
  5. Root canal anatomy
221
Q

What is difference between Endo studies and implant studies as far as how they define success?

A

Endo success defined as healing, while implant success is defined as survivability

222
Q

With respect to function and proprioception, how do implants and contralateral natural teeth differ?

A

Implants have lower bite force, reduced efficiency, smaller occlusal contact areas

223
Q

Which requires more post op intervention according to the Goodacre study: endo or implant?

A

Single tooth implants require 5 times more post op intervention

224
Q

What is the comparative cost between an implant and crown versus endo treatment and a crown?

A

A restored implant is 70-400% more than endo with a crown

225
Q

Options to fix a narrow alveolar ridge to prepare for an implant?

A
  1. Narrow platform fixture

2. Ridge expansion via: guided bone regeneration, distraction osteogenesis, or split alveolar ridge

226
Q

What is used in conjunction with Guided bone regeneration to control the soft tissue bridging of a defect?

A

e-PFTE membrane (whatever that is)

227
Q

How much time should be allowed for soft tissue healing at an extraction site?

A

6-12 weeks

228
Q

What are some extra-oral areas to harvest for bone graft?

A

illium, calvarium, clavicle, tibia, fibula, scapula

229
Q

What are some intra-oral areas to harvest for bone graft?

A

Mandibular symphysis, retromolar area, body of mandible, ramus of mandible

230
Q

What are 2 types of resorbable membranes?

A
  1. Non-resorbable (e-PTFE)

2. Resorbable (collagen or synthetic polymers)

231
Q

What is the best way to close a flap for healing?

A

Tension-free flap closure with smallest needle and suture material with mattress holding sutures or interrupted sutures

232
Q

What can be used to enhance bone grafts?

A

Platelet-rich plasma or growth factors

233
Q

Do you need a surgical template/guide? (not even sure what this question is asking)

A

Yes

234
Q

What are 4 ways to restore inadequate keratinized tissue for implant?

A

Free gingival graft
Connective tissue graft
Alloderm-acellular dermal graft
Skin graft

235
Q

What should you do if you have inadequate oral mucosa for implant?

A

Guided tissue expansion

236
Q

What should you do if the patient has gingival excess at the implant site?

A

Esthetic crown lengthening

237
Q

All platforms/diameters/surgical systems have what for ease of use?

A

Color coding

238
Q

What bone requires tapered 4.3mm drill?

A

Types 2,3,4

239
Q

Dense bone drills are used in what bone type?

A

Bone types 1 and 2

240
Q

What are 4 things a dense bone drill does for implant site?

A
  1. Dense bone drill is the final bone drill
  2. Removes steps left by tapered drills
  3. Will not oversize the site
  4. Allows passive fit
241
Q

When is a dense bone drill used?

A

After the final tapered drill

242
Q

Does an implant always need to be placed at the same level in the bone?

A

No it varies. They can be level with crest, slightly above crest or the collar above crest.

243
Q

What are 4 reasons for the variability in depth of implant?

A
  1. Limited intra-arch space
  2. Narrow bone bucco-lingual
  3. Esthetics
  4. Increase crown:root ratio
244
Q

What determines initial stability of the implant and prevents over tightening the implant?

A

Surgical torque wrench

245
Q

Primary stability with the surgical torque wrent between ___ and ___ Ncm?

A

35 to 40 Ncm

246
Q

What is used in the surgical area and with the instruments?

A

Copious cooled irrigation

247
Q

What is drill speed for the tapered groovy and dense bone drills?

A

800 rpm

248
Q

What is the drill speed for the straight groovy bone drills?

A

2000 rpm

249
Q

What is the rpm/ Ncm for screw tap drilling?

A

25 rpm or 45 Ncm torque

250
Q

What is the rpm/Ncm for implant placement?

A

25 rpm or 20-45 Ncm torque

251
Q

What is the final torque with the torque wrench?

A

35-45 Ncm

252
Q

What motion is used for implant site drilling?

A

In and out with drill in bone for 1-2 seconds

253
Q

How far does the drill preparation extend beyond the implant? (not sure what this questions is asking)

A

1mm (must be accounted for in treatment planning)

254
Q

Which drill type is single use: tapered or straight?

A

Straight

255
Q

When are tapered drills to be replaced?

A

After 20-30 uses or when cutting efficiency lessens

256
Q

Heat generated from drill can be transmitted how far in bone and what does this ultimately result in?

A

> 3mm, implant failure

257
Q

What temperature must you not exceed when preparing the site?

A

47 degrees Celsius

258
Q

What are some factors to minimize heat?

A

Copious cooled irrigation
Incremental drilling
Intermittent drill pressure
New (sharp) drills

259
Q

How far below the CEJ or gingival margin should the implant be placed?

A

2mm

260
Q

According to Dr Waldrop, you need to do a bone graft if the space in the socket is more than what distance?

A

2mm

261
Q

What are 2 uses for a surgical guide?

A
  1. Implant placement

2. Index implant for temporary crown

262
Q

In order to alleviate lateral occlusal forces, posterior occlusal tables should be wide or narrow?

A

Narrow

263
Q

Of the 3 flow charts for approaches to treatment, what was the first consideration before the implant?

A

Site: immediate implant at EXT site
Site: Flap technique
Site: Flapless technique

264
Q

With the 3 flow charts for approaches to treatment, after it is determined what the site will be (e.g. EXT site, flap, flapless), what is asked next?

A

Bone graft or no bone graft?

265
Q

With the 3 flow charts for approaches to treatment after it is determined if the site will require a bone graft or not, what are the common options in all 3 graphs?

A

Healing abutment or immediate provisionalization

266
Q

With the 3 flow charts for approaches to treatment the Immediate placement at EXT site and the Flap site, when it required a bone graft, what was the other option besides healing abutment or immediate provisionalization?

A

2 stage implant

267
Q

With the 3 flow charts for approaches to treatment, what is the consideration in all of them in the esthetic zone

A

connective tissue graft with or without bone graft

268
Q

The design of the surgical guide not only provides room for the restoration and ensures adjacent roots are not hit, but it also ensures what occlusally?

A

That occlusal forces will be directed vertically down the long axis of the implant and dissipated periapically

269
Q

Surgical guide is made from what size clear omnivac splint material?

A

.060

270
Q

How many teeth should the surgical guide extend on either side of the surgical site?

A

2 teeth either side

271
Q

What must be placed in tray and cured before putting in Triad custom tray material?

A

bonding agent

272
Q

The hole in the surgical guide should be equivalent to what round bur size?

A

10 round (~3mm)

273
Q

Which side should the groove go?

A

Buccal

274
Q

Is the implant placed midway between contacts or between roots?

A

Between contacts

275
Q

What are the 5 implant lengths?

A 
8mm
10mm
11.5 mm
13 mm
16 mm
276
Q

When implant placed, ideally, where should the flat side of the internal hex face?

A

Buccally

xD2 Implantology (5 decks)

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