Oct 24 and 31 Clelland Lecture Flashcards
Why are surgical guides needed?
Stay away from adjacent teeth
Avoid complicated prosthetics
Communicate proper depth, facial-lingual position for emergence profile
Avoid custom or angled abutments - cannot have screw access through the facial of the restoration
Where do you want a single tooth implant placed for ideal esthetics in the maxillary anterior?
2-3mm form the FGM of the contralateral tooth is needed for the crown to transition from 4mm to 8mm without over-contour
Conventional surgical guides paired with panoramic and PA radiographs are often sufficient - List 3 indications for CBCT
1) Sinus lift
2) Narrow ridges
3) Proximity to critical landmarks, such as IAN
Are there any potential medico-legal ramifications for use of CBCT?
Yes, so make sure you get it checked by the radiologist because anything missed is on you!
List some possible complications that can occur with computer generated guides?
Drills and guides are not always easily accommodated intraorally especially in the posterior
Can be a challenge to remove implant holder from guide
Guides can break
Adequate irrigation can be a challenge, and failure to irrigate properly will result in bone destruction
Failure is more likely to occur in areas of advanced bone resorption
Is there an additional cost for CBCT use?
Yes, but it has gotten cheaper
When are anti-rotation features needed for implant prostheses?
Any single unit crown needs to incorporate anti-rotaitonal feature
Splinted multiple unit implant prosthesis should engage no more than 1 anti-rotaitonal feature
List some possible consequences that may occur if a patient does not return for tightening of a loose screw
Supraocclusion caused by a loose screw can lead to a broken screw Multiple broken screws Abutment frature Abutment fracture and retrieval of hex Bend or break an implant Implant failure
Screw loosening is often the first sign of Biomechanical overload
How can a dentist prevent contacts not on the long axis of the tooth?
Use a custom or angled abutment to correct angulation
How can a dentist prevent excessive cantilever contacts
Minimize the occlusal table width
How can you prevent excessive lateral contacts?
Flatten the contact area
How can you prevent excessive interproximal contacts?
Reduce the contact
How can you prevent inadequately tighten screws?
Tighten the screw, dipshit.
What are some factors involved in the decision whether to splint 2 adjacent impants
Crown to implant ratio
Anterior guidance
