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BOARDs > Oral Surgery: Implants > Flashcards

Oral Surgery: Implants Flashcards

1
Q

Indications for Implant

A

Replace missing tooth

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2
Q

Contraindications for Implant

A
  • Uncontrolled Diabetes
  • Immunocompromised Patients
  • Volume and Height of Bone
  • Bisphosphonate therapy
  • Bruxism
  • Smoking
  • Hx of Head/neck radiation
  • Cleft Palate
  • Adolescents (not done growing 22-24 y.o.)

NOT OLD AGE

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3
Q

Implant Types

A

Subperiosteal: have failed over years

Transosteal

Endosteal

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4
Q

Subperiosteal Implants

A

Implant under periosteum
* NO true osteointegration

Poor Prognosis

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5
Q

Transosteal Implants

A

Only Mandibular Anterior
* Extraoral Approach

4 needed to support mandibular denture

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6
Q

Endosteal Implants

A

Placed in bone
* Largest category

Root form shape=most common today

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7
Q

Endosteal Implant Components

A

Implant Body
Abutment
Abutment Screw
Implant Crown

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8
Q

Implant Body

A

aka implant or fixture
* Axisymmetric (symmetric along long axis)

Procedures:
Sequentially enlarge the osteotomy
* reduce heat generated
* Pilot hole helps maintain axis w/free hand surgery
inserted into Tapped holes
* some implants are self tapping: cut threads into bone as its placed

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9
Q

Abutment

A

1 piece
=Abutment + Abutment screw
* No antirotation component

2 Piece:
* Abutment & Abutment screw are separate (more common)
* Antirotation component

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10
Q

Implant Crown

A

Screw Retained:
=screw through crown into implant
* Crown & abutment= 1piece
* Abutment screw is separate

Cement Retained:
=Abutment attached to implant separately ( w/cement)

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11
Q

Screw Retained Implant: pros vs cons

A

Pros:
* REtrievable
* Better for restoring restricted restorative space

Cons:
* Screw access hole: Decrease esthetics
* Not possible for angled implants

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12
Q

Cement Retained Implant: Pros vs Cons

A

Pros:
* Esthetics

Cons:
* Cement trapping=peri-implantitis
* Nonretrievable
* Needs more restorative space

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13
Q

1 vs 2-piece implants

A

Different from 1 & 2 piece abutments

1 piece:
= implant & abutment are attached together
* drilled into bone as 1 unit
* CANNOT correct angle b/w abutment and implant

2 piece:
=implant & abutment are separate
* implant is placed
* then abutment Is attached
* Then crown attached to abutment

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14
Q

Anti-rotation component

A

Prevents rotation of the abutment in the implant-> Provides stabilization

Different w/each brand
* Internal or External Helix

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15
Q

Implant surface

A

Rough surface: For bone integration
* No PDL for implants, Decreased ability to take heavy forces.
* restore w/light occlusion

Smooth surface: For soft tissue
* Gingival fibers orient next to implant
* Parallel to implant cuff

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16
Q

Socket Preservation

A

Maintains height & width of alveolar ridge
* re atraumatic Ext: Do not break buccal plate

17
Q

Osseointegration vs Fibrousintegration

A

Osseointegration:
* direct histologic contact b/w bone & implant surface

Fibrousintegration:
* Presence of fibrous tissue layer b/w implant & bone
* Will be mobile=Failed osseointegration & implant placement

18
Q

Primary vs Secondary Stability

A

Primary Stability:
* How the implant is when you first place it
* how locked in the threads are

Secondary Stability:
* Post-osseointegration
* long term healing of bone to thentitanium alloy

19
Q

Bone quality: Type 1-4

A

Implant success rate goes from High to low as you increase bone type

Type 1: Anterior Mandible
* lots of Dense cortical bone
* not a lot of trabecular bone for vasculatiry
Best

Type 2: Posterior Mandible
* good mix of cortical & trabecular bone

Type 3: Anterior Maxilla
* Less cortical bone & More trabecular bone= Decrease stability

Type 4: Posterior Maxilla:
* worst type of bone
* not a lot of cortical bone

20
Q

How far does an implant need to be placed from adjacent teeth?

A

1.5 mm

21
Q

How far does an implant need to be placed from another implant?

A

3 mm

22
Q

How far away does an implant need to be placed from IAN?

A

2 mm

23
Q

How far away does an implant need to be placed from mental Nerve?

A

5 mm

24
Q

Implants need to be placed 1mm away from…

A

Buccal plate
Lingual Plate
Inferior BOrder
Max Sinus
Nasal Cavity

25
Q

1 vs 2 Stage Surgery

A

1 Stage:
* imlant and healing abutment are placed at same appt
* possible w/good primary stability
* Creates a good ST emergence profile

2 stage:
* implant is placed and capped w/a cover screw during osseointegratiion
* Open up and place abutment at next visit
Used if:
* Poor primary stability
* Graft placement is indicated
* Immunocompromised pt (Closing up decrease infection risk)

26
Q

When is 2 stage surgery indicated over 1 stage surgery?

A
  • Poor primary stability
  • Graft placement is indicated
  • Immunocompromised pt (Closing up decrease infection risk)
27
Q

Implant Impression:

A

Once healing is complete, final impression is made so crown & abutment are properly oriented

Impression coping: transfer angulation and location of implant to master cast
* Open Tray: hold in tray for coping to pop out
* Closed tray: No hole in tray

Analog: Implant replica that is set into the cast

28
Q

Surgical Stent

A

Used to help guide the implant drill as we deliver the implant

LAD
* Location
* Angulation
* Depth

29
Q

What are the 4 characteristics of implant success?

A
  1. Immobile
  2. No peri-implant radiolucency
  3. Peri-implant bone loss < 0.2mm per year after 1st year
  4. No symptoms (pain, parasthesia, infection)
30
Q

Implant Failure

A

associated with:
* Gram Negative anaerobic rods & filaments

Temp: 47 C for 1 min or 40 C for 7 mins to compromise osseointegration

If any 4 keys to implant success are present=failure
* mobility
* pain
* radiolucency *
peri-implant Bone loss

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