Osseointegration

Question 1

When are implants generally used?

Answer 1

When tissue quality and quantity to support conventional prosthetics is inadequate

Attempts to replace missing tissue has led to local tissue derangement = worse condition

Question 2

Indications for implants

Answer 2

Retention problems
Loading of mucosa
Psychological problems accepting dentures
Trauma
Oncological manangement (tissue has been removed)
Diastema
Patient expectation

Question 3

Contraindications for implants

Answer 3

Smoking - contributes to periodontitis (peri-implantitis)

Poor general health - surgery

Bone condition/volume

Patient expectations

Cost

Question 4

What is osseointegration?

Answer 4

Direct structural and functional connection between ordered living bone and the surface of a load carrying implant

Question 5

Factors for implant integration (6)

Answer 5

Biocompatibility
Implant design
Implant surface
State of host bed
Surgical technique
Loading conditions

Question 6

Alternative treatments to implants?

Answer 6

No treatment
RPD/CCD (complete denture)
Bridge
Implant retained vs implant supported

Question 7

Kennedy class I RPD and ISMOD are very similar

• they are both retained anteriorly which means they have a tendency to rock and food can pack beneath them posteriorly

Why are Kennedy class I RDP not as well tolerated?

Answer 7

Patient expectations
- Kennedy class I RPD patients can function without the denture so the denture seems like a hinderance whereas ISMOD patients cannot function without so it seems like a major improvement

Question 8

How does the design of the anterior tooth position on an implant supported overdenutre?

Answer 8

Patients tend to want the denture to look good rater than function

This often means moving the teeth anteriorly

Implants act as an axis of rotation

The further away the teeth are from the axis of rotation (so the further away the teeth are from the implants) the more rocking

Question 9

List 2 differences in the impression takign stages of complete conventional and implant supported overdentures

Answer 9

CC = zinc oxide eugenol fro major impressions
ISMOD = impregum

CC = registration on permanent base
ISMOD - may not be