Partially Edentulous Patients Flashcards
____ is used when a screw to retain the prosthesis would go thru the cusp if placed on the occlusal surface
Lingual set screw
Problems with _____:
- Increased risk of fracture; usually not an option due to difficulty of fabrication and placement
- Very small screw an can’t be properly torqued in most scenarios leading to loosening
Lingual set screw
What are the 2 alternate options where a lingual set screw could be used?
Cement retained
Titanium angled base
For a cement retained crown, and ____ is used to help seat the crown on the abutments properly upon insertion
Seating jig
What are the 2 most important characteristics of cements used in cement retained implant crowns?
Retrievability
Radiographic Detection
TempBond (zinc oxide with eugenol) demonstrated the _____
grey level values for the cements tested.
highest
All cements containing ____ (TempBond, TempBond NE, Fleck’s)
could be detected radiographically
zinc
________ is a major concern of cement retained prostheses due to its strong association to periimplantitis
Undetected excess cement
_________ washes away over time and the restoration will become loose. This creates some
problems and may compromise the implant as well.
TempBond (zinc oxide with eugenol)
_________ cements are the most radiolucent and difficult to detect radiographically, the hardest to retrieve, most
difficult to remove excess, and the majority contain fluoride (associated to titanium corrosion), and should therefore be avoided
whenever possible
Definitive Resin based
_______ cements are specifically made for implant prostheses, combining radiopacity, resistance to wash-out and
secure retention, improved retrievability and non fluoride formulation (Ex: Premier Implant Cement; Telio CS CEM Implant)
Implant Resin based
How does fluoride affect implants as far as using a cement that releases fluoride?
Causes corrosion of titanium
If there is excess cement from placing an implant via cement retained, what is likely to occur?
Peri-implantitis
What situations should be avoided in the posterior maxilla as far as FPD implant retained treatment plans?
Long span FPD (2+ pontics)
Distal Cantilever
A longer (larger) cantilever tooth has ____ force
Increased force
What are the 2 teeth that were mentioned that are mostly acceptable for cantilevers?
Mand PM
Max laterals
Technical complications associated with \_\_\_\_\_\_ • Implant Fractures • Veneer Fracture • Abutment Screw Fracture • Screw Loosening • Loss of Retention
ICFDP (Implant supported cantilevered FPD)
The ____ the MD width of cantilever is better
Smaller width is better
Is a mesial or distal cantilever more favorable?
Mesial more favorable
Should the fit of an implant cantilever be passive or snug?
Passiv
T/F: •Unilateral, short-span ICFDP is a predictable and dependable
solution for the restoration of a partially edentulous area of the
mouth when there is a lack of bone to support an implant or there
are anatomical structures that need to be avoided.
True
Implant supported distal cantilever prostheses,
have __% implant survival rate.
95%
Problems with \_\_\_\_\_ Technical Problems 1. Implant fracture 2. Tooth intrusion 3. Intrusion of teeth with telescopic crown 4. Cement bond breakdown 5. Abutment tooth fracture 6. Abutment screw loosening 7. Fracturing of veneers 8. Prosthesis fracture Biologic Problems 1. Peri-implantitis 2. Endodontic problems 3. Loss of an abutment tooth 4. Loss of an implant 5. Caries 6. Root fracture
Connecting teeth to implants
What is the most common issue when connecting implants to teeth in FPDs?
Tooth intrusion
Clinical Recommendations for _______
1. Select healthy teeth—periodontally stable and in dense bone.
2. Rigidly connect the tooth and implant (no stress breakers), employ large solder joints to enhance rigidity, or use one-piece
castings.
3. Avoid telescopic crowns (no copings).
4. Provide retention form with minimal taper of axial walls on abutment teeth. Enhance resistance form with boxes and
retention grooves if the clinical crown is not long.
5. Parallel the implant abutment to the preparation of the tooth and use a rigid connection.
6. Use permanent cementation (no screw retention or temporary cementation).
7. The bridge span should be short. Preferably, place one pontic between two abutments. However, with additional tooth
or implant support or cross-arch stabilization, additional pontics can be used.
8. Occlusal forces should be meticulously directed to the opposing arch.
9. In general, do not use TISPs in patients with parafunctional habits. If they are treated with TISPs, overengineer the case
by maximizing the number of implants and splinting.
10. Cantilever extensions should be used cautiously; however, they may be employed when tooth or implant support is
adequate (E.g. cantilever-implant-implant- pontic-tooth-tooth).
11. TISPs in patients with uncontrolled caries should be avoided; ISPs are preferred.
12. Pulpless teeth with extensive missing coronal tooth structure or root canal anatomy that is inadequate to predictably retain
a core or post and core should not be used in a TISP.
Tooth-Implant Supported FPD (TISP)
Long-term success rates for tooth-implant connections are _____ VS implant-supported
restorations with regard to prognosis for teeth, implants, and suprastructure.
lower
Use of rigid or nonrigid connectors leads to more favorable clinical outcomes in terms of long-term stability,
occurrence of complications, and tooth intrusion in TISFPDs?
Rigid connectors
Is there a particular crown to root ratio needed for implants?
No
will a shorter or longer implant be more affected by smaller amount of bone loss?
Shorter implants
How much distance (mm) between the bone and papilla will black triangles begin to occur in tooth-tooth environment?
5mm
How much distance (mm) between the bone and papilla will black triangles begin to occur in tooth-pontic environment?
6.5 mm
How much distance (mm) between the bone and papilla will black triangles begin to occur in tooth-implant environment?
4.5 mm
How much distance (mm) between the bone and papilla will black triangles begin to occur in pontic-pontic environment?
6 mm
How much distance (mm) between the bone and papilla will black triangles begin to occur in implant-pontic environment?
5.5 mm
How much distance (mm) between the bone and papilla will black triangles begin to occur in implant-implant environment?
3.5 mm
Which restorative environment is the least likely to get black triangles as there is less distance between bone and papilla?
Implant to implant
Which restorative environment is the most likely to get black triangles as there is more distance between bone and papilla?
Pontic-pontic
Do you want a wider or narrow implant platform for posterior teeth?
Wider
Do you want a wider or narrow implant platform for mand anterior teeth?
Smaller
