Principles of dental implant surgery

Question 1

What X ray is gold standard for implant planning?

Answer 1

CBCT

Question 2

What is the guideline for the amount of bone needed for implant placement?

Answer 2

At least 1.5mm of bone between implants.
3mm between adjacent implants.
At least 1mm of bone on the buccal and lingual aspects of implants placed

Question 3

Why do we need a safe buffer zone of bone when drilling in for implant placement?

Answer 3

When drilling, an implant drill is 1-2mm longer than the bone of the final implant.
Therefore need to have a safe buffer zone so you dont drill too deep.
Avoid vital structures.

Question 4

Is a narrower or thicker implant more likely to have occlusal loading?

Answer 4

A narrower implant

Question 5

Why is the length of a mandibular implant limited?

Answer 5

Due to the amount of bone above the inferior alveolar canal positioning.

Question 6

What is the main advantage and disadvantage of short implants?

Answer 6

Advantage = easier to remove than longer implants

Disadvantage = Likely to be lost easier due to bone loss

Question 7

What does keratinised tissue around an implant lead to?

Answer 7

Patients with less than 2mm of keratinised tissue were more likely to have plaque accumulation, inflammation and bleeding and recession leading to exposure of the abutment.

Question 8

What can be placed around the implant to fix the lack of keratinised tissue?

Answer 8

Gingival graft

Question 9

What are the pre-operative procedures which are involved in implant surgery?

Answer 9

Pre-Operative:
- Make sure the patient is fully informed of their situation with all the treatment options
- Know the costs, risks and benefits of the treatment options
- Potential post operative complications
- Consent needed

Question 10

How do we gain soft tissue access for implant placement?
How do we prepare the bone site for implant placement?

Answer 10

Incisions and raise minimal thickness flaps - determined by surrounding and underlying anatomy.

Start with a narrow drill and get larger.
Allows for minimal trauma to bone and allows the surgeon to adjust the drill orientation.

Question 11

What is the primary stability determined by?

Answer 11

• Density of the bone
• Surgical technique
• Implant design

Question 12

What is the two stage process to placing dental implants?

Answer 12

1) Incision cut into gum, implant screws are placed and area is closed for healing

2) Small incision is made on the alveolar crest and healing abutments are placed

Question 13

How long do we give for soft tissues to heal?

Answer 13

8 weeks