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xD2 Implantology > Prosthodontics > Flashcards

Prosthodontics Flashcards

1
Q

What are the 5 general steps in fabricating an implant-supported prosthesis?

A
  1. Make impressions
  2. Select and prep abutment
  3. Fabricate crown or prosthesis
  4. Abutment delivery
  5. Prosthesis delivery
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2
Q

What are 2 levels at which impression can be taken?

A
  1. Implant level

2. Abutment level

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3
Q

Which type of impression is taken after an abutment has been delivered clinically?

A

Abutment level impression

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4
Q

Which impression is taken with copings that fit onto implants directly. No abutments are present?

A

Implant level impression

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5
Q

“implant level impression” means what must be placed before the impression is taken?

A

implant analog, device that mimics the implant in the stone model

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6
Q

“Abutment level impression” means what must be placed before the impression is taken?

A

Abutment analog

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7
Q

What is an abutment that requires abutment delivery prior to impression?

A

Internal friction

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8
Q

Which impression type requires subgingival placement of copings, and is more difficult?

A

Implant level impression

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9
Q

Which impression type requires impression copings?

A

Implant level impression

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10
Q

This impression means abutments can be chosen on a model in the lab

A

implant level impression (re: have a fixture in the cast to try things in on)

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11
Q

This impression means the abutment is chosen in the mouth chairside

A

Abutment level impression

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12
Q

Which impression might require abutment modification?

A

Abutment level (b/c implant level impression abutment can be modified in the lab)

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13
Q

Which impression has custom abutments available?

A

Implant level impression

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14
Q

Which impression has the interim and final crown fabricated in lab?

A

implant level impression

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15
Q

What are 2 types of impression copings for implant level impressions?

A
  1. Closed tray

2. Open tray

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16
Q

Which type of impression copings remain on the implant complex after the impression is removed and need to be placed into the impression manually?

A

Closed tray impression/transfer impression coping

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17
Q

What is an implant level impression type where impression copings are automatically retained in the impression after removal, usually requiring manipulation of a long screw that is not present in transfer copings?

A

Open tray/pickup impression

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18
Q

Which implant level impression type allows for more precise impressions?

A

Open tray/pickup impression

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19
Q

In what area of the mouth are implant level impressions using open tray/pickup impression copings contraindicated?

A

Posterior mouth due to decreased access. Closed tray/transfer copings indicated

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20
Q

What is an implant level impression type that is useful in multiple implant cases?

A

Open tray/pickup

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21
Q

What should be done after placing a transfer coping in an implant, but before taking the closed tray implant level impression?

A

Radiograph to ensure it is fully seated

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22
Q

Transfer copings are designed to fit into the impression in how many positions?

A

Only one

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23
Q

In what coping is the screw more prominent: transfer or pickup?

A

Pickup

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24
Q

Internal friction systems use what type of copings?

A

Resemble pickup copings, but clip onto implant

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25
Q

Which implant level impression is more precise, causes less distortion, but requires more interarch space, tray perforation, and can splint multiple copings?

A

Pickup copings/open tray implant level impression

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26
Q

When pouring cast of implant level impression, how far should the gingival moulage cover the implant analog?

A

~3mm cover of analog

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27
Q

Which abutment has set collar heights and taper and can be modified?

A

Prefabricated abutments

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28
Q

Which abutments are entirely fabricated in the lab, usually delivered with a machined metal connection and waxable sleeve?

A

Custom abutments/UCLA abutment

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29
Q

Which abutments are straight cylinders with no taper or margin level. Preparation is required to set height, angulation, taper, and margin

A

Prepable abutments

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30
Q

What is an implant component that lies between the implant and the crown?

A

Abutment

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31
Q

How is an abutment retained on an implant?

A

Abutment screw. Can be a source of movement.

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32
Q

What are 7 considerations for abutment selection?

A
  1. Case type
  2. Implant diameter
  3. Intra-arch space
  4. Interarch space
  5. Angulation
  6. Gingival margins
  7. Subgingival contours
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33
Q

Can abutments used for screw retained restorations normally be modified?

A

No

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34
Q

When restoring without abutments, what is the character of the restoration?

A

Screw retained

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35
Q

What impression is taken if restoring without an abutment?

A

Implant level impression

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36
Q

If the abutment preparation has occurred in the mouth, when is the abutment delivered?

A

At same time

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37
Q

When are abutments normally delivered?

A

Between implantation and final prosthesis delivery

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38
Q

Can abutments be delivered at time of final restoration?

A

Yes

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39
Q

When can the abutment be placed at the same time as the implant?

A

Immediate loading

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40
Q

What must be done once abutment is placed?

A

Cover screw with cotton plug to allow access if needed

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41
Q

What is the term for a restoration retained by a screw that must be torqued into place?

A

Screw retained prosthesis

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42
Q

Are screw holes left uncovered for bar retained dentures?

A

Yes

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43
Q

What type of cement is recommended for cemented prosthesis?

A

Temporary cement

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44
Q

Major concern with posterior implant and restoration?

A

Access ( vs. esthetics for anterior restoration)

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45
Q

Single (implant-supported) crowns are prone to what?

A

Rotation

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46
Q

What can be done posteriorly to adjacent teeth to increase contact area and aide in improving implant prosthesis stability?

A

Flatten contacts on adjacent teeth

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47
Q

A posterior crown should have what buccolingual width and why?

A

Reduced buccolingual dimensions to minimize biting force

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48
Q

Contact points for occlusion should be placed how on the implant prosthesis?

A

To direct along long axis of implant

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49
Q

What are 2 negative things single units are associated with?

A
  1. Minimal retention

2. High risk of uncementation

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50
Q

What type of impressions are made with screw retained crowns?

A

Implant level impressions

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51
Q

What is the only system where the delivered crown could not be different than on the model?

A

Internal friction system

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52
Q

What is an impression type to take for anterior implants?

A

implant level

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53
Q

What is an abutment that is preferred for anterior implants?

A

Custom abutment or large prefabricated abutment

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54
Q

What abutment shape is desired for anterior implants?

A

Shaped like cross section of tooth

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55
Q

What is an abutment available for use in the esthetic zone that eliminates the metallic shadow?

A

Porcelain abutment

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56
Q

What will cause a dark margin with anterior implant?

A

Margin of prosthesis not apical enough and thereby shows through the thinnest gingival

57
Q

What should be used to obtain ideal gingival tissue contours?

A

Provisional crown

58
Q

What should be seen when provisional first inserted?

A

Tissue blanching for ~20 min

59
Q

What is a big consideration when planning a bridge restoration using implants as the abutments?

A

Due to the fact that there a no ligaments, there must be NO error in path of insertion

60
Q

What impressions are indicated for implant retained bridges?

A

Open tray/pickup coping implant level impression

61
Q

If you modify the implant abutments for a bridge in the mouth, is it advised that those be removed, or should they be provisionalized and remain in the mouth?

A

Remain in mouth and provisionalize

62
Q

What is the term used to describe the precise insertion of a bridge into its full position without resistance?

A

Passive fit

63
Q

Why is passive fit important to implant supported prostheses?

A

Because implants have no mobility

64
Q

What is necessary if sectioning and soldering was done for an implant supported prostheses?

A

Master impression

65
Q

How does a resin key work?

A

Engages coronal portions of abutments while resting on adjacent teeth. Made in lab to help orient abutments during delivery

66
Q

When delivering multiple abutments, start with which one first?

A

Most distal first to allow for better visability

67
Q

What is recommended to minimize nocturnal lateral forces on an implant retained prostheses?

A

Nightguard

68
Q

Why is a full arch implant retained prosthesis a whole different ball of wax than what has been discussed?

A

Nno vertical stop is present and denture setup is necessary

69
Q

What is required before abutment selection for a full arch implant retained prosthesis?

A

Wax up containing final teeth positions

70
Q

Nonsplinted implants prefer what delivery: laboratory or chairside?

A

Chairside

71
Q

Splinted implants prefer what delivery: laboratory or chairside?

A

Laboratory

72
Q

What type of implants are joined by a bar to enable attachment to a removable prosthesis?

A

Splinted implants

73
Q

What is the key to long-term success of the implant prosthesis?

A

Implant maintenance

74
Q

What will always exist around the microgap of the implant/abutment connection

A

Inflammatory infiltrate

75
Q

What are 3 microgaps and their micron sizes?

A

External hex connection ~ 40 microns
Internal flat conections ~ 30 microns
Internal conical connections ~ 2-10 microns

76
Q

What is one of the main goals of long term implant maintenance?

A

Maintain bone level

77
Q

The most apical epithelial cell is located how far from most coronal bone cells in implant epithelial attachment?

A

1 mm

78
Q

The epithelial attachment around implant is different or the same as around a tooth?

A

The same (rete pegs and hemidesmosomal attachment)

79
Q

Is the connective tissue seal around the implant the same or different from that of a tooth?

A

Different. No transverse fibers

80
Q

what is the character of the 40 microns adjacent to the implant and how does it act?

A

Absence of blood vessels, abundance of fibroblasts interposed between thin collagen fibers. Acts like a tight rubber band around implant

81
Q

What is the character of the area beyond that first 40 microns?

A

Fewer fibroblasts but more collagen fibers and blood vessels

82
Q

What does suppuration indicate during implant maintenance checks ?

A

Indicates hard accretion, most commonly cement. Must be removed

83
Q

What is the bone level expected when using a two- stage screw type implant?

A

Bone at first thread

84
Q

For other types of implants (ones that are NOT two-stage), where should bone level be expected?

A

2 mm from implant platform

85
Q

What is an implant problem that is a reversible condition analogous to gingivitis whose main sign is gingival inflammation around implants without evidence of bone resorption?

A

Mucocitis

86
Q

What is a common cause of mucocitis?

A

Abutment loosening

87
Q

What is a method to detect abutment loosening?

A

Look for abutment separation on X-ray

88
Q

What is the most common cause of mobility?

A

Uncemented crown

89
Q

Do plaque and calculus gather on implants as they do on teeth?

A

Yes

90
Q

If a patient has <3mm sulcus, but bleeding on probing, what should be done?

A

Disturb biofilm, adjust homecare, recheck in 7-10 days

91
Q

Can stainless steel instruments be used to scale implants?

A

No, can scratch titanium leaving nidus for plaque retention

92
Q

What are acceptable materials for implant scalers?

A
  1. Nylon
  2. Graphite
  3. Titanium-plated
93
Q

?Which implant scaler is most effective on tenacious calculus,but manufacturer states they will scratch titanium?

A

Titanium plated curettes?

94
Q

What is an implant problem recognized by radiographic or clinical evidence of bone loss?

A

Peri-implantitis

95
Q

Implant level impression abutments are selected where?

A

The laboratory

96
Q

Which copings remain on the implant when the impression is removed?

A

Transfer type impression coping

97
Q

Which copings remain in the impression when removed?

A

Pick up type impression coping

98
Q

How do you verify that abutments and crowns are engaging external connection systems?

A

A combination of clinical and radiographic checks are recommended

99
Q

For crowns in the esthetic zone, how can soft tissue support be created?

A

In the abutment and the crown

100
Q

What is implant indexing?

A

A method of impression taking at the time of surgical placement

101
Q

What is passive fit?

A

The placement of a bridge without resistance

102
Q

Why should you test if screws can turn without resistance until the last quarter turn?

A

It is useful for verifying proper fit in multiunit restorations

103
Q

What is recommended after delivery of a screw-retained bridge?

A

Block the screw access hole with a temporary material

104
Q

What does mobility of an implant-supported crown generally mean?

A

Loosening of an implant component

105
Q

Which component of a removable prostheses may need to be replaced during maintenance?

A

The female component

106
Q

When using two-stage implant, where is the radiographic bone level expected to be?

A

At the level of the first thread

107
Q

Clinical inflammation around a single restored implant, associated with pain or pressure but no radiographic bone loss, is most likely due to what?

A

Loosening of a component

108
Q

If an implant has been placed apically, a 7 mm peri-implant probing shows no sign of inflammation, and there is no radiographic change and no bleeding, this probably indicates what?

A

Normal functioning

109
Q

At a maintenance visit, an implant-retained bar is found to be mobile at one extremity. What should be undertaken?

A

Verify that the screw is loose and place a new one

110
Q

When observing a routine radiograph for an implant patient, you see a horizontal dark line between the implant and what seems to be the abutment. This is probably what?

A

A sign of component loosening

111
Q

Instruments used for maintenance must not be made out of what material?

A

Stainless steel

112
Q

If a patient has removable dentures, what generally needs to be done at yearly visits?

A

Change of female attachments

113
Q

What should be recommended to patients for home care?

A

Super-floss or yarn

114
Q

Oral hygiene instructions for implants should include what specific technique?

A

Wrap-around

115
Q

What percent of the adult population endentulous

A

10% (endentulism rises with age >60)

116
Q

Is there any significant difference in treatment effectiveness between conventional denture treatment with or without preprosthetic surgery?

A

No

117
Q

All implant supported prostheses use how many implants and it is common?

A

5 or 6 implants. Limited use due to cost and complexity

118
Q

Which is more cost effective: retain a few remaining teeth to support prosthesis or replace with implants and cover with prosthesis?

A

Implants

119
Q

What is the average vertical bone resorption per year in anterior mandible without implants?

A

0.4mm

120
Q

Which resorbs quicker: maxilla or mandible?

A

Mandible 4 times quicker

121
Q

What type of implant is covered by gingiva at placement, then reexposed at second surgery? It can also be covered by a healing abutment.

A

2 stage implant

122
Q

What is the mean annual marginal bone loss around implants?

A

0.9mm first year, then 0.1mm per year thereafter

123
Q

Which has best functional efficiency for mandibular treatments: implant borne hybrid, implant overdenture(tissue borne), conventional lower denture?

A

Implant borne hybrid(90%)>Implant overdenture(tissue borne)(60%)> conventional lower denture (10%)

124
Q

What is treatment cost difference for implant supported overdenture versus conventional denture?

A

3 times

125
Q

Can a patient tell a difference in stability between a 2 implant retained or greater amounts of implants to retain the overdenture?

A

No

126
Q

How many implants provide sufficient support for mandibular overdenture?

A

2

127
Q

Which implants have more problems: maxillary or mandibular?

A

Mandibular

128
Q

What are some problems with maxillary implants?

A

Thin bone, loose bone structure, large sinus, divergent implant axes, less favorable force distribution

129
Q

How many implants to use for maxillary implant supported overdenture?

A

4

130
Q

What are 3 single unit crown implant restorative options?

A
  1. Screw retained abutment
  2. Stock abutment, cemented crown
  3. Custom abutment, cemented crown
131
Q

What are the single unit abutment options?

A
  1. Angled
  2. Straight
  3. Direct Gold Coping (engaging)
132
Q

Nobel Biocare Snappy abutment (cementable crown) comes in 4 and 5.5 mm heights and can have what added to them to allow for what type of impression?

A

Impression coping put on for closed tray abutment level impression than abutment analog put in and cast poured over

133
Q

What is put on on top of the cottonball once the abutment is screwed onto the implant and before the crown is cemented on?

A

Fermit

134
Q

Implants should be offered as what?

A

An option for replacing missing teeth

135
Q

What should you not try to do with implants?

A

Replace all missing teeth

136
Q

What are 2 things to beware of with implant restorations and really any procedure?

A

High smile lines and high expectations

137
Q

What are 4 reasons to provisionalize?

A
  1. Esthetics
  2. Function
  3. Soft tissue management
  4. Patient request
138
Q

What are five things you need to consider yourself during an implant treatment process?

A
  1. Is the implant prescription consistent with the treatment plan?
  2. Is the potential result consistent with the patient’s expectations?
  3. Do I have a lab with a level of expertise that have good experience (WTF?)
  4. Clinician comfortable with type for treatment
  5. Attention to detail and patient selection

xD2 Implantology (5 decks)

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