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Implant > Radiographic Assessment Options For Dental Implants > Flashcards

Radiographic Assessment Options For Dental Implants Flashcards

1
Q

Role of imaging

A

Pre/peri/post-operative roles

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2
Q

Preoperative modalities

A

Roles/ technologies / assessment

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3
Q

Radiographic templates (ITI Video)

A

Prescriptive/ indicative

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4
Q

Why is cross sectional CBCT imaging unique in contrast to tomography and multi-slice CT imaging

A

It is a dynamic and interactive process
Can be used to direct the placement of implant fixtures - indirectly by construction of restrictive surgical guides or directly by the use of image guided navigation

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5
Q

Preoperative roles

A

Determine bone volume
Prosthodonticall/Surgical driven site assessment
Bone quality
Width/height
Orientation
Correlation
Anatomic consisderations
Proximity to vital structures

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6
Q

What is the quality of bone within the alveolar ridge?

A

Cortical bone/trabecular bone pattern
Bone resorption topography

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7
Q

What vital structures encroach on the residual alveolar ridge ?

A

Maxilla - sinus, nasopalatine canal
Mandible- mental foramen, inferior alveolar canal

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8
Q

Consider prosthetic space requirements

A

Inter-coronal space
Oro-facial space
Inter-radicular space
Inter-occlusal space

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9
Q

Fixed inter occlusal space

A

Allow for soft tissue, abutment, metal, restorative material, +/- cement
Anterior - 10-12mm
Posterior - 8-9 mm

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10
Q

Removable inter occlusal space

A

Allow for soft tissue, adequate abutment and prosthetic thickness
Bar - greater than or equal to 15 mm (15 -17 mm)
Attachment - greater than or equal to 7mm (10-12mm)

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11
Q

A guide, derived from the diagnostic ___________, used to assist in the preparation for and the placement of implants. It dictates drilling _________ and angulation.

A

Wax-up, position

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12
Q

Post operative objectives

A
  1. Monitor osseointegration - bone to implant interface, marginal bone level stability
  2. Immediate or delayed review of implant position
  3. Establish osseointegration failure
  4. Prior to implant retrieval
  5. Graft success
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13
Q

Monitoring ossoeintegration : Radiographic success criteria

A

Subjective (patient satisfaction)
Prosthetic criteria
Peri-implant soft tissue criteria
Implant - absence of pain, mobility, Radiographic

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14
Q

Implant radiography

A

< 1.5 mm crestal bone loss at 1 yr
<0.2 mm annual crestal bone loss after 1st year
Absence of peri-implant radiolucency

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15
Q

Bone to implant interface

A

0.2 mm pa limitation
Non integration = continuous RL
Overshoot artifact
Apical RL = drill/mental foramen

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16
Q

Marginal bone level stability

A

Initial angular defect after loading
Subsequent bone loss

17
Q

Subsequent bone loss type

A

Branemark - 0.05 mm/yr
Roughened surface - 0.4-0.5 mm/yr

18
Q

Subsequent bone loss load

A

0.05-0.1 mm /yr
2 stage - 0.5-1mm 1st year
1 stage - 0.6mm (Mn) 1.1 mm (Mx)

19
Q

Radiographic grid ruler Half units of interthread distance (thread pitch)

A

Branemark 0.6 thread pitch, accuracy = 0.3mm

20
Q

Digital intraoral radiography

A

Highest resolution of all modalities
10% magnification
Long cone paralleling technique mandatory
Cost and utility
Rigid = minimizes distortion
Measurement algorithm = reduces intra/inter observer realizability

21
Q

Digital intraoral radiography advantages

A

Identification of local anatomy
Assessment of mesio-distal orientation- relative root angulations
Measurement accuracy = good MD, excellent A-C (vertical) using standardized (callibration) techniques

22
Q

Digital intraoral radiography disadvantage

A

No bucco-lingual information

23
Q

Pano advantages

A

Available
Simple to perform
Cheap
Excellent screening of the status of the dentition

24
Q

Pano linear measurement calibration

A

-Digital image calibration with RO balls provides clinically acceptable vertical measurement accuracy (95% confidence interval approx 10%)
-2mm safety zone
-Linear opaque markers assist in determining trajectory for measurement

25
Q

Pano measurements and implant criteria

A

Interarch
Space between adjacent teeth
Space between roots
Residual ridge

26
Q

Pano interarch (ridge to occlusal platform) distance

A

6.5 mm minimum

27
Q

Pano restorative space (between crowns)

A

6.5 mm minimum

28
Q

Pano Me-Di bone volume (between roots)

A

1.5 mm from root to implant on either side
Implant diameter plus 3mm (min 6.5 mm)

29
Q

Pano minimal residual alveolar ridge dimensions mandible

A

12 mm above IAC for 10 mm Implant
Therefore height = implant (10 mm) + safe zone (2mm)

30
Q

Pano minimal residual alveolar ridge dimensions max

A

11mm from maxillary sinus for 10 mm implant
Height = min. Implant height (10mm) + safe zone (1mm) = 11mm

31
Q

CBCT advantages

A

Assess available alveolar bone in 3D - quality, height and width
Bone and proposed implant inclination
Spatial relationship of Anatomic structures

32
Q

CBCT disadvantages

A

Limited availability, moderate cost, technique sensitive, extended learning curve

33
Q

Application of CBCT in implantology

A

Significant increase in radiation dose to the patient (c.f pano and selected PA) is offset by increased reliability and accuracy in assessment and predictability in treatment outcome

34
Q

CBCT avoiding para sagittal parallax error

A

Displacement or difference in the apparent position of an object viewed along two different lines of sight

35
Q

CBCT avoiding vertical parallax error

A

Displacement or difference in the apparent position of an object viewed along two differnet lines of sight

36
Q

CBCT software measurement/virtual implant simulation

A

Review orthogonal images
Review 3D volumetric rendering
Create reformatted panoramic image and cross sections
Measure bone volume at specific sites
Select appropriate virtual implant type and size
Prosthetcially driven virtual implant placements- Oro-facial, apical-coronally, mesiodistally

Implant (10 decks)

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