Restorative Implant Dentistry I Flashcards
1
Q
% of 50-59yo in US w single or multiple posterior edentulous spaces bordered by natural teeth:
A
30%
2
Q
Single tooth replacement in post region, % annual dental care reimbursment:
A
7%
3
Q
5 options for post single tooth missing:
A
RDP, FDP, Untreated, resin-bonded, implant
4
Q
TF? 10y survival rate of teeth adjacent to an RPD is lower than that of an RPD or untreated.
A
T FDP: 92%, Untreated: 81%, RDP: 56% 10y survival
5
Q
15y survival rate for FDP:
A
74%
6
Q
50% mean life span of FDP:
A
9.6y
7
Q
10y and 15y survival rates of FDPs:
A
74%, 50%
8
Q
10y survival of post teeth adjacent to FDP:
A
92%
9
Q
10y survival of post teeth adjacent to edentulous arae:
A
81%
10
Q
10y survival of post teeth adjacent to RDP:
A
56%
11
Q
Most common problem with Resin-bonded posterior single tooth prosthesis:
A
debonding
12
Q
debonding rate, resin-bonded posterior single tooth prosthesis in 3y:
A
50%
13
Q
Disadv of resin-bonded posterior single tooth prosthesis:
A
High debond rate, inconvenient (pt and dr), decay on abutment teeth
14
Q
10y urvival rate of posterior single tooth implant:
A
97-100% (this included maxillary posterior, though, which are far more likely to fail than mandibular, right?)
15
Q
Disavd to implants:
A
high initial cost, surgical risk
16
Q
Adv of single tooth implants:
A
No need to splint adjacent teeth, psychological need, no prep of adjacent teeth, hygiene (no floss or pontic), dec cold/ contact sensitivity, esthetics, maintains bone, dec adjacent tooth loss
17
Q
% dec in bone width 3y after extraction:
A
30%
18
Q
TF? An implant slows the bone remodelling process.
A
T
19
Q
Disadv of implant placement:
A
pt compliance, time of tx, consequence of failure, cost, special training/equip
20
Q
Endossous root form implant complications:
A
surgical, implant loss, bone loss, soft tissue, mech, esthetic/ phonetic, nonoptimal placement
21
Q
If implant is placed too close to nerve:
A
numbness, damage
22
Q
If implant hits adjacent tooth:
A
root resorption
23
Q
If lingual bone is perforated w an implant:
A
may perforate the artery, life threatening
24
Q
What type of complication is bone loss after implant placement?
A
biological
25
Contraindication and limitation, post single implants:
limited time, inadequate bone/ intra tooth space, mobility of adjacent teeth
26
Faciopalatal bone volume must be greater than:
5mm
27
MD space needed for an implant greater than 3.5mm diameter:
greater than 6.5mm
28
healthy vertical and lateral movement of posterior teeth:
vert: 28um, lateral: 75um
29
mobility of __+ of adjacent tooth = high risk of implant failure:
2+
30
When can an implant move when it's not the implant iteslf moving?
if bone is moving, if jaw bone is flexible it can move w bone
31
Which direction of bone volume is more important F-L or MD?
FL
32
If using a 3.5 mm implant, how much F and L space is needed?
1.5mm both F and L, then you need 6.5mm
33
% total chewing efficiency of Mad2M
Les than 5%
34
Problems wi 10% higher bite force for a Man2M:
risk of bone loss, porcelain fracture, abutment screw loosening
35
TF? An extruded Max2M will lead to problems wth occlusion.
F
36
Problem with implant replacement for Man2M:
Interference in excursive moves, less predictable, higher location of man canal there, subman fossa depth greater, bone to occ plane angle greater, limited crown ht space for cement retention, limited access for occ screw placement/ correct implant body, crossbite position - implant placed more B than maxillary tooth, hygiene access more difficult, cheek biting, cost
37
Muscle closest to the 2nd molar:
masseter
38
How to avoid inc risk of bone loss, porcelain fracture, abutment screw loosening, and occlusal interferences during excursions with Man2M implant:
metal crown, not ceramic
39
Why is there inc risk for uncementation for Man2M implant?
Lack of crown ht space for cement retention
40
Are abutments typically shaped to resemble the ideal crown prep for the respective tooth?
ask
41
Which part supports the implant prosthesis?
abutment
42
Abutment classifications:
internal/ external, custom/ stock (prefabricated), screw-retained/ frictional lock (cement-retained)
43
What type of abutment is cement-retained?
Friction-locked
44
External abutment connection:
hexagonal projection, abutment connected through the hexagonal screw in the middle
45
TF? Main source of mechanical retention of the implant is between abutment and screw
F. Small s.a. of connection bw the two
46
TF? interface between implant and abutment is weak.
T
47
When force is placed on an implant, where is the stress located?
interface and screw, screw bends, crown fractures
48
Function of having an abutment that screws into the implant.
If all stress is focused on interface (external) the stress is very coronal, compared to internal, the center of rotation is inside, apical, & evenly distributed
49
TF? There is an inc in peak stress w use of an abutment compared to without.
F. dec
50
To where is force distributed without an abutment?
interface, tension leads to bone resoprtion
51
2 types of implant/ resto interfaces:
flushed, platform switching
52
Flushed interface:
smooth transition bw the 2
53
Platform switching interface:
implant diameter greater than abutment diameter at interface, gap can harbour bacteria (but the benefit is that bone can grow into that space, preserving bone height
54
This is a new concept in implant dentistry for controlling postop crestal bone level:
Platform switching
55
How is bone/ abutment interface effected in platform swtiching?
abutment is further from implant, If interface is directly adjacent to bone and there is no interface between, this can lead to bone resorption
56
Safety zone that keep bacteria out:
platform
57
Disadv of flush design:
interface is closer to the bone (check if this is a disadv)
58
Platform switching may preserve:
interimplant bone height and soft tissue levels
59
acceptable interface width, non-platform switching
1mm
60
Indications for custom abutment:
esthetic area, anteriors
61
Cad Cam implant abutment design is based on:
gingival tissue contour, company will send custom milled abutment
62
How to compensate if implant is placed suboptimally
with the custom abutment B-L gingival tissue lower or higher, etc., especially the esthetic area
63
When to use prefabricate and not cutom made posts?
posterior, non-esthetic area
64
Anatomic abutment:
abutments w avg gingival ht for a given tooth
65
Adv of custom abutments:
gingival tissue ht, inter-arch/ interdental space, implant position/ angulation
66
Materials stock abutments come in:
titanium, zirconia, chrome cobalt alloy, gold collar (tzcg)
67
Abutment type that requires preparation:
stock abutment
68
Varieties of prefab abutments:
narrow, reg, wide, dif gingival/ post heights
69
Why don't we do cast to gold abutments anymore?
we have Cad cam
70
We provide this to lab for custom abutment:
diagonal stick cast provisional?(check)
71
Steps for custom abutment fabrication for natural emergence:
remove healing abutment, place custom abutment & screw retained temp, remove, take final impression of newly molded gingival tissue
72
What influences gingival color of implant-suupported all ceramic restorations the most?
abutment material
73
Delta E:
color difference, the lower delta E the better
74
Highest and lowest mean delta E for abutment materials:
Titanium: highest, zirconium: lowest
75
What does a delta E of 2 mean?
50% of dentists can recognize the difference, so delta E of 8 means that 87.5% could notice the difference?
76
TF? There are sig differences bw the color of peri-implant soft tissue around zirconia abutment and one around gold abutment.
F.
77
TF? largest factor influencing peri-mplant soft-tissue color is thickness of the tissue.
F. doesn't appear to be a crucial factor
78
Materials to choose to provide good peri-implant soft tissue color if esthetics are a concern:
gold or ceramic (zirconia)
79
Delta E, acceptable and unacceptable range:
acceptable: 3-4, unacceptable: 8+
80
% of pts that require additional visits for screw tightening of screw retained implants:
10%
81
% of pts that require additional visits for screw tightening of screw retained FDP's:
25%
82
% of peri-implantitis cases w implants:
5-10%
83
% of porcelain fracture of implants:
16.7%
84
Which is easier to deal with, screw loosened implant or uncementing of implant?
loosening, if uncemented, must cut it off
85
% esthetic failure of implants:
5-7%
86
Adv of screw retained implants:
retrievable, limited inter-arch space, implant bridge, interim abutment, soft tissue magmt
87
Adv of cement retained implants:
esthetic, ideal occlusion, easier fabrication, red cost, passive framework, max retention
88
Space req for cement-retained implant:
4mm O-G
89
Implant option for limited restorative space due to supereruption:
screw- retained or do opposing as well
90
Must have more than __ mm for occlusal clearance for crown material:
1mm
91
Need __mm of space for cement retention:
5mm
92
_mm bw bone and occlusal table:
8mm
93
Implant choice for less than 3mm space:
screw-retained
94
Implant choice for 3-4mm space:
screw-retained or resin cement
95
Implant choice for more than 4mm space:
conventional cement
96
TF? When drilling a larger hole for an implant, increase the size of the drill in a stepwise manner.
T
97
This is done in 2 stage implant placement:
cover screws w tissue
98
What next after tissue heals over implants:
place healing abutments
99
Step after healing abutments:
abutment connection or fixture level impression making
100
Step after abutment connection or fixture level impression making:
Impression coping, snap on mechanism
101
Step after Impression coping, snap on mechanism:
PVS impression (closed tray), impression copings remain in the pvs material
102
What gets inserted into the impression coping?
Implant abutment analog
103
After Implant abutment analog is inserted into impression coping:
inject soft tissue model around the implant abutment analogs, then die stone material around the pink tissue model, then burn-out wax-up cylinder
104
Alstep after burn-out:
wax up, cut-back, metal framework, opaque, porcelain build up, final prosthesis
