RP - implant pros Flashcards
what is an implant?
an artificial tooth root that is surgically anchored into the jaw to hold a replacement tooth or teeth or a denture in place.
what is the benefit of using implants?
they don’t rely on neighbouring teeth for support
name the 3 parts of a dental implant?
titanium dental implant
abutment
(abutment screw)
crown
describe osseointegration and dental implants?
there is no PDL
direct communication with bone
what is the gum around abutment of an implant called?
peri-implant mucosa
what can an implant restore?
a single tooth (implant crown)
multiple teeth (implant bridge)
can secure a denture firmly (implant overdenture)
eyes, ears, hearing aids and noses
list the implant treatment sequence
plan and consent
place
uncover and connect abutments
restorative procedures
restore
monitor and maintain
what medical disorders may compromise implant treatment and why?
chemoradiotherapy
polypharmacy - mucosa not in good condition
immunosuppression - no healing between bone and implant
MRONJ risk - if taking bisphosphonates
cardiac issues - on anticoagulant
mental health
diabetes and thyroxine - thought to increase implant failure rate
what is NHS implant funding for?
patients with:
- H+N cancer
- severe hypodontia
- severe trauma
- cleft palate
what are the risks associated with implants?
minor surgical risks (pain, bruising, bleeding)
major surgical risks
paraesthesia
perforation into nasal cavities or max antrum
failure to integrate
late failure
bruxism and implants
peri-implantitis
failure of substructures and components
why does bruxism pose an issue with implants?
no PDL so no sense of biting force
what modalities are used for implant planning?
history and exam
radiographs
other imaging - CBCT/ CT
surgical and radiographic templates
ridge mapping (study casts and pins in mucosa)
when taking radiographs for implant planning, what views do you want?
2 different planes
lat ceph and OPT
how do you implant plan on a OPT?
10mm GP cones sit in appliances - they show how much bone is available
remember OPT is 1.3x normal size
when would you want to use a CBCT for implant planning?
plot the IDC - need to give canal a wide birth from implant
determine angle of implant
where do you gather information to produce surgical and radiographic templates?
radiographs, scans, exisitng prosthesis, and casts
what are the 4 types of implants?
system
tapered
platform
co-axis (different angle on emergence)
what are the post op complications associated with implants?
failure
infection
explain the stages involved in implant surgery?
- raise flap and drill bone with torque controlled drill
- place implant
- place cover screw so bone doesnt integrate inside the middle part of implant
- suture flap back in to place
explain the stages involved 3 months after an implant has been placed?
- uncover implant with tissue punch
- place abutment
- take imp with coping over abutment (use putty wash impression)
- choose colour
- place temporary restoration
- cast impressions with lab dummy
what is the crown of implants usually made from?
porcelain
what is a blunt triangle?
gingivae beside implant is blunter
how can implants be retained?
cement retained
screw retained
what are issues associated with cement retained implants?
difficult to remove
can get cement around margins which can lead to inflammation and bone loss around the implant
what are advantages of screw retained implants?
if implant is damaged it can be screwed off and fixed
what can be used to secure a denture to implants?
locator abutments
ball abutments
gold bar
CAD CAM titanium bar
describe locator abutments?
on implant - abutment placed with internal and external components
SS cap placed in denture
locator insert inside ss cap
describe a ball abutment?
ball and socket
cold cure silver cap in denture
what are common post implant treatment complications?
peri-implantitis mucositis
peri-implantitis
loose/ fractured components
late implant failure
what is the role of the GDP in implant patients?
oral health advice
triage and diagnosis (if possible) of a complication
referral of the complication to an appropriately trained, indemnified and competent implant dentist
manage taking account of SDCEP guidelines
