RP - implant pros

Question 1

what is an implant?

Answer 1

an artificial tooth root that is surgically anchored into the jaw to hold a replacement tooth or teeth or a denture in place.

Question 2

what is the benefit of using implants?

Answer 2

they don’t rely on neighbouring teeth for support

Question 3

name the 3 parts of a dental implant?

Answer 3

titanium dental implant
abutment
(abutment screw)
crown

Question 4

describe osseointegration and dental implants?

Answer 4

there is no PDL
direct communication with bone

Question 5

what is the gum around abutment of an implant called?

Answer 5

peri-implant mucosa

Question 6

what can an implant restore?

Answer 6

a single tooth (implant crown)
multiple teeth (implant bridge)
can secure a denture firmly (implant overdenture)
eyes, ears, hearing aids and noses

Question 7

list the implant treatment sequence

Answer 7

plan and consent
place
uncover and connect abutments
restorative procedures
restore
monitor and maintain

Question 8

what medical disorders may compromise implant treatment and why?

Answer 8

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

Question 9

what is NHS implant funding for?

Answer 9

patients with:
- H+N cancer
- severe hypodontia
- severe trauma
- cleft palate

Question 10

what are the risks associated with implants?

Answer 10

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

Question 11

why does bruxism pose an issue with implants?

Answer 11

no PDL so no sense of biting force

Question 12

what modalities are used for implant planning?

Answer 12

history and exam
radiographs
other imaging - CBCT/ CT
surgical and radiographic templates
ridge mapping (study casts and pins in mucosa)

Question 13

when taking radiographs for implant planning, what views do you want?

Answer 13

2 different planes
lat ceph and OPT

Question 14

how do you implant plan on a OPT?

Answer 14

10mm GP cones sit in appliances - they show how much bone is available

remember OPT is 1.3x normal size

Question 15

when would you want to use a CBCT for implant planning?

Answer 15

plot the IDC - need to give canal a wide birth from implant
determine angle of implant

Question 16

where do you gather information to produce surgical and radiographic templates?

Answer 16

radiographs, scans, exisitng prosthesis, and casts

Question 17

what are the 4 types of implants?

Answer 17

system
tapered
platform
co-axis (different angle on emergence)

Question 18

what are the post op complications associated with implants?

Answer 18

failure
infection

Question 19

explain the stages involved in implant surgery?

Answer 19

1. raise flap and drill bone with torque controlled drill
2. place implant
3. place cover screw so bone doesnt integrate inside the middle part of implant
4. suture flap back in to place

Question 20

explain the stages involved 3 months after an implant has been placed?

Answer 20

1. uncover implant with tissue punch
2. place abutment
3. take imp with coping over abutment (use putty wash impression)
4. choose colour
5. place temporary restoration
6. cast impressions with lab dummy

Question 21

what is the crown of implants usually made from?

Answer 21

porcelain

Question 22

what is a blunt triangle?

Answer 22

gingivae beside implant is blunter

Question 23

how can implants be retained?

Answer 23

cement retained
screw retained

Question 24

what are issues associated with cement retained implants?

Answer 24

difficult to remove
can get cement around margins which can lead to inflammation and bone loss around the implant

Question 25

what are advantages of screw retained implants?

Answer 25

if implant is damaged it can be screwed off and fixed

Question 26

what can be used to secure a denture to implants?

Answer 26

locator abutments
ball abutments
gold bar
CAD CAM titanium bar

Question 27

describe locator abutments?

Answer 27

on implant - abutment placed with internal and external components
SS cap placed in denture
locator insert inside ss cap

Question 28

describe a ball abutment?

Answer 28

ball and socket
cold cure silver cap in denture

Question 29

what are common post implant treatment complications?

Answer 29

peri-implantitis mucositis
peri-implantitis
loose/ fractured components
late implant failure

Question 30

what is the role of the GDP in implant patients?

Answer 30

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