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Implantology > s10 - surgical Techniques > Flashcards

s10 - surgical Techniques Flashcards

1
Q

What is the definition of a dental implant?

A

A prosthetic device made of alloplastic material implanted into oral tissues to support/retain a prosthesis.

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2
Q

List the 3 main materials used in dental implants.

A
  1. Commercially Pure Titanium (Ti CP) 2. Titanium Alloy (Ti-6Al-4V) 3. Zirconium (Zr).
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3
Q

What are the 4 grades of Ti CP, and how do they differ?

A

Grades I-IV; Grade I is purest, Grade IV has highest tensile strength.

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4
Q

Name the 4 main components of a dental implant system.

A
  1. Fixture 2. Abutment 3. Connections 4. Restorations.
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5
Q

Compare screw-retained vs. cement-retained restorations (1 advantage each).

A

Screw: Retrievable. Cement: Better esthetics (no access hole).

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6
Q

What is a key disadvantage of cement-retained restorations?

A

Cement residue can cause peri-implantitis if not fully removed.

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7
Q

Define osseointegration.

A

Direct structural/functional connection between living bone and implant surface (Brånemark, 1985).

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8
Q

How was osseointegration discovered?

A

Brånemark observed titanium fusing with rabbit tibia bone during microcirculation studies (1950s).

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9
Q

List the 4 phases of osseointegration in order.

A
  1. Hemostasis 2. Inflammatory 3. Proliferative 4. Remodeling.
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10
Q

What occurs during the hemostasis phase?

A

Blood clot forms; platelets adhere to implant surface.

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11
Q

What is the role of macrophages in the inflammatory phase?

A

Clean debris/bacteria and secrete VEGF for angiogenesis.

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12
Q

What 3 processes occur in the proliferative phase?

A
  1. Angiogenesis 2. Osteoprogenitor cell migration 3. Woven bone formation.
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13
Q

How does remodeling phase differ from proliferative phase?

A

Osteoclasts replace woven bone with load-oriented lamellar bone.

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14
Q

Compare contact vs. distance osteogenesis.

A

Contact: Bone forms on implant surface. Distance: Bone grows from existing bone toward implant.

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15
Q

What are the 4 prerequisites for osseointegration?

A
  1. Primary stability 2. Suitable material/surface 3. Atraumatic surgery 4. Uncontaminated implant.
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16
Q

Why is heat control critical during drilling?

A

Temperatures >47°C for 1min cause bone necrosis.

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17
Q

How does surface roughness affect osseointegration?

A

Rough surfaces enhance contact osteogenesis and bone-to-implant contact.

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18
Q

What 4 elements are assessed in preoperative evaluation?

A
  1. Medical history 2. Dental history 3. Clinical exam 4. Radiographs.
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19
Q

What are 3 uses of mounted study models?

A
  1. Occlusion analysis 2. Ridge evaluation 3. Surgical stent fabrication.
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20
Q

Why is a diagnostic wax-up important?

A

Visualizes prosthetic outcome and guides implant positioning.

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21
Q

What 2 vital structures must radiographs identify in the mandible?

A
  1. Inferior alveolar nerve 2. Lingual concavity.
22
Q

What is the minimum bone height required above the maxillary sinus?

23
Q

What imaging modality is gold standard for assessing IAN position?

24
Q

List 3 risks of lingual plate perforation in the mandible.

A
  1. Hemorrhage 2. Implant displacement 3. Infection.
25
What is the recommended distance between implant and adjacent tooth?
≥1.5mm.
26
What are the 5 key steps in the original Brånemark protocol?
1. Sterile implant 2. Atraumatic surgery 3. Remote flap 4. Primary stability 5. Unloaded healing (mandible: 3mo; maxilla: 6mo).
27
List 3 preoperative procedures for Stage I surgery.
1. Informed consent 2. Antibiotics 3. Chlorhexidine rinse.
28
Why is copious irrigation during drilling critical?
Prevents overheating (>47°C causes bone necrosis).
29
What drill speed is recommended for osteotomy preparation?
1500-2000 rpm (except tapping: <45 rpm).
30
Compare flap vs. flapless techniques (1 advantage each).
Flap: Better visualization. Flapless: Less postoperative pain/swelling.
31
What is the main disadvantage of flapless surgery?
Risk of bony plate perforation due to poor visibility.
32
What are 3 purposes of a surgical template?
1. Guides implant position 2. Avoids vital structures 3. Ensures prosthetic-driven placement.
33
How is primary closure achieved after flap elevation?
Periosteal releasing incisions + tension-free suturing.
34
When can a removable prosthesis be worn after Stage I surgery?
After 7-14 days, with soft reline material.
35
What is the purpose of Stage II surgery?
To expose the implant and place a healing abutment.
36
Describe Lekholm & Zarb's bone quality Type I.
Homogenous compact bone (entirely cortical).
37
Which bone type (I-IV) has the lowest density?
Type IV (thin cortical + low-density trabecular bone).
38
What is the minimum safe distance from the IAN?
2mm.
39
Why is 5mm anterior to the mental foramen recommended?
Avoids anterior loop of IAN (present in 48-55% of cases).
40
What are 2 risks of mandibular lingual plate perforation?
1. Sublingual artery hemorrhage 2. Implant displacement into soft tissue.
41
What radiographic finding suggests a lingual concavity?
Concave lingual cortex on CBCT (66% prevalence in posterior mandible).
42
Why is 1-1.5mm bone required below the maxillary sinus?
Prevents implant intrusion into sinus.
43
Define primary stability.
Mechanical stability from friction between implant and bone at placement.
44
What are 2 methods to assess primary stability?
1. Insertion torque 2. Resonance frequency analysis (ISQ scale).
45
What ISQ value indicates good stability?
>70 (scale: 1-100).
46
Compare immediate vs. early loading.
Immediate: <48h. Early: 48h-3mo.
47
What is conventional loading?
Prosthesis attached after 3-6mo unloaded healing.
48
What is the minimum distance between two implants?
3mm.
49
Why is 2mm buccal bone required at the implant shoulder?
Prevents soft tissue recession and bone loss.
50
List 3 complications of IAN perforation.
1. Paresthesia 2. Hematoma 3. Chronic neuropathic pain.

Implantology (7 decks)

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