Surgical Protocol for Implant patients Flashcards
How do you assess dental implant success?
Immobile when tested clinically
No periimplant radiolucency
Vertical bone loss less than 0.2mm annually after 1st year of service of implant
Absence of persistent or irreversible signs and symptoms such as pain, parasthesia, infections, neuropathies, or mandibular canal violation
Minimum success rate of 85% at the end of 5 year observation period
Which implant system is best?
No evidence in literature that one implant system is better than any other
What surgical decisions affect treatment outcomes?
Immediate vs early vs delayed placement
Flap vs flapless surgery
One stage vs two stage surgery
3D implant positioning
Simple augmentation
Suture techniques
What is the difference between single stage and two stage implants?
Single stage = transmucosal abutment
Two stage: Cover screw and primary closure
Why is using a flap important? What are the risks if you don’t?
To see the buccal plate. If you can’t see it you risk:
Perforation
No augmenation
Implant exposure
Implant is more likely to fail
How can direction of the implant being placed be assessed?
Using a direction indicator which allows us to visualize the M-D (will not indicate the B-L positioning)
Allows avoiding nerves and sinuses
What level should the emergence of the prostheses of the implant start?
Ideal implant terminates 3mm below CEJ of adjacent teeth
How is an implant inserted?
1) Assess ridge width and availability of buccal bone.
2) Using 2mm drill to create first hole.
3) Use direction indicator to assess direction
4) Narrow platform drill for 3mm hold to be formed.
5) Implant placed and suture around it.
If two stage:
6) Cover screw is left flush with the margin.
What is the ideal amount of torque to use for an implant placing drill?
If torque <30Ncm it can be placed into the bone
What is the jumping space?
The space between the buccal plate and the implant. It needs to be <2mm if it is larger it needs bone to be grafted between it and the buccal bone.
When is simple augmentation used?
Designed for small defects
Cannot be used to gain primary stability because the graft has no rigidity so it can’t hold the implant well in place
Used with xenograft or autogenous grafting tissue
What are fenestrations and dehiscence?
Fenestration: Window above the root through the bone can be caused by an abscess.
