Tamer Al-Sprinty Q1 Implants Flashcards by Tim Agee

3 Major groups of Dental Implant:

Sub-periosteal

Transosteal

Edosteal

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Sub-periosteal implants are large and made of Chrome Cobalt, which causes ____ and leads to infection

Resorption

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Endosteal Mx, Mn, and ____ Blades

Ramus

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don’t use Endosteal Ramus Blade anymore. They fail and take up a good section of the Ramus

True

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Epithelial migration caused infections on older, larger implants

True

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Transosteal implant is a ________, and we no longer use it

Through and Through

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Osseointigration was discovered by Branemark in the 60’s with what material?

Titanium

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Pure titanium is a little weak, so now we use Titanium alloy

True

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Ceramics are the newest implant, used in Europe

True

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3 Forms of Titanium alloy used in implant dentistry:

Which is most common?

Alpha

Beta

Alpha-Beta (most common)

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Direct structural/functional contact between living bone and surface of a load-carrying implant

Osseointigration

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Titanium is resistant to ________

Spontaneously forms coating of ________

This is inert and promotes bone formation on its

Corrosion

Titanium Oxide

surface

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Gap between implant and bone can’t be too large or too small

True

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Don’t overheat the implant site when drilling over ____ degrees C

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There should be no micro motion of the implant

there should be no contamination of the implant

True

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There should be ____mm of healthy bone Buccal/Lingual to the implant

1mm

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If the Implant is mobile, a ____ encapsulation has formed instead of osseointigration

Fibrous

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Peri-Implant radiolucency can be caused by what 3 things?

Contamination

Burn-out at tip (too hot) - no irrigation

Dense bone - burnout

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If there is a mean Marginal Bone Loss of greater than _________ after 3 years, there was a problem with the implant

1.5mm

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Short implants have a higher failure rate

True

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Type I bone

Type IV bone

dense

trabecular

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2 reasons Anterior Mn is good for implants:

Cortical Bone thick

Trabecular bone dense

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Maxillary implants are less effective in the Posterior Maxilla for what 2 reasons?

Cortical Bone thin

Trabecular Bone diffuse

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Contraindications for Implants: Pregnancy, uncontrolled ______, radiation, unrealistic _________

Diabetes

Expectations

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The Healing Phase of Implants differs according to what?

Manufacturer

If pt is old, ad dexterity, lean toward removables

True

Machined surface Implants take ____ months for Osseointigration

6 months

2 Early Improvements on Machining Titanium: Their problems:

Sand Blasted: contaminants Plasma Spray: Giant cells/ macrophage reactive

Rough surfaces create better initial Anchorage Accelerates biologic events leading to Osseointigration

True True

3 Examples of Surfaces available now on Implants:

TiOBlast Sand/Acid Etched Double acid Etched

High Crystalline _________ as a coating is best available implant surface today But there is also a ______ Metal that has proved highly effective

Hydroxyapatite Trabecular

Trabecular Metal is made from __________ *element 73

Tantrum *highly biocompatible

What measures Surface Osseointigration?

Bone Appositional Index

Bone Appositional Index is greater with rough surfaces

True

HydroxyApatite coatings is more bioreactive and leads to more rapid...

Healing

At 6 weeks Appositional Index is close to ____% for HydroxyApatite implants ___% for original titanium surfaces

70% 30-50%

Hydroxyapatite has more _____ than titanium coated controls

Bone Contact

Machined Ti success rate: HA-coated Ti success rate:

95. 2% | 97. 92%

T/F | Can't graft height in the Posterior Mn

True

Implants should be at least ___mm in length ___mm in diameter

10 mm 4 mm

Short and wide diameter implants are susceptible to overload due to unvaforable

crown/implant ratio

2 strategies used to eliminate Cantilever Effects:

Wide diameter Multiple implants

Small diameter Implants can become loose or...

Fracture

If there is less than 1mm of bone Buccal/Lingual to an implant...

Graft

What system is Pure Titanium? What is stronger?

Branemark Ti alloy

Off axialed loading should be avoided most especially where? 2 reasons why?

Posterior Mx increased forces, poor bone quality

Off axis loading of singe unit implant restorations increase stress where? Vertical loading produces the lowest _____ to supporting bone

implant/cortical bone interface stress

Where does off-axis loading increase stress in the Implant?

Neck | at tip

Where in the mouth should Implants be placed axial to occlusal loads? Anterior can be off axis b/c forces used are _____ of those used posteriorly

Posterior Quadrants 1/4

Implant overload is rarely seen in the Anterior

True

Short and angled implants have high failure rates

True

Bone loss around Implants can be caused by what?

Infection, overheating bone, Cantilever, occlusal forces, off axis, implant type (too small), type of bone, crown:implant ratio off

It is preferable to Splint Implants in the Posterior - only do this if...

Good OH

Central contact of the Implant should be around the Axis Hole

True

If Implant is less than ___mm you should put 1 implant/tooth If Implants are more than ___mm you can do 2 Implants to replace 3 teeth

13 13

2 Types of Cantilevers:

Buccal/Lingual Mesial/Distal

What type of connection is preferred?

Internal

If the Occlusal Table is excessively wide, what type of cantiliever is created?

B/L

Avoid B/L Cantilevers by doing what?

Narrowing B/L occlusal table in Posterior Teeth

3 cases in which Cantilever is ok:

Mx LI *implant either in Central or Canine) Mn Central *implant in Lateral Complete Edentulous *Posterior

When in doubt, always add the 3rd Implat

True

2 Occlusal Factors to control to avoid Implant Overload

Cusp angles Occlusal table width

You should avoid the use of Implants less than __mm

10mm

External Connections are susceptible to what?

Lateral forces tipping crown *flexes,

What design eliminated rotational tipping and micro-movement of crowns on implants?

Internal Hex connection

Splinting has better distribution of forces and improved anti_______ features

rotational

2 reasons to not Splint in the anterior:

decreased forces better bone

Splint the Anterior if you are working in ______

Pink Porcelain

Why don't we Splint to Natural Dentition?

PDL flex Sinking tooth

Splinting to natural dentition causes what?

bone loss sinking dentition

Eliminate what contacts on Posterior restorations? Why?

working, balancing no PDL

Anterior implant restorations can share some _____

Anterior Guidance

Can do Implant on smokers, but there is a higher failure rate

True

Pt must be available for ___weeks after Implant placement b/c _____

4 weeks adjustments

If pt is Edentulous, what might not provide enough support? what do we need for the support?

Fixed complete denture Overdenture (has the flanges)

The more bone loss you have, the more options you have for the implant/denture set-up for Edentulous pts

True

Edentulous: less than 10mm to gingiva, use... 10-14mm, use... 15-20mm, use...

PFM locator implant, overdenture, fixed detachable locator, overdenture

Implants have longer crowns

true

In the fully edentulous, a high smile line might indicate what?

Over-denture *avoids display of prosthetic border

Most commonly a smile reveals how far posteriorly? 2nd most common?

2 PM equal between 1PM and 1M

Ideally there should be ___mm of keratinized mucosa around implants

3-4 mm

Thin scalloped gingiva does better with what?

Immediate Implants

PFM requires how much interarch space in the Posterior? Overdenture? Fixed complete (hybrid)?

5 mm 8-10mm 15-20mm

Anterior Single Crown: space btwn opposing tooth and implant abutment should be a minimum of...

1mm

A minimum of 1mm of B/L sides of implant will avoid _________

fenestration/dehiscence

M/D implant to tooth distance: Inter-Implant minimum distance:

1.5-2 mm 3 mm

Keep the Implant at least ___mm away from the Mental Foramen

5 mm

Mn arch implants are usually placed anterior to what?

Mental Foramen *5mm

The Inter-Foraminal distance on the Mn should be wide enough to place how many implants? Ave distance:

4-5 47 mm

If you're using _______ instead of Wax, you don't have to re-cast

Pink Acrylic

The emergence profile of the Surgical Stent should be ____mm under the gingiva

1-2mm

What is GP for on the surgical guide?

radiograph

What is sent to Belgium?

Simplant

Implant is place ___mm deep of the Surgical Guide

3 mm

Implant failure in the Esthetic Zone is due to poor judgement/Tx planning

True