Tamer El-Finale Implants Flashcards
Avg age (of death) in 205 estimated to be…
90
By 2020, how many elderly adults will be edentulous in one or both arches?
30 million plus
Out of 33 million edentulous pts, ____% have received implant Tx
2-4%
Reasons for Implants
opposed to dentures
Success
Bone preservation
Chewing/Tasting
Improve quality of life
3 Removable implant options (for edentulous)
Ball OverDenture
Locator OverDenture
Bar OverDenture
3 Fixed Implant options (for edentulous)
Fixed Detachable Prosth
Porcelain Fused to Metal Fixed Prosth
Zirconia Fixed Prosth
How often should a Fixed Detachable Prosth be removed?
5 years
3 options for 8-10 mm Inter-occlusal space:
Locator OverDenture
Porcelain fused to Metal Fixed Prosth
Zirconia Fixed Prosth (fixed complete)
Option for 12-15 mm interocclusal space:
Fixed detachable Prosth
2 options for 15-20 mm interocclusal space:
Locator Bar Overdenture
Hader Bar Overdenture
If 10-15mm interocclusal space, what are 3 options?
PFM
Zirconia
Locator
2 fixed dentures (implant supported) that Don’t have a Flange:
Porcelain fused to metal prosth
Zirconia fixed prosth (fixed complete)
Where do you measure interocclusal space?
Articulator
*never in mouth
What type of Implant-supported prosthesis is better if a Pt has a Dexterity Problem?
Removeable
Ideally there is ___mm of keratinized mucosa around the implants
3-4 mm
If implants aren’t parallel, what should you use?
Always use _____ abutments with Splinted Implants
Bar
non-engaging
Both Locator or a Bar Overdenture in the edentulous Mn requires how many implants?
*removable prostheses
2-4 implants
Removable Prostheses (Locator or Bar Overdenture) requires how many implants in the Mandible?
Fixed Detachable in the Mn?
Porcelain fused to Metal Fixed in the Mn?
All Ceramic Fixed in the Mn?
2-4 implants
4-5 implants
6 implants
6 implants
Removable Prostheses (Locator/Bar) requires how many Implants in the Maxilla?
Fixed Detachable in the Mx?
Porcelain fused to Metal fixed in the Mx?
All Ceramics in the Mx?
4
4-6
6-8
6-8
The Mx arch should have a minimum of how many implants no matter what?
4
Ball O-Ring or Locator Overdenture requires _____ implants?
*Mn
2-4
Where should implants be placed in the Mn for an Overdenture?
22-23
26-27
Why are forward implants desireable in the Mn for an Overdenture?
limits fulcruming
For tests: healing after implant placement is:
4-6 months
The top of an abutment needs to be how far above the gingival tissue?
*cleaning purposes
1 mm
3 Advantages to using a Locator Overdenture:
***aside from being very low profile
Durable
Easy for Pt
15 and 30 degree angles
Locator Overdenture is Low Profile, meaning its attachment height is as low as ____ mm from the internal connection of the implants
2.5 mm
If you have very Limited Interocclusal Space, what is best to use?
Locator Overdenture
**8-10 mm
Retention of Abutments (for Locator Overdenture) 1.5 lbs for _____, 3 lbs for _____, and 5 lbs for _______
Angle can be corrected up to ____ degrees per abutment
blue, pink, white
10 degrees
***standard
Standard: blue, pink, white (1.5, 3, 5) and 10 degrees
Extended: 1.5 lbs is ______, 4 lbs is ______
Angulation correction is:
red, green
20 degrees
***no need for angled abutment
Algled Locator Abutment out of Italy:
MedentiLOC
If you have abutment in your office, take the impression at what level?
If you have to order the abutment, take impression where?
Abutment Level
Fixture Level
Why make a fixed Mx in a U-shaped arch (remove palatal)?
What must it have?
Taste
metal reinforcement of the acrylic
If a denture fractures you can add metal to the framework or create space by doing what?
Alveoplasty
T/F
If there are implants in the Anterior Mn, the posterior will continue to lose bone
True
Because Mn continues to lose bone in sites away from implants a hard reline should be done how often?
2 years
Advantage of Ball Overdenture:
Disadvantage:
Good stress distribution
Less retention, stability
***compared to other prostheses
T/F
With a Ball Overdenture, implants must be parallel or constant insertion and removal results in rapid wear of the ring
True
Success rate of implant supported Overdentures in the Maxilla:
Succes rate of implant supported Overdentures in the Mandible:
- 3%
- 5%
**total 95.4%
Additional benefit to implant retained overdentures?
mastication
Disadvantage to a Straight Bar Overdenture?
fulcrum
A Bar Retained Overdenture requires how much space?
measured from where?
***this is interocclusal space
15-20 mm
implant head to the Plane of Occlusion
A bone reduction guide will require what?
Verification Jig
T/F
You must know where the denture teeth will be prior to fabricating the bar underneath
So scan the denture teeth and the implants
True
True
What is imperative for a Metal Framework?
Passive fit over Implants
***MUST try-in
Hybrid Prosthesis:
Fixed Detachable
*only detaches every 5 yrs (by dentist)
If you don’t have passive fit with a metal framework, what then?
Section
How far can you Cantilever a Hybrid (fixed detachable) Prosthesis?
A-P spread x 2
1.5 for clinic
A-P spread x 2 =
posterior Cantilever in a fixed detachable (Hybrid)
Why is it tough to do a Hybrid Prosthesis with a Square Arch?
small A-P spread
How much space is needed under a Hybrid Prosthesis in order for the Pt to clean?
1.5 mm
T/F
Cantilever length should not exceed 2 times the A-P spread
True
Implant Supported Prosthesis: Maxillary Arch, min. length:
implants:
A-P spread:
10 mm
4
1 cm
Implant Supported Prosthesis: Mandibular Arch, min. length:
implants:
A-P spread:
10 mm
4
1 cm
Type of fixed prosthesis delivered same day as Implant Surgery:
type of abutment:
All on 4’s
conical
Porcelain fused to metal implant supported prosthesis is ______ implants
what arch?
6-8 implants
Upper
1st year of Maintenance, appointments how often?
After?
every 3 months
6 months
3 Appointment instruments for implant supported prosthesis cleaning?
Plastic scalers
Titanium scalers
Cavitron w/ plastic tip
What 2 (or 3) Prostheses require at least 15mm of InterOcclusal Space?
Locator Bar Overdenture
Hader Bar Overdenture
***but also might be Fixed Detachable (Hybrid), which is really 12-15 mm (but 15-20 on another slide)