Tamer El-Sprinty Q2 Implants COPY Flashcards by Tim Agee

Distraction Oseogenesis is breaking bone, attaching, and _________

screwing away

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Implant failure in the esthetic zone is due to poor judgement and Tx Planning

True

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Keys to successful Mx Anterior implant - M/D papillae and the ____

FGM

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4 Diagnostic keys to predictable esthetic Implants:

relative tooth position/dimension of edentulous space

form/biotype peridontium

tooth shape

position of osseous crest

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Not enough facial bone can result in the FGM being too Apical

True

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____mm Implant to Adjacent tooth

B/L thickness of bone must be…

1.2-2 mm

1 mm

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Minimum edentulous space M/D width in anterior (LI):

Minimum Bucco-Lingual width

6 mm

5 mm (b/c small width implant - 3.1mm or so)

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Interarch distance for a single restoration must be:

If less than 1/2 mm to this distance…

If more than 1/2 mm to this distance..

also…

5 mm

grind

crown

Extraction, Ortho Intrusion

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Flat thick gingiva has a better prognosis

True

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What kind of Mucosa has Circumferential fibers and a Gingival Cuff that forms around implants similarly to those seen around natural dentition?

Attached keratinized mucosa

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If an Implant emerges through _____ keratinized mucosa, it sill have a gingival cuff similar to natural dentition

This is because it has _____ fibers

Attached

Circumferential

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There must be ___mm of keratinized mucosa around Implants

3-4 mm

*attached preferable, but unattached ok of good OH

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What tooth shape has best prognosis for an Implant?

Why?

Square

longer contact (no Black Holes)

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Class I papilla:

Class IV papilla:

4 papilla:

1 papilla:

Palacci vs Ryser

intact

gone

intact

gone

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Tarnow study found that Bone ___ mm to papilla will regenerate at 100%

6mm:

7mm:

5 mm

56 %

27%

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There needs to be ___mm between Implant surface and Tooth to maintain Interproximal Bone

1.5 mm

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If the recession of the bone is more than 5 mm from the Incisal Edge, the pt will have what?

*resorption can occur if the surgeon put implant too close to the adjacent tooth

Black Triangle

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T/F

It is more difficult to maintain or create a Papilla between 2 adjacent Implants

True

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Adjacent implants need to be how far apart?

3 mm

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Pontica have better results with the Interdental Papilla

True

*can play with soft tissue a little more

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The implant should be placed how far away from the CEJ?

In the Anteriors, placement needs to be a little more ______

distance?

2-3 mm

LIngual

2 mm lingual to the facial surface

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If you aren’t 3 mm from the CEJ with placement what is compromised?

If you are deeper than 3mm from the CEJ what happens?

emergence profile

bone loss/difficulty cleaning

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Anterior measurments need be: B/L:

M/D:

Apico:coronal:

5 mm

6 mm

2-3 mm from CEJ - another 10mm of height, slightly Lingual for facial space, 2mm on facial

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If you have less than 6mm M/D space, what?

Ortho

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Regular pt success rate: Smoker success rate: *what we say in clinic

95% 85%

smoker failure: non-smoker failure:

11. 28% | 4. 76%

Smoking cessation for a total of ____ weeks will yield the same results as non-smokers

9 weeks

More MBL (marginal bone loss) in smokers

True

3 occlusal considerations for implants:

contact in central fossa low cusps reduce size occlusal table

Preferable way to retain implants:

Screw

3 cases Cement retained implants be used?

improper angulation correction Mn PM (esthetics) Mn incisors

Soft tissue will grow on top: ___ will stay above soft tissue

cover screw healing abutment

What type of impression is used for Parallel Implants? What type is used for severely Angled Implants?

Transfer (Closed Tray) Pick-Up (Open Tray)

2 general parts to any implant

body restorative part

Where natural roots converge, use what? *also for narrow ridge, limited bone

Tapered implants

Screw uses _______ Abutment Cemented uses ______ Abutment

non-engaging engaging

2 Indications for Non-Engaging "Cast-To" gold abutment:

Lack of inter-occlusal clearance Poor implant angulation that would lead to unesthetic restorations

2 types of Abutments:

engaging non-engaging

CAD CAM can produce customized abutments with good emergence profiles in what 2 materials?

Ceramic Titanium

Atlantis abutments are very precise

True

Atlantis scans, restores virtually, designs abutments virtually, and mills out of titanium blanks

True

Dual transition accommodates soft/hard tissue needs

True

HA surface is more bioreactive than Ti

True

Cement what 2 areas of the Mn?

Incisors Premolars *and less ideal angles ***SCREW everywhere else

Cover Screw is a ____ Stage surgery Healing Abutment is a _____Stage surgery Provisional Abutments are more conducive to what?

2 1 soft tissue healing

Cover Screw stays at the level of the... Healing Abutment is above the...

bone gingiva

Verify radiographically that your Abutment is seated with what?

We take impressions with ___

medium body PVS

In a closed tray technique we put the posts in and pour up

True

Open tray has holes drilled and is for what?

divergent implants

With Cement, we use a _______ Abutment With Screw, we use a ________ Abutment

Engaging Non-engaging

What type of Abutment do we use with Splinting?

Non-Engaging *something about path insertion

If you have to use a Cement Retained Mx LI, what type of Abutment?

Engaging

Any pre-formed Abutment with a finish line must be a _________

Engaging ***b/c will be cemented

All CAD/CAM abutments are customized in Ceramic or Ti and are ______ retained meaning they have ______ abutments

Cement Engaging

A tooth must have a ____mm Ferrule in order to hold a crown after RCT The dentin must be ___mm thick __mm Biologic Width

2. 0 mm 1. 0 mm 2. 0 mm

RCT - what is more important, post length or diameter?

Length

2 reasons to err on the side of the Palatal when placing Implants on the Anterior:

Better Primary Stability Won't risk facial puncture of bone

The expected Soft Tissue Shrinkage is _____ mm after 6 Months

0.6 mm

Why do we want a LIght Contact in occlusion for an Implant?

no PDL

Problem with 2 Adjacent Implants:

more difficult to create/maintain Papilla

Distance between 2 Implants:

3 mm

A multiple unit Cement Retained will have _______ abutments Multiple unit Screw Retained will have _______ abutments

Engaging non-engaging

Tooth to implant distance:

1.5 - 2.0 mm

Anterior restorations can be restored as individual single units or splinted

True

Survival rate of Onlay Bone Graft

98%

Limitations for Mx Posterior Implants include Quality and ______ Also pneumatized ________, _____ cortical bone poor quality ____ bone

Quantity Mx Sinus thin trabecular

If you can't establish Canine Guidance, make sure you have....

Group Function

The use of autogenous bone in a sinus lift may be necessary for success

True

Posterior Mn limiting factor for Implants

IAN *10mm or longer implant may be difficult **also width of bone

The use of Short and Wide Implants in the Post Mn has not been predictable

True *prone to occlusal overload, bone loss

There are minimal Perio complications with Implants

True

Implants predictably maintain cortical bone

True

Cost, technique, and Maintenance are all downsides to Implants

True

What is more difficult to maintain: FPD or Implant? More difficult to Diagnose/Tx plan?

Implant Implants

Biological complications are more frequent with FPD and RPD than an Implant

True

Branemark:

osseointigration

Kalamchi - there is no absolute contraindication for an implant

True

Subperiosteal, Transmandibular, Blade, Endosteal - all Implant types

True

What type of implant are implants?

Endosteal

Bisphosphonate patient may require special consideration

True

2 things we need for Tx planning Implants:

Articulated study models CBCT *3rd - surgical guide

Original protocol was how long for healing before implant placement?

3-6 months

A Sinus Fill elevates the ________ Membrane

Schneiderian

Should implants ever be connected to natural teeth?

What is minimum Surgical Access for an Implant Site?

35 mm

Distance from Implant to F/L: to Root Surface: between adjacent implants:

1 mm 1.5 mm 3 mm

The head of the implant must be ____ mm Apical to the planned CEJ This allows CT and _____ epithellial biological width to form the transmucosal portion of the implant

2-3 mm Junctional

Final Impressions made _____ weeks after placement

6-12 weeks

An Overdenture requires ____ Implants in the Mx Overdenture requires ____ Implants in the Mn

4-6 2-4

Maximum heat generated while drilling out implant site:

47 degrees Celsius

There should be initial stability and no micro-movement after placement of an Implant

True

Stability of the Implant at 12 Weeks is influenced by what? not what?

Diameter not length

Kalamchi ____% of the implant surface integrates with bone

50-70%

Bone Density D1: D2: D3: D4:

homogenous compact thick compact, dense trabecular thin cortical, dense trabecular thin cortical, low density trabecular

Bone type: Ant Mn Post Mn Ant Mx Post Mx

D1 D2 D3 D4

Matl acting as a scaffold for new bone BMP recruits undifferentiated cells to become osteoblasts Living bone cell transport from doner site to recipient site

Osteoconductive Osteoinductive Osteogenic

Alloplastic matl is: Allograft is: Only Osteogenic source of bone graft:

Osteoconductive Osteoconductive/Osteoinductive Autogenous

A patient can be too old for an implant

False

Use the Surgical Guide, but Don't rely on the surgical guide

True