Trauma From Occlusion- Dental Implants 10/16/15

Question 1

What is Primary Stability?

Answer 1

Stability of implant at time of placement (mechanical interlocking mechanism between a screw and the bone surface. **Should not be able to spin with finger pressure once seated!

Question 2

Describe the healing at the interface of the implant….

Answer 2

Bone formation and remodling (3 months for mandible, 6 months for maxilla)

Question 3

What are the 3 stages of functional loading of the implant?

Answer 3

1. Immediate loading (at time of implant placement)
2. Early loading (before conventional healing time)
3. Late loading (3-6 months later based on location.)

Question 4

What are the consequences of Implants with excessive occlusion?

Answer 4

• Porcelain Fracture
• Implant to abutment (Screw losening or fracture)
• Implant fixture fracture
• Increasing mobility of adjacent teeth
• Eruption or malocclusion of adjacent teeth (observed following functional loading of the dental implant)

Question 5

Myelinated fiber content of the inferior nerve is reduced by 20% after extraction.

Answer 5

Good to know

Question 6

T or F, Gradual increase in free nerve endings close to the implant-bone interface occur during healing.

Answer 6

True

Question 7

T or F, Tactile sensitivity and Thickness discrimination both get worse after implant.

Answer 7

True.
Tactile = 1-2g —-> 50-100g
Thickness discrimination = 20um ——->50-100um

Question 8

After loss of PDL, how does an implant get sensory feedback?

Answer 8

Receptors within the bone (Elasticity) instead of Viscoelasticity (with PDL).

Question 9

What are static forces?

Answer 9

Constant forces applied as in orthodontic movement

Question 10

What are Functional forces?

Answer 10

Expected intermittent multidirectional forces that would occur when a tooth/implant is in normal function.

Question 11

What are Excessive forces?

Answer 11

Forces well beyond those of teeth and implants in function (Cantilevered implants).

Question 12

In Functional occlusion, what does loading time depend on?

Answer 12

• Primary stability of implant
• Implant design
• Restorative design
• Presence/absence of risk factors

Question 13

T or F, Functional, well controlled loading can increase bone to implant contact.

Answer 13

True!

Question 14

Is 100% bone-implant contact possible?

Answer 14

No!

Question 15

Occlusal trauma is a _______ etiological factor for periodontal disease, but it can be a _____ etiological factor for peri-implant disease.

Answer 15

Secondary

Primary

Question 16

What do you do if a patient with bruxism wants an implant?

Answer 16

Get in their face and yell “You can’t handle the Implant!”……Or you could use a longer, and wider implant with good bone structure and make them a night guard.

Question 17

T or F, Research has shown that implant diameter is more critical than length in reducing bone stress.

Answer 17

True!

Question 18

T or F, Vertical loads induced higher bone strain and implant stress than lateral loads.

Answer 18

False! Lateral loads induced higher bone strain!

Question 19

T or F, Distal tilted implants can produce height tensile stress when compares with distal vertical implants.

Answer 19

True!