trauma from occlusion: dental implants

Question 1

what are the key characteristics of natural teeth that relate to occlusal forces?

Answer 1

PDL Attachment Apparatus

Can “adapt” to heavy forces

Tooth mobility as a physiological/ pathological phenomena

Question 2

how do dental implants differ in their response to occlusal forces? (in comparison to natural teeth)

Answer 2

Direct bone-implant surface mechanical binding (osseointegration)

Continuous bone remodeling at bone-implant surface interface

Implant mobility as a pathological phenomena

Question 3

implants are attached to the bone by ____________

Answer 3

Osseointegration

Question 4

what is primary stability of an implant?

Answer 4

stability of the implant at the time of placement (mechanical interlocking mechanism between a screw and bone surface)

Question 5

what factors influence primary stability of implants?

Answer 5

• Bone density

- Implant fixture design

Question 6

how long is the healing time for mandibular implants? maxillary implants?

Answer 6

Mandible- 3 months

Maxilla- 6 months

Question 7

what are the 3 types of implant loading?

Answer 7

Immediate Loading (at the time of placement)

Early loading (before conventional healing time)

Late loading (following 3 or 6 months based on location)

Question 8

what types of failures can occur in an implant with excessive occlusal force?

Answer 8

Porcelain Fracture

Implant to abutment (screw loosening or fracture)

Implant fixture fracture

Question 9

T/F: implants that have excessive occlusal force will not effect the adjacent teeth

Answer 9

FALSE

they can increase mobility of adjacent teeth

Question 10

why do implants not have the same proprioception as normal teeth?

Answer 10

Sensory feedback through receptors localized within pdl (viscoelasticity) and within bone (elasticity)

the PDL is what gives most proprioceptive feedback

Question 11

what are the 3 types of forces placed on implants?

Answer 11

Static forces

Functional forces

Excessive forces

Question 12

what type of implant is at a high risk for excessive forces?

Answer 12

cantilevered implants

Question 13

the Loading time of an implant depends on:

Answer 13

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

Question 14

T/F: Functional (and well controlled) loading may increase bone to implant contact

Answer 14

true

Question 15

occlusal trauma can be a __________ etiological factor for peri-implant disease

Answer 15

primary

Question 16

what causes “Retrograde Peri-implantitis”?

Answer 16

occlusal trauma

causes bone loss around implant

Question 17

why must the forces on implants always follow the long axis?

Answer 17

implants lack a PDL so they are unable to “give” in response to any lateral forces

Question 18

T/F: Research has shown that implant length is more critical than diameter in reducing the bone stress.

Answer 18

FALSE

Research has shown that implant diameter is more critical than length in reducing the bone stress.

Question 19

the “all-on-4” implant placement technique is used for what?

Answer 19

full dentures