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73 Cards in this Set
- Front
- Back
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What should you do for implant hygiene 2 weeks after placement?
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We don't want the patient brushing the area aggressively; instead use a chlorhexidine rinse for 2 weeks after placement.
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T/F
After the implants have been placed, the implant-supported restoration and surrounding soft tissue should be evaluated at each maintenance appointment. |
True
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What should you evaluate regarding the implant at each maintenance appointment?
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1. Quality of the peri-implant tissue
2. Presence of plaque and calculus (implants attract plaque and calculus just like teeth) 3. Radiographic appearance of the implant and peri-implant structures. (we should be taking an x-ray every year; in the first year you can expect about 1.5 mm of bone loss {due to surgical placement of the implant} every year after that you can expect about 0.2 mm of bone loss) 4. Presence of support at the abutments 5. Mobility of the abutment or restoration 6. Patient comfort and function |
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What can calculus build-ups on implants lead to?
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Calculus build-ups can cause areas of soft tissue inflammation. This may result in progressive bone loss if left untreated.
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What three things should you check for when evaluating soft tissue surrounding implants?
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1. Color
2. Texture 3. Firmness Healthy implant tissue should minic healthy tissue around a natural tooth. Bad signs include Inflammation and Supparation |
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What do you evaluate for radiographically regarding implants?
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1. Bone Level
2. Bone Adaptation 3. Thread exposure 4. Pathosis (see RL around the implant apex) |
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Why should you not probe around an implant?
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It can disturb the hemidesmosomal attachment. If you are going to probe, use a plastic probe.
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What kind of plastic probe Maintains consistency of probing force between clinicians and from examination to examination?
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PDT Sensor Probe
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What are 3 different kinds of implants?
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o subperiosteal
implant which is positioned ON bone (most often mandible) and lies beneath the periosteum • required two surgeries, performed under general anesthesia requiring hospitalization o transosseous a mandibular implant which extends through the bone and engages both the inferior and superior bone surface o endosseous implant which is placed within bone today we use root-form (vs. blade) developed by… • Dr. Branemark o Swedish physician who was researching the wound healing process and discovered “osseointegration” |
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What is a mandibular implant which extends through the bone and engages both the inferior and superior bone surface
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Transosseous
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What is an implant which is positioned ON bone (most often mandible) and lies beneath the periosteum. Also, required two surgeries, performed under general anesthesia requiring hospitalization?
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Subperiosteal
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What type of implants do we use today?
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Endosseous Root Form implants
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Implants are not a tooth. What are two main determinants to support this?
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o a prosthetic replica, unlike a natural tooth, it has no…
periodontal ligament a biological attachment of the soft tissue in to the implant or implant abutment |
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T/F
Osseointegration is continuous bone attachement to the implant |
False
Osseointegration is attachment is not continuous…there are islands of attachment separated by marrow spaces only 40-50% of implant surface is attached to the bone |
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What are the 3 requirements to obtain osseointegration?
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precise, meticulous preparation of site to prevent the bone temperature from rising above 47 degrees (will lead to necrosis)
no loading of dental implant immediate primary stabilization of the implant |
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What are osteoblasts?
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o fully differentiated cell that fxns in the formation of bone tissue
o synthesize the bone matrix and produce inorganic salts o will develop into osteocytes |
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What are osteocytes?
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o osteoblast that became embedded w/ the bone matrix (occupies bone lacuna)
o contact other osteocytes w/ cytoplasmic processes |
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What are osteoclasts
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o large multinucleated cells that fxn in the breakdown and resorption of osseous tissue
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What types of bone are best used for dental implants?
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types II and III are best for implants (I too dense and less vascularity; IV associated w/ higher implant loss)
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What bone type is type I?
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Cortical plate - dense compact bone
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What bone type is type II?
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Thick compact bone w/dense trabecular core
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What bone type is type III?
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Thin cortical plate w/dense trabecular core
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What bone type is type IV?
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Thin cortical plate w/low density trabecular core
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Are implants the standard of care?
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Yes
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What are the Absolute Contraindications to placing implants?
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1. Uncontrolled Cardiovascular Disease
2. Uncontrolled Diabetes 3. Neoplastic Diseases - (chemotherapy, immunosuppression, radiation tx) - only when they are undergoing treatment 4. Drug-addicts 5. Psychiatric instability - i.e. schizophrenia, paranoia, dysmorphia, cerebral lesions/pre-senile |
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T/F
Smoking is an absolute contraindication |
False
However, increases chances of failure 300-400% Greater risk in type III and IV bone |
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T/F
Blood dyscrasias, hyperthyroidism, renal disease, liver disease, varying heart disease, hepatitis, pregnancy and smoking are all absolute contraindications to implant placement. |
False
These are all contraindications but NOT Absolute |
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T/F
Positioning of implant is based on biologic determinants of the planned prosthetic design |
True
We now modify the bone to our prosthetic needs |
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What do we evaluate on the treatment arch?
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The arch receiving the implant
evaluate - Height, Width, arch relationships, occlusal plane, existing dentition, fixture positions, esthetic plans |
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What do we evaluate on the opposing arch?
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Occlusal plane, type of dentition, arch relationship, type of restoration material to be used
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What is the minimum height above the platform of abutment for adequate retention (intra-arch distance)?
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5mm above the platform of abutment
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What is an External Force applied to a Prosthesis, implant, abutment, tooth?
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Load
Functional load is generated across prosthodontic interfaces (bone-implant; abutment-implant; fixation screw-abutment; crown-abutment) |
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What are occlusal factors that we want to account for?
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1. Teeth only come into contact during swallowing and during parafunctional movement
2. Posterior teeth should disclude during working, non-working and protrusive movements 3. We want to decrease stress in implant of system - Decrease Occlusal Overload 4. Develop occlusal force along long-axis of implant (perpendicular to the occlusal surface) |
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What are the different sizes of implants?
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red/pink = 3.5 mm
yellow = 4.3 mm blue = 5.0 mm green = 6.0 mm |
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What are the different types of antirotational mechanisms?
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Standard hex
Tall hex Internal hex Morse taper Tri-channel Spline |
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What is so good about the tri-channel anti-rotational mechanism?
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Tri-channel resists tipping forces and compressing
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How much room do you need from the implant to the adjacent tooth?
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2 mm from implant to adjacent tooth
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How much room do you need from implant to implant?
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3mm
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How much room do you need from cortical plates?
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1-1.5 mm
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How much room do you need from any critical structures?
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2 mm
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How much room do you need from the sinus?
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Can be placed to edge or slightly beyond edge of sinus or antrum
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What are the objectives of the surgical stent?
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1. Must clearly define the 3D position to the Surgeon
2. Opening should be adequate for 2mm pilot drill 3. Must locate mesio-distal, buccal lingual... |
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In implant prosthetics, what esthetic zone issue is the most difficult to obtain an esthetic result?
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High smile line is the most difficult w/which to achieve an esthetic result
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When determining implant position the goal is to place the fixture head as close as possible to the direction of forces in order to: ___________________
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Reduce Lever Arm and Reduce bending movement
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How should you align implants in the anterior as opposed to the posterior?
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Anterior - Angulation should allow the long-axis to emerge through the cingulum
Posterior - Align implants so the fixture's long axis emerges from center of occlusal surface |
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What is a tiunite surface?
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Treated surface of implant that increases osseointegration
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What stage implant has the abutment portion permanently fixed to the root portion of fixture?
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One stage implants
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What stage implant allows for placement of abutment on top of fixture whenever (if desired)?
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Two-stage implants
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What type of surgery is where implant fixture is placed in bone and the soft tissue is entirely closed over the fixture?
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Two stage surgery
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What type of surgery is where the abutment on implant is left protruding through the tissue?
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One-stage surgery
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What type of graft material is from the same species, but a different donor?
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Allograft
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What type of graft material is synthetic?
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Alloplast
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What type of graft material is biologic, but Different Species?
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Xenograft (most commonly used)
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What type of graft material is self-donating?
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Autograft
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What should we torque our unigrip screwdriver to ?
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35 Newton Centimeters
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What types of impression material are acceptable to capture implants?
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Vinyl polysiloxanes - most commonly used
Polysulfide rubbers Polyethers (NO alginate or reversible hydrocolloids) |
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What are the absolute goals of accurate impressions?
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1. Captures 100% of Hard and Soft Tissues
2. Exact Fixture position and Orientation of the Anti-rotational device |
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What is the difference between a Transfer impression (closed tray) and a Pick up impression (open tray)?
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Transfer impression (Closed tray) - Captures image of impression post and LEAVES THEM IN PATIENTS MOUTH
Pick up Impression (Open Tray) - Removes impression post from patients mouth |
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What do you want to pour up your implant models in?
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Low to zero expansion die stones
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What could happen if the cemented implant restoration has a short abutment?
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Short abutment may lead to chronic loosening of crown
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¿De qué se trata el cuento que le cuenta su papá?
what is the story he tells his dad |
¿Qué hizo Ricky cuando no encontro el bigote en la calle?
why did ricky when they found a mustache on the street (very strange people apparently hacked this card) |
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What is the benefit of gold screws over titanium?
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Gold has lower coefficient of friction. Able to tighten more effectively as compared to titanium alloys
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What can mechanical fatigue lead to?
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1. Fracture screw
2. Screw loosening 3. Porcelain fracture 4. Component failure |
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What are the criteria for diagnosis of Peri-implantitis?
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1. Inflammation
2. Pocket depth 3. Radiographic bone loss 4. Mobility (loss of implant) |
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What is the difference between peri-implantitis and retrograde peri-implantitis?
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Retrograde is Trauma Induced
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When do you probe an implant?
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Only in presence of pathology
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What type of bacteria is present in peri-implantitis?
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GRAM NEGATIVE BLACK PIGMENTED ORGANISMS
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How is the papilla preserved?
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4-5 mm at contact point to crest of bone
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What is the microbial situation with healthy implants?
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Healthy implants are similar flora to healthy teeth
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What is an implant with problems limited to soft tissue and NOT Involving Supporting Bone?
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Ailing implant
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What is an implant with progressive Loss of Supporting Bone but Not Clinically Mobile?
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Failing implant
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What type of implant is Clinically Mobile?
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Failed Implant
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What type of instruments are used for scaling implants?
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Plastic, Teflon, Gold, or Wooden
(NEVER use ultrasonic or PRophy jet) |
