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13 Cards in this Set
- Front
- Back
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What is the most widely used material for IMPLANTS?
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Titanium and its alloys
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What are the indications for IMPLANT SUPPORTED FPD?
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- unfavourable abutments (number/location)
- virgin potential abutment teeth - questionable prognosis of abutment teeth - maintain bone after extraction |
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What are the indications for IMPLANT SUPPORT OVERDENTURES?
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- replacement of lost hard and soft tissue
- unfavourable ridge for complete denture - unfavourable orientation / inclination for implant supported FPD - patient wants removeable prosthesis - economic constraints |
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What are the ABSOLUTE CONTRAINDICATIONS for implants?
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None, except those absolute C/I's to elective surgical procedures
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What are the RELATIVE CONTRAINDICATIONS for implants?
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- age < 18yo (implant may submerge due to growth)
- immunocompromised / immunosuppressed: diabetes, HIV, transplant, cancer, etc - osteoporosis (controversial), Bisphosphonate IV or PO, radiation - smoking - alcoholismm - bruxism - poor oral hygeine and periodontal disease - local factors: location, orientation, bone quantity, quality, periodontal biotype |
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What are the classes of BONE QUANTITY?
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A: most of alveolar ridge present
B: moderate ridge resorption C: advanced ridge resorption but basal bone remains D: advanced ridge resorption with minimal to moderate basal bone resorption E: advanced ridge resorption with extreme basal bone resorption |
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What are the classes of BONE QUALITY:
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TYPE I: homogenous cortical bone
TYPE II: thick cortical bone layer around dense trabecular bone core TYPE III: thin cortical bone layer around dense trabecular bone core TYPE IV: thin cortical bone layer around low density trabecular bone core |
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Where is the BEST and WORST quality of bone?
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BEST: anterior mandible (Type I)
WORST: posterior maxillay (TYPE IV) |
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What are the IMPLANT SEQUENCING PROTOCOLS (placement)?
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PLACEMENT
- immediate: same day as extraction - immediate-delayed: done 6-8 weeks after extraction - delayed: done > 3 months after extraction - Placement time will depend on each clinical situation (number of roots, need for bone graft, sinus lift, medical status, etc) - primary stability must be achieved in minimum of 4mm of bone |
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What are the IMPLANT SEQUENCING PROTOCOLS (loading)?
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Immediate: same day as placement
Immediate delayed: 6-8 weeks after implant placement (indicated most of the time) Delayed: >3-6 months after implant placement Based on the three stages of healing after placement. |
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What are the THREE STAGES of healing after IMPLANT placement?
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1-8 days: Basic healing, wound, blood clots, platelets, fibrin mesh, mesenchymal preosteoblasts, early woven bone matrix, unorganized collagen fibers with ability to become bone. Only PRIMARY STABILITY - mechanical can be achieved
6 weeks: Osseointegration, biologic integration and mineralization, starts to begin at 3-4 weeks. SECONDARY STABILITY - biologic. Implant can be loaded at this point with the same failure rate as loading at 3months. > 6 weeks: living interface, constant remodelling and resorption at implant interface. Osseointegration can increase over time. 1.5 mm of bone needed for remodelling. |
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What are the different options for IMPLANTS?
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- pure-titanium vs titanium. alloy
- polished surface vs rough (roughened has better outcome) - cement retained vs screw retained - implant abutment - sizes |
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What are the SPACE REQUIREMENTS for implants?
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INTERPROXIMAL SPACE:
- 1 mm of bone on both sides of implant PLUS 0.5 mm to compensate for the PDL of each adjacent tooth. e.g. 3.75mm body / 4.1 mm platform implant will need at least 6.6mm of interproximal space between 2 natural teeth. When implants are placed next to one another we want at least 3.0 mm INTERPROXIMALLY. Buccal-lingual needs at least 1.0mm of bone on both sides of the implant. |
