Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
46 Cards in this Set
- Front
- Back
|
Whats the role of the dental hygienist in implant placement/care?
|
Tx and maintenance. Education about implants (90% success rate, picture documentation, show prospective pts potential end results, descriptive brochures.
|
|
|
What are some contraindications/cautions for implants?
|
Tx and maintenance. Education about implants (90% success rate, picture documentation, show prospective pts potential end results, descriptive brochures.
|
|
|
What are the 3 components of a dental implant?
|
1.Body: fixture placed directly into bone 2. Abutment: screws into body and will support restoration 3. Superstructure: prosthetic restoration that is screwed or cemented into place
|
|
|
This type of implant is "within the bone". It is the most commonly used today.
|
Endosseous
|
|
|
Term: Direct contact of a load carrying dental implant (inert metal) with bone without any intervening connective tissue.
|
Osseointegration
|
|
|
Due to osseointegration, an implant is essentially ankylosed and missing a part of the periodontium (this is one of the main differences between a natural tooth and an implant). What aspect of the periodontium is missing?
|
PDL
|
|
|
What are the major signs of implant success?
|
1. Full occlusal function w/out pain 2. Initial marginal bone height loss in first year of 1-2mm, crestal bone height loss of no more than 0.1-.2mm/yr 3. Inflammation of fingiva ok unless affecting contour or bone level 4.clinical immobility 5. absence of persistent and/or irreversible pain and infection 6. No periimpant radiolucency 7. No irreversible mechanical failures (implant fractures)
|
|
|
What type of implant has the best long-term success?
|
machined pure titanium with screw shape (may be coated to help with integration, hydrocyapatite surface show more potential for bonding)
|
|
|
These types of implants are "under the periosteum". They rest on top of the bone for support and may or may not be fixed by screws. What situation might these be used in?
|
Subperiosteal. Sometimes for edentulous pts where there is insufficient bone mass for root type implant.
|
|
|
These implants are "through the bone". Placed through the mandible from under chin into mouth. Called mandibular staple implants. These aren't used commonly-why? When might they be used?
|
Transosteal. More commonly associated with complications and infections. Only used in severely resorbed mandibles (greater risk of tissue damage and infection).
|
|
|
These types of implants are "in and through the tooth" they are known as endodontic stabilizers. A post is insterting into a root canal space that extends 1cm beyond the apex. Are these commonly used? Why?
|
Endodontic. Not used in the US bc of potential for root fracture, renention probs and root resorption.
|
|
|
What characteristics of bone should be examined to determine the quantity and quality or density of bone?
|
Width-distance F-LN between cortical plates (min. 5mm). 2. Height: crest of edentulous ridge to anatomical structure (MX sinus or MN canal) 3. Bone length: M-D in edentulous site or distance between 2 adjacent implants. 4. Bone density (reflects strength of bone) I: homogenous cortical bone II. Core of dense cancellous bone with thick layer of compact bone III: thin layer of cortical bone surrounding dense trabecular bone of favorable strength IV: thin cortical bone surrounding core of low-density trabecular bone (this has poor strength)
|
|
|
True or false: Pressure loading on top of an implant should be avoided during the healing period
|
TRUE
|
|
|
How long does osseointegration take for the MN? MX?
|
MN: 3-4 months MX-5-6 months. Some manufacturers claim implants can be loaded as early as 2 months after placement.
|
|
|
After the second stage (when healing abutment is placed), how long does it take to heal before the restoration can be placed?
|
2-3 weeks
|
|
|
For a single-stage surgery is the superstructure loaded that day too? How long does healing take?
|
No, loading occurs at a later time. The main difference between from a two stage is that a portion of the implant body (collar) or abutment (post) is left exposed untl the time the restoration is placed. Still requires 3-6 monts healing time
|
|
|
Impants with ______________can be put into function immediatedly as long as the forces are controlled and below the critical movement threshold.
|
primary stability (not mobile when placed)
|
|
|
For immediate implant placment in an extraction socket, what are the conditions for success? What are the drawbacks?
|
Success:adequate bone, primary stability achieved, and no infection present. Drawback: Protracted healing time, excessive pain/swelling, ridge defect after extraction
|
|
|
Name of the procedure where bone graft is placed in an extraction site.
|
Socket preservation. It minimizes bone resorption after extraction
|
|
|
This procedure increases tha amount of bone in the maxilla for implant placement
|
sinus lift
|
|
|
This procedure is used to increase the bone height in the alveolar ridges by cutting the bone into 2 pieces which are gradually separated by 1mm a day to form new bone between the cut pieces.
|
Distraction osteogenesis
|
|
|
What are some restorative option for implants (possible superstructures)
|
Fixed prosthesis, implant supported overdentures (add stability, help stop alveolar ridge resorption, better function, all-on-4 (not removable)), fixed partials (fixed bridges on multiple implants), single tooth replacement
|
|
|
On implants the JE adheres to implant surfaces and is referred to as a ______________.
|
Perimucosal seal
|
|
|
Do implants have connective tissue fibers?
|
Yes, but they're parallel to the tooth surface and don't insert into the implant
|
|
|
Do implants have cementum?
|
no
|
|
|
True or False: Any mobility in an implant is a sign of failure.
|
TRUE
|
|
|
The only blood supply to an implant area is through?
|
periosteal vessels and bone marros space (doesn't have a PDL)
|
|
|
Do oral biofilms grow faster on titanium or enamel?
|
Titanium
|
|
|
Why is inflammation more widespread around implants?
|
due to lack of limiting attached connective tissue fibers (transseptal or supracrestal groups)
|
|
|
Inflammation into the bone marrow is associated with? (implants or natural teeth)
|
Implants
|
|
|
Is the bacteriology different between implants and natural teeth?
|
NO
|
|
|
How should your appointment progress for a pt with implants?
|
try not to slip with Nevi and puncture one of her over inflated fun bags.
|
|
|
No really…how should your appointment progress for a pt with dental implants?
|
review med history, IO/EO, rads: every 3 months for first year then every 6-12 months to ck for bone loss, remove superstrucure if necessary/possible and clean it, ck tissues for inflammation, check for plaque and review OHI, probe (platic or nylon), record BOP, clean implant abutments using non metallic instruments, irrigate with antimicrobial solution if indicated, replace superstructure, ck occlusion, review dental hygiene, reschedule for 3-4 months depending on eval of tissue and oral hygiene.
|
|
|
What should you do to assess the soft tissue around an implant?
|
Assess color, contour, consistency, texture, presence of erythema, edema, suppuration
|
|
|
Why is probing an implant controversial?
|
Some think it may create a path for bacteria to enter through peri-implant seal. Gentle probing with a plastic probe is recommended around implants. Changes in PD over time may indicate disease.
|
|
|
Is BOP around an implant necessarily due to inflammation?
|
Not necessarily may be caused by probing force. Controversy exists.
|
|
|
True or False: Presence of keratinized gingiva is associated with improved tissue health (around an implant)
|
TRUE
|
|
|
What type of radiographs should be taken of an implant?
|
Pano taken for baseline. Individual Pas or vertical bitewings taken with gridded film to ck bone height and density. (success is 0.2 mm or less of bone loss per year). 6-12month interval
|
|
|
How much mobility is acceptible for an implant?
|
Zero (no PDL and osseointegration). Remove prosthesis every year and test.
|
|
|
What is the recipe for success for an implant?
|
1. frequent inspection and debridement. 2. No mobility 3. Prosthesis must fit accurately and securely 4. No trauma from occlusion 5. No radiographic radiolucencies around implant 6. pts dental behavior pattern (good compliance)
|
|
|
What are three reasons for implant failure?
|
1. excess cement 2. occlusal overload (may result in mechanical failures of both implant and prosthetic suprastructures-looseing/fracturing screws, marginal bone loss) 3. Poor oral hygiene
|
|
|
This is reversible inflammation of the soft tissues around an implant. Plaque-induced inflammation similart to gingivitis in natural teeth.
|
Peri-implant mucositis
|
|
|
This is similar to periodontitis around an implant. It's an aggressive lesion (can be slight to severe). Shows loss of supporting bone.
|
Peri-implantitis
|
|
|
How is peri-implantitis treated? (slight problems, moderate and severe)
|
Slight: OHI, nonsurgical local therapy (debridement, controlled-release antibiotics and mouthrinses). Moderate: systemic antibiotics or flap surgery. Severe: flap surgery for access, regenerative therapy, or removal of implant.
|
|
|
What type of instruments can be used to clean implants?
|
No metal (stainless steel or carbon steel). Can use: plastic, graphite, Teflon, or nylon
|
|
|
Is in-office irrigation necessary for implants?
|
Maybe? More research needs to be done. If you do it, don't be too aggressive in forcing tip. Use plastic irrigation tips or cannulas and irrigate to the base of the pocket.
|
