Implants - Lecture 2
Pano radiograph limitations?
- 20-30% inherent magnification (distortion) - LOW resolution - only 17% measurements between crest and canal were accurate within 1mm
Everything before this card was review from the past lecture/pre-test
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longevity of single crowns supported by implants vs. FPDs vs. implant tooth-supported protheses?
96.4% 94.5% 91.3%
Distortion values for radiographs? PA, Pan, CT
:PA 14%, Pan 23%, 1.8% CT distortion reported Use CT -- lowest one
What is a Ferrule (endo)
A metal ring or cap placed around a pole or shaft for reinforcement or to prevent splitting. e.g. In a brush the ferrule binds the bristles or hair to the handle
what is the dimensions of the GP seal? (endo)
Minimum 4-5mm
Radiographic guide:
a template planned and fabricated to indicate the location of implant osteotomies during the radiographing procedures
Surgical guide:
a template planned and fabricated to indicate the location of implant osteotomies to the surgeon
Are centric and eccentric contacts achieved with immediate restorations (temporization) protocol?
No!
Criteria for implant success (Smith and Zarb)
- Imobile - NO peri-implant radiolucency - Mean vertical bone loss is less than 0.2mm annually - NO pain, discomfort, infection
What is the expected bone loss in the first year after implant placed?
1.0mm but only <0.2mm annually following the first year
Without PDL, that is the minimum buccal plate bone thickness?
1.5-2mm thickness is needed to self-supply enough blood to maintain height around implant.
Minimum thickness of bone: Labial and palatal bone plate?
1.5mm --prefer 2mm of labial bone to retain gingival height in order to avoid subsequent recession with exposure of crown margin
Minimum space between implant and natural teeth? Minimum space between implants?
1.5mm 3.0mm Need more between implants for increased blood supply
Best quality of bone you should put your implants in?
2 and 3
Ideal vertical distance (depth): between the top of the implant and CEJ of adjacent natural teeth:?
2-3mm --* The bigger the discrepancy between the diameter of implant and diameter of missing tooth, the deeper implant should be.
What is the dimensions you need for a ferrule? (endo)
2mm tall 1mm thick this is needed because the post that goes down into the canal can fracture the tooth, so the ferrule is needed to keep it in place
IAN loops were found in ____% of the patients?
31% -- higher in males than females
survival Tate of FPD after 15 years?
74%
CBCT advantages?
94% CT measurements between the crest and canal were accurate within 1mm -- cross sectional imaging
What is the most dangerous pre-fabricated post?
Active threaded post
is the major key to maintain bone around implants?
Blood supply
What is the bottom line of surgical placement?
Bottom line is that whatever surgical plan we use, we should be able to achieve initial implant stabilityand subsequent long-term implant success.
What does cement do to the gum tissue if left?
Cement causes peri-implantitis and can lead to bone loss.
What to look out for when looking at edentulous regions periodical radiographs of implants?
Distortion! --- look for the treads if looking at already present implants
How much dose does the CBCT do to you compared to Pan and FMX?
FMX ~170 Pan ~24 CBCT ~80
Immediate implant placement protocol?
Immediate implant placement at the time of extraction of a non-infectedtooth can shorten overall treatment time by 2 to 4 months.
Two stage vs one-stage implants?
In the two-stage procedure, implants remain covered by gums until stage 2 surgery In one-stage procedures, implants are left uncovered
How close can you get to the Mn canal with the implant?
Keep the implant no closer than 2mm to the Mn canal
Loops of the IAN occur in about ____ ______ of patients and cary in size from _____ to _____
Loops of the IAN occur in about one thirdof patients and vary in size from 0.7 to 4.6 mm.
Do we have a better quality of bone in the Mx or Mn?
Mandible has better quality of bone! Higher success rate
What's the most common area on the Mn arch that interferes with implants?
Mn canal
Does Mn or Mx bone heal faster?
Mn implants: 3-4 months Mx implants: 4-6 months
What's the most common area on the Mx arch that interferes with implants?
Mx sinus
Only ____% measurements from crest to canal were accurate within __mm?
Only 53% measurements from crest to canal were accurate within 1 mm.
Immediate restoration protocol?
Only for esthetic concerns (getting married) -- can not put any loading forces on this implant. -- this is temporary
What does screwmentation =
Screw retain + cement-retained
what is the preferred pre-fabricated posts?
Tapered smooth fiber post
True or false? Significant implant failure: located in the Mx arch, diabetes, smoking and head and neck radiation?
True!
One stage implant protocol?
You put a healing abutment above the tissue vs. suturing over the implant cover and let it heal (requires one more surgery) -- only for young healthy individuals
Without 1.5-2.0mm thickness, what happens?
bone will resorbs away and soft tissue will recede with the bone.
cast dowel and core -- pre-fab or custom?
custom post! you make an impression of the canal
