OS- implants

Question 1

what are implants?

Answer 1

Titanium screws that are osteointegrated into bone.

Question 2

What do we need to place an implant?

Answer 2

BONE

Question 3

The patient has lost bone, explain how it could have been lost?

Answer 3

Congenitally (cleft lip and palate/ hypodontia)
Trauma
Pathological- tumours/infection/ dysplastic lesions.
Natural (Bone loss occurs over time)

Question 4

What is bone augmentation used for in implants?

Answer 4

The idea of replacing deficent bone & inserting the implant into the augmented material.

Question 5

Compare the different ways of augmenting bone?

Answer 5

Autogeneous-Graft harvested from yourself
Xenograft -type of graft harvested from a different species.
Allograft -irritated sterilized freeze dried bone blocks.
Alloplastic - synthetic material
Bone bioengineering- Inject bone morphogenic proteins

Question 6

How does bone bioengineering work to augment bone defects ?

Answer 6

The injection of bone morphogenic proteins (growth factors) induce bone formation and stimulate angiogenesis (the formation of new blood vessels)

Question 7

Name and compare the main principles of bone grafting?

Answer 7

Osteoconduction- The concept of using a sacffold that supports the bone forming cells.

Osteoinduction- When osteogenesis is induced by recruiting immature cells for bone formation (i.e. using own bone forming cells are used to form bone)

Question 8

How can we add grafting material for bone agumentation?

Answer 8

As an onlay- on top of the bone.
interpositional- between two layers of bone.
Sinus lift- sinus lift procedure to lift up the maxillary sinus membrane & put the bone graft underneath - giving enough space for the implant.

Question 9

What is inferior dental nerve retraction?

Answer 9

Surgery- When we move the nerve laterally before placing the implant.
We then place the IADN over the implant.

Question 10

What is distraction osteogenesis?

Answer 10

The idea of bone lengthening without using a graft - you separate the bone until the callous forms. Then lengthen the callus. (bone should lengthen at 1mm rate per day)

Question 11

What is a zygomatic implant?

Answer 11

The implant is placed into a piece of bone just behind the maxillary sinus

Question 12

What are the indications for a zygomatic implant?

Answer 12

• Severe maxillary atrophy
• A really large sinus impacting implant positioning ,
• Sinus pneumatization
• To avoid harvesting a bone graft

Question 13

Give 3 general factors that need to be considered before referring a patient for implants

Answer 13

• Patient has good oral hygiene
• Do they smoke
• Cost
• Is there enough viable bone or alternative availability of suitable bone
• Periodontal history
• History of contact sport
• Age
  Patient understands what is likely to be involved & is willing to comply with treatment

Question 14

Give 3 local factors that need to be considered before referring a patient for implants.

Answer 14

• bone height
• Bone width (Bucco-palatal
• Root position of 21 and 24
• Soft tissue adequacy
• Smile line
• Local periodontal health/ plaque control
• General biotype.