Hermann and Tarnow

Question 1

Hermann looked at?

Answer 1

Crestal bone levels

Question 2

Tarnow looked at?

Answer 2

inter-implant distances

Question 3

consequence of loosing peak of bone if implants placed too close together? loss of interdental bone will result in..?

Answer 3

with loss of the inter-dental bone height/ crest you get an esthetic problem as well recession and loss of the gingiva/ papilla inter-proximally

POOR ESTHETICS

Question 4

minimum distance needed when placing adjacent implants? what does this prevent?

Answer 4

3mm he is saying it will prevent the loss of the CREST OF BONE INBETWEEN

*NOT SAYING IT WILL PREVENT BONE LOSS FROM OCCURING

Question 5

Major assumption Tarnow made? relationship to the Hermann study?

Answer 5

that bone loss is inevitable – meaning it will always happen

Hermann said you can avoid bone loss depending on the type

Question 6

schematic of hermann design

Answer 6

1. extracted
2. implants 6 weeks later
3. abutment placed 3 weeks after that
4. sacrifice and looked at histologically

Question 7

which implant showed no bone loss?

Answer 7

Type A – tissue level implant as it is significantly above the crest of bone

Question 8

what guarantees bone loss will occur?

Answer 8

if the interface is at the crest of bone or submerged apical to the crest of bone

Question 9

why did Tarnow always see bone loss?

Answer 9

Because he put every implant AT THE CREST OF BONE – so if place it at the crest of bone you are guaranteeing bone loss to occur

Question 10

what does submerged mean?

Answer 10

when placing the implant you put the soft tissue back over it and had primary closure

Question 11

original branemark said you got bone loss when?

Answer 11

not at the time of placing the implant but subsequent to the screwing in of the abutment

so when patient came back to put the abutment on - the crest of bone was at the same level then when you took radiogrpah of the abutment you ALWAYS had bone loss after a period of time

Question 12

Hermann’s conclusions

Answer 12

the location of the abutment interface relative to the implant is crucial whether or not you will have bone loss in the future or not and also the location of the roughened surface or polished collar

Question 13

if you have polished collar it should always be where?

Answer 13

coronal to the bone because it can lead to bone loss

Question 14

Hermann assumptions

Answer 14

canine model translates to the human model

Question 15

do the studies compliment eachother?

Answer 15

that you will get bone loss ineviteably if you use the certain design

Question 16

implications of Tarnow study

Answer 16

If using implant like tarnow used – expect bone loss and expect to lose the peak of bone between as well if place them closer than 3mm

Question 17

if placing a supra-crestal implant what are we most concerned with?

Answer 17

what surface is that is supra-crestal

Question 18

implications of sub crestal and at the crest for implants

Answer 18

will get bone loss

Question 19

if supra crestal surface is roughneded what are the implications

Answer 19

potential for plaque build up

Question 20

platform switching use?

general

Answer 20

try to combat the problem that we see with implant placements like Tarnows

brings interface FURTHER AWAY from the EDGE OF THE IMPLANT IN A HORIZONTAL DIRECTION

Question 21

which direction is being manipulated in platform switching

Answer 21

HORIZONTAL

brings interface FURTHER AWAY from the EDGE OF THE IMPLANT IN A HORIZONTAL DIRECTION

Question 22

solutions for limiting bone loss (2 we discussed)

Answer 22

1. interface between abutment and implant more coronal

2. platform switching

Question 23

describe the platform switching **

Answer 23

method used to preserve alveolar bone levels around dental implants

placing screwed or friction fit restorative abutments of NARROWER DIAMETER in implants of wider diameter

Question 24

platform matching and implications

Answer 24

when the implant and abutment interface is matched in a horizontal direction so it lines up – results in more bone loss

Question 25

if platform switch and place at crest of bone?

Answer 25

likley no bone loss

Question 26

location of polished collar

Answer 26

coronal to crest always - so when place the abutment it sits above crest of bone and then no bone loss

Question 27

alveolar ridge resoprtion occurs a lot of times from what?

Answer 27

denture wearing related problems

Question 28

require a complete denture what should always be recommended?

Answer 28

implant supported dentures – as we see a lot of ridge resorption with denture wearing

PREVENTING THE ADDITIONAL RESORPTION OF THE RIDGE FROM WEARING A DENTURE