Factors Effect Flashcards
(38 cards)
What are the factors effects implant osseointegration ?
1- implant material ( Ti gold standard )
2- implant finish
3- status of the bone
4- implant loading condition
5- surgical techniques
6- Macro and micro design of implant
What is Osseointegration ?
Direct interaction between implant and bone at microscopic level
Asymptomatic rigid fixation of alloplastic material during function
What is the type of stability in primary and secondary ?
Primary : pure mechanical ( micro motion lead to failure )
Secondary : is the long term success , biochemical ( after healing of bone ) and depends on the degree of bone formation
Deferences between bone remodeling and modeling :
Remodeling : replace old bone with new bone ( Slow / same shape ) , Decrease primary increase secondary
Modeling : changing the shape/size of bone as response to force or stress ( fast / different shape )
Repair : physiological process were body facilitate repair of bone fracture
Bone regeneration : development of new bone in deficient sites with using surgical protocols ( osteogenesis, osteoinduction, and osteoconduction )
What are the components of osteogenesis,
osteoinduction, and osteoconduction ?
Bone graft + osteoblasts = OSTEOGENESIS
Bone graft + angiogenesis = OSTEOCONDUCTION
Bone graft + growth factors = OSTEOINDUCTION
Implant with Higher survival rate sites to lower survival rate and why :
- Anterior mandibular teeth ( 100 % ) thick outer cortical bone
- Anterior maxillary teeth ( 94 % )
- Posterior mandibular teeth ( 92% ) neurovascular bundle’s
- Posterior maxillary teeth ( Nasal floor and maxillary sinus )
What imagine modality to see bone density?
CBCT
Alveolar bone proper “Cortical bone” other names ?
- Lamina dura ( RO lining )
- cribriform plate ( because of blood vessels )
- bundle bone ( because of pdl fibers )
Deference between cortical and cancellous bone ?
- Cortical bone Microscopic structure is osteon and it’s organized and surrounds blood vessels
- cancellous bone microscopic structure is trabeculae and it’s unorganized and surrounds blood vessels
Osseointegration Prerequisites ?
• Precise fit
• Primary stability ( Achieved in surgery place and torque measurement )
• Bioinert No - tissue reation )
• Bioactive ( + favorable tissue reaction )
Osseointegration Process :
0 day ( 2 hours ) : production of Coagulum
4 weeks : New trabecular bone
6 weeks : Dense trabecular bone
12 weeks : New mature bone
BIC is what ?
Bone to implant contact and measures degree pf ossteointegration
Most common incision
Creatal incision ( should be beveled and suitable for submerged and non submerged )
In case of bone grafting what incision should we use ?
Vertical releasing incision
( should be beveled 45- 60 degree to the center of the flap not the IDP and not of middle of facial surface )
( Should extend beyond the muccogingival line and AVOID it in palatal/ lingual ( thicker fibers )
In implant osteotomy what is the benefit of placing surgical guide template ?
Directs the angulation of the implant
What torque and speed we use in implant osteotomy ?
Low speed (1500 - 2000 rpm ) , High torque , copious irrigation ,
Generic drilling sequence ?
- blade no 12
- Pilot drill ( low speed diamond with taper end ) ( 1.5-2 mm hight ) drill into center by 7-9 mm
- position verification ( must take PA with it to asses position and angulation ) ( maximum speed 800 rpm )
- 2nd Twist drill ( re assess the position and angulation) ( 2.5 mm in width ) ( maximum speed 800 rpm )
- final shaping drill ( widen the osteotomy to implant diameter )
- Taper drill or thread former ( only for thicker bone ) less than 30 rpm
- implant insertion 45 Ncm by hand piece or hand ratchet then take PA
Sequence change according to the implant and bone ( soft or hard ).
Methods of measuring implant stability( primary ) include :
- Percussion testing
- Insertion torque (IT) by a machine that determine the stability of the implant, it gives readings: 15,25,30,35
- Reverse torque test
1 stage vs 2 stage approach ?
1-stage approach (non submerged):
- Healing Abutment
- one surgical intervention.
- shortens treatment times.
- Partially edentulous patients
2-stage (submerged) :
- cover scrow
- when primary stability not obtained and GTR
- when expected that removable temporary prostheses could transmit excessive forces
- fully edentulous patients.
When to remove sutures?
After 7-10 days ( should use CHX 0, 12 % )
What is the most common suturing material ?
Non absorbable like :
silk use for flap because it’s cheaper
Nylon
Absorbable material for sutauing used for what?
Extraction & Bone graft ( we use figure of 8 for it )
Most commonly used suturing technique?
Simple interrupted
When late complications aries and what is it ?
After 3 months
- Implant mucositis : inflammation of soft tissue
- Perimplantitis: inflam. of the bone cause bone loss
- Implant fracture
