Final; Dental Implants in Health

Question 1

This is the direct attachment or connection of vital osseous tissue to the surface of an implant, without intervening connective tissue; physical binding

Answer 1

osseointegration

Question 2

This is the clinical term to define osseointegration

Answer 2

rigid fixation

Question 3

True or False

Implants can be 100% integrated into bone

Answer 3

False, 100% bone connection does not exist, approx. 60% bone to implant contact

Question 4

What are the steps in placing an implant

Answer 4

• incision
• mucoperiosteal flap elevation
• preparation of a bed of the cortical and spongy bone (osteotomy)
• insertion of the titanium device

Question 5

There is this type of displacement of bone tissues at the tight contact at the cortical bone level regarding initial implant stability

Answer 5

lateral

Question 6

What is the ultimate goal of the implant regarding the bone

Answer 6

for it to become anchylotic with the bone; establish a mucosal attachment
- You can always add bone onto the rest of the implant if you need to if it is stable in 3 walls

Question 7

What is the process of bone healing at 24 hours

Answer 7

• resorption of cortical bone
• woven bone formation
• blood clot formation
• proliferation of vascular structures into newly forming granulation tissues

Question 8

What is the process of bone healing at 1 week

Answer 8

• reparative macrophage and undifferentiated mesenchymal cells
• modeling at the apical trabecular region and at the furcation sites of a screw shaped implant

Question 9

What is the process of bone healing at 2 weeks

Answer 9

new bone formation can be detected at the “furcation sites” of a screw shaped implant

Question 10

What is the process of bone healing at up to 6 weeks

Answer 10

callus formation and lamellar compaction within woven bone

Question 11

True or False

During bone healing, there is a temporary decrease in implant stability

Answer 11

True

Question 12

This is the distance that can be filled with new bone between the implant and the remaining host bone

Answer 12

“jumping distance”

Question 13

What is the ideal tolerable bone “jumping distance”

Answer 13

20-40μm

Question 14

When is a good time for dental implant loading

Answer 14

accepted healing period for osseointegration is 6 months for maxilla and 3 months for mandible

Question 15

What are the 4 types of implant loading

Answer 15

• immediate loading (same day)
• early loading (weeks)
• late loading (months)
• progressive bone loading (something new every week)

Question 16

What is good/poor bone quality

Answer 16

• you want a MIX of cortical and trabecular, cortical gives you the stability, while trabecular gives you the blood supply
• Too much cortical = not enough blood
• Too much trabecular = not enough stability

Question 17

This increases surface area, and bone response is stronger to surfaces with irregularity values

Answer 17

porosity

Question 18

An implant should be surrounded with a minimum of how much alveolar bone thickness

Answer 18

1mm

Question 19

What are the minimum ridges of bone thickness between implant/implant and implant/tooth

Answer 19

implant/implant - 3mm

implant/tooth - 4mm

Question 20

The coronal part of an implant should be places approx. how many mm apical to the adjacent CEF

Answer 20

5mm

Question 21

Obtaining this between implants and teeth is critical

Answer 21

maximum parallelism

Question 22

Implants do not have this, which means they cannot tolerate horizontal forces

Answer 22

PDL

Question 23

An implant can be places at a maximum of this angle

Answer 23

20 degrees

Question 24

What are the two parts of transmucosal attachment

Answer 24

• barrier epithelium (2mm)

- zone of connective tissue (1-1.5mm)

Question 25

The collagen fiber bundles are in which direction corresponding to the implant surface

Answer 25

parallel

Question 26

The zone that is adjacent to the implant surface is rich from what and poor from what?

Answer 26

rich from fibroblast, but poor from blood vessels

Question 27

The zone that is in lateral direction and continuous with the first zone has fewer fibroblasts but is rich in what

Answer 27

collagen fibers and blood vessels

Question 28

The blood supply is coming from which blood vessels

Answer 28

supraperiosteal

Question 29

What is the difference between one and two stage implant placement

Answer 29

two stage = submerged tech. | one stage = non-submerged tech.

Question 30

This is the same that exists between implant and abutment

Answer 30

microgap; generally located at the alveolar crest

Question 31

Where does the biologic width on an implant exist

Answer 31

around unloaded and loaded non submerged one part titanium implants; approximately 3mm

Question 32

What are the 6 parameters used to evaluate peri-implant health

Answer 32

1; absence of mobility 2; radiographic examination 3; absence of bone loss ≥2mm/year following the first year 4; absence of any pain, complaint, or infection 5; functional and esthetic acceptance of implant 6; success rate of 94-98% following 5 years and 90-94% following 10 years

Question 33

What are the three techniques to evaluate dental implants

Answer 33

peri-implant probing existence of mobility radiographic examination

Question 34

This of an object is strongly correlated to the boundary constrains of the structure

Answer 34

resonance frequency analysis (RFA) | the higher the # the better stability

Question 35

is keratinized tissue or attached gingiva required around dental implants

Answer 35

yes, especially in partially edentulous

Question 36

What is the success rate for implants placed at grafted sites

Answer 36

about the same - stability

Question 37

With an implant there is no _____ ______ attachment

Answer 37

Soft tissue

Question 38

With implants what seals the implant post to the bone?

Answer 38

Mucosal seal

Question 39

What is stronger a soft tissue attachment or mucosal seal?

Answer 39

soft tissue attachment (found in natural teeth)

Question 40

How much mobility is acceptable with an implant?

Answer 40

ZERO

Question 41

What is rigid fixation?

Answer 41

Osseointegration

Question 42

Why does 100% bone connection not exist?

Answer 42

There are small non-binding pocket areas along the surface of the implant

Question 43

New implants differ from older implants how? Some older styles are still used today.

Answer 43

Older implants - smooth | Newer implants - roughened surfaces - screw design

Question 44

Why would we pick a roughened implant design over a smooth?

Answer 44

For additional surface area binding

Question 45

When would you expect to see the temporary decrease in stability of the implant improve?

Answer 45

After 6 week plateau

Question 46

When is a good time for dental implant loading? Maxilla and Mandible?

Answer 46

``` Maxilla = 6 months (thinner cortical bone) Mandible = 3 months (thicker cortical bone) ```

Question 47

What is the worst type of bone quality for implants? What is best?

Answer 47

Type IV bone, then Type I | Best is between Types II and III

Question 48

What type of implant is most used today in the US?

Answer 48

Titanium (covered with titanium dioxide)