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fliecher Flashcards

(54 cards)

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1
Q

clinical manifestations of ridge resorption

A 
headaches 
improper speech
diet
painful oral sores 
fracture
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2
Q

physiologic impact of edentulism

A

frustration
depression
isolation
embaressment

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3
Q

as the bone loss progresses

- actions and consequences

A

additional denture adhesive is used

relining material

reshaping of dentures

multiple sets

complete loss of denture function

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4
Q

a common cause of denture related problems

A

alveolar ridge resorption

 This is something that is completely avoidable today
• Yet, we still see patients that are completely edentulous in one or both arches
• We need to do a better job at explaining to our patients about the benefits of implants

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5
Q

total implant procedures per year in the USA

A

has increased exponentially each year

graph showed from 2011 - to 2021

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6
Q

o How would you treat this case if you didn’t have implants?

A
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7
Q

tx changes early on with implants

A

implants with ball clasps

- make a partial denture now with less material and it can be completely retentive and functional for the patient

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8
Q

Ball attachments

A

utalized to retain the denture

- will prevent resorption in area that they are placed

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9
Q

branemark implant

A

titanium and cylindrical

- screw shaped

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10
Q

supporting structure in tooth

A

periodontium

  • alveolar bone
  • PDL
  • gingiva
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11
Q

supporting structure in implant

A

peri-implant tissue

  • osseointegrated bone
  • NO pdl
  • gingiva
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12
Q

supporting structures (mucosal seal forms)

A

free gingival margin
gingival sulcus
free gingival groove

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13
Q

maxillary implants success rates in function from 1-4 years?

5-10 years?

A

1-4 = 95%

5-10 = 81%

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14
Q

mandibular implants success rates in function from 1-4 years?

5-10 years?

A

1-4 = 99%

5-10 = 91%

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15
Q

implant success based on

A 
biocompatibilit 
bomechanics 
surgical protocol
prosthetic protocol
orla hygeine
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16
Q

broad breakdown of patient selection

A

medical eval
dental eval
psychological evaluation

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17
Q

medical eval

A

rule out disease

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18
Q

dental evaluation

A 
cariies exam
perio disease eval
OHI eval 
bone level
- quality 
- quantity
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19
Q

psychological eval

A

realisitic expectation

full understanding of procedures and complications

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20
Q

what to use to measure for adequate bone

A

pano / periapical rx

  • clinical
  • CBCT scan –tremendous amount of information and all of the information that we’re going to need, as far as the amount of bone that’s available

height width depth

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21
Q

tx plan decisions

A 
type of implant 
design of prosthesis 
diagnosis 
extractions 
tissue augmentation
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22
Q

as little as ___ for healing after implant

23
Q
  • How important is the recall appointment to the long-term success of the dental implant and restoration, what is done during the appointment?
  • Implant Recall Appointment
Study These Flashcards
A 
o	Assessment and documentation
	Radiographic exam
	Mobility evaluation
	Osseointegration test?
	Soft tissue examination
o	Disease control instructions 
o	Scaling and prophylaxis
24
Q

assess what at recall at site

Study These Flashcards
A 
	Soft Tissue Examination
•	Color
•	Texture
•	Shape
•	Bleeding
•	Exudate
•	Keratinization
25
probe implant?
yes - cant just tell by x-rays alone - have to look clinically but NO metal ; use plastic or titanium instruments Implants that get probed have no lower success rate, long-term, than implants that don't
26
after healing how do we know when an implant is ready to be restored?
different stability test - percussion - torque and tactile - resonance frequency analysis (RFA)
27
T/F size of osteomty slightly smaller than implant
true -- helps with mechanical retention and stability
28
when does primary stability decrease?
around 2-3 weeks have a decrease - trauma from the surgery is causing initial bone to be lost on a microscopic level • At the same time, get secondary stability increasing and bone placement at a much faster rate • New bone formation takes place at a faster rate • Also depends on the surface treatment of the implant itself
29
SLA active
getting stability sooner - but end result is same with same stability just occuring sooner with this QUICKER RATE -- and if quicker - less liklihood of problems occuring
30
reverse torque test
o Spin the implant into place clockwise o After a period of time, will put a driver on the implant and will try to unscrew it o If osseointegrated, won't move o If it isn't, it will spin and come out o Putting strain on the implant and may have osseointegration and cause it to lose it by doing the test o For a long time, only test we had available
31
resonance frequency analysis (RFA) basics? include ISQ
uses a tuning fork the stiffer the interface b/w the bone and implant - the higher the frequency ISQ -- implant stability quotient - has a NON-LINEAR correlation to micro stability -- the scale is 1-100 ISQ
32
the more stable the implant the ISQ is
the higher frequency the ISQ quotient is
33
ISQ has a strong correlation to ? | measures?
micro mobility RFA measures ressistance to lateral micro mobility
34
torque measures
resistance to shear forces
35
by measuring on two diff occasions?
you can verify not only the intial mechanical stability - but also determine the degree of osseointegration
36
insertion torque? | what influences it?
measures the rotational friction together with the force required to cut the bone diameter of the implant will influence the torque
37
collar effect?
o Peak torque can give high values due to the “collar effect” when the implant collar is seated in cortical bone
38
ISQ graph and important marks
 Micromobility decreases approximately 50% between 60 to 70 ISQ • Between 60 and 70, have stability of a dental implant that can be restored more reliable test than torque test
39
Stability Development Over Time
o As a result of osseointegration, initial mechanical stability is supplemented, and/or replaced by biological stability, and the final stability level for an implant is the sum of the two o Stability does not generally remain constant after implant placement. For example, there is likely to be an initial decrease in stability, followed by an increase as the implant becomes biologically stable
40
low stability medium high? in terms of ISQ
low is 60 and below medium is 60-70 high is 70 and above If we look at ISQ on day we place it and then 6-8 weeks later and assess the differences, get a pretty good idea of whether or not the implant has a high level of stability
41
o Implant failure will appear radiographically as
vertical bone loss radiolucency around implant
42
what largely determines the patients potential abiblity to maintain home care
the design
43
prophy procedure
home care - begins at first consultation - stress professional monitring - review homecare routine tissue conditions peri- implant stability bone level (rx) deposit removal recall intervention
44
ultrasonics on implants?
o Conclusions: all ultrasonic scaling caused the production of titanium particles and caused damage to the SLA coating of the implant. Ultrasonic scalers should be used with great caution  He doesn't like to use ultrasonics on implants • Not a whole lot of evidence out there  Shows that pieces of the metal are coming off  No clear cut evidence that ultrasonics shouldn't be used around a dental implant
45
cement on an implant is
a contributing factor to peri-implantitis and mucositis
46
if cement on implant can see this on radiograph
no - not all the time have to raise a flap
47
dynamic 3D navigation and robotic assisted surgery
new techniques and no surgical guide used
48
dynamic 3D navigation
o No surgical guide used o Shows your handpiece on the screen, live, so you can see exactly where your handpiece is o Need to keep the bur cool to not cause the bone to necrose  With a surgical guide, the water is being blocked and the tip of the bur isn't reached by the water o Problem: surgeon isn’t looking at the patient, looking at the computer screen
49
robotic assisted surgey
o Advantage of this over 3d navigation  With 3d navigation, will get visual and audible cues, but nothing that will stop you from doing it incorrectly  This, will not allow you to go in at the wrong angle  physically stop you  You still use the pedal, but the position in space is done by the robotic arm  If patient moves, it moves in real time  no lag o The issue: robotic arm is sensitive and finicky  Takes a while to be comfortable with it
50
basic of delayed implant placement
with soft tissue healing and only partial hard tissue / bone healing
51
immediate placement advantages
1 surgical procedure reduced over all tx time these are both potential advantages
52
immediate placement disadvantages
morphology of socket may lead to compromised implant positino morphology of socket can compromise intital implant stabilit lack of soft tissue volume for primar closure increased risk of recession complexitiy of procedure increases
53
flapless in immediate?
yeah maybe cause youll have the extraction socket to guide you - up to individual
54
images needed for immediate
pano periapical CBCT

implant 2 (11 decks)

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