Midterm Review Flashcards
(276 cards)
1
Q
What is the implant component that lies between the implant and the crown?
A
Abutment
2
Q
What is the screw that clamps the abutment onto the implant?
A
Abutment screw
3
Q
What are flat small implants that are inserted into a cut in the bone?
A
Blade implants
4
Q
What is a software associated radiographic technique that produces an exact cross-sectional view of the mandible or maxilla?
A
Computed tomography (CT)
5
Q
What is the CT scanner that uses a cone-shaped radiographic source and a large detector to produce a 3-D radiographic image?
A
Cone beam CT
6
Q
What is the screw that blocks the implant entrance during the healing period after surgery?
A
Cover screw
7
Q
What is the distance between the implant platform and the edges of the extraction socket. Used as a reference for feasibility of immediate implant placement?
A
Critical Space
8
Q
What is the subgingival change in shape of the abutment and/or the crown, between the implant platform and its emergence from gingival tissues?
A
Emergence profile
9
Q
What is an implant-to-abutment attachment that sits on top of the implant platform. Common shape is external hexagon?
A
External Connection
10
Q
What is a temporary abutment that is used in place of a cover screw after an implant has been inserted and removed before the restoration is placed?
A
Healing abutment
11
Q
What is an arbitrary scale of values assigned to various radiopaque densities when using computed tomography?
A
Hounsfield numbers
12
Q
What is technique in which implants are restored/loaded at the time of implant placement?
A
Immediate loading
13
Q
What is a titanium device placed in bone that replaces the root of a tooth and enables the attachment of a prosthesis?
A
Implant
14
Q
What is an implant-to-abutment attachment placed inside the implant body, found in internal friction systems?
A
Internal connection
15
Q
What is a system where abutments are retained by friction against the inner walls of the implant?
A
Internal friction system
16
Q
What is the term for Irreversible microscopic changes in the metal of implants and components when an excessive force applied; often leads to fracture?
A
Mechanical fatigue
17
Q
What are Implants that are exposed to oral cavity on day of placement?
A
One Stage Implants
18
Q
What is the term for attachment of bone to the surface of an implant?
A
Osseointegration
19
Q
What the name of the procedure by which the sinus floor is elevtted via the osteotomy prior to implant placement?
A
The Osteotome technique
20
Q
What is progressive bone loss and inflammatory tissue pathology that results from plaque accumulation and bacterial infiltration around implants?
A
Peri-implantitis
21
Q
What is a reversible condition characterized by gingival inflammation around implants without evidence of bone resorption?
A
Mucositis
22
Q
What are flat, mesh-like implants that lie on the osseous surface?
A
Periosteal implants
23
Q
What is a clinical procedure in which soft tissue is measured at several locations of an edentulous ridge in order to estimate the width of underlying bone architecture?
A
Ridge mapping
24
Q
What is the term for cylinder or screw-shaped implants that are also the most common implants used today?
A
Root form implants
25
What is an acrylic appliance used during surgery that indicates where the ideal implant placements must be for restorative purposes?
Surgical guide
26
What is a lightweight, soft, noncorroding metal used to make implants?
Titanium
27
What are Implants that are covered by the gingival immediately after placement and that require a second surgery to uncover them?
Two-stage implants
28
What are implants a replacement for?
Tooth roots
29
What does titanium do when exposed to oxygen and what is its purpose?
Forms titanium dioxide (natural ceramic coating) enables bone cells to attach
30
Do bone cells react better to rough or smooth titanium surfaces?
rough
31
What are 3 ways to roughen titanium surface of implants?
1. Mechanical (blasting)
2. Chemical (acids)
3. Combo mechanical/chemical
32
Is roughening done the entire length of the implant and why?
No the area near the implant head left smooth to decrease bacterial attachment.
33
What is another method to enhance bone healing?
Hydroxyapatite coating
34
What are 2 reasons for the thread shape and pitch on the implant?
1. Transfer biting force to surrounding bone
| 2. Enhance placement and stability
35
Is osseointegration a clinical or histological observation?
histological
36
Is the osseointegration of the implant and bone continuous along the implant?
Not continuous. Only 40-50% implant surface in contact with bone
37
When does osseointegration begin?
At time of implant placement
38
What forms between the bone and the implant w/in the first few minutes of implant placement?
blood clot
39
What attaches to the implant after the surgical trauma has caused surface bone cells to die and inflammation to take place?
fibrous mesh attaches
40
Describe the sequence of events leading to osseointegration and their time frame.
Necrosis – time of placement
Inflammation – within days
Osteoid Matrix formation – 2-3 wks Maturation – 6 -12 wks
41
Does osseointegration stop after 6-12 weeks or continue for the life of the implant?
matures for life of implant
42
Does the implant surface undergo changes as does the bone around it?
es, the ceramic oxide layer thickens over time
43
Do all implant types require abutments?
No, some have the crown screw directly into the implant
44
With external connection root form implants, how high does the attachment rise above the implant
Approximately 1 mm
45
Can two stage implants be exposed to the oral environment on the day of placement like a one stage implant?
yes, but covered with a healing abutment
46
in blade implants and periosteal implants (mesh like frame that overlays buccal-lingual), is the abutment separate of inseparable from the implant itself?
Insperable
47
Where is force predominantly dissipated in the implant?
at the neck
48
What is the benefit of an implant with respect to bone?
constant remodeling around implant preserves bone volume
49
What is a clamping force that the screw applies between the two parts of the implant
preload
50
What term refers to implants that are still in the mouth at the time of examination, regardless of the state of the prosthesis or patient satisfaction?
survival
51
What term refers to implants that are not only in the mouth, but are also functional and satisfactory?
success
52
What is more frequent with smoking and implants?
Peri-implantitis
53
What type of diabetes contraindicates implant placement?
Uncontrolled
54
What should be considered with implant placement in a controlled diabetic at time of implant placement?
Antibiotic therapy
55
Does osteoporosis appear to influence implant success rates?
No
56
With respect to age, what should be considered for implant treatment planning?
If patient is young, you should consider whether they are done growing.
57
How will an implant act in a person still growing?
Like an ankylosed tooth
58
Why are implants good for a person who has undergone head and neck radiation?
If xerostomic, pt’s mucosa does not react well to removable prosthesis, so implants avoid the mucosal pressure
59
What is the necessary interarch distance in the posterior required to build a fixed implant-supported prosthesis
7mm
60
What is the necessary interarch distance in the anterior required to build a fixed implant-supported prosthesis?
8-10mm
61
What is the total distance between adjacent teeth required for single-tooth implants?
7mm from CEJ to CEJ
62
What is the manual formula for determining 7 mm bone requirement between adjacent teeth in single-tooth implants?
1 mm bone M & D, PDL is 0.5mm, 4 mm diameter implant 4mm + (2 x 1mm) + (2 x 0.5mm) = 7mm
63
What amount of bone is required buccal and lingual for implant?
1mm B, 1 mm L 4 mm implant + 1mm B + 1 mm L = 6 mm bone width
64
Where is bone usually narrower, at the crest or the base, and which is most critical?
narrower at crest, crestal bone width is most critical
65
What Periapical radiograph technique best minimizes distortion?
Paralleling technique
66
For what are panoramic radiographs utilized?
1. Estimate bone quality
2. Estimate bone quantity
3. Presence of anatomic limitation (e.g IAN, sinus)
67
What is prevalent on a panoramic?
Distortion
68
If doing an overlay on a distorted panoramic, should you round up to the next ratio overlay or round down?
Round up, allows for a more conservative plan
69
What are the Hounsfeld numbers used in CT for water, trabecular bone, cortical bone respectively?
Water = 0
Trabecular bone = 200
Cortical bone = 1000
70
Hounsfeld numbers are an indication of what?
Bone density
71
What is the main shortcoming of Conebeam CT?
bone density (Hounsfield units) is not as reliable as conventional CT
72
What is an acrylic appliance worn by the patient that is used to visualize diagnostic teeth or markers on a radiograph, and that can be modified to a surgical guide?
radiographic template
73
A radiographic template utilized for computed tomography called _________ and what is the acrylic mixed with to be radiopaque?
Scannographic template
| Barium sulfate
74
Bone quality Class I/D1 describes what type of bone?
Compact/ thick cortical bone
75
Bone quality Class II/D2 describes what type of bone?
Thick cortical bone surrounds trabecular bone
76
Bone quality Class III/D3 describes what type of bone?
Thin cortical bone surrounds highly trabecular bone
77
Bone quality Class IV/D4 describes what type of bone?
Thin cortical bone and spongy core
78
What is the only way to get a subjective analysis of bone quality?
CT scan with Hounsfeld units
79
Is bone quality directly correlated to implant success?
Not directly, but it does play a role
80
Which bone quality class is hardest to prep surgically due to poor blood supply?
C1/D1
81
Which bone quality class has been associated with higher implant loss?
CIV/D4
82
What is a system for classifying bone volume?
A to D. A is most intact edentulous architecture and D is most atrophic
83
What guides implant length selection?
bone availability (measure from crest to vital structure)
84
For posterior mandibular osteotomy, how far is it recommended to stay away from IAN?
2mm
85
What is the distance required between the edges of 2 adjacent implants?
3mm
86
What is the distance required between the edge of an implant and the adjacent tooth?
1.5mm
87
For posterior teeth implants, where should the long axis emerge through?
Center of occlusal surface
88
For anterior teeth implants, where should the long axis emerge through?
Cingula
89
What must be completed before implant treatment planning begins?
initial disease control phase
90
Should implants be connected to natural teeth?
It should be avoided
91
If a cantilever is to be used, should it be used for short or long spans?
No. Only to be used for short spans.
92
How far should the cantilever extend distally?
no further than 1.5 distal to the A-P Spread
93
What is the A-P Spread?
The mesiodistal distance between the most forward and the most posterior implant
94
If a narrow arch decreases the number of implants anterior, thereby decreasing the overall A-P spread, should a cantilever be considered, or is a removable appliance indicated?
removable appliance indicated
95
If considering a splinted implant for a removable prosthesis, what is the consideration and space required?
Splint requires more material. Require +12mm
96
When is bone grafting necessary?
When bone width or height is inadequate for receiving an implant
97
Which is more successful: width bone augmentation or height bone augmentation?
Width augmentation
98
What is the amximum amount of bone height that can be gained with bone graft?
2mm
99
What are the origins of the various bone grafts?
Autogenous (self: hip, chin)
Allografts (freeze dried bone)
Xenografts (bovine origin)
Biomaterials
100
What is the ideal waiting period after tooth extraction before implant placement?
8 weeks
101
If doing a two-stage implant, how long after uncovering should you wait before final restoration of the implant?
6 weeks
102
Can implant placement and bone grafting be done at the same time?
Yes, if there is primary stability and minimal grafting required
103
What is required for primary stability to place an implant immediately after extraction?
Must engage 5 mm or more bone, either apically or horizontally
104
What is the critical space in the extraction socket?
Distance between implant platform and edges of extraction socket. Should be <2mm
105
Which is usually a better candidate for immediate implant placement after extraction: anterior or posterior?
Anterior teeth because diameter of implant is close to CEJ diameter of extracted tooth
106
Why are posterior extractions not a good candidate for immediate implant placement?
Posterior teeth have wider diameter than implant so socket exceeds critical space of <2mm
107
Implants are most often made of what material?
Titanium
108
Why is a rough implant surface desirable?
Ossification is improved around a rough implant.
109
What percentage of contact between bone and implant is necessary for osseointegration?
40-70%
110
What is the first event after implant placement in the process of osteointegration?
Formation of a blood clot
111
What results from excessive force on implant crowns?
fatigue of implant components, leading to fracture
112
What is preload?
tension placed by screws to protect implant components from displacing forces
113
True or false: Plaque and calculus accumulate on implants similar to the way they accumulate on teeth
True
114
Connective tissue fibers around the implant neck are parallel or perpendicular to the implant?
Paralell to implant surface
115
Does peri-implantitis spread rapidly to bone?
Yes
116
What is the term for when an implant is still present in a patient's mouth after a period of time?
Survival
117
What is the Minimum interarch space for a fixed implant- supported prosthesis?
7mm
118
What does ridge mapping measure?
soft tissue thickness clinically to deduce bone width
119
With respect to implants, what are panoramic radiographs used for?
Ruling out bony pathologies and estimating bone availability
120
What is the most precise radiographic technique?
Computed tomography
121
Does cone beam CT use more or less radiation than conventional CT?
Less radiation than conventional CT
122
What are Hounsfield numbers?
Arbitrary numbers set for tissue density on computed tomographs
123
What are radiographic templates used for?
Used to visualize diagnostic teeth
124
What is a scannographic template?
An aide to visualized diagnostic teeth on a computed tomography image
125
Which bone is the densest: D1 or D4?
D1
126
What amount of bone is required buccal and lingual when selecting and implant?
1 mm bone buccal and lingual of implant
127
What is an advantage of screw-retained prostheses?
Ease of retrieval
128
What is an advantage of cemented prostheses?
Ease of fabrication
129
Should connecting implants and teeth be avoided at all costs, or avoided but can be performed?
Should be avoided whenever possible, but can be performed with careful consideration
130
Distal cantilevers should be avoided whenever possible, but if must be used, they should be limited to what type of span ?
Short spans
131
What is immediate implant placement?
placement of an implant at the time of tooth extraction
132
What is immediate loading?
placement of a restoration at the time of implant placement
133
Should provisional restorations rest on bone grafts or newly placed implants?
No
134
Does bone grafting work best to augment ridge height or ridge width?
Ridge width
135
Should gingival grafts be performed prior to fabricating final restoration or after the final restoration is delivered?
prior to fabricating final restoration
136
What is the implant with the longest period of clinical trial?
Subperiosteal (doesn't integrate into bone)
137
Who is the father of modern implantology?
Per-Ingvar Branemark
138
What are 4 keys to osseointegration?
1. Atraumatic surgery
2. 1mm bone, B & L at crest
3. No micromovement
4. Adequate healing time
139
What temperature must not be exceeded during implant site preparation to make the surgery atraumatic and avoid bone necrosis?
47 Degrees Celsius
140
If there is movement in the implant, what integration will there be: fibro-osseous or osseointegration?
Fibro-osseous/unacceptable
141
What are 5 criteria for implant success?
1. Immobile
2. Less than 0.1mm bone loss annually (used to be 0.2mm/annually)
3. No pain, infection, neuropathies, paresthesia, or IAN violation
4. No x ray evidence of peri-implant radiolucency
5. 85% still in 10 yrs = success
142
What type of titanium does the ITI-implant system use and what kind of implant placement does it utilize?
1. Commercially pure titanium
2. Single stage transcended through gingival into oral
cavity
143
How is ITI different from Branemark?
Branemark said implant should be two stage and level with bone
144
What type of titanium and what type of implant placement is the Core Vent system?
titanium-6 aluminum-4 vandium alloy 2 stage
145
How is Core-Vent different from Branemark?
Does not use commercially pure titanium
146
If patient needs ortho, should it be done before or after implant placement?
Before; implants do not move
147
What is the titanium type and implant placement for the Integral-Calcitek implant system?
Hydroxyapatite coated bullet form
| Tapped into hole
148
Are parts interchangeable between implant systems?
No
149
What are 3 basic components of dental implant?
Implant body Abutment
| Retaining screw
150
What are the different types and coatings for titanium?
1. CP (commercially pure) titanium
2. Titanium alloy (Ti6Al4V)
3. Titanium plasma sprayed (TPS)
4. Hydroxyapatite coated (HA)
5. Microtextured Combination (micro-textured and HA)
151
What are 3 terms describing implant/bone interface?
1. Fibro-osseointegration
2. Osseointegration
3. Biointegreation
152
What is the advantage of microtextured titanium?
Uniform 1-2 micron surface roughness gives 44% more surface area than mechanical titanium
153
Where is Type I bone found?
Anterior mandible
154
Where is Type II bone found?
Posterior mandible
155
Where is Type III bone found?
Anterior maxilla
156
Where is Type IV bone found?
Posterior maxilla
157
Where do implants work better, maxilla or mandible?
Mandible
158
Which bone type osseointegrates fastest even though it has the lowest blood supply?
Type 1
159
Why is Type 1 bone the best for implants?
Because majority of implant is in thick cortical
160
Why is a tapered implant good to use in type 4 bone?
It compresses that bone increasing the mechanical retention
161
Which place is most difficult for implant placement and why?
Posterior. Greatest force, least space, poorest bone quality, anatomic structures (IAN, Max Sinus)
162
How do natural tooth biomechanics dissipate lateral occlusal forces?
By the PDL
163
How do Ideal implant biomechanics direct occlusal forces?
Along vertical axis of implant, dissipate periapically
164
Where are lateral occlusal forces concentrated in an implant?
At crest of ridge on abutment screw
165
What is the main difference between a "failing" implant and an "ailing" one?
"Ailing" implant still has some osseointegration
166
How far can a cantilever be placed?
1.5 times the A-P spread
167
What does a cantilever do with forces?
Increased force at crest and on abutment screw
168
How do you place three or more implants in a row?
Offset to give a tripod effect
169
All torque is measured in what units?
Newton centimeters
170
What is the max angle on an angle abutment that has been found to not significantly effect occlusal loading?
30 deg
171
What diameter should be chosen for the implant?
What is the largest diameter that leaves 1mm bone B & L and allows for coronal anatomy?
172
What is the problem with long implants?
1. Lots of heat generated at most apical portion
| 2. Longer implants have higher failure rate
173
What is the ideal implant length?
11-13 mm
174
What is the maximum crown to implant ratio?
1:1
175
What are 2 contraindications for a long implant in posterior mandible?
1. Retromylohyoid line (thin)
| 2. IAN
176
What is the minimum amount of space between edge of implant and adjacent tooth?
1.5 mm
177
What is the minimum amount of space between edges of adjacent implants?
3mm
178
What type of occlusion is desirable on implants?
light centric and no lateral contacts
179
What are the surgical steps for implant placement?
```
Reflect flap
Twist drill 1.5mm
Direction indicator
Tapered drill 3.5 mm
Direction indicator
Tapered drill 4.3 mm
Implant placement
```
180
Who steers the multidisciplinary implant case?
Restorative dentist
181
What are the 5 roles of implant surgeon?
1. Initiate or assist treatment planning
2. Perform site preparation surgery
3. Perform fixture placement surgery
4. Assist with impression and temporization 5. Treat ailing & failing implants
182
What are 7 relative systemic health contraindications for implant surgery?
1. Uncontrolled diabetes
2. Severe immunodeficiency
3. Uncontrolled vascular disease
4. Heavy smoking
5. Alcoholism
6. Post-irradiated jaws
7. Bisphosphonates (Fosamax)
183
What are 3 spaces to evaluate clinically before implant?
1. Mesial-Distal
2. Buccal-Lingual
3. Interarch (w/ teeth in MIP)
184
Minimum B-L width and what makes up the number?
8-9mm
| 3.75 to 4.3 mm implant + 1 mm bone B + 1mm bone Lingual + 1 mm soft tissue B + 1 mm soft tissue lingual
185
Which crown type requires less interarch space?
Screw retained
186
What is the minimum interarch space and numbers that make it up?
7.0 mm 5.0mm abutment + 2.0mm crown thickness
187
If the patients have all the available spaces, what space can still contraindicate implant placement?
Patient cannot open enough for implant surgical hardware
188
What is the minimum distance required for surgical hardware?
35mm
189
What does a periapical radiograph show for implant planning?
periodontal status Periapical status
Root alignment
Mesio-distal space
190
What are 3 major things seen on Panoramic for Implant planning?
Bone volume
Bone morphology
Anatomical concerns
191
What anatomic structures should you be concerned with for implant planning that can be assessed radiographically?
Nasal floor
Maxillary sinus
Mandibular canal
Mental foramen
192
What is the distortion on a PA radiograph?
0-10%
193
What is the distortion on a Panoramic radiograph?
25-30%
194
What should be done when treatment planning an implant in the vicinity of the mental foramen?
Add a few mm anterior to allow for the nerve loop
195
CT scan gives what information?
Anatomic info and bone density
196
In what areas is a rectangular platform implant used?
```
Maxillary central incisor
Maxillary canines
Maxillary premolars
Mandibular canine
Mandibular premolars
Some molars
```
197
what is the diameter or regular platform implants?
4.0-4.5 mm
198
Wide platform implants used in what areas?
Molars
199
What is the diameter of wide platform implants?
5.0-6.0 mm
200
Narrow platform used in what areas?
Maxillary lateral incisors
Mandibular incisors
Some premolars
201
What is the diameter of narrow platform implants?
3.0-3.5 mm
202
When determining placement angle for implant, what should be drawn on casts?
Adjacent tooth roots
203
What are 3 considerations for fixture position?
Apical enough for emergence profile
Slightly palatal for gingival bulk
More than 1.5-2.0 mm from adjacent roots
204
What are 2 things tapered implants do?
1. Allow missing adjacent roots
| 2. Wider portions compress bone to make it more dense
205
How long after atraumatic extraction to wait if doing delayed fixture placement?
4-6 months (during the Q and A session before the test, he said more like 3-4 months)
206
What are 3 criteria for immediate implant placement after extraction?
1. Absence of infection
2. Sufficient residual socket walls
3. Adequate bone for primary stabilization (lateral and apical)
207
What is another term for "socket preservation"?
GBR = guided bone regeneration
208
What can a majority of implant "misadventures" be attributed to?
A lack of attention to detail in diagnosis and treatment planning phase
209
What are 4 general steps in implant treatment?
1. Patient selection
2. Diagnosis and treatment planning
3. Informed consent
4. Dental implant treatment
210
What is a risk associated with Fosamax (bisphosphonate)?
Bisphosphonate-related oseonecrosis of the Jaws (BRONJ)
211
What bisphosphonate user can be a candidate for implant surgery?
Asymptomatic patient on oral bisphosphonates for less than 3 years
212
What should be done if pt is asymptomatic bisphosphonate user for more than 3 years?
Coordinate with prescribing doctor to take a 3 month drug holiday prior to surgery
213
When should the bisphosphonate drug holiday end after implant placement?
After osseous healing has occurred
214
What blood test and its readings can be done to determine osteonecrosis risk in a more than three year oral bisphosphonate user?
CTx (C-terminal telopeptide)
| 150 pg/ml = Minimal risk
215
On a drug holiday, how much will the pg/ml increase per month of the drug holiday?
25 pg/ml for each month (the desire is to get them to >150 pg/ml)
216
What are 2 major factors that most frequently determine whether or not a patient will receive dental implants?
1. Desire
| 2. Dollars
217
What are 6 things to eval in dentate patient clinical exam for implant treatment planning?
1. Overall dentition and periodontium
2. Tooth/teeth to be replaced
3. Status of adjacent teeth
4. Occlusion/interarch space
5. Bruxism/habits
6. Alveolar Ridge
218
True or false: you should connect natural teeth with implant supported restorations.
False
219
What items should be covered by informed consent?
1. Treatment alternatives
2. Not a magic cure, not 100%
3. No guarantees, requires maintenance
4. Can still get peri-implantitis
5. Surgery risks
6. Final Treatment may differ
220
What are 5 factors to consider when deciding between root canal therapy or implant or another treatment?
1. Patient desires and needs
2. Strategic Value of tooth
3. Periodontal support
4. Condition of remaining tooth structure
5. Root canal anatomy
221
What is difference between Endo studies and implant studies as far as how they define success?
Endo success defined as healing, while implant success is defined as survivability
222
With respect to function and proprioception, how do implants and contralateral natural teeth differ?
Implants have lower bite force, reduced efficiency, smaller occlusal contact areas
223
Which requires more post op intervention according to the Goodacre study: endo or implant?
Single tooth implants require 5 times more post op intervention
224
What is the comparative cost between an implant and crown versus endo treatment and a crown?
A restored implant is 70-400% more than endo with a crown
225
Options to fix a narrow alveolar ridge to prepare for an implant?
1. Narrow platform fixture
| 2. Ridge expansion via: guided bone regeneration, distraction osteogenesis, or split alveolar ridge
226
What is used in conjunction with Guided bone regeneration to control the soft tissue bridging of a defect?
e-PFTE membrane (whatever that is)
227
How much time should be allowed for soft tissue healing at an extraction site?
6-12 weeks
228
What are some extra-oral areas to harvest for bone graft?
illium, calvarium, clavicle, tibia, fibula, scapula
229
What are some intra-oral areas to harvest for bone graft?
Mandibular symphysis, retromolar area, body of mandible, ramus of mandible
230
What are 2 types of resorbable membranes?
1. Non-resorbable (e-PTFE)
| 2. Resorbable (collagen or synthetic polymers)
231
What is the best way to close a flap for healing?
Tension-free flap closure with smallest needle and suture material with mattress holding sutures or interrupted sutures
232
What can be used to enhance bone grafts?
Platelet-rich plasma or growth factors
233
Do you need a surgical template/guide? (not even sure what this question is asking)
Yes
234
What are 4 ways to restore inadequate keratinized tissue for implant?
Free gingival graft
Connective tissue graft
Alloderm-acellular dermal graft
Skin graft
235
What should you do if you have inadequate oral mucosa for implant?
Guided tissue expansion
236
What should you do if the patient has gingival excess at the implant site?
Esthetic crown lengthening
237
All platforms/diameters/surgical systems have what for ease of use?
Color coding
238
What bone requires tapered 4.3mm drill?
Types 2,3,4
239
Dense bone drills are used in what bone type?
Bone types 1 and 2
240
What are 4 things a dense bone drill does for implant site?
1. Dense bone drill is the final bone drill
2. Removes steps left by tapered drills
3. Will not oversize the site
4. Allows passive fit
241
When is a dense bone drill used?
After the final tapered drill
242
Does an implant always need to be placed at the same level in the bone?
No it varies. They can be level with crest, slightly above crest or the collar above crest.
243
What are 4 reasons for the variability in depth of implant?
1. Limited intra-arch space
2. Narrow bone bucco-lingual
3. Esthetics
4. Increase crown:root ratio
244
What determines initial stability of the implant and prevents over tightening the implant?
Surgical torque wrench
245
Primary stability with the surgical torque wrent between ___ and ___ Ncm?
35 to 40 Ncm
246
What is used in the surgical area and with the instruments?
Copious cooled irrigation
247
What is drill speed for the tapered groovy and dense bone drills?
800 rpm
248
What is the drill speed for the straight groovy bone drills?
2000 rpm
249
What is the rpm/ Ncm for screw tap drilling?
25 rpm or 45 Ncm torque
250
What is the rpm/Ncm for implant placement?
25 rpm or 20-45 Ncm torque
251
What is the final torque with the torque wrench?
35-45 Ncm
252
What motion is used for implant site drilling?
In and out with drill in bone for 1-2 seconds
253
How far does the drill preparation extend beyond the implant? (not sure what this questions is asking)
1mm (must be accounted for in treatment planning)
254
Which drill type is single use: tapered or straight?
Straight
255
When are tapered drills to be replaced?
After 20-30 uses or when cutting efficiency lessens
256
Heat generated from drill can be transmitted how far in bone and what does this ultimately result in?
>3mm, implant failure
257
What temperature must you not exceed when preparing the site?
47 degrees Celsius
258
What are some factors to minimize heat?
Copious cooled irrigation
Incremental drilling
Intermittent drill pressure
New (sharp) drills
259
How far below the CEJ or gingival margin should the implant be placed?
2mm
260
According to Dr Waldrop, you need to do a bone graft if the space in the socket is more than what distance?
2mm
261
What are 2 uses for a surgical guide?
1. Implant placement
| 2. Index implant for temporary crown
262
In order to alleviate lateral occlusal forces, posterior occlusal tables should be wide or narrow?
Narrow
263
Of the 3 flow charts for approaches to treatment, what was the first consideration before the implant?
Site: immediate implant at EXT site
Site: Flap technique
Site: Flapless technique
264
With the 3 flow charts for approaches to treatment, after it is determined what the site will be (e.g. EXT site, flap, flapless), what is asked next?
Bone graft or no bone graft?
265
With the 3 flow charts for approaches to treatment after it is determined if the site will require a bone graft or not, what are the common options in all 3 graphs?
Healing abutment or immediate provisionalization
266
With the 3 flow charts for approaches to treatment the Immediate placement at EXT site and the Flap site, when it required a bone graft, what was the other option besides healing abutment or immediate provisionalization?
2 stage implant
267
With the 3 flow charts for approaches to treatment, what is the consideration in all of them in the esthetic zone
connective tissue graft with or without bone graft
268
The design of the surgical guide not only provides room for the restoration and ensures adjacent roots are not hit, but it also ensures what occlusally?
That occlusal forces will be directed vertically down the long axis of the implant and dissipated periapically
269
Surgical guide is made from what size clear omnivac splint material?
.060
270
How many teeth should the surgical guide extend on either side of the surgical site?
2 teeth either side
271
What must be placed in tray and cured before putting in Triad custom tray material?
bonding agent
272
The hole in the surgical guide should be equivalent to what round bur size?
#10 round (~3mm)
273
Which side should the groove go?
Buccal
274
Is the implant placed midway between contacts or between roots?
Between contacts
275
What are the 5 implant lengths?
```
8mm
10mm
11.5 mm
13 mm
16 mm
```
276
When implant placed, ideally, where should the flat side of the internal hex face?
Buccally
