Oral surgery Flashcards
(80 cards)
What % of UK are completely edentulous?
6%
What % of UK have had at least 1 tooth removed?
74% (3 in 4 people)
What % of nerve injuries caused by dental treatment are a result of implant placement?
30%
NHS rules for implants: smoking
Patients must be a non-smoker for a minimum of 3 months prior to implant placement (including vapes etc)
% of implants that fail due to patient smoking
10
NHS rules for implants : age
No <18 years
Some men may even need tx later as not fully grown
NHS rules for implants : diabetes
MUST be well controlled
HBA1c >8% (>64mmol/mol) is not ideal
NHS implant rules: risk of trauma
Associated with bone disorders and epilepsy —> avoid in these patients.
What is a key absolute contraindication of implant placement?
IV bisphosphonates (and for most clinicians oral bisphosphonates)
Who can get an implant on the NHS
METICO
Mucosal disorders
• May also include cases of severe xerostomia.
• Normal prosthesis may not be possible for them.
Edentulous
• Repeatedly unsuccessful with dentures
• Profound gag reflex/atrophic mandible
Traumatic
• Tooth loss from trauma
Inherited
• Any congenital condition causing tooth loss i.e down syndrome
• Can also include aggressive perio as this is an immune system disorder.
Cancer/cyst
• Surgical treatments resulting in tooth loss
Orthodontics
• Don’t have suitable existing teeth that can be used for anchorage to facilitate ortho tx.
What implant system is used in Tayside?
Straumann (although this is a slightly older system)
Important qualities for implant material
Safe, biocompatible, biomechanically compatible, MRI safe, and image compatibility.
Host factors affecting osseointegration
Bone density, bone volume and bone implant surface area, parafunctional habits
Implant factors affecting osseointegration
Macro design
Chemical composition and biocompatibility
Surface tx and coatings
Implants tilting, prosthetic passive fit, cantilever, crown height, occusal table, loading time.
Which of the following materials has not been used as a dental implant?
- Type 4 titanium alloy
- Titanium/ zirconium alloy
- Cobalt chromium
- Iron
- teeth
o Type 4 titanium (used to be mostly used)
o Titanium/zirconium alloy (now the standard)
o Cobalt chromium (historically been seen)
o Iron would rust!!!
o Teeth have been implanted.
When is a sinus lift indicated?
To increase bone volume; bone graft placed usually a mix of cow and patients then left for 6mnths healing then implants placed.
How sucessful are implants?
Survival and success
Buser; 8 yr - 96.7% and 93.3%
Lambrect; 10 yr - 99.2% and 96.4%
o No upper age limit on implants placement
o Would have to assess rheumatoid arthritis
o 17 years old is too young for implants, but would be exposed to repeated trauma – NOT an outright no…
o A 23 year old patient who has a non-vital tooth 11 and wants an implant: Doesn’t fit with the criteria
o Fits the criteria
o HBA1c must be 8 or less
o Risk of MRONJ
o No nicotining containing anything
o A patient with sjögren’s syndrome: FITS the criteria – xerostomia and mucosal disorders
o Overload the implants not ideal
o Biocompatibility – important
o MRI safe – not important for osseointegration
o Bone volume – at least 0.7-1cm for ideal outcomes
o Surface modification – important for mechanical licking
o Angulation of implant loading – want it to be axial
B - he’s got active disease and so doesn’t fit the indications.
A - remember not fitting the guidelines and contraindications are DIFFERENT —> METICO vs contraindications such as smoking
C - is an absolute contraindication
Oral bisphosphonates is a relative contraindication
