Overview of Implantology / Peri-implant diseases and conditions Flashcards by Michael McMahan

What 4 landmarks should we

consider during implant placement?

Inferior Alveolar Canal/Mental Foramen
Incisive Foramen
Maxillary Sinus/Nasal Cavity
Lingual undercut

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•premolar and molar areas of the mandible.
• a loop of the nerve can be found to
extend mesially.

Mental foramen:

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How many mm away from mental foramen should you be w implant?

3mm

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How many mm away from IAN should you be w implant?

2 mm

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What is the most accurate way to detect the IAN and mental foramen?

CBCT

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•Important to avoid perforaMng the lingual plate
during preparaMon of the implant site since
perforaMons can result in extensive and even life-
threatening bleeding (Bruggenkate et al, 1993)
•Reflec*ng a lingual flap in order to visualize the
ridge is a safe way of performing surgery

Lingual undercut

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_____: related to the degree of bone loss or

bone resorption present

Quantity:

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_____: related to the degree of bone loss or

bone resorption present

Quantity:

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_____:: related to the degree of bone density

present

Quality

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Type ____ bone: hard and dense like oak wood
•less blood supply than other types (compact bone)
•takes longer for an implant to integrate
•found in the mandible

Type 1

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Type _____ bone: thick layer of compact bone
surrounds a core of dense, trabecular bone
consistency of pine wood

Type II

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Type ___ bone: thin layer of corMcal bone
surrounds a core of dense trabecular bone
consistency of balsa wood

Type III

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Type ____ bone: thin layer of corMcal bone
consistency of Styrofoam
surrounds a core of low density trabecular bone
commonly found in posterior maxilla

Type IV

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What roughness or smoothness is desired for implants to enhance osseointegration?

Moderately rough

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What is the Sa value in micrometers for a moderately rough implant surface?

1-2 micrometers

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_______ Implants:
•connecMon at sol Mssue level
•smooth neck that shapes the sol Mssue
•come in different sizes depending on where we are
placing it: WN (wide neck) or RN (regular neck)
•used for one-stage implant surgery

Tissue Level

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______ Implants:
•connection at bone
•allows for different customized and angled abutments,
which is important if it is a compromised case or in the
aesthetic zone
•allows for two-stage implant surgery

Bone Level

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What brand of implant is used at uMKC for tissue level implants generally?

Straumann

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Implants 
–2 Piece system 
–Very popular system 
–Extensive Research 
–Good customer care 
-No tissue level implants
-No 1 piece

Nobel Biocare™

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\_\_\_\_\_\_ Implants 
–1 or 2 Piece implant 
–Very popular system 
–Extensive Research 
–Good customer care

Straumann™

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____ implant shape
• Increased Surface Area
• Greater Force Transfer
• Most Common Design

Straight - Cylindrical

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____ implant shape
• Osteotomy more complex to correct
• Preferred with root proximity or limited
bony envelope due to narrower

Tapered - Conical

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____ stage implant placement
•An implant is placed with a transmucosal healing abutment
(it “sMcks out” the sol Mssue aler the surgery)
•Hard and sol tissues heal around the entire fixture.
•Upon completion of osseointegration, the restorative phase
can begin.

One stage

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___ stage implant placement
•The implant is “buried” under the sol tissues
•In this case we do not use an healing abutment but a
cover screw.
•Preferred in case of big bone augmentations and
when the primary stability is not optimal
•Wound Protection
•Will require a 2nd surgery in 3-4 months to uncover
the implant.
•A 2nd chance to correct any sol Mssue deficiencies.

Two stage

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What are the 4 simple steps of surgical implant placement

``` –Flap reflection after anesthesia –Osteotomy preparation (Sequential drilling with drill bits of increasing size) –Implant placement with adequate torque –Suturing ```

_____: measurement of the resistance that the implant encounters during its advancement in the apical direction by means of a rotating movement on its axis. (Ncm)

Insertion torque:

MESIO-DISTAL • - at least ____ mm between teeth and implant

1.5

____ mm for papilla in anterior teeth

3-4mm

___ mm between 2 adjacent implants

3 mm

BUCCO-LINGUAL (anterior zone) - As bone thickness approached ____ - ____mm, bone loss decreased significantly and some evidence of bone gain was seen

1.8 - 2 mm

IN posterior, how many mm is needed BL bone for implant?

1 buccal 1 lingual so 2 mm total

Concept of placing an abutment of a narrower diameter on the implant of a wider diameter to preserve alveolar bone levels at the crest of a dental implant - It reduces per-implant bone resorption at the one crest: - Shils the inflammatory cell infiltrate inward and way from the adjacent crestal bone - Maintains the supracrestal attachment - Increases distance of implant-abutment junction from the crestal bone - limits possible interface of bone with micro-movements

Platform switching

Siebert ridge atrophy classification | buccolingual loss of tissue

Class I (

Siebert ridge atrophy classification | (apicocoronal loss of tissue)

Class II (apicocoronal loss of tissue)

Siebert ridge atrophy classification | both loss of tissue

Class III

is a surgical procedure that uses barrier membranes with bone grafts to augment atrophic bony ridge

GBR (Guided Bone Regeneration)

What mm are considered short implants?

6-7mm

Is crown to root ratio valid for implants?

Nope

How many mm is lost on average horizontally post extraction?

3.8 mm

How many mm is lost on average vertically post extraction?

1.24 mm

Peri-implant fibers _____ cuff, | oriented _______

parallel cuff; oriented longitudinal

Epithelial cells attached | by ______ to implants

hemidesmosomes

``` Collagen fibers do not insert into the implant but creates a ____ around the implant (but they still create a sealing) ```

cuff

Blood supply by terminal branches of large vessels from ______ for implants

periosteum.

More or less inflammatory response in implants | than gingival tissues

Are there fewer or more capillaries around an implant?

Fewer

ALer one year of loading, up to ___ mm of bone loss can be considered physiologic bone remodeling and WNL

1.9 mm

“An inflammation in absences of continuous marginal peri- implant bone loss. The clinical sign of inflammation is bleeding on probing. Additional signs may include erythema, swelling, and suppuration.”

Peri implant mucositis

What is the main sign of peri implant mucositis?

Bleeding on probing

“Is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and progressive loss of supporting bone. Clinical sign of inflammation is detected by bleeding on probings, while progressive bone loss is identified on radiographs”

Peri implantitis

What are the main signs of peri implantitis?

BOP with progressive loss of bone

• Presence of bleeding and/or suppura0on on gentle probing. • Increased probing depth compared to previous examina:ons. • Presence of bone loss beyond crestal bone level changes resul:ng from ini:al bone remodeling ( ≥2 mm a=er the first Y of func:on) —> Ideally you would like to have a BASELINE XRAY

Peri implantitis

I n t h e a b s e n c e o f p r e v i o u s e x a m i n a t i o n d a t a : • Presence of bleeding and/or suppura:on on gentle probing. • Probing depths of ≥6 mm. •Bone levels ≥3 mm apical of the most coronal por:on of the intraosseous part of the implant.

Peri implantitis

``` • Absence of inflammation • No BOP • Bone loss ≤ 2mm. ```

Peri implant health

``` Signs of inflammation • BOP and/ or SOP • > PD compared to baseline • Bone loss ≤ 2mm. ```

Peri implant mucositis

``` • Signs of inflammation • BOP and/or SOP • > PD compared to baseline (≥ 6mm) • Progressive bone loss (≥ 3 mm) ```

Peri implantitis

Similar to periodontitis, peri-implantitis lesion is dominated by ____ and ______

plasma cells and lymphocytes

Similar to periodontitis, peri-implantitis lesion is dominated by plasma cells and lymphocytes but characterized by a larger proportion of _____ and ______

polymorphonuclear leukocytes and | macrophages

Area proportions, numbers and densities of plasma cells, | macrophages and neutrophils are higher or lower in peri-implantitis

Higher

What is the main etiological factor of peri implantitis?

Plaque

What is a risk factor that has strong evidence to be more at risk for peri implantitis?

Previous periodontal disease

Implant sites with a band of

Does a rough or smooth surface catch and hold onto more bacteria?

Rough

Do you place implant or treat perio disease first?

Treat perio disease first

Overview of Implantology / Peri-implant diseases and conditions Flashcards

(64 cards)