Flashcards in Trauma From Occlusion- Implants Deck (52):
True or False: Dental implants act similarly to ankylosed teeth.
What is osseointegration?
DIRECT bone-implant surface mechanical interlocking
(as opposed to indirect interaction of natural tooth which has a PDL that attaches cementum to bone)
Natural teeth can adapt to heavy forces due to the PDL attachment apparatus; implanted teeth experience _____ at bone-implant surface interface.
continuous bone remodeling
What is the difference between tooth mobility and implant mobility?
Tooth Mobility: Physiological (PDL remodeling) or Pathological phenomena
Implant Mobility: always a Pathological phenomena... the implant is failing and should be removed
True or False: There is a threshold for dental implants and crossing that amount would result in microfractures.
What is "primary stability" associated with dental implants?
the stability of the implant at the time of placement; mechanical interlocking mechanism between the screw and bone
Which two factors will influence primary stability of the dental implant?
1. bone density
2. implant fixture design
What is the conventional healing time for mandibular implants?
What is the conventional healing time for maxillary implants?
Why do maxillary implants take longer to heal?
less dense bone (more trabecular/spongy)
What are the three stages of functional loading on an implant?
Immediate (at time of placement)
Early (before conventional healing is complete)
Late (following 3-6 mos conventional healing time)
The implant restorative design is one of four designs:
1. Single Tooth (most difficult)
2. Multiple Unit-Fixed-Splinted (group control)
3. Full Mouth-Fixed-Implant Supported
4. Full Mouth-Removable-Implant Supported
What are the implications of implants in "excessive" occlusion?
Screw loosening or fracture
Implant fixture fracture
Mobility of adjacent teeth
Eruption/Malocclusion of adjacent teeth
True or False: With dental implants, nerve endings are lost and reduction in mechanoreceptors makes it difficult to feel.
True or False: Myelinated fiber content of the mental nerve is reduced by 20% with dental implants.
False: fiber content of INFERIOR ALVEOLAR nerve is reduced by 20%
Tooth extraction leads to _______ _______ in the peri-implant area.
True or False: During healing, there is a gradual increase in free nerve endings close to the implant-bone interface.
In the peri-implant area, where are mechanoreceptors found?
in the periosteum
(they are adapting after loss of tooth)
"Tactile Sensibility" is sensory feedback through receptors that are localized within the _____ and ____.
Receptors located in the PDL are sensing _______.
(remember viscosity is the resistance to fluid flow)
Receptors located in the bone are sensing ______.
(the ability to resist a distorting influence or stress and to return to original size and shape when stress is removed)
_____ _____ is necessary for fine tuning of jaw and limb motor control.
Tactile Sensibility (sensory feedback)
What is "thickness discrimination"?
the ability to detect a certain thickness when the item is between antagonistic teeth upon tooth loading
What is the difference in thickness discrimination between natural teeth and implants?
Natural: 20 micrometers upon 1-2 grams of loading
Implant: 50-100 micrometers upon 50-100 grams
Does the thickness discrimination increase or decrease after implants?
Discrimination decreases....however, that means that the THICKNESS that is sensed must INCREASE
(less mechanoreception results in heavier loading)
How many movement PHASES does a natural tooth have? How many does an implant have?
What are the two "movement phases" of a natural tooth?
Primary: non-linear and complex
Secondary: linear and elastic
What is the "movement phase" of an implant?
linear and elastic (same as natural "secondary phase")
How many movement PATTERNS does a natural tooth have? How many does an implant have?
What are the movement patterns of natural teeth compared to implant teeth?
Primary= immediate movement
Secondary= gradual movement
Gradual movement only
With an implant, where is stress concentrated?
How does proprioception differ between a tooth and an implant?
osseoperception = implant
PDL mechanoreceptors = tooth
What are the 3 types of forces?
What is a static force?
constant force applied as in orthodontic movements
What is a functional force?
intermittent, multidirectional forces that would occur when a tooth/implant is in normal function
What is an excessive force?
force that well-exceeds those of teeth/implants in normal functioning (cantilevered implants)
Which aspect of a tooth or implant will "take the force?"
True or False: Functional loading may increase bone-to-implant contact; however, 100% bone-implant surface contact is not possible.
True... 100% is NOT possible
Loading time (for functional occlusal forces) depends on:
1. primary stability of the implant
2. implant design
3. restorative design
4. presence/absence of risk factors
Occlusal trauma is a _______ etiological factor for periodontal disease.
Occlusal trauma can be a ________ etiological factor for PERI-implant disease.
What is "Retrograde Peri-implantitis?"
a lesion that is periapical to an osseointegrated implant. The condition is identifiable by radiological examination and from clinical symptoms such as pain and tenderness
Bruxism can create complications for dental implants. What can be done to combat these complications?
1. use LONGER and WIDER implants
2. ensure properly THICK bone is in place for support
Implants cannot tolerate _____ forces well. Therefore, forces should be directed ________.
parallel to the long axis of the implant
What is the "all on 4" implant technology?
a new technology in which an entire arch is supported by four implants
Research has shown that implant ______ is more critical than length in reducing the bone stress.
New concepts allow for ______-______ implants.
______ loads induced more bone strain and implant stress than _______loads.
In order to avoid a "distal cantilever" when using the All-on-4 technique, the last implant on each side should be tilted with the root apex pointing toward the _____.
True or False: With typical implants and with the All-on-4 technique, multiple implants within an arch should be arranged in parallel.
False: Typical implants YES parallel
All-on-4: the implants that are farthest distal should be tilted with "crowns to distal" and "root apex toward midline"
Distal-tilted implants (the crown is distal) can produce higher _____ strength when compared to vertical implants.