intimate contact of vital bone and the implant surface WITHOUT intervening soft tissue
Implant study
Implant survival 5 yrs?
Implant survival 10 yrs?
5 yrs: 97.2%
10 yrs: 95.2%
Implant study:
Survival 5 yrs for implant supported SCs?
Survival 10 yrs for implant supported SCs?
Survival 5 yrs for implant supported SCs: 96.3%
Survival 10 yrs for implant supported SCs: 89.4%
implant "survival"
implant is still present in mouth, doesn't mean that the implant is in good health (success)
implant "success"
very hard to measure
Implant study:
% of patients free from complications?
66.4%
- incidence of complications usually increase w/ time
Tooth vs Implant
gingival margins for implant is more apical
Tooth: perio ligaments, CT fibers, long JE
Implant: direct contact of vital bone and implant surface, circumferental fibers that are parallel
histological differences between implant and tooth
tooth: supracrestal gingival fibers, network of CT fibers that are attached above bone to teeth to suppose tooth and tissue and protect against bacteria
implants don't have network of CT fibers
Attachment: implant vs tooth
hemidesmosomal attachment to the implant
epithelial interface: implant vs tooth
implant: keratinized mucosa, dense gingical fibers promote close adaptation of the mucosa around the implant resulting in gingival cuff (similar to sulcus in a natural tooth)
implant around non-keratinized lack circumferential gingival fibers and gingival cuff fails to form.
bone loss: implant vs tooth
tooth: bone loss can be localized to one side of tooth
vs.
implant:consistent circumferential bone loss
Mech of bone loss around implant
name 3
1. infection theory
2. biomechanical overload theory
3. additional factors (compromised healing)
Bone loss/Implant failure:
peri-implant infection
Name some additional co-factors that contribute to bone loss/implant failure via compromised healing
- host factors that influence healing
- quality of surrounding bone
- quality of surrounding soft tissue
- trauma of surgical procedures
- trauma from "other" post-tx incidents
Region of BEST quality and MOST quality
anterior mandible
Region of bone with LEAST quantity and WORST quality
Posterior maxilla
What is implant anchorage dependent upon? (name 3)
1. thickness of cortical bone (most important)
2. quality (density) of trabecular bone
3. bicortical stabilization
Non-axial loads
load magnification = bone loss
why are cantilevers contraindicated?
causes load magnification around implant adjacent to the cantilever
Bone loss: tooth vs implant
tooth (periodontal): site specific bone loss and INFECTIOn driven
implant (peri-implant): CIRCUMFERENTIAL bone loss, biomechanical overload as well as infection driven