Perio: Osseointegration Lecture 1

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  1. Osseointegration
    intimate contact of vital bone and the implant surface WITHOUT intervening soft tissue
  2. Implant study

    Implant survival 5 yrs?
    Implant survival 10 yrs?
    • 5 yrs: 97.2%
    • 10 yrs: 95.2%
  3. 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%
  4. implant "survival"
    implant is still present in mouth, doesn't mean that the implant is in good health (success)
  5. implant "success"
    very hard to measure
  6. Implant study:

    % of patients free from complications?
    66.4%

    - incidence of complications usually increase w/ time
  7. 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
  8. 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
  9. Attachment: implant vs tooth
    hemidesmosomal attachment to the implant
  10. 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.
  11. bone loss: implant vs tooth
    tooth: bone loss can be localized to one side of tooth  

    vs.

    implant:consistent circumferential bone loss
  12. Mech of bone loss around implant

    name 3
    • 1. infection theory
    • 2. biomechanical overload theory
    • 3. additional factors (compromised healing)
  13. Bone loss/Implant failure:

    peri-implant infection
  14. 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
  15. Region of BEST quality and MOST quality
    anterior mandible
  16. Region of bone with LEAST quantity and WORST quality
    Posterior maxilla
  17. What is implant anchorage dependent upon? (name 3)
    1. thickness of cortical bone (most important)

    2. quality (density) of trabecular bone

    3. bicortical stabilization
  18. Non-axial loads
    load magnification = bone loss
  19. why are cantilevers contraindicated?
    causes load magnification around implant adjacent to the cantilever
  20. 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
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318303
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Perio: Osseointegration Lecture 1
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D3 Spring
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