implant prosthesis may be ______ or have a ______ shape
cylindrical
blade
what is the leading cause of failure of an implant?
mobility
what can cause mobility of an implant in the bone? (2)
lack of osseo-integration or adequate bone
what are three contraindications to implant placement?
inadequate bone
uncontrolled periodontal disease
smoking
t/f an electric toothbrush should not be recommended for a pt with implants
false! it will not cause damage, it is ok to use
can an air polisher be used around implants?
yes
______ instruments cannot be used around implants unless they are _________, ______ _______, or ________
metal
titanium
titanium alloy
graphite
with careful case selection, what is the success rate of implants?
90%+
t/f implants are great for retention and stabilzation of mandibular dentures
true
what are the three main types of implants?
subperiosteal
transosteal
endosseous
what do transosteal implants do?
support mandibular denture in the pt with severe bone resorption
what is the MOST COMMON implant used today?
ENDOSSEOUS!
which implant is more successful in the mandible due to DENSER BONE?
endosseous
which implants are under the periosteum and rest on the bone?
subperiosteal
where are subperiosteal implants most common?
on the mandible
which implant is biocompatible, light weight, and does not corrode?
endosseous
endosseous implants are ____-like for osseous integration
screw
some endosseous implants have _________ or ______ proteins to enhance osteointegration
hydroxyapatite
plasma proteins
who makes the acrylic stent guide for paralleling of multiple implants?
the dentist
what does a dentist use to get the correct angulation of an implant?
he makes an acrylic stent (guide)
how long does it take for the integration of an implant after placement?
3 months, then uncover the implants, place screw into the implant, place healing abutment, replace flap and let heal
which implants have replaced the subperiosteal implants used today?
the endosseous implants
which implant is also called the mandibular staple?
transosteal implant
for subperiosteal implants, what is the first, second, and third step?
first: surgical incision to expose bony ridge. impression of the bony ridge is taken. the surgical wound is closed
second: a replica is made of the bony ridge from the impression. the metal framework is cast in the lab. it has metal projections that will extend through the tissues.
third: a second incision to reopen the initial wound is made. the implant framework is inserted over and under the periosteum. the tissues are sutured closed and the projections are showing in the oral cavity.
how is a transosteal implant inserted?
a horizontal support beam is atached to the metal rods that are inserted into the holes drilled ALL THE WAY through the mandible! required intraoral and extraoral incisions! not used much. it is invasive in nature.
excessive _____ will damage bone during implant placement
heat
what is a prosthesis attached by (when dealing with implants)
a small screw of gold alloy
what is an immediate-placement surgical procedure?
when an implant is placed immediately into a fresh extraction site (mmmm yummy)
which implant placement can either be a one-step or two-step surgical procedure depending on the approach?
endosseous
t/f there is PDL or JE with an implant
false! there is not! no need to probe it (says the speaker at the UDA convention)
what helps keep microorganisms from invading the tissues with an implant?
the biological seal (close adaptation and attachment of sulcular epithelium to implant surface)
t/f an implant restoration can collect plaque and calc
true!
what can happen if plaque and calc are not controlled around an implant?
inflammation and bacterial invasion can progress into the bone and contribute to failure
what should be done for homecare for a patient with implants?
customize for the patient what to use!
t/f wooden plaque removers are too abrasive around implants to use
FALSE! they do not scratch the implant. they are good to use
how long should CHX be used if recommended for pt?
1-2 wks at a time to prevent staining
t/f listerine can be used daily with implants
true
oral irrigation should be used on ____ pressure around implants
low
what are 5 brushes that can be used with implants?
soft bristle
interproximal
end tufted
alter angulation of plastic handle
rotary with pointed bristles
how often is a hygiene visit recommended for implant patients?
3-4 months
what should be asked when a pt comes in for a visit for a check up on implants?
is there any mobility
bleeding
soreness
looseness of prosthesis
what is used to check bon integration/level?
radiographs
routine probing is ____ recommended!
NOT
what kind of curettes and scalers can be used with implants?
plastic or graphite
metal instruments with ____ or _____ coating can be used
teflon
gold coating
what can be used if polishing is absolutely necessary?
tin oxide
what usually causes early implant failure? (5)
poor surgical technique
heat to bone in drilling
infection of implant site
poor bone quality (osteoporosis)
loading forces too soon
what are two causes of failure after integration?
bacterial infection from prei-implant tissues into bone
overloading implant during FUNCTION-loss of supporting bone
