Implant Dentistry: Bladed vs Subperiosteal Implants

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Questions and Answers

What is a primary concern when removing bladed implants in cases of inflammation?

  • The potential for significant bone destruction and defects (correct)
  • Avoiding damage to the inferior alveolar nerve
  • Maintaining the implant's surface integrity for potential reuse
  • Ensuring minimal discomfort for the patient

Why are subperiosteal implants custom-made?

  • To accommodate variations in jaw anatomy and bone structure (correct)
  • To allow for adjustments during the osseointegration process
  • To reduce the risk of infection
  • To ensure compatibility with standard prosthetic components

Compared to bladed implants, what is a key advantage of root form implants regarding insertion and removal?

  • They can be easily modified chair-side to achieve optimal fit
  • They require specialized surgical instruments for placement and removal, promoting precision
  • They are generally easier to insert and remove due to their design (correct)
  • They promote faster osseointegration, reducing the risk of early implant failure

What is the primary function of the metallic posts featured in subperiosteal implants?

<p>To serve as attachment points for the final prosthesis (C)</p> Signup and view all the answers

What is the rationale for considering bladed implants when there is severe bone resorption?

<p>They can be an option when vertical bone height above the ID canal is very limited (C)</p> Signup and view all the answers

Besides short implants, what is another alternative to address limited bone height for implant placement?

<p>Bone augmentation procedures (B)</p> Signup and view all the answers

Where is a subperiosteal implant framework placed in relation to the bone and periosteum?

<p>Underneath the periosteum, above the bone (B)</p> Signup and view all the answers

Which of the listed materials is commonly used for constructing the framework of a subperiosteal implant?

<p>Chrome cobalt or titanium (D)</p> Signup and view all the answers

In cases of severe vertical bone resorption in the edentulous mandible, what is a primary consideration when choosing between bone augmentation and subperiosteal implants?

<p>The patient's medical conditions and financial constraints. (C)</p> Signup and view all the answers

What is a significant limitation of bone augmentation in cases of severe vertical bone resorption, making subperiosteal implants a potentially viable alternative?

<p>The potentially invasive surgical procedures and low success rate. (D)</p> Signup and view all the answers

For All-on-Four implants in the mandible, what anatomical landmark defines the posterior limit where bone levels should be minimally 3–4 mm above the ID canal?

<p>The mental foramen. (D)</p> Signup and view all the answers

What is the primary advantage of choosing implants with a fixed supported prosthesis over partial dentures?

<p>Implants offer a superior long-term outcome in stability, aesthetics, and functionality. (B)</p> Signup and view all the answers

In the All-on-Four implant technique, what is the primary rationale for tilting posterior implants in the mandible?

<p>To maximize contact with the cortical bone and avoid anatomical structures. (A)</p> Signup and view all the answers

What is a key advantage of using All-on-Four implants in the mandible for full-arch restoration?

<p>They can support a 12-unit bridge with a high success rate. (A)</p> Signup and view all the answers

According to Brånemark's definition, what is the key characteristic of osseointegration?

<p>The fusion of bone with the surface of the implant threads. (D)</p> Signup and view all the answers

Why is the theoretical approach of examining osseointegration (removing the implant and examining it under a microscope) not clinically applicable?

<p>It requires removing the implant, which negates the purpose of implant placement. (D)</p> Signup and view all the answers

When fabricating subperiosteal implants, which method ensures the most accurate fit and adaptation to the patient's unique bone structure?

<p>Either traditional or digital impressions can be used. (B)</p> Signup and view all the answers

Why are transosteal implants no longer commonly used in modern implant dentistry?

<p>Advancements in implant techniques and availability of better alternatives. (D)</p> Signup and view all the answers

Which of the following methods is used for clinical evaluation of osseointegration?

<p>Radiographic evidence and stability tests (ISQ or resonance frequency analysis). (B)</p> Signup and view all the answers

What does 'rigid fixation' of a dental implant primarily rely on?

<p>Osseointegration, where bone fuses with the implant threads. (D)</p> Signup and view all the answers

What is the primary disadvantage of transosteal implants compared to current root form implants and bone augmentation techniques?

<p>Surgically invasive nature. (B)</p> Signup and view all the answers

What does ISQ (Implant Stability Quotient) measure?

<p>The stability of the implant using resonance frequency analysis. (D)</p> Signup and view all the answers

Why is stability considered crucial for successful dental implants?

<p>Allows for immediate loading and function of the implant supported prosthesis. (D)</p> Signup and view all the answers

Which level of magnification is critical when defining osseointegration?

<p>Light microscopic level (C)</p> Signup and view all the answers

What does the term 'rigid fixation' primarily signify in the context of dental implants?

<p>The implant has achieved sufficient osteointegration to endure functional loads and support restorations. (A)</p> Signup and view all the answers

Which of the following best describes the function of the Osstell® device?

<p>To assess the stability of dental implants using resonance frequency analysis (RFA). (A)</p> Signup and view all the answers

What is the significance of the Implant Stability Quotient (ISQ) value provided by the Osstell® device?

<p>It quantifies the implant’s stability, with higher values indicating greater stability. (A)</p> Signup and view all the answers

In which of the following scenarios would the use of the Osstell® device be LEAST beneficial?

<p>Prior to extracting a failing dental implant. (B)</p> Signup and view all the answers

According to the guidelines, what ISQ value generally indicates that an implant is ready for immediate or early loading?

<p>ISQ &gt; 65 (C)</p> Signup and view all the answers

What advantage does the Osstell® device offer over manual testing methods for assessing implant stability?

<p>It offers an objective measurement, reducing subjectivity in the evaluation. (B)</p> Signup and view all the answers

What is the primary principle of operation behind the Osstell® device's measurement of implant stability?

<p>Analyzing the resonance frequency of the implant when subjected to vibrations. (A)</p> Signup and view all the answers

What is the clinical significance of monitoring secondary stability during the healing period of a dental implant?

<p>Tracking bone remodeling and osteointegration around the implant. (B)</p> Signup and view all the answers

What advantage do implants designed for cases of bone loss in the coronal third of the root form have, compared to fully threaded implants?

<p>They are easier to clean and maintain. (A)</p> Signup and view all the answers

Which factor is least critical when selecting the implant design, length, and width?

<p>Patient's systemic health (C)</p> Signup and view all the answers

What is the typical length range for standard dental implants?

<p>7 to 16 mm (A)</p> Signup and view all the answers

In what clinical situation might a short dental implant, approximately 4mm in height, be most appropriately utilized?

<p>In cases with limited bone height. (A)</p> Signup and view all the answers

Zygomatic implants are specifically designed for anchorage in which anatomical location?

<p>Zygomatic bone (A)</p> Signup and view all the answers

In which area are narrow implants most suitable?

<p>Anterior regions (D)</p> Signup and view all the answers

For which scenario would wide implants be most appropriate?

<p>Replacing a molar (C)</p> Signup and view all the answers

What is the primary advantage of tapered implants over traditional cylindrical implants?

<p>Enhanced stability in soft bone (D)</p> Signup and view all the answers

What is the primary function of the implant body's threads?

<p>To optimize bone contact and enhance stability. (C)</p> Signup and view all the answers

Which characteristic is MOST important for the crest module (neck) of a dental implant?

<p>The connection to the abutment or crown and anti-rotational elements. (C)</p> Signup and view all the answers

In implant design, what is the significance of anti-rotational elements found at the crest module?

<p>They ensure correct alignment and prevent loosening of the abutment or crown. (A)</p> Signup and view all the answers

Why might a dental implant have a flat or rounded apical portion?

<p>To adapt to different bone densities and anatomical considerations. (C)</p> Signup and view all the answers

What is a primary purpose of the apical portion?

<p>Enhanced primary stability during implant placement. (C)</p> Signup and view all the answers

What is the MAIN advantage of parallel-walled implants?

<p>They provide uniform surface contact with the bone. (B)</p> Signup and view all the answers

What would NOT contribute toward primary stability?

<p>Crest module shape (C)</p> Signup and view all the answers

Which portion contributes to primary stability AND initial fixation?

<p>Body (D)</p> Signup and view all the answers

Flashcards

Severe Bone Resorption

Significant loss of bone, especially height above the ID canal.

Bladed Implants

Implants designed for challenging conditions but may cause bone destruction.

Root Form Implants

User-friendly implants that resemble natural root structures; easier insertion and removal.

Short Implants

Proven successful implants designed for limited bone height situations.

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Bone Augmentation

A procedure to increase bone height for better implant placement.

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Subperiosteal Implants

Framework implants placed above the bone and under gum tissue, tailored for the patient.

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Customization of Implants

Subperiosteal implants must be custom-made to fit individual jaw and bone structures.

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Framework Material

Typically made from chrome cobalt or titanium, secured mechanically to the bone.

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All-on-Four Implants

A technique utilizing four implants to support a full arch restoration.

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Transosteal Implants

Implants that penetrate the mandible, stabilized by screws.

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Custom-Made Implants

Implants tailored specifically to a patient’s anatomy.

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Tilted Implants

Implants placed at an angle to utilize available bone effectively.

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Edentulous Mandible

A mandible without teeth, often requiring augmentation or implants.

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High Success Rate of Implants

A characteristic indicating the likelihood of implant stability and longevity.

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Rigid Fixation

Implant has achieved sufficient stability to support functional loads.

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Osteointegration

Process where the implant fuses with the bone, providing stability.

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ISQ

Implant Stability Quotient, a measurement of implant stability ranging from 1 to 100.

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Osstell® Device

Device that measures implant stability using resonance frequency analysis.

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Resonance Frequency Analysis (RFA)

Technique that uses vibrations to assess implant stability.

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Primary Stability

Initial stability right after implant placement, crucial for loading protocols.

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Secondary Stability

Stability that develops during the healing period post-implant placement.

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Clinical Guidelines for ISQ Values

ISQ > 65 indicates the implant is ready for immediate or early loading.

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Bone loss and implants

Implants with less threading are easier to clean in cases of bone loss.

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Implant selection factors

Selection of implant design depends on bone quality, quantity, and space requirements.

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Standard implant lengths

Standard implants range from 7 to 16 mm in length for most clinical needs.

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Zygomatic implants

Zygomatic implants are longer than 16 mm for unique anatomical situations requiring anchorage in the zygomatic bone.

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Implant widths

Implants come in narrow, standard, and wide options for different anatomical spaces.

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Mini-implants

Mini-implants are used for temporary support or very limited space cases.

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Tapered implants

Tapered implants mimic natural tooth roots and enhance stability in soft bone.

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Partial Dentures vs Implants

Partial dentures are temporary solutions, while implants provide long-term stability, aesthetics, and functionality.

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Evidence of Osseointegration

Clinically examined through radiographic evidence and stability tests instead of removing the implant.

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Implant Stability Quotient (ISQ)

ISQ measures implant stability through resonance frequency analysis.

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Two-piece Implants

Two-piece implants consist of a separate implant body and abutment, allowing for better customization.

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One-piece Implants

One-piece implants integrate the implant and abutment in a single unit for simpler placement.

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Radiographic Evidence

Radiographic evidence confirms bone integration around the implant via imaging techniques.

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Parallel-Walled Implants

Implants providing uniform contact with dense bone areas.

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Crest Module (Neck)

Upper implant part connecting to prosthesis; features anti-rotation and abutment attachment.

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Body (Middle Section)

The central part of the implant designed for optimal bone contact and stability.

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Apical Portion (Apex)

The tip of the implant that sits within the bone, varying in design for bone density.

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Anti-Rotational Elements

Features ensuring the implant does not twist during placement or use.

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Bone Contact Optimization

Design aspect of implants to enhance stability through better bone contact.

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Tissue-Level vs Bone-Level Implants

Implants differing in how they interface with gum and bone tissue.

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Study Notes

Implant Terminology

  • Misch's Contemporary Implant Dentistry, 4th Edition, 2019, is a key reference.
  • Rola Shadid, BDS, MSc, P. Board, Associate Prof., Fellow AAID, American Board of Oral Implantology, is mentioned.

Outline

  • Implant modalities (root form, subperiosteal, blade/plate, transosteal) are discussed.
  • Terminology of root form types and implant body regions are explained.
  • A comparison of one-piece and two-piece implant systems, as well as tissue-level versus bone-level implants.
  • Implant surgery approaches (one-stage, two-stage, immediate restoration) are outlined.
  • Prosthetic attachments and fabrication are covered.
  • Biologic width around teeth and implants is highlighted.
  • Also included are implant pros.

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