Podcast
Questions and Answers
What is one of the primary mechanical complications associated with implants?
What is one of the primary mechanical complications associated with implants?
Which factor is NOT considered in Misch’s treatment planning approach?
Which factor is NOT considered in Misch’s treatment planning approach?
What is the expected impact of cantilever designs in implant cases?
What is the expected impact of cantilever designs in implant cases?
Which of the following is a biomechanical factor that may contribute to implant failure?
Which of the following is a biomechanical factor that may contribute to implant failure?
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What is the failure rate for implants placed in soft bone regions shorter than 10 mm?
What is the failure rate for implants placed in soft bone regions shorter than 10 mm?
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What is a recommended approach when treating an edentulous mandible with weak bone?
What is a recommended approach when treating an edentulous mandible with weak bone?
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Which position is considered ideal for key implants in an edentulous maxilla treatment plan?
Which position is considered ideal for key implants in an edentulous maxilla treatment plan?
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What is a disadvantage of independent crowns compared to splinter crowns?
What is a disadvantage of independent crowns compared to splinter crowns?
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What should be prioritized to manage stress in an implant treatment plan?
What should be prioritized to manage stress in an implant treatment plan?
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In terms of masticatory dynamics, which aspect do splinter crowns improve?
In terms of masticatory dynamics, which aspect do splinter crowns improve?
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What is the ideal diameter for a single-tooth implant when considering adjacent teeth?
What is the ideal diameter for a single-tooth implant when considering adjacent teeth?
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Which of the following statements about the use of resin-bonded prostheses in the aesthetic zone is accurate?
Which of the following statements about the use of resin-bonded prostheses in the aesthetic zone is accurate?
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What is the recommended diameter for an implant when replacing a first molar that has a mesiodistal size of 10 mm?
What is the recommended diameter for an implant when replacing a first molar that has a mesiodistal size of 10 mm?
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Which factor is crucial in determining the implant's placement diameter in relation to the buccolingual dimension of bone?
Which factor is crucial in determining the implant's placement diameter in relation to the buccolingual dimension of bone?
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What is typically necessary before placing maxillary premolar implants?
What is typically necessary before placing maxillary premolar implants?
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What occurs if a cantilever of 4-5 mm is created at the marginal ridge of a crown due to incorrect implant selection?
What occurs if a cantilever of 4-5 mm is created at the marginal ridge of a crown due to incorrect implant selection?
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Which treatment planning method is optimal when the mesiodistal space is between 12-14 mm?
Which treatment planning method is optimal when the mesiodistal space is between 12-14 mm?
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What is a common challenge when placing implants, particularly concerning abutment screws?
What is a common challenge when placing implants, particularly concerning abutment screws?
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Study Notes
Prosthodontics - 2nd Committee - 1st Lecture: History and Components of Implants
- Branemark's Research: Swedish orthopedic professor, Branemark, observed revascularization in rabbit fibula in 1952 via light microscopy.
- Osseointegration: Implant directly contacts bone in 1965. First dental implant placed on an edentulous patient.
Types of Dental Implants
- Subperiosteal: Metal framework placed on jawbone, posts protrude above gum tissue.
- Transosteal: Metal framework below gum tissue, posts run through jawbone.
-
Endosteal: Metal framework inserted within jawbone.
- Cylinder
- Blade
- Screw
Implant Indications
- Tooth loss
- Congenital tooth absence
- Poor oral muscle coordination
- Discomfort from removable dentures
Implant Applications
- Single tooth replacement
- Partial/complete edentulism
- Maxillofacial prosthetics
- Craniofacial prosthetics
Implant Components
-
Implant body:
- Titanium screw-shaped
- Hydroxyapatite-coated screw-shaped
- Titanium plasma-sprayed cylinder
- Hydroxyapatite-coated cylinder
- Types: Smooth, machined, textured, coated
- Crown, abutment, abutment screw
Implant Abutments
- Stock, tissue level, straight, angled, bone level, custom, milled, UCLA, locator, screw-retained, cemented, temporary.
- Tissue level abutments are closely related to the implant platform.
- Bone-level abutments are closely related to the abutment platform, especially in anterior teeth.
- Temporary abutments include impression and healing, using metal or plastic.
Contraindications
- Uncontrolled systemic disorders
- Psychiatric disorders
- Radiation therapy
- Smoking
- Poor oral hygiene
Permanent Abutments
- Material: Titanium, Zirconia
- Manufacturing: Stock, custom (UCLA).
-
Retention: Screw-retained, cement-retained.
- Screw-retained advantages: Easy removal, solves retention issues, no cement issues. Disadvantages: Aesthetic concerns, difficult passive fit control.
- Cement-retained advantages: Easier passive fit, more resistant to screw loosening, easier occlusal alignment, easier occlusal alignment. Disadvantages: Prosthesis may need removal if a problem arises; cement residue is possible.
Internal vs. External Connection
- Internal connections (Morse taper, cone screw) are advantageous in maintaining platform switching and reducing stress.
- External connections are used but have disadvantages that need to be accounted for in dental procedures.
Platform Switching
- Emerged in 1991
- Advantages: reduced bone loss when used supracrestally
- Platform switching involves making the abutment diameter smaller than the implant diameter.
2nd Lecture: Stress in Dental Implants
- Biomechanical stress is an important risk factor in implant dentistry
- Patient factors (parafunction, crown height, chewing dynamics) influence stress.
- Occlusal guards can help reduce stress conditions
3rd Lecture: Stress in Single-Tooth Implants
- Agenesis, trauma, and endodontic failure are causes of maxillary anterior single-tooth loss.
- Possible replacement options: Classic fixed prostheses (fixed dental bridge), Removable partial dentures (RPD), Resin-bonded fixed prostheses (temporary).
4th Lecture: Single-Tooth Replacement Treatment Options
- Maxilla distributes force; mandible absorbs force.
- Different bone densities (D1-D4) affect implant placement.
- Alternative options: removable partial dentures, resin-bonded bridges, fixed partial dentures, implant-supported prostheses.
5th Lecture: Maxillary Anterior Single-Tooth Replacement
- Patient considerations: Compliance, anxiety, treatment duration, consequences, cost.
- Aesthetic considerations: patient age, mobility of adjacent teeth, crown height, bone, soft tissue coverage, available bone.
- Various prostheses with advantages and disadvantages are given based on certain factors.
6th Lecture: Implant Key Positions and Treatment Plans
- Ideal implant treatment is quick, inexpensive, comfortable, minimal complications, and appropriate.
- Treatment planning logic involves pre-loading and post-loading failure rates.
- Biomechanical factors (stress, male patients, bruxism, opposing implants, etc.) influence the position.
7th Lecture: Implant Body Size, Biomechanics, and Aesthetics
- Implant body size is an important indicator of stress.
- Increasing the implant diameter reduces stress and increases functionality reducing stress and increasing functional area and reducing risk of fracture during parafunction.
- Stress is affected by characteristics of the patient (bite-force, masticatory muscle characteristics, gender, age, etc.).
- Wide-diameter implants increase surface area.
Summary of Aesthetic Considerations
- Aesthetic treatment should match the natural tooth diameter.
- Distance between implant and adjacent tooth should be 1.5 mm minimum.
- Distance between implants should be at least 3 mm.
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Description
Explore the fascinating history and components of dental implants in this first lecture of the Prosthodontics 2nd Committee. Learn about Branemark's groundbreaking research, the types of dental implants, and their various applications and indications.
