Podcast
Questions and Answers
What is the primary advantage of implant-supported restorations for partially edentulous patients?
What is the primary advantage of implant-supported restorations for partially edentulous patients?
What is considered a contraindication for implant therapy?
What is considered a contraindication for implant therapy?
What is the purpose of obtaining a medical clearance for surgery?
What is the purpose of obtaining a medical clearance for surgery?
What test is commonly used to check glycemic control in patients with diabetes over the last 90 days?
What test is commonly used to check glycemic control in patients with diabetes over the last 90 days?
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In partially edentulous patients with Kennedy class I and II, what restoration option is typically indicated?
In partially edentulous patients with Kennedy class I and II, what restoration option is typically indicated?
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Which of the following conditions can impair normal wound healing and is considered a risk factor for implant therapy?
Which of the following conditions can impair normal wound healing and is considered a risk factor for implant therapy?
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What is a major concern for patients with uncontrolled diabetes undergoing implant therapy?
What is a major concern for patients with uncontrolled diabetes undergoing implant therapy?
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Which of the following is NOT listed as a contraindication for implant therapy?
Which of the following is NOT listed as a contraindication for implant therapy?
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What is a consequence of nicotine's vasoconstrictive effects on healing?
What is a consequence of nicotine's vasoconstrictive effects on healing?
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What minimum mesial-distal space is required for a standard diameter implant?
What minimum mesial-distal space is required for a standard diameter implant?
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Why are drugs and alcohol abuse considered contraindications for implant therapy?
Why are drugs and alcohol abuse considered contraindications for implant therapy?
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What is the minimum interocclusal space required for the restorative stack on an external hex-type implant?
What is the minimum interocclusal space required for the restorative stack on an external hex-type implant?
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What is a common evaluation performed during a pretreatment evaluation?
What is a common evaluation performed during a pretreatment evaluation?
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What is the initial recall interval for implant maintenance visits during the first year after treatment?
What is the initial recall interval for implant maintenance visits during the first year after treatment?
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Which statement about keratinized tissue around implants is true?
Which statement about keratinized tissue around implants is true?
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Which method is NOT recommended for the removal of dental plaque and calculus from implant components?
Which method is NOT recommended for the removal of dental plaque and calculus from implant components?
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Which imaging method is crucial for verifying the level of peri-implant crestal bone?
Which imaging method is crucial for verifying the level of peri-implant crestal bone?
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What is the significance of evaluating general wear facets in patients?
What is the significance of evaluating general wear facets in patients?
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What type of cases can be considered predictable in achieving satisfactory esthetic results?
What type of cases can be considered predictable in achieving satisfactory esthetic results?
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What is a reason for adjusting the recall maintenance visits for implant patients?
What is a reason for adjusting the recall maintenance visits for implant patients?
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When should radiographs for baseline documentation be taken for dental implants?
When should radiographs for baseline documentation be taken for dental implants?
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What is the implication of an HBA1c level of 8% in individuals?
What is the implication of an HBA1c level of 8% in individuals?
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Which of the following medications is not typically associated with Medication Related Osteonecrosis of the Jaws (MRONJ)?
Which of the following medications is not typically associated with Medication Related Osteonecrosis of the Jaws (MRONJ)?
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In patients who have taken oral bisphosphonates for over 3 years, what precaution should be considered before oral surgery?
In patients who have taken oral bisphosphonates for over 3 years, what precaution should be considered before oral surgery?
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What is the major risk for patients with a history of radiation treatment to the head and neck during surgery?
What is the major risk for patients with a history of radiation treatment to the head and neck during surgery?
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How does smoking affect the success rate of dental implants?
How does smoking affect the success rate of dental implants?
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What physiological effect of carbon monoxide in smokers can lead to implant failure?
What physiological effect of carbon monoxide in smokers can lead to implant failure?
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Which surgical procedures should ideally be avoided in individuals treated with IV bisphosphonates?
Which surgical procedures should ideally be avoided in individuals treated with IV bisphosphonates?
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What type of medication is associated with antiangiogenic effects that can lead to MRONJ?
What type of medication is associated with antiangiogenic effects that can lead to MRONJ?
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Which anatomical landmark is NOT typically evaluated using panoramic radiographs?
Which anatomical landmark is NOT typically evaluated using panoramic radiographs?
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What is the minimum distance an implant should be placed anterior to the mesial aspect of the mental foramen?
What is the minimum distance an implant should be placed anterior to the mesial aspect of the mental foramen?
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Which device can be modified into a surgical guide after use as a radiographic template?
Which device can be modified into a surgical guide after use as a radiographic template?
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What percentage of patients may present with bony septa arising from the floor of the maxillary sinus?
What percentage of patients may present with bony septa arising from the floor of the maxillary sinus?
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What is the recommended imaging technique for evaluating all implant sites?
What is the recommended imaging technique for evaluating all implant sites?
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What should be done if a patient's CBCT reveals an abnormality in one of the maxillary sinuses?
What should be done if a patient's CBCT reveals an abnormality in one of the maxillary sinuses?
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Which characteristic is true for surgical guides used during surgery?
Which characteristic is true for surgical guides used during surgery?
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What is a common method for fabricating a surgical guide?
What is a common method for fabricating a surgical guide?
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Study Notes
Introduction to Implant Therapy
- Implant success rates exceed 90-95% in healthy patients with adequate bone and normal healing.
- Accurate diagnosis of the dentoalveolar condition and the patient’s overall health is crucial for determining implant therapy eligibility.
Case Types and Indications
-
Partially Edentulous Patients
- Options include single tooth or multiple teeth restoration.
- Implant-supported restorations preserve adjacent teeth without alteration.
- Suitable for Kennedy class I and II patients with fixed restoration needed.
-
Edentulous Patients
- Can receive either implant-assisted removable prosthesis or implant-supported fixed prosthesis.
- Examples include full arch fixed prostheses, ceramometal fixed prostheses, and maxillary implant-retained overdentures.
Pretreatment Evaluations
- Essential to gather chief complaint and thorough medical history.
- Consider potential risk factors or contraindications that may affect wound healing.
- Medical clearance from physicians may be necessary if risks are identified.
Contraindications to Implant Therapy
- Unrealistic expectations and the influence of certain medications like IV bisphosphonates.
- History of radiation exposure and chemotherapy treatment.
- Severe psychologic disorders, uncontrolled diabetes, and poor oral hygiene pose additional risks.
- Limited jaw opening can also be a contraindication.
Diabetes Mellitus
- Uncontrolled diabetes hampers wound healing and increases infection risk.
- Glycosylated hemoglobin (HBA1c) test indicates diabetes control; values above 8% indicate poor metabolic control.
Medication Related Osteonecrosis of the Jaws (MRONJ)
- MRONJ is serious bone destruction in the maxillofacial region associated with antiresorptive or antiangiogenic drugs.
- Dental procedures, including implant surgery, may trigger MRONJ in patients treated with IV bisphosphonates.
- Consider discontinuation of oral bisphosphonates three months prior to surgery if the patient has been on them for over three years.
Osteoradionecrosis of the Jaws (ORN)
- Patients treated with radiation in the head and neck may experience healing challenges post-surgery.
- Risk of non-healing exposure and bone infection necessitates avoiding surgical interventions in these patients.
Habits and Behavioral Considerations
- Smoking: Increases implant failure risk (odds ratio of 2.25); vasoconstriction and reduced healing in smokers lead to higher complication rates.
- Substance Abuse: Drugs and alcohol may jeopardize compliance with treatment and are considered contraindications for implant therapy.
Intra-Oral Clinical Examination
- Dental Examination: Assess arch shape, sizes, and occlusion for implant planning.
- Evaluation of Edentulous Space: Minimum space requirements vary by implant diameter.
Pretreatment Evaluation
- Hard and Soft Tissue Evaluation: Medical history and tissue health need careful assessment.
- Keratinized Tissue: Debate exists over its necessity around implants; no definitive conclusion reached.
Radiographic Evaluation
- PA, panoramic radiographs, or CBCT are standard for imaging.
- Critical landmarks include maxillary sinuses, mandibular canal, and mental foramen.
- Three-dimensional imaging is recommended for accurate site assessment before implant surgery.
Surgical Guide
- Surgical guides indicate ideal implant placement and can be created from diagnostic teeth replicas or long axis reproductions.
Supportive Implant Treatment
- Regular maintenance begins post-exposure of implant and continues throughout its lifespan.
- Recall intervals tailored to individual patient needs based on oral hygiene.
Examination of Dental Implants
- Utilize visual inspection, digital palpation, and radiographic images to monitor implant health.
- Initial radiographs taken at placement, connection, and delivery serve as baseline documentation for future comparative purposes.
Methods for Professional Recall Maintenance
- Regular plaque and calculus removal; essential to use non-metal tools for cleaning titanium surfaces to avoid damage.
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Description
This quiz covers the essential aspects of supportive implant treatment, focusing on maintenance and recall intervals based on oral hygiene and disease susceptibility. Ideal for dental professionals, it includes insights into managing patients post-implant surgery. Enhance your understanding of implant care protocols.
