Dental Implants Definitions
Dental Implants
- It is an integral component of the oral implant complex, which also consists of supportive bone, interposed keratinized and mucosal oral soft tissues, and prosthetic superstructure.
Structure of dental Implants:
Peri-implantitis
- It is a progressive peri-implant bone loss in conjunction with soft tissue inflammatory lesions.
Osseointegration
- It is defined as the direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant without intervening soft tissues
Osteoconduction.
- It is an effect by which the matrix of the graft forms a scaffold that favors outside cells to penetrate the graft and form new bone
Osteoinduction
- A process by which graft material is capable of promoting cementogenesis, osteogenesis, and new periodontal ligament
Dental Implants Important Notes
1. Classification of implants
- Based on shape and forms
- Endosteal
- Subperiosteal
- Transosteal
- Intramucosal
- Endodontic
- Based on Surface characteristic
- Titanium plasma sprayed coating
- Sand blasting-surface etching
- Laser-induced surface roughening
- Hydroxyapatite coating
Dental Implants Long Essays
Question 1. Define Osseointegration and classify dental. implants. Add a note on the maintenance of im- plants.
Answer:
Classify dental Osseointegration
classify dental Definition:
- It is defined as the direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant without intervening soft tissue
- It is a fundamental requirement and essential component for implant success
classify dental Maintenance Of Implants
1. At the office
- The patient is recalled at regular intervals to provide optimal preventive services
- Probing pocket depth and mucosal margins are notes
- Radiographic crestal bone levels are established
- Evaluation is done initially after 1 day, 1 month, 3 months, 6 months, and then at yearly intervals
- At every visit following evaluation is done
- Evaluation of soft tissue around the implant
- Implant mobility
- Prosthesis
Read And Learn More: Periodontics Question and Answers
-
- Radiograph
- Plaque and calculus scores
- Debridement of the implant should be carried out with plastic instruments that do not damage the implant surface
- A rubber cup can be used to polish the implant surface with a non-abrasive toothpaste, fine polishing paste, or tin oxide
2. Home care methods
- A soft circular toothbrush is used around implant restoration
- Powered and sonic toothbrushes are used around titanium implants
- Foam tips, interproximal brushes, and disposable wooden picks are used for plaque removal from embrasures
- Chemical antiplaque agents can be delivered with interdental aids
- Every implant patient requires lifetime careful maintenance to ensure implant health and longevity
Question 2. Dental implants.
Answer:
- It is an integral component of the oral implant complex, which also consists of supportive bone, interposed keratinized and mucosal oral soft tissues, and prosthetic superstructure.
Dental implants Material Used:
Dental implants Metals:
- Stainless steel
- Gold
- Titanium
- Tantalum
- Zirconium
Dental implants Ceramics:
- Aluminium oxide
- Titanium oxide
Dental implants Calcium Phosphate:
Bioactive and Biodegradable Ceramic:
- Hydroxyapatite
- Bioglass
- Carbon
Dental implants Polymers:
- Polymethyl methacrylate
- Polytetrafluoroethylene
- Polyethylene
- Polypropylene
Dental implants Indications:
1. Edentulous patient:
- Edentulous mandible
- Edentulous maxilla
2. Partially edentulous:
- Free end edentulous
- Multiple missing
3. Single tooth loss:
Dental implants Contraindications:
- Diseases
- Uncontrolled DM
- Malignancy
- Disease of CT
- Blood dyscrasia
- Malignancy
- Psychologic disorders
- Iatrogenic
- Immunosuppressant therapy
- Drug addiction
- Radiation to jaw
Dental implants Procedure:
Dental Implants Short Essays
Question 1. Perl-Implantis.
Answer:
- It is a progressive peri-implant bone loss in conjunction with soft tissue inflammatory lesions.
- It begins at the coronal portion of the implant.
Perl-Implantis Clinical Features:
- Erythema over the area
- Bleeding on probing
- Pocket formation
- Bone destruction
- Suppuration
- Presence of calculus
- Tooth mobility present
Perl-Implantis Diagnosis:
- Bone loss
- Clinical attachment loss
Perl-Implantis Management:
- Occlusal therapy – Occlusal correction
- Anti-infective therapy
- Scaling and root planning
- 0.12% chlorhexidine
Perl-Implantis Surgical Techniques:
- Correction of bone defects
- Re-osseointegration
- Maintenance
- Recall visits planned for at least every 3 months
Question 2. Osseointegration
Answer:
Osseointegration Definition:
- It is defined as the direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant without intervening soft tissues
- It is a fundamental requirement and essential component for implant success
Osseointegration Process:
Osseointegration Requirements:
- Immobility of implant relative to the bone
- Avoid excessive occlusal forces
- Proper vascular supply and oxygen tension
- A strict aseptic technique should be maintained
- Profuse irrigation during drilling
Osseointegration Significance:
- Once osseointegration is achieved, implants can resist and function under occlusal forces for many years
Question 3. Failures of implants
Answer:
Failures Of Implants Are Due To:
1. Improper patient selection:
- Patients who are unmotivated to control plaque
- Chronic smokers
- Patients with systemic conditions like uncontrolled diabetes
- Patients with insufficient quality and quantity of A process by which graft material is capable of promoting- bone to support the implant fixture
2. Surgical complications:
- Oversized osteotomy site preparation
- Broken burs
- Improper angulation
- Inappropriate instrumentation
- Perforation
- Hemorrhage
- Inadequate amount of soft tissue
3. Complication in early stages:
- Postoperative infections
- Dysaesthesia
- Dehiscence
- Sinusitis
- Radiolucencies
- Mobility
4. Late failures:
- Mechanical complications
- Occlusal overloading
- As osseointegrated implants have no periodontal ligament, the adverse forces generated by occlusal activity may lead to high stress and microfractures in the coronal bone to im- plant contact
- Abutment screw fracture
- Biological complication
- They are bacterial in origin
- Characterized by bone loss combined with soft tissue inflammatory response that- demonstrates suppuration with probing depth greater than 6 mm
- Presence of pockets, bleeding on probing, and purulence
Question 4. Osteoinduction, osteoconduction, osseointe-gradation
Answer:
Osteoconduction:
- It is an effect by which the matrix of the graft forms a scaffold that favors outside cells to penetrate the graft and form new bone
Osteoinduction:
- A process by which graft material is capable of promoting cementogenesis, osteogenesis, and new periodontal ligament
Osseointegration:
- It is defined as the direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant without intervening soft tissues
- It is a fundamental requirement and essential component for implant success
Question 5. Maintenance of dental implants
Answer:
1. At the office:
- The patient is recalled at regular intervals to provide optimal preventive services
- Probing pocket depth and mucosal margins are notes
- Radiographic crestal bone levels are established
- Evaluation is done initially after 1 day, 1 month, 3 months, 6 months, and then at yearly intervals At every visit following evaluation is done
- Evaluation of soft tissue around the implant
- Implant mobility
- Prosthesis
- Radiograph
- Plaque and calculus scores
- Debridement of the implant should be carried out with plastic instruments that do not damage the implant surface
- A rubber cup can be used to polish the implant sur- face with a non-abrasive toothpaste, fine polishing paste, or tin oxide
2. Home care methods:
- A soft circular toothbrush is used around implant restoration
- Powered and sonic toothbrushes are used around
- Foam tips, interproximal brushes, and disposable wooden picks are used for plaque removal from embrasures
- Chemical antiplaque agents can be delivered with interdental aids
- Every implant patient requires lifetime careful maintenance to ensure implant health and longevity
Question 6. Biology of soft tissue around an implant.
Answer:
- Mucosal tissues around intraosseous implants form a tightly adherent band consisting of dense collagenous lamina propria
- It is covered by keratinized stratified squamous epithelium
- Implant epithelium junction is similar to junctional epi-thelium
- The epithelial cells are attached to the titanium implant employing hemidesmosomes and basal lamina
- A biologic seal exists between epithelial cells and implant
- Sulcus forms around implant lined with sulcular epithelium that is continuous apically
- Collagen fibers are non-attached and run parallel to the implant surface
Dental Implants Short Answers
Question 1. Home care methods for implant maintenance.
Answer:
- A soft circular toothbrush is used around implant restoration
- Powered and sonic toothbrushes are used around titanium implants
- Foam tips, interproximal brushes, and disposable wooden picks are used for plaque removal from embrasures
- Chemical antiplaque agents can be delivered with inter-dental aids
- Every implant patient requires lifetime careful maintenance to ensure implant health and longevity
Question 2. Implant-bone interface
Answer:
- The relationship between implant and bone involves mechanisms like
1. Fibro-osseous integration:
- When soft tissues are interposed between surface and bone, it is known as fibro-osseous integration.
2. Osseointegration:
- It is defined as the direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant without intervening soft tissues
- It is a fundamental requirement and essential component for implant success
3. Biointegration:
- It is achieved in cases where the implant is coated with bioactive materials like hydroxyapatite
- These materials stimulate bone formation
Dental Implants Viva Voce
- The epithelial cell attaches with the implant surface by hemidesmosomes
- The probing depth of 3 mm with no bleeding around 15. The minimum amount of bone required all around an implant is presumed to be healthy
- The arrangement of collagen fibers around an implant is parallel and unattached
- Functional ankylosis is a synonym for osseointegration
- The critical temperature of bone cells is 47°C for 1 min
- Osteoclasts are derived from monocytes
- The oxide layer on the titanium surface mainly contains titanium dioxide
- The probable reason for poorer clinical outcomes with implants in the posterior maxilla is the deficiency in primary stability
- Periotest device is used for detecting the mobility of both the implants and teeth
- The vascular supply of the peri-implant gingival tissue is less than that of gingival tissue around teeth
- The inflammatory reaction in the soft tissues around implants is regarded as periimplantitis
- The term osseoperception refers to tactile sensitivity at the bone-implant surface
- The noninvasive method to assess the implant mobility is the resonance frequency analyzer
- An absolute contraindication for implant therapy is radiotherapy of the head and neck
- The minimum amount of bone required all around an implant after its placement is 1-1.5 mm
- Modification of implant surfaces using the additive technique includes HA coating and oxidative process
- The subtractive implant surface modifications include acid itching and sandblasting
- The recommended speed for drilling the surgical site for implant placement is 800-12