W4 - Replacing Missing Teeth - Tulio

Question 1

How does aleolar bone heal following exo?

Answer 1

• Collapse of cortical bone wall especially the bundle bone
• Diminished blood supply from PDL - Affects survival of cortical bone
• Contraction of wound as it heals
• Bundle bone disappear after 2 weeks and is gradually replaced by woven bone (Phase I)
• Phase 2 includes resorption that occurred from the outer surfaces of both bone walls

Question 2

What is bundle bone?

Answer 2

Histologic name for alveolar bone that provides attachment to PDL fibres

Question 3

What is D1-D4 classification and what does it mean?

Answer 3

• D1: more cortical, less cancellous (stronger but less nutrients for healing)
• D2 - ideal for implants
• D3 - ideal for implants
• D4: less cortical, more cancellous (weaker but more nutrients for healing)

Question 4

What can you do if the required space for teeth is greater than the space present? (4)

Answer 4

• Interproximal stripping
• Distalisation
• Arch expansion
• If difference less than 2mm can ask lab to make implants smaller

Question 5

What type of implant bridge should be avoided?

Answer 5

Avoid cantilever toward distal

Question 6

What is seiberts classification of alveolar bone changes after exo?

Answer 6

Question 7

What tx’s have been proposed over the years to treat bone defects?

Answer 7

Guided tissue regeneration

Guided bone regeneration

Tissue engineering

Question 8

What bone has more cortical bone?

Answer 8

Body of mandible

Question 9

What is the issue with reduced cancellous bone?

Answer 9

Reduced regenerative capacity (less blood vessels and cells)

Question 10

What are the steps of implant tx plan?

Answer 10

• CC
• Pt interview
• Examination
• Diagnostic (casts, imaging, photos, surgical template)
• Quote and consent
• Treatment
• Maintenance

Question 11

What factors influence implant success?

Answer 11

• Implant based (implant length/diameter, number, brand and bone augmentation)
• Prosthesis based (type of reconstruction, type of edentulism, loading time)
• Surgeon based (operator training)
• Patient based (pts condition, compliance)

Question 12

Why shouldn’t you place bridge using implant and teeth as abutments?

Answer 12

Micromovement of tooth due to PDL. Crown can decement → caries