Implants Flashcards
When treatment planning the zygomatic (Zygomaticus) implant, which of the following requirements must be met?
(A) Posterior wall of the maxillary sinus must be at least 4 mm thick
(B) Ability to place two anterior maxillary conventional implants
(C) Minimum of 10 mm of thickness of the body of the zygoma
(D) Minimum of 42 mm between the two zygomatic implants
B
Which adjunctive implant surgical technique would optimally address a 15 mm vertical deficiency of bony and soft tissues in the anterior maxillary alveolus?
(A) Insertion of hydroxylapatite blocks using a tunneling technique
(B) Distraction osteogenesis
(C) Onlay bone grafting
(D) Subepithelial grafting
B
Connective tissue grafts are less predictable if performed at the time of: (A) extraction. (B) cortico-cancellous grafting. (C) implant placement. (D) implant uncovering.
B
When performing a ridge splitting technique to expand the edentulous ridge for insertion of an interpositional bone graft prior to implant placement, what is the preferred preoperative minimum ridge width? (A) 1 mm (B) 2 mm (C) 3 mm (D) 4 mm
C
For a subantral osseous augmentation, non-resorbable HA can be added to autogenous bone in order to: (A) add bulk to the graft. (B) improve initial implant stability. (C) decrease infection rate. (D) improve osteogenesis.
A
Following anterior tooth removal, how long does it take to get 3-4 mm of both buccal-lingual and apico-coronal ridge resorbtion? (A) 1 month (B) 3 months (C) 6 months (D) 1 year
C
In harvesting subepithelial connective tissue grafts, the advantage of a dual incision is:
(A) graft thickness is defined by the second incision.
(B) it allows for primary closure.
(C) donor site pain is uncommon.
(D) a dressing is rarely needed at the donor site.
A
Antibiotic therapy in dental implant surgery:
(A) eliminates postoperative infection.
(B) decreases incidence of early peri-implantitis.
(C) reduces integration time of implants.
(D) decreases the failure rate of implants.
D
Which of the following is most important for implant health over time?
(A) Adequate volume of good quality soft tissue
(B) Osseointegration
(C) Adequate inter-occlusal space
(D) Adequate bone graft consolidation
B
Osteogenesis occurs with which of the following grafting materials? (A) Allogeneic bone grafts (B) Xenograft bone grafts (C) Alloplastic bone grafts (D) Autogenous bone grafts
D
When compared to subepithelial connective tissue grafts, free gingival grafts:
(A) result in less scarring.
(B) revascularize more rapidly.
(C) are less predictable for root coverage.
(D) provide superior color matching.
C
The palatal roll technique for soft tissue augmentation around implants:
(A) is only useful with small gingival defects.
(B) can correct horizontal defects up to 5 mm.
(C) can be used to reconstruct the papilla.
(D) should be performed one month prior to uncovering an implant.
A
Connective tissue grafts are less predictable if performed at the time of: (A) extraction. (B) cortico-cancellous grafting. (C) implant placement. (D) implant uncovering.
B
When performing a ridge splitting technique to expand the edentulous ridge for insertion of an interpositional bone graft prior to implant placement, what is the preferred preoperative minimum ridge width? (A) 1 mm (B) 2 mm (C) 3 mm (D) 4 mm
C
For a subantral osseous augmentation, non-resorbable HA can be added to autogenous bone in order to: (A) add bulk to the graft. (B) improve initial implant stability. (C) decrease infection rate. (D) improve osteogenesis.
A
Following anterior tooth removal, how long does it take to get 3-4 mm of both buccal-lingual and apico-coronal ridge resorbtion? (A) 1 month (B) 3 months (C) 6 months (D) 1 year
C
n harvesting subepithelial connective tissue grafts, the advantage of a dual incision is:
(A) graft thickness is defined by the second incision.
(B) it allows for primary closure.
(C) donor site pain is uncommon.
(D) a dressing is rarely needed at the donor site.
A
A grafted socket/implant site in the esthetic zone should be approached using a flapless technique when:
(A) the osseous level is at least 3 mm below the alveolar plane.
(B) the mucogingival junction is at a crestal position.
(C) alveolar width is 6 mm or greater.
(D) adjacent subpapillary bone is compromised.
D
Which of the following is most important for implant health over time?
(A) Adequate volume of good quality soft tissue
(B) Osseointegration
(C) Adequate inter-occlusal space
(D) Adequate bone graft consolidation
B
Appropriate placement of an endosseous dental implant is determined by:
A. Placing the implant where available bone exists.
B. Where the patient expects the implant to be placed.
C. A surgical guide fabricated for the placement of the implant.
D. Placing the implant where adequate soft tissue exists to submerge the implant.
ANSWER: C
RATIONALE:
Implant placement should be guided by the prosthetic requirements, and may be best accomplished by using a surgical guide. Contemporary tissue grafting and regenerative techniques allow fixture placement in prosthetically appropriate positions.
REFERENCE:
Principles of Oral & Maxillofacial Surgery, Peterson, Indresano, Marciani, Roser; 1997, Vol 2, page 1144
Regarding platelet rich plasma is use in bone grafting procedures, which statement is most accurate?
A. It involves bank blood, concentrate added to a bone graft.
B. Autologous whole blood containing leukocytes and fibrinogen which promote clotting
within the graft
C. Primary use is in the donor site to prevent an osseous defect.
D. Efficacy stems from concentration of growth factors by sequestering and concentrating
autologous platelets.
ANSWER: D
RATIONALE:
Platelet-rich plasma is an autologous source of platelet-derived growth factor and transforming growth factor beta that is obtained by sequestering and concentrating platelets by centrifugation. This technique produces a concentration of human platelets containing growth promoting substances (including platelet-derived growth factor and transforming growth factor beta) within them. These growth factors increase the maturation rate 1.5 to 2 times compared to grafts without platelet-rich plasma.
REFERENCE:
Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE; Platelet-rich plasma; Growth factor enhancement for bone grafts. Oral Surgery, Oral Medicine, Oral Pathology, Vol 85, No. 6, June 1998, page 638
What is the minimum radiographically safe minimal distance that an implant may be placed from the superior lamina of the inferior alveolar canal when utilizing a panoramic radiograph? A. 0.5 mm B. 1.0 mm C. 2.0 mm D. 5.0 mm
ANSWER: C
RATIONALE:
When using a panoramic radiograph, variations in vertical magnification within the radiographic image make a safety margin of 2.0mm between the end of the implant and the inferior alveolar canal desirable. Because of its greater precision, computed tomography enables the clinician to select an implant that will be 1.0mm above the canal. Implant burs vary depending on the manufacturer and the surgeon must understand that the specified length (for example, a 10mm marking) may not reflect an additional millimeter included for drilling efficiency.
REFERENCE:
Kraut RA, Chalal O. Management of patients with trigeminal nerve injuries after mandibular implant placement. JADA 133(10): 1351-4, 2002 Oct
Tarnow DP, Magner AW, Gletcher P. The effect of the distance from the contact point to the crestal bone on the presence or absence of the interproximal dental papilla. Journal of Periodontology 1992 Dec:63(12) 995-996.
The recommended solution for irrigation during implant site preparation is:
A. chilled normal saline
B. chilled sterile water
C. body temperature Dextrose 5% in sterile water
D. body temperature sterile water
ANSWER: A
RATIONALE:
Chilled solution is recommended for better cooling. Water, and other hypotonic solutions have been shown to cause rapid death of bone cells.
REFERENCE:
Giglio, Laskin, “ Perioperative Errors Contributing to Implant Failure”, OMS Clinics of North America, May 1998, p.200
Peri-implantitis can be categorized as:
A. an early failure
B. a late failure
C. a complication of overheating of the bone
D. a complication of rough –surface implants
ANSWER: B
RATIONALE:
Peri-implantitis is defined as radiographically detectable peri-implant bone loss occurring after initial successful osseointegration combined with soft tissue inflammation lesion that demonstrates suppuration and probing depths of 6mms or more. The process begins at the coronal aspect of the implant, whereas the more apical portion remains clinically stable (osseointegrated).
REFERENCE:
Truhlar, “Peri-implantitis”, OMS Clinics of North America, May 1998, p. 299-301
