IMPLANTOLOGY REVIEW

QUESTIONS

1. A Swedish research team led by P.I. Branemark coined the term___________ for a
new concept based upon atraumatic implant placement and delayed implant loading.

a. fibro-osseointegration
b. peri-implantology
c. mucointegration
d. osseointegration
e. none of the above

2. When placing 5 endosseous dental implants in the anterior mandible, the surgeon
should place the first implant approximately ______mm anterior to the mental
foramen.

a. 5
b. 3
c. 1
d. 9
e. 7

3. After the first implant is placed anterior to the mental foramen, the second dental
implant should be placed:

a. in the symphysis area.

b. anterior to the mental foramen on the opposite side.
c. 3mm away from the first implant.
d. 5mm away from the the first implant.
e. it doesn't matter.

4. The mandibular prosthetic implant options available for the completely edentulous
patient is/are:

a. Fixed-detachable prosthesis.
b. All implant supported overdenture.
c. Implant and tissue supported overdenture.
d. all of the above.

5. Which of the following would have the greatest impact on the

successful osseointegration of a dental implant?

a. Type of implant used

b. Length of the implant used
c. Position of the gingival incision
 d. Heat generated in the bone
e. Surface treatment of the dental implant

6. Why is it not advisable to place a dental implant immediately into an extraction

site?

a. size of the extraction site may not be ideal

b. shape of the extraction site may not be ideal
c. location of the extraction site may not be ideal
d. presence of infection or inflammation
e. all of the above

7. The use of smoking tobacco will ___________ the statistical success rate of
endosseous dental implants.

a. increase
b. decrease
c. not affect
d. not effect
e. be age related to

8. An endosseus dental implant has between the bone and implant a:

a. periodontal ligament
b. peri-implant ligament
c. epithelial ligament
d. a bone-implant interface

9. Handpieces for preparation of dental implant receptor sites are:

a. highspeed/high torque
b. lowspeed/high torque
c. lowspeed/low torque
d. none of the above

10. The rule of BULL applies to the :

a. balancing (non-working) side only

b. working side only
c. both balancing and working side
d. neither
e. 0o occlusion

11. Which of the following may contaminate the surface oxide layer of a titanium
dental implant by touching it when the implant is being placed?

a. a dissimilar metal
b. a surgical glove
c. soft tissue
d. surgical sterile towel
 e. all of the above

12. The anteroposterior curvature and the mediolateral curvature in the alignment of
the occluding surfaces and incisal edges of artificial teeth that are used to develop
balanced occlusion is called:

a. Anti-Monson Curve
b. Compensating Curve
c. Curve of Spee
d. Curve of Wilson
e. Curve of Pleasure

13. The preferred floss to use to clean dental implant abutments is:

a. regular waxed dental floss

b. regular non-waxed dental floss
c. superfloss or yarn
d. dental tape floss
e. all of the above

14. Overloading a dental implant can be prevented by:

a. having centric contact only

b. limiting the length of cantilever to 1 and 1/2 the distance between the center of
the two implants
c. having surgically well spaced dental implants
d. have a passive fitting framework
e. all of the above

15. In the event an endosseous dental implant is mobile, the proper procedure is:

a. to splint the failing implant with a temporary prosthesis.

b. to remove the failing implant, debride the socket, and consider placing a bone
graft with a resorbable membrane.
c. to resubmerge the implant with a surgical cover screw, cover with resorbable
membrane, and allow reintegration to occur, four months on the mandible, 6
months on the maxilla, before uncovering.
d. to take the implant out of function and allow reintegration to occur over a 4-
month period for the mandibular implant or a 6-month period for the maxillary
implant.

16. You need a minimum of ______mm of bone height to place an endosseous (root
form) dental implant.

a. 6
b. 10
c. 8
d. 13
e. 12
17. The most practical and useful screening film used for radiographic survey is the :

a. Periapical
b. Panoramic
c. Overlay grids
d. Denta-a-scan
e. Tomograph

18. Which of the following factors would have the greatest negative influence on a
dental implant's success?

a. hypertension
b. patient over 70 years of age
c. smoking
d. alcohol
e. post by-pass surgical patient

19. Chlorhexidine gluconate should be used with implant patients for:

a. routine mouthrinses twice daily

b. limited professional irrigation every 3 months
c. site-specific applications around tissue-abutment junctions
d. contraindicated due to the staining effects

20. A dental implant supported prosthesis should fit ________ on the dental implant.

a. tightly
b. passively
c. snuggly
d. loosely

21. What are the criteria for success of a dental implant?

a. clinical immobility under load-bearing conditions

b. symptom free
c. minimal loss of crestal bone
d. no peri-implant radiolucency
e. all of the above

22. The histologic definition of osseointegration is best described by which of the

following:

a. direct connection between living bone and load-bearing endosseous implant at

the light microscopic level
b. tissue to implant contact with healthy dense collageous tissue between the
implant and bone
c. fibrous integration with development of a periodontal ligaement-like structure
d. none of the above
23. The minimum required distance from the apex of a mandibular posterior implant
to the superior aspect of the inferior alveolar canal is _________mm.

a. 1
b. 2
c. 3
d. 4

24. The most common materials used for two-stage endosseous implants today
include which of the following:

a. titanium, titanium alloy

b. titanium, surgical stainless steel
c. vitallium, surgical stainless steel
d. none of the above

25. What procedure(s) are available to reduce heat generated during preparation of an
implant site?

a. copious amounts of irrigation

b. start with small diameter drills
c. low RPM handpieces
d. sharp drills
e. all of the above

26. The minimal interdental tooth distance recommended for one dental implant is:

a. 8 mm
b. 10 mm
c. 13 mm
d. 17 mm
e. 20 mm

27. The landmark you should locate first when placing five dental implants in the
anterior mandible is:

a. attached mucosa
b. mental foramen
c. crest of the ridge
d. labial vestibule
e. lingual vestibule

28. Ideally a dental restoration should consist of two dental implants connected
together with their cast metal superstructure. If only one dental implant is used to
replace a tooth, you MUST use:

a. a standard gold cylinder

b. an antirotational cylinder
c. cementable crown
d. a cementable abutment
 e. all of the above

29. The standard mandibular fixed-detachable implant prosthesis cannot be used in

the maxilla because of:

a. ethetics
b. air escaping when speaking
c. the midline placement of the center implant
d. all of the above

30. Surgical complications usually involve wound dehiscences can be due to:

a. smoking
b. diabetes
c. high doses of corticosteroids
d. wearing a prosthesis too soon
e. all of the above

31. For complete denture balanced occlusion, the lingual cusps of the maxillary
posterior teeth on the non-working side contacts which areas of the mandibular
posterior teeth?

a. the facial inclines of the lingual cusps

b. the lingual inclines of the lingual cusps
c. the lingual inclines of the facial cusps
d. the facial inclines of the facial cusps
e. the central fossae

32. How often should the screw-retained (dentist retrievable) implant prosthesis be
removed and cleaned?

a. at each appointment
b. once a year
c. only when necessary to replace parts or inadequate access for cleaning
d. never

33. The maximum amount of taper to allow for proper draw on an overdenture
attachment such as an "O" ring is:

a. 7 degrees
b. 10 degrees
c. 12 degrees
d. 15 degrees
e. 17 degrees

34. The best material to use for a successful bone graft around a dental implant is:

a. heterogenous
b. autogenous
c. homologous
 d. xenografts
e. allografts

35. The external hex on a dental implant was originally placed to:

a. aid in making the final impression

b. prevent anti-rotation allowing implant to integrate
c. prevent anti-rotation of the prosthesis
d. aid in surgically placing the implant
e. all of the above

36. When removing and replacing healing abutments and/or impression copings, you
should be able to put as much manual torque on the implant without causing
discomfort to the patient. If the patient feels any discomfort, it may suggest that:

a. tissue is caught between the implant and the abutment

b. the dental implant is failing
c. bone may prevent seating of abutment
d. you should not initiate the final restorative phase
e. all of the above

37. In Dr. Reneau's article, he states that implants are similar to natural teeth in that
they have a "biologic width" of at least:

a. 1mm
b. 2mm
c. 4mm
d. 5mm
e. none

38. Ideally, the occlusal scheme on a partially edentulous implant restoration, i.e. a 3
unit fixed partial denture, should:

a. have balanced contacts only

b. be in slight infraocclusion
c. have working contacts only
d. have the same intial contact as the adjacent natural teeth
e. all of the above

39. To achieve easy access to retention screws, we usually fill the access holes on a
fixed-removable prosthesis with:

a. gutta percha
b. cotton pellets and silver amalgam
c. cotton pellets and zinc phosphate
d. cotton pellets and light cured resin
e. leave them open

40. A hader bar in the overdenture is placed perpendicular to the midline of the
mandible to facilitate:
a. easy removal of the overdenture
b. engaging the hader bar and contacting the posterior ridge at the same time
with the overdenture
c. less space required for the overdenture in the anterior area
d. setting overdenture parallel to the mandibular ridge
e. all of the above

41. When the mandible moves forward in protrusive, the posterior teeth disengage.
This is called:

a. Compensating Curve
b. Curve of Monson
c. Curve of Pleasure
d. Christensen's Phenomenon
e. none of the above

42. The average length of time that a two-stage mandibular dental implant should be
buried is:

a. 2 months
b. 3 months
c. 4 months
d. 5 months
e. 6 months

43. The three general classifications of dental implants are:

a. Root form, blade, and threaded

b. Transosseous, subperiosteal, and endosseous
c. Endosseous, subperiosteal, and threaded
d. Cylinders, screws, and hexes
e. Cylinders, threaded, and hexes

44. Screws that become loose in an implant fixed partial denture can be corrected by
using a torque wrench at ________Ncm.

a. 5
b. 8
c. 10
d. 15
e. 20

45. To capture the hex of the implant in your final impression, you must use a:

a. Closed tray and a one-piece impression coping

b. Open tray and a one-piece impression coping
c. Open tray and a two-piece impression coping
d. Closed tray and a two-piece impression coping
e. It does not matter what you use
46. The type of implant that "rides on" bone is:

a. Blade implant
b. Endosseous implant
c. Transosseous implant
d. Subperiosteal
e. Paragon

47. To ensure the development of keratinized tissue around a dental implant the best
time to augment the soft tissue is:

a. Stage I surge
b. Stage II surgery
c. Before the implant is placed
d. At the final delivery appointment of the prosthesis
e. At the first recall after the prosthesis is delivered

48. The restoration of the partially edentulous patient is more difficult because it
requires:

a. a surgical stent
b. more soft tissue modifications
c. more pre-operative planning
d. inter-specialty cooperation
e. all of the above

49. The first person to use the titanium alloy and commercially market dental implants
to the general dentists was:

a. Linkow
b. Niznick
c. Branemark
d. Formiggini
e. Venable

50. Guided tissue regeneration is a surgical procedure used to eliminate a boney

defect around a dental implant. This process:

a. increases connective tissue growth while retarding the ingrowth of bone in the
defect.
b. decreases the connective tissue growth while increasing the growth of bone in
the defect.
c. utilizes a resorbable Gortex membrane.
d. has a 100% success rate.
e. all of the above.

51. A gentle surgical technique requires that you do not heat bone above_________
for one to five minutes. Above this temperature, bone tissue damage occurs.

a. 53 C
 b. 47 C
c. 41 C
d. 35 C

52. The mediolateral curve in natural occlusion.

a. Curve of Monson
b. Compensating Curve
c. Curve of Spee
d. Curve of Wilson
e. Curve of Pleasure

53. The anteroposterior curve in natural occlusion.

a. Curve of Monson
b. Compensating Curve
c. Curve of Spee
d. Curve of Wilson
e. Curve of Pleasure

54. Titanium (Ti) is?

a. a reactive metal
b. inert in tissue
c. possesses good mechanical properties
d. the ninth most abundant element on earth
e. all of the above

55. The minimal interdental tooth distance recommended for two dental implants is:

a. 8 mm
b. 10 mm
c. 13 mm
d. 17 mm
e. 20 mm

56. The reason cotton pellets are placed in an access hole in a screw retained implant
prosthesis is to:

a. to absorb the moisture

b. to protect the head of the screw
c. to allow the access holes to be seen on radiographs
d. to make it easier to remove the acrylic resin next time
e. b and d

57. In cleaning a fixed-detachable implant prosthesis, you should use:

a. ultrasonic scaler
b. metal tip hand scaler
c. plastic scalers subgingivally
 d. remove prosthesis and place in ultrasonic cleaner
e. all of the above

58. Immediate failure of dental implants (within the first year) can be due to:

a. overheated bone
b. implant not stable at time of surgery
c. contaminated implant surface
d. infection
e. all of the above

59. Which of the following implant surface material is not used.

a. titanium
b. stainless steel
c. titanium alloy
d. hydroxyapatite

60. The type of anesthesia recommended for 90 to 95% of Dental Implant patients is

a. Local Anesthesia
b. I.V. sedation
c. General Anesthesia
d. Pre-op medication

61. The two basic designs of endosseous dental implants we use are

a. threaded and cylinders

b. cylinders and transosseous
c. blades and threaded
d. subperiosteal and transosseous

62. Adell and el. Criteria for a successful dental implant is:

a. no radiolucency around implant.

b. no more than .2 mm vertical bone loss after the first year.
c. no implant mobility.
d. absence of symptoms.
e. all of the above.

63. The reason for plasma coating of a titanium dental implant (TPS) is to:

a. add plasma to the surface to increase its acceptance in bone

b. produce a rough surface that improves anchorage in bone
c. make the implant more biocompatible
d. add sterilized blood particles to the implant surface to improve the anchorage
in bone
e. none of the above
64. The most important consideration of the following as related to
implant placement

a. Length of time in which flaps are open.

b. Control of temperature generated during preparation of bone
c. Position of flap incisions
d. Configuration of the implant

65. The development of the two stage dental implant is credited to the Swedish
medical researcher by the name of _____________

a. Vernino
b. Madden
c. Strock
d. Branemark

66. The anatomical factors of bone important for the placement of a dental implant of
bone is/are:

a. width
b. height
c. quality
d. all of the above

67. ____________ mm of bone is the minimum required on the buccal or lingual side
of a dental implant.

a. 1
b. 3
c. 5
d. 7
e. 10

68. 20% of the implants can be lost in grafted bone because the quality of bone is
poor. This bone is usually type ___________.

a. I or II
b. II or III
c. III or IV
d. IV or V
e. all of the above

69. Pre-treatment of the implant patient should include:

a. Medical workup.
b. Evaluation of status of existing teeth.
c. Restorative considerations.
d. All of the above.

70. Hydroxylapatite (HA):

a. is a major constituent of the juman body's hard tissue
b. coated implants appear to have a faster bony adaptation
c. is not tolerated well by the periodontal tissues
d. comes in many forms
e. all of the above

71. Contraindications to the placement of endosseous implants include all of the

following with the exception of:

a. acute illness
b. pregnancy
c. terminal illness
d. well-controlled diabetes

72. Researchers in the Branemarkclinic have found that heating bone at ________
for_______ results in irreversible tissue damage which could prevent
osseointegration:

a. 35 degrees, 10 minutes
b. 47 degrees, 1 minute
c. 52 degrees, 3 minutes
d. 60 degrees, 4 minutes

73. Goals of Stage II (surgical uncovering) include all of the following except:

a. accurately attach the abutment to the implant

b. preserve attached tissue
c. delivery of final prosthesis
d. recontouring soft tissue as necessary

74. Oral hygiene around dental implants is best performed with

a. plastic scaling instruments

b. gold plated scaling instruments
c. stainless steel scaling instruments
d. ultrasonic scaling instruments

75. An interim (temporary) prosthesis is useful to:

a. evaluate esthetics
b. check interocclusal space
c. evaluate anti-rotational effectiveness
d. apply progressive loading to the implant
e. a&d