Prepare for dental implant certification questions with these practice answers. This covers implant types, placement procedures, complications, and patient care.
Q: What are the 3 main implant classifications?
Answer: MorphologyConstituent materialPosition:-Subperiosteal-Transosseous-Endosseous
Q: T/FSuccess rate for Endosseous implants is > 95%.Mandibular implants are More successful than Maxillary implants.
Answer: 1st True2nd True
Q: List the location of Endosseous implants from most to least successful
Answer: -Anterior mandible-Anterior maxilla-Posterior mandible-Posterior maxilla-Grafted areas
Q: What are the 6 Criteria for implant success?
Answer: 1: implant is Immobile when tested clinically2: No evidence of peri-implant radiolucency3: Vertical bone loss < 0.2 mm annually following the first year of service4: No signs/symptoms of Pain, infection, parasthesia, etc5: Success rate of 85% after 5 years and 80% after 10 years minimum for success6: Implant design must allow for crown placement that is satisfactory to the patient and dentist
Q: What Variables affect osseointegration of implants?
Answer: -Biocompatibility-Macro and microstructure-Surgical techniques-Time of Loading-State of hosting bone
Q: What physical properties of titanium make it useful as an implant material?
Answer: -Low solubility in almost all media-Non-toxic (no cytotoxicity, genotoxicity, etc)-Metal surface passiveness due to the Oxide layer (titanium dioxide TiO₂)
Q: What is Roxolid?
Answer: -Monophosphate Alloy of Titanium and Zirconium that acts like a pure metal-Developed for dental implants
Q: How does Roxolid compare to pure Titanium?
Answer: -Increased Tensile Strength compared to pure titanium-Allows for smaller diameter implants
Q: What surface alterations are available for Dental implants?
Answer: -Hydroxyapatite (HA)-Titanium plasma spray (TPS)-Surface altered: acid etched
Q: What are problems with the Hydroxyapatite coating for dental implants?
Answer: -Porosity, Separation, and Dissolution-Failure of the implant long term
Q: List the dental implant Surface Properties that influence the behavior of osteoblasts
Answer: -Chemical and Biocompatible properties-Surface Energy-Morphology-Roughness
Q: A combination of the ______ and ______ surface properties have deomstrated to be more significant in promoting growth and apposition of bone tissue to the implant surface and successful outcome of osseointegration.
Answer: -Surface Morphology-Surface Roughness
Q: How does Contact angle affect the Surface Energy and healing times?
Answer: Low contact angle = Higher surface Energy = Faster Healing times
Q: T/FThe Titanium Plasma Sprayed (TPS) dental implant surface has a Higher % bone contact at 3 weeks than the Sandblasted Large grit and Acid etched implant surface (SLA).
Answer: False: SLA surface has Higher % bone contact at 3 weeks than the TPS surface
Q: The SLA surface should be Hydro______ (phobic or philic).Why?
Answer: -Hydrophilic: allows blood to move into the deep cavities of the SLA surface increasing healing times (2 times faster osseointegration)-The hydrophilic SLA surface is called SLActive
Q: Describe the Stability pattern in implants over time in terms of Primary and Secondary stability
Answer: -Implant initially placed and maintained w/ Primary stability; mechanical action of the implant screw into the bone- 3-4 weeks: Stability dip, transition from mechanical Primary stability to osseointegration (Secondary stability)- 8 weeks: Stability is mostly Secondary (osseointegration with new bone)
Q: What is the “Breakpoint” as it relates to implant stability following placement?
Answer: The change from decreasing to increasing stability (transition from primary to secondary stability)
Q: What is the Advantage of the Morse taper connection over an external hex?
Answer: -The 8° morse taper absorbs 91% of the functional load. The abutment threads only take 9% of the functional load-The abutment threads take much more functional load with the external hex
Q: T/FThe Conical seal design requires a radiograph to ensure proper connection of the abutment.The Conical seal design minimizes micro-movements and reduces micro-leakage.
Answer: 1st False: no radiograph needed2nd True
Q: T/FAll Soft tissue level implants have Vertical offset.All Bone level implants have Zero offset only.
Answer: 1st True2nd False: Horizontal or Zero offset
Q: The Straumann Bone level implant has _______ offset at the implant-abutment connection.
Answer: Horizontal
Q: Overload of a Posterior implant can occur under what circumstances?
Answer: -Implant Not centered over the crown-Implant is Angled (implant should be placed as Perpendicular as possible)-Heavy occlusal forces on the implant crown
Q: The average molar dimension in a M-D direction is ______ mm.The average molar dimension in a F-L direction is ______ mm.
Answer: M-D: 11 mm for mandible, 10 mm MxF-L: 11 mm for Mn and Mx
Q: List the main factors affecting implant loading
Answer: -Cuspal inclination-Implant inclination-Horizontal implant offset-Apical implant offset
Q: For every 10° increase in Cusp inclination, there is approximately a ______% increase in torque.For every 10° increase in Implant inclination, there is approximately a ______% increase in torque.
Answer: 30%5%
Q: For every 1 mm increase in horizontal offset there is approximately a ______% increase in torque.For every 1 mm increase in Vertical implant offset, there is approximately a ______% increase in torque
Answer: 15%5%
Q: T/F-Inclined Force on an implant is distributed only to the Crestal bone and Not to the apex of the implant body.-The Maximum lateral extension of the crown should equal the implant diameter.
Answer: 1st True2nd True
Q: What methods are available to Resist Adverse leverage?
Answer: -Two implants to support one molar crown (very difficult to maintain hygiene)-Use of Wide diameter implants
Q: List the categories for High blood pressure
Answer: Normal: <120 / <80Prehypertension: 120-139 / 80-89Stage 1: 140-159 / 90-99Stage 2: >160 / >100Hypertensive crisis: >180 / >110
Q: Why is Smoking a risk factor for implant placement?
Answer: Smoking causes Vasoconstriction leading to Decreased blood supply which causes Impaired wound healing
Q: What are the risk factors for Diabetic patients?
Answer: -Impaired wound healing-Higher risk of Infection-Check HbA1c to assess diabetic control
Q: What are the risk factors for patients with Cirrhosis?with Hepatitis?
Answer: Cirrhosis: increased bleeding riskHepatitis: disease transmission risk
Q: What medications are the main risk factors for implant placement?
Answer: -Anticoagulants: get INR reading, don’t stop anticoagulant therapy, get med consult-Bisphosphonates: IV form (3-12% ARONJ) greater risk than oral form (<1% ARONJ). discontinuing bisphosphonate therapy may not lower risk of ARONJ
Q: How much space is needed for an implant in a B-L, M-D, and inter arch distances?
Answer: 7 mm of B-L bone7 mm of M-D space7 mm of interarch space
Q: At least ______ mm of bone is necessary around all surfaces of an implant although _______ mm is preferred._______ mm of space is necessary between adjacent implants to develop a papilla.
Answer: 1 mm minimum. 2 mm preferred3 mm between adjacent implants for papilla development
Q: How much keratinized tissue is needed for implant placement
Answer: 4 mm of keratinized tissue (2mm on either side)-Mucosa is more likely to recede leading to bone loss
Q: What are the 2 types of CBCT images
Answer: -Small/limited volume-Regular field of view
Q: List the classifications of Bone qualityWhere are these classification usually found in the jaws?
Answer: Class 1: compact, cortical bone (anterior Mn)Class 2: Thick cortical bone around highly trabecular bone (posterior Mn)Class 3: Thin cortical bone around highly trabecular bone (anterior Mx)Class 4: Thin cortical bone around spongy core (posterior Mx)
Q: List the Seibert’s classification of ridge deformities
Answer: Class I: loss of Horizontal thicknessClass II: loss of Vertical thicknessClass III: Loss of horizontal and vertical thickness
Q: What is the general pattern of ridge remodeling following tooth extraction?
Answer: -Lingual shift in alveolar shape-Width reduction greater than height reduction-Greatest loss from 6 months – 2 years-Maxillary resorption 4x greater than mandibular
Q: What is the difference between a Single stage and Two stage implant placement?
Answer: -Single stage: following placement of the implant the healing abutment is place through the tissue. gingival tissues sutured around the abutment-Two stage: following implant placement the healing abutment is covered by the soft tissue. soft tissue sutured over the abutment
Q: List the classification of Alveolar and Basal Bone loss (A-E)
Answer: A: Most of the alveolar ridge presentB: Moderate alveolar ridge resorptionC: Advanced alveolar resorption, only basal bone remainsD: Basal bone resorption has taken placeE: Extreme basal bone resorption has taken place
Q: What is the role of Periapical radiographs for implant imaging?How much magnification occurs w/ Periapicals?
Answer: – Pre-operative evaluation- Intraoperative use: assessment of the pilot hole during surgery- Post-implant monitoring-Magnification factor: 1.02 – 1.1
Q: What is the role of the Panoramic radiograph for implant imaging?
Answer: -Overview of maxilla and mandible for anatomic structures and bone pathoses (may lead to inaccurate estimation of anatomic location and dimensions due to negative vertical angulation. lingual objects projected superiorly)-Used for initial planning of treatment
Q: What are the magnification factor (MF) patterns for panoramic radiographs? vertical and horizontal MF
Answer: -Vertical MF varies Slowly-Horizontal MF varies Steeply
Q: List the Advantages of Computed Tomography (CT)
Answer: -Minimal superimposition-Uniform magnification (1:1) → Accurate measurements-Bone density evaluation
Q: List the Disadvantages of CT
Answer: -Limited availability of reformatting software-Sensitive to technique errors-Metallic image artifacts-Special training needed for interpretation of the image-Higher cost-Higher radiation risk
Q: List the Advantages of using Imaging stents prior to implant placement
Answer: -Reduces risk and liability-Reduces surgical surprises-Reduces treatment time → increased productivity-Increases accuracy-Increased level of patient care