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A) ERA attachment
B) O-Rings
C) Lew Attachment
D) Hader Attachment
2) 510K FDA approval means:
A) The device is approved by for clinical trials only
B) It is a new medical device
C) It is similar to previously approved medical device
3) The head of a blade should be placed:
A) Crest of Ridge
B) Widest bicortical area
C) Where initial pilot holes are drilled
4) The shoulder of a blade should be placed:
A)
B)
C)
D)
E)
45
35
20
15
8) A patient is to undergo radiation treatment and one of his recently placed implants
is failing. You removed the falling implant and make the patient wait how long to
start radiation treatment:
A)
B)
C)
D)
7 days
10 days
21 days
45 days
Anterior Mnd
Anterior Mx
Posterior Mnd
Posterior Mx
10) A single Mnd implant is removed 2-3 weeks after placement due to paresthesia.
What is the minimum time to wait for replacement of implant:
A)
B)
C)
D)
One year
6 Months
2 Months
1 month?
2-0
5-0
Vicryl
Chromigut
18) At the uncovering stage, there is a 3mm band of attached gingival lingual to
implant. Your incision should be made: Pg 393
A) Buccal to implant
B) Crest of ridge over the implant
C) way through the band of attached gingival
19) Intraoral donor site is preferred over the iliac crest site because:
1)
2)
3)
4)
Intaoral donar sites are intramembranous in orgin and are denser, have less resorption,
and revascularize more rapidly then endochondral grafts such as found in the iliac crest.
20) A patient has 5 symphyseal implants in molar mastication (occlusion) the middle
implants is in: Pg 311
A)
B)
C)
D)
21) For a single implant, the minimum acceptable length from soft tissue to opposing
occlusion is:
(Minimum inter-ach space for a fixed restorations?) Pg 137
7 mm in posterior
8 to 10 mm in anterior
12mm+ for removable
34) A woman has been on coumadine. A good test to determine if she is a good
candidate for implants Is: Pg 43
A) Partial thrombin time PTT (Intrinsic Pathway)
Aspirin inhibits platelet function because it interferes with hepatic
production of prothrombin by blocking the use of K vitamins
B) PT (Extrinsic Pathway) associated with Liver damage
Long term antibiotics
International normalized Ratio (INR) Accepted PT are 2.0 to 2.5. Coumadin is
a Vit K antagonist, it interferes with synthesis of Prothrombin.
The 3 phases necessary for hemostasis involve the vessels, the platelets, and coagulation
both extrinsic ( outsite blood vessels) and intrinsic (inside the blood vessels)
Vascular Phase occurs immediately and corresponds to the vasoconstriction of severed
arteries responding to extravascular pressure
Platelet phase begins a few seconds after vessels severed . Corresponds to formation of
Platelet Plug
Blood coagulation phase is initiated by 2 mechanisms- extrinsic ( outsite blood vessels)
and intrinsic (inside the blood vessels)
Platelet Count Obtained in CBC normal 200,000 and 300,000/ml
Clinical manifestations below 80,000
Bleeding Time- measures both coagulation pathways as well as platelet function and
capillary function
Partial Thrombin Time used to determine ability of blood to cogaulate in the blood
vessel Test the intrinsic and common pathways of coagulation ( factors VII through XII )
Prothrombin Time measres the ability of the blood to coagulate outside the vessels
35) 90% of all bleeding problems can be prevented by:
A) Complete blood count
B) PT
C) PTT
D) Medical History
36) CPR compressions breaths for a single and for dual rescuer are
A) 15:2
B) 5:1
37) The best way to determine if a patient has an or-ant fistula is:
A) The nose blowing test
B) Put H20 in sinus and see if patient feels anything *
38) A patient returns to the clinic 2 weeks after an implant (2 stage) was placed
and presents with an imflammed implant and a fistula around the top of the
implant. Other than that this patient is asymptomatic. The implantologist
should suspect?
A) An infection
B) A loose cover screw
39) A patient presents to the clinic 2-3 weeks post op. The x-ray is WNL and the
patient is asymptomatic, bone is exposed around the implant. The
Implantologist should:
40) After sinus surgery, patient has inflammation and swelling and a foul taste in
his mouth with discharge. Patient is on Clindamycin you should:
C) Put patient on augmentin
D) Put patient on Flagyl ,cleocin
E) Refer to of ENT
41) 5 minutes into procedure patient starts gasping for air. Patient has no pulse
and no respiration: CPR is started and now you should:
F)
G)
H)
I)
Administer Solu-Cortef
Administer sublingual nitroglycerin
Administer sublingual Epinephrine
Administer IM -Epinepherine
51) A patient with cardiac disease can best be revealed by elevated levels of which;
A) Elevated levels of LDH, SGOT, Potassium
B) Elevated levels of LDH, SGOT, Sodium.
52) Which antibiotic chelates calcium and arrests bone growth. Pg 458
A) Amoxicillin
B) Penicillin
C) Ceflaxin
D) Tetracycline
53) The radiograph that shows the most immediate information is:
A)
B)
C)
D)
Panorex
PA
Digital radiograph
Cephalametric
54) There were two questions on the position of the head in relation to the viewing of a
Panorex and the sinuses.
52) During the immediate placement of an implant, when the osteotmy extents
into the sinus, the best long term prognosis in this case is:
A) You can maintain the integrity of the sinus membrane
B) Add graft material
53) If the implant dentist wants to prophylactilly premeditates the patient he
should put the patient on:
One hour before procedure and no more than 24 hour after the surgery.
Exponentially
Linearly
Variably
Log linearly
Splint Teeth
63) A patient comes in for a mid treatment check up & radiograph revels 30% of bone
loss around top of implant, treatment:
A) Debride , irrigate & graft
64) For a single tooth implant replacing #8, the osteotomy should be placed:
A) In line with Incisal edge of #9
B) In line with the cingulum of #9
C) Forward to #9
65) On the vertical-horizontal aspect of reabsorbing Mand and Max and their relationship
as they reabsorb are the crest of the ridge getting?
A)
B)
C)
D)
Wider
Narrower
Mx wider & Mand narrower
Mand wider & Max narrower
66) The best impression material for making an implant supported overdenture is:
A)
B)
C)
D)
Polyethylene
Poly Vinyl Siloxane
Add-red silicone
Alginate
Ceramic Carbon
Titanium
Titanium Alloy
Surgical Steel
10-15 um/day
30-50 um/day
60-75 um/day
100-115 um/day
C) 100-125 rpm
70) The best way to insure accurate coping placement is;
A) Proper placement of transfer pin into impression
B) Rigid impression material
71) If a blade has a 50% sauceration and exudates what to do:
A) Take out Implant
72) After Successful bilateral mandibular blocks, patient still feels pain while drilling in
symphysis, where is it coming from?
A)
B)
C)
D)
Mylohyoid
C3- C2
Lingual
Sub-lingual
73) After an implant is placed in the mandibular 1st molar area, buccal swelling, where
did it come from?
A) Below buccinator attachment *
B) Above buccinator attachment ?
After an implant is placed in the maxillary 1st molar area, buccal swelling, where did it
come from? Pg 218
C) above buccinator attachment *
D) Above buccinator attachment ?
74) Which has greatest affect on prognosis of root form implants of the same size, shape
and cyclic loading?
A) Axial Relationship *
75) Which is true of Autogenous bone grafts?
A) Cancellous bone grafts heal differently than cortical bone grafts
76) Consider the first bacteria to colonize a new implant are set up Beneficial bacteria
scergious and actinomyces viscosis. Which of the following statement is most true about
the host response to this plaque.
A) There is no detectable response *
81) Why would someone have difficulty swallowing after an implant supported
overdenture is placed ?
A) Crown Ratio is incorrect
B) Maxillary teeth placed to far palatally *
C) Maxillary teeth placed to far buccally
82) If you have normal mucosa and the patient is complaining that her tongue is burning,
the problem is?
A)
B)
C)
D)
Cardiac problem
Diabetic problems
Psychological problems*
All the Above PG 61 0f study guide
83) Concerning the A-P distance for a cantilever, which palate shape gives the shortest
A-P distance?
A)
B)
C)
D)
Tapered
U-shaped
Square
V-shaped
84) Patient has anterior bar retained denture and has pain and bone resorption what would
you do?
A) Decrease anterior bite force *
B) Antibiotic treatment
85) To avoid galvanic corrosion you dont want to place the following implant with a
gold suprastructure? Pg 277
A)
B)
C)
D)
Ceramic
Ti Alloy
Nickel Cobalt
Cr-Lo alloy
1 year
6 months
3 months
2 months
95) 2mm bone loss around all 5 lower anterior implants and inflammation around one of
them, what is happening
A) Bar flexes
B) Bar doesnt fit properly *
96) How do you stop bleeding from upper or lower lips?
A) Direct pressure on facial up against body of mandible *
97) In severely resorbed mandible incision should be made
A) Buccal
B) Crest of Ridge
C) Lingual *
98) Which describes transient burst of localized remodeling following surgical wounding
of cortical bone?
A) Rapid accelerator phenomenon *
99) Patient with cardiac disease can be revealed by blood test with elevated levels of ?
A) LDH, SGOT, Potassium
B) LDH, SGOT, Sodium
100) Which of the following categories of antibiotics are the strictest compliance due to
their mechanism of?
A) Static *
101) 5 mandibular implant in edentulous area with a fixed bridge, what is the force
applied?
A) Compression *
B) Tension
C) Shear
3months
1 month
6 months
1 year
102) Alloplast They are the most common osteoconductive bone grafting material.
Alloplastic materials are exclusively synthetic bicompatable products developed to cover
a broad range of indications. Examples are ceramics, polymers and composites. The
most frequently used are ceramics. Ceramics They are characterized as bioinert. An
example of bioinert is aluminum oxide and titanium oxide or bioactive ie. (Calcium
phosphate)
103) Bioactive Ceramics- Which are calcium phosphate (an example is synthetic
hydroxy appetite (HA) Calcium phosphate material displays a complete lack of toxicity.
104) Tri Calcium Phosphate- Is ceramic and is characterized as bioactive. Displays
complete lack of toxicity and can bond with bone. Example- HA (hydroxy appetite)
105) Osteoconductive- Which is characterized bone growth by apposition from the
surrounding bone. Therefore this process must occur in the presence of bone or
differentiated menchymal cells. Osteoconductive materials are biocompatible. Bone or
soft tissue can develop by apposititon without evidence of a toxic reaction. If
osteoconductive materials are placed in ectopic sites (ie. Subcutaneously) they do not
initiate bone growth, the material remains the same or unchanged or resorbs.
106) An HA coated root form implant may have the most advantages in which type
of bone?
D4 bone has proven to be the one most at risk. Hence the benefits of hA are most
required in this type of bone. Although it may have the greatest risk relative to bacteria,
the benefits of gap healing, faster bone mineralization, and increased bone contact all
favor HA. Higher success rates have been reported when HA coated implants have been
used in soft bone. The HA should be added to an implant body with the most
macroscopic load- bearing surface area to minimize crestal bone loss, larger diameter and
an increased number of implants are also suggested in this very weak bone.
from the bone matrix. When placing subcutaneously in the absence ot bone, it has
been shown to induce bone formation tn the ectopic site. Example is frozen bone,
freeze dried bone and dimineralized freezed dried bone.
111) OsteoconductionCharacterizes bone growth by apposition from the surrounding bone. Therefore
this process must occur in the presence of bone or differenciated mesenchymal cells.
Osteoconductive materials are placed in ectopic sites. (example Subcutaneously)
they do not iniciate bone growth. Instead the materials remain relatively unchanged
or resorbed. The most common osteoconductive bone grafting materials used in
implant dentistry are are alloplasts and xenografts. Alloplasts materials are
synthetic. Most frequently used are ceramics ie. Alluminum Oxide and Titanium
Oxide (bioinert) or (bioactive) which are calcium phosphate.
Bioinert ceramics do not exhibit direct bonding with the host bone and are
mechanically held in contact with the bone.
112) What is the difference of a press fit surface area compared to a screw form?
Screw root forms are threaded into a bone site and have macroscopic retentive
elements for initial bone fixation. Three basic screw thread implant is greater than
a cylinder implant by a minimum of 30% and may exceed 500% depending on the
thread geometry. This increase in functional implant surface area decreased the
stress imposed on the bone implant surface and is also dependent on thread
geometry. Most cylinder implants are essentially smooth sided and bullet shaped
implants that require a bioactive or increased surface area coating for retention in
the bone. If these same materials were placed on a threaded design the surface area
of bone contact would be more than 30% higher compared with the smooth cylinder
design. The greater the functional surface area of the bone implant contact, the
better the support system for the prosthesis. In addition if bone loss occurs around
a coated implant a biological smear layer attaches to the coating. The contaminated
coating must often be removed from the bone. However once the coating is removed
the cylinder implant primarily imposed shear loading to the bone implant interface.
Bone is 65% weaker in shear force compared with compression. As a result future
bone loss is even more likely. Once the surface is decontaminated and bone is
regenerated next to the implant, the threaded implant can still transmit compression
and tensile forces to bone. Hence surgical correction of bone loss has better
prognosis with screw type implants.
113) If the patient has a bleeding disorder what tests would you order?
PTT Test- It is used to determine the ability of the blood to coagulate within the
vessels. Therefore it tests the intrinsic and common pathways of coagulation.
PT Test- It is used to determine the ability of the blood to coagulate outside the
vessels therefore tests the extrinsic and common pathways of coagulation. Both
systems are necessary for normal coagulation.
114) The patient has swelling and trismus (the ability of the patient to open his
mouth) on the left side of his face due to surgical space infection, what muscle does
this affect.
Masseter muscle
117) When placing an implant in #7 site with limited thickness and osteotomes the
implant surgeon must be aware that?
The facial mucoperiosteum is reflected to a minimum when bone expansion is
planned. The facial cortex receives its blood supply from the overlying facial
periosteum and complete facial soft tissue reflection compromises its blood supply.
118) There is a graft over an implant the membrane Is exposed there is slight
inflammation what is the coarse of treatment?
Use Chlorahexadine and AB
119) When an implant is exposed, tissue is sore and the patient is in a surgical
denture what is the approach?
Relieve Denture
120) Which of the following is the major difference between aspirin and the newest
NSAIDs ?
D) Regulated be law (Aspirin causes GI problems and NSAIDS dont)
121) Which of the following will cause an increase in eosinophils?
Eosinophils- leukocytes (Immune Response) The normal total white blood cell
(WBC) ranges from 5000 to 10,000/ML and often varies with each disease. WBC
count are critical to the dental out-patient particularly for patients with immune
diseases or undergoing chemotherapy. The counts can indicate infections, leukemic
disease, immune disease and toxicity of drugs.
parasitic
122) All of the following statements pertain to condition of the blood, which one is
the exception?
E) Reduced uric levels are indicative of gout
123) What type of leukocyte is present in the greatest numbers during the
inflammatory process?
The determination of an inflammatory process is important for the implant dentist
and may occur without leukocytosis. An increased count of band neutrophils
indicates inflammation.
124) Which of these values in a blood chemistry exam will most likely be abnormal
in a patient with alcoholic hepatic diseases?
Primary hepatic disease is reflected in elevation of liver disease, biliruben
measurement is of primary importance.and alkaline phosphatase
125) Which of these values in a chem. Exam would most likely be abnormal if the
patient has cardiac disease?
Lactic dehydrogenase (LDH) is an intracellular enzyme presented in all tissues.
Normal is o-625 U/L.
126) Scientific studies about routine antimicrobial oral prophylaxis generally agree
that a blood level of antibiotic be present at the time of wounding and there is no
advantage to sustaining medications post operatively for which duration of time.
A) 1 Day
127) Which of the following penicillin is also specifically indicated for gram negative
organisms?
Amoxicillin- Ampicillin was developed in an attempt to extend penicillins spectrum
of activity. Unlike Penicillin G & V Ampicillin is active against several gram
negative organisms including H. Influenza and Escherichia coli, implicated
respectively in sinus and urinary tract infections. Amoxicillin provides an identical
antimicrobial spectrum and demonstrates an oral bioavailability greater than that
of either Ampicillin or Penicillin V.
128) The accumulation of plaque around dental implants will initiate gingivitis in
the same manner and the same rate as in natural dentition?
Gingivitis is a bacteria. ( Induced inflammation around the region of the marginal
gingival above the crest of the bone) it may be classified as 1) acute necrotizing 2)
Ulcerative 3) Hormonal 4) drug induce 5) spontaneously occurring. These
categories can also relate to the gingival tissue around an implant because the mode
of attachement of the gingival to a tooth and implant have been reported to be
similar. The bacteria in gingivitis around a tooth may affect the epithelial
attachment but without loss of connective tissue attachment of a tooth extends an
average of 1.07mm above the crestal bone, at least 1mm of protective barrier above
the bone is left. In contrast there is no connective tissue attachment zone around an
implant hence no connective tissue barrier exists to protect the crestal bone around
an implant
A) This is a false statement it is faster in implants
130) Hydroxyapatite coatingHA coating by plasma spraying was brought to the dental profession by de Groot,
Kay et al, showed with scanning electron microscopy and spectrographic analysis
that the plasma sprayed HA coating could be crystalline and could offer chemical
and mechanical properties compatible with dental implant application. HA coating
can also lower the corrosion rate of the same substrate alloys. Numerous
histological studies have documented the greater surface area of bone apposition the
the implant in comparison to uncoated implants which may enhance the
biomechanics and initial load bearing capacity of the system. HA coating has been
credited with enabling HA coated TI or TI alloy implants to improved bone to bone
attachment compared with machined finished.
131) Coating applied most commonly to root form implants use the technique of?
Plasma Spraying- Porous or rough titanium surfaces have been fabricated by
plasma spraying a powder form of molten droplets at high temperatures. A
temperature of 15,000 C, an argon plasma is associated with a nozzle to provide
very high velocity 600m/sec partially molten particles of titanium powder (0.05 to
0.1mm diameter) projected with a 0.04 to 0.05 mm thickness.
132) Surface coated root form implants which do not have coatings extended to the
very top have metallic collars that are?
C) Machine finished Studies on osseous healing around implants suggest
that crestal remodeling is limited to smooth region of the collar as a result
of this remodeling the sulcar epithelium migrates to the bass of the
implant collar. Besides the possible prevention of HA exposure an
additional advantage of using a machined coronal portion is the potential
for an improved interface at the abutment connection. Although the
machined collar region may provide this advantage it contributes little to
the bio mechanical support at the bony crest. Where stresses are most
severe. Therefore the machined collar is limited in height to 0.5 to 1mm.
It provides the biologic and abutment connection advantages and limits
the bio-mechanical disadvantage.
Misch 340 highly polished on top, then machined
Misch page 16
133) Gingival tissue can attach to metal . This can be seen by the presence of ?
Muccopolysaccarides- also called glycosaminoglycans. There is a high content of the
muccopolysaccarides in the linear body that coats the dental implant. With
sufficient stickiness or glue like properties to form a biologically active and trauma
resistant attachment at the base of the regenerated sulcus. The the biological seal
around dental implants is a definitive entity that must be present to prevent external
toxins and agents of the oral cavity from moving into internal enviroment of the
jaw.
Hemidemosomes-which are attachment plaques to hold epitheliam cells to the basil
lamina.
A series of events occur following implant surgery the attached gingival regenerates
around the implant forming an epithelial cuff more appropriately termed the free
gingival margin. Even though this area has been edentulous is some cases for long
periods of time, the regenerating epithelium forms the free gingival margine
complete with free gingival groove and a gingival sulcas. The epithelium
regenerates into the sulcas and form nonderatinized sulcular epithelium and a zone
of epithelium cells at the base of the sulcas that interface the implant surface these
regenerated cells have the same morphology as the junctional epithelial cells seen
around natural teeth. These epithelial cells at the base of the sulcas produce a series
of biologic attachment structures that are recognized as part of normal cell biology
and physiology.
134) The time of healing after placement of maxillary posterior root form implants
are?
4 to 8 months of healing time is required.
135) Which of the following are associated with the formation of the epithelial
attachment complex to implants?
D) Hemiodemesomes and HA
147) Which of the following is the most recommended treatment of the failing dental
implant?
C) Quickly remove the implant since bone loss is progressive
148) All of the terms are correctly associated with tri calcium phosphate except one?
B) Osteoinductive involves new bone formation (tissue obtained from cadavers
and processed)
149) All of the following terms are correctly associated with demineralized freezedried bone except one?
C) Alloplastic- synthetic materials (osteoconductive). They come in ceramics,
polymers and composites.
Ament is non resorbable
151) The synthetic suture material vicryl is made of : braided, white or dyed violet,
polylactic acid.
154) Intra-oral bone grafts have been used for alveolar repair to allow implant
placement with extremely favorable results. Block grafts can be harvested from the
mandibular ?
Symphysis or Ramus
155) Acceptable donor sites for autogenous bone grafting are The Zygoma, Femur,
plateau, medial maleus and the bony orbit?
C) One of the Above (Zygoma)
Smaller amounts of bone and autograft may be harvested from the maxillary
tuberosity, zygoma, extrosseous tori, Residual ridge ostoplasty, extractin
sites, implant osteotomy and bone collection devices.
156) When performing a sinus floor elevation at least how may mm of bone is
required if implant are to be places at the same time?
A) 10-height
161) The anterior palatine second division block when administered successfully
creates.
E) Anesthesia of the premolars and molars
162) If an implantologist intends to use several root form implant systems, he must
be sure to arm himself with:
B) The specifically recommended drills and countersinks of that system.
167) Which of the following conditions (May be caused) can be produces when
prescribing sedatives for patients on anti hypertensive drugs?
A) Hypotension (subnormal arterial blood pressure)
168) Which of the following terms describes the transient burst of localized
remodeling following the surgical wounding of cortical bone?
B) RAP (Regional acceleratory phenomenon)
169) Hypoxia is a concern with the administration of narcotics and may potentially
trigger cardiac disease which of the following poses the least risk?
C) Increasing nitrous oxide supplementation