rfe_311___315_exam_bank

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Reminder: About 80-90% of the final questions will be from this bank, the remaining will be

case based and application based.

RFE 311 & RFE 315 1 KCS

IMPLANT DENTISTRY EXAM BANK

1. Define osseointegration. (4 points, 1/4 page)

2.

What are the critical components of an acceptable clinical trial? (10 points)

3. Compare the masticatory performance of individuals with complete upper and lower

dentures with patients using an implant assisted lower denture opposing a complete

maxillary denture. (4 points)

4. Compare the masticatory performance and chewing strokes required to reach

swallowing threshold of a fully dentate individual with a patient wearing upper andlower dentures. (4 points)

5. Compare the masticatory performance of Kennedy Class II patients restored withremovable partial dentures vs fixed, implant supported partial dentures. (12

points)

6. Describe the difference between a resilient and a nonresilient attachment. In youranswer provide a clinical example where each of the attachment types could be used.

(8 points)

7. In specific situations attachments are used to connect implants to natural dentition

when fabricating fixed partial dentures. Both precision and semi-precisionattachments have been used. Which type is preferred and why. (4 points)

8.

Patients fitted overdentures assisted by natural tooth abutments chew more effectivelythan patients fitted with overdentures assisted by osseointegrated implants. Why do

you think this is true? (4 points)

9. List those clinical factors which are critical if a titanium screw shaped implant placed

into a favorable bone site is to achieve osseointegration. (6 points, 1/2 page)

10. Define A-P spread. When is it used? Why is it important? (6 points, 1/2 page)

11. Osseointegrated implants used to retain and support single teeth restorations have had

good success. Please discuss their use for each of the following sites and provide the

following information: (1) prognosis, (2) special surgical considerations if any, (3)other prosthetic options, and (4) your recommendation.

a. Maxillary central incisor site. (4 points, 1/4 page)

b. Mandibular first bicuspid site. (4 points, 1/4 page)

c. Mandibular first molar site. (4 points, 1/4 page)

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RFE 311 & RFE 315 2 KCS

d. Maxillary first molar site. (4 points, 1/4 page)

12. Subperiosteal implants are reasonably successful for the first 4 to 5 years of use.

However, after this period the incidence of local infections and implant failuresincrease dramatically. Please explain. (6 points, 1/2 page)

13. Dental cantilevers have been incorporated into the design of many types of implantsupported prostheses. Discuss the method used to determine cantilever length for the

following situations:

a. Six implants have placed in the maxilla and you wish to extend the restoration

posteriorly with a distal cantilever. (4 points, 1/3 page)

b. Five implants have been placed in the anterior mandible and you wish to develop

a distal cantilever. (4 points, 1/3 page)

14.

Posterior quadrant of the mandible in a partially edentulous patient where have placedimplants in each of the premolar positions and your considering a distal cantilever in

the molar region. (4 points, 1/3 page)

15. In the edentulous maxilla, implant assisted overlay prostheses are best suited for most

patients, as compared to fixed restorations. Explain. (10 points, full page)

16. The success rates for the current generation of osseointegrated implants in the anterior

mandible exceed 97% after 5 years. This rate of success has not been duplicated inthe posterior quadrants of partially edentulous patients. Please explain. Please

address both the mandible and maxilla during your discussion. (12 points, full page)

17. Define “combination” syndrome. (4 points, 1/4 page)

18. Describe the peri-implant soft tissues histologically from the crest of the peri-implant

gingiva down to area of the implant that is osseointegrated. (8 points, 1/2 page)

19. When evaluating a patient for an implant in the maxillary anterior region, what are

the clinical parameters that need to be taken into consideration. (12 points, 3/4 page)

20. What are the most important factors to be considered if osseointegration is to be

achieved consistently? (regarding preparation of bone sites and placement of

implants) (10 points, 1/2 page)

21. Describe the layers in the bone-implant interface zone of an osseointegrated titanium

implant. Start from the center of the implant and proceed outward. (8 points, 1/2 page)

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RFE 311 & RFE 315 3 KCS

22. Describe the difference between a pickup type impression coping and a transfer typeimpression coping. Which type would you favor? Please explain. (6 points, 1/3

page)

23. In the anterior maxilla when designing a single tooth restoration, why are ridged lapdesigns considered less than ideal (6 points, 1/3 page)

24. List those factors that affect the mastication efficiency of a patient with a well madecomplete denture. (10 points, 1/2 page)

25. With reference to the previous question describe how each of these is affected withthe addition of two implants to the anterior mandible and the fabrication of

mandibular overlay denture opposed by a maxillary complete denture. (10 points, 1/2

page)

26. List the possible difficulties associated with cementing crowns on commercially

fabricated implant abutments? (6 points, 1/3 page)

27. List those factors which have led to a higher failure rate for osseointegrated implants

used to restore the posterior quadrant of the maxilla. (8 points, 1/2 page)

28. Success rates for implants used to restore edentulous spaces in the posterior quadrant

of the mandible have been lower than those reported in the anterior mandible.

Explain. (8 points, 1/2 page)

29. Define “implant assisted restoration.” (4 points, 1/4 page)

30. Define “implant supported restoration.” (4 points, 1/4 page)

31. In the edentulous maxilla most patients are best fitted with implant assisted

restorations. Explain. (6 points, 1/3 page)

32. An implant assisted palateless, overlay denture is planned for this patient. Indicatethe minimum number of implants you would use, the tooth positions you would favor

for placement into the edentulous ridge and your reasons for selecting these positions.

(6 points, 1/2 page)

33. What is the difference between fibrous-encapsulated implants and osseointegrated

implants? Which is clinically more predictable? Please explain your answer. (10

points, 1/2 page)

34. Which of the original implant surfaces (machined, titanium plasma spray, hydroxyl

apatite) resulted in the highest bone to implant contact? Does this relate to theclinical results? Explain. (8 points, 1/2 page)

35. What are the advantages of roughening the surface of an implant by acid etching orsome similar method? (6 points, 1/3 page)

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RFE 311 & RFE 315 4 KCS

36. Why is attached keratinized mucosa preferable to unattached nonkeratinized tissue

around implants. (6 points, 1/2 page)

37. Describe the biologic processes that take place associated with the bony tissues nextto the surface of a titanium implant immediately following placement until complete

healing has taken place. (10 points, 1/2 page)

38. How long does this process take in humans ? (2 points, 1/4 page)

39. What strategies can be employed to avoid implant overload when restoring singlemolar defects in the mandible (6 points, 1/3 page)

40. What factors determine the load carrying capacity of an implant supported prosthesis?(10 points, 1/2 page)

41. Brunski et al (2000) has proposed a possible mechanism of implant failure associated

with implant overload and bone resorption. Please describe in detail (10 points, 3/4 page)

42. The magnitude of occlusal loads delivered to the bone through a three unit implant-supported fixed bridge restoring a posterior quadrant is controlled by many factors.

What are they? Which of these are under control of the restorative dentist (12 points,

1/2 page)

43. In edentulous patients (both maxilla and mandible) what strategies would you use toavoid implant overload when planning for and designing implant supported

prostheses? (8 points, 1/2 page)

44. When restoring an edentulous posterior quadrant of a partially edentulous patients

what strategies would you use to avoid implant overload when planning for and

designing an implant supported fixed partial denture. (14 points, 3/4 page)

45. Immediate loading of osseointegrated implants is somewhat controversial. Please

explain. (6 points, ¼ page)

46. Describe clinical situations where immediate or early loading of osseointegrated

implants would be feasible. (6 points, 1/2 page)

47.

Describe some of the potential problems associated with placing implants into freshextraction sites. (6 points, 1/2 page)

48. Compare the bone quality and quantity of the edentulous posterior maxilla andanterior mandible with respect to their suitability as implant sites. (8 points, 1/2 page)

49. What factors influence the implant anchorage in bone? (6 points, 1/2 page)

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RFE 311 & RFE 315 5 KCS

50. What are the advantages of implant assisted overlay dentures in the maxilla asopposed to fixed implant supported prosthesis? (8 points, 1/2 page)

51. What are the minimum requirements for an implant supported prosthesis in the

mandible with respect to number, length and arrangement? (6 points, 1/2 page)

52.

What are the minimum requirements for an implant supported prosthesis in themaxilla with respect to number, length and arrangement. (6 points 1/3 page)

53. What factors should be taken into account when you are deciding between restoring

an edentulous mandible with a fixed hybrid prosthesis vs. an implant assisted overlaydenture? (10 points, 2/3 page)

54. When restoring posterior quadrants of partially edentulous patients withosseointegrated implants, how do you minimize the buccal or lingual cantilever

effect? (6 points, 1/3 page)

55.

When considering patients for implants in the edentulous mandible, describe some ofthe common problems that are encountered and need to be considered before

embarking a specific course of treatment. (6 points – 1/2 page)

56. Name each level in a standard implant pillar, the material of which it is constructed

and its purpose. (6 points – 1/2 page)

57. Explain how the UCLA abutment is different from a standard abutment. What

problems it can solve. (6 points – 1/2 page)

58. Explain the difference between an implant level and an abutment level impression

and describe two techniques for making the impression. (8 points – 1/2 page)

59. Describe a technique for improving the accuracy of the master impression in an

edentulous patient when 4-6 implants are arranged in the anterior symphyseal region.

(6 points) 1/2 page)

60. How can labial-buccal plate deficiencies be resolved in single tooth defects in the

anterior maxilla? Which of the two methods available would you prefer? Pleaseexplain. (4 points – 1/2 page)

61. Explain what is meant by an AP spread and how it is used. (4 points – 1/4 page)

62. What are the factors necessary to allow opening the palate on a maxillary implant

assisted overdenture? When should you cover the palate? (6 points –1/2 page)

63. What factors affect load distribution of an implant supported fixed partial denture

designed for the posterior quadrants of the maxilla or mandible? (10 points – 1/2

page)

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RFE 311 & RFE 315 6 KCS

64. What purposes are served by the use of provisional implant restorations in partiallyedentulous patients? (8 points 1/2 page)

65. What factors (with respect to the anatomy of the site and surface of the implant)

influence the effectiveness of implant anchorage in bone? (6 points – 1/2 page)

66.

When restoring the edentulous maxilla, what are the advantages of overlay denturesover fixed prostheses?

67. When restoring an edentulous maxillary or mandibular arch with a fixed implant

supported prosthesis, how is the cantilever length determined? (4 points – 1/4 page)

68. In the edentulous mandible, what factors influence the treatment choices available

(fixed vs. removable)? With each factor indicate whether this factor would lead youto prefer a fixed or removable option. With each factor explain the reason for your

preference. (20 points – whole page)

69.

What issues need to be considered when deciding whether or not to immediately loadan implant retained prostheses? (8 points, 1/2 page)

70. What biologic processes need to be complete before an implant is fully anchored in bone? (12 points, 1/2 page)

71. What are the advantages of the two implant assisted overlay denture as compared tofixed prostheses when restoring the edentulous mandible? (8 points – 1/2 page)

72. When designing an implant assisted overlay denture for the mandible, what prime

support areas must be engaged to absorb posterior occlusal forces? (4 points – 1/4

page)

73. When designing a two implant assisted mandibular overlay denture for a patient,

where are the two most desirable implant locations? Please explain your answer. (4

points – 1/2 page)

74. Prior to processing the two implant assisted overlay denture, the clip housings are

secured to the bar via Hader clips and the rest of the bar is blocked out with plaster orstone. Why? (4 points – 1/3 page)

75. What is meant by the phrase “prosthetically-driven” implant placement? (4 points –

1/3 page)

76. When surgically placing an implant into a bony site, what strategies are used to avoid

overheating the bone? (8 points – 1/2 page)

77. List the relative medical contraindications to placing osseointegrated implants in

patients with bone sites of reasonable quantity and quality. (8 points – 1/2 page)

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RFE 311 & RFE 315 7 KCS

78. List the relative dental contraindications to placing osseointegrated implants in patients with bone sites of appropriate volume. (8 points- 1/2page)

79. What are the objectives to be accomplished at second stage surgery? (6 points – 1/2

page)

80.

What impact have the changes in surface micro-architecture (acid etching etc.) hadon predictability and implant anchorage as determined by reverse torque tests andhistomorphometry of titanium implants? (10 points – 1/2 page)

81. Why have HA coated implants been less predictable than titanium implants? Pleaseexplain in detail. (6 points – 1/3 page)

82. What are the most common problems patients experience with their mandibulardentures that lead patients to inquire about dental implants? (6 points – 1/3 page)

83. What impact would the placement of two implants in the symphyseal region and the

fabrication of an implant assisted overlay denture have on each of problems citedabove? (8 points, 1/2 page)

84. Single tooth implant restorations can be either screw retained or cement retained.Cite arguments in favor of each method. Based on your knowledge to this point,

which would your prefer? Please explain. (8 points – ½ page)

85. When using a “Hader” bar to retain an implant assisted overlay for the edentulous

mandible, why are the two implants positioned in the cuspid region? (4 points 1/3 page)

86.

When making implant assisted overlay dentures for the mandible, why is theimpression border molded? (4 points, 1/4 page)

87. When fabricating an implant assisted overlay denture for the edentulous mandible,

why does the land of the master cast have to be wider than normal? (2 points, 1/4 page)

88. How do you decide whether to restore an edentulous mandible with a fixed or a

removable prosthesis? Please explain. (12 points, 1/2 page)

89.

What are the most common problems encountered when considering implants for theedentulous mandible? Please explain why each problem you list is significant? (10

points, 2/3 page)

90. In this patient only 4 implants can be placed in the edentulous maxilla because of

pneumatized maxillary sinuses.

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RFE 311 & RFE 315 8 KCS

91. Indicate by drawing, where each of the implants should be positioned with respect toone another. Be specific. (4 points, 1/3 page)

92. What type of tissue bar would you design for this patient, an implant supported, or

implant assisted design? (2 points, 1/8 page)

93.

Indicate by drawing, the design of the tissue bar you would recommend. Be specificwith respect to the types of attachments you would use and their position. (6 points,1/2 page)

94. Why do you need to border mold an impression when fabricating a palateless implantassisted overlay denture? (4 points, 1/4 page)

95. When performing implant surgery, why is it important to use standard sterile surgicaltechnique? (6 points, 1/3 page)

96. What are the possible undesirable outcomes if a fixed implant supported prosthesis in

an edentulous patient is designed with excessive cantilevers combined withinsufficient A-P spread? (4 points, 1/4 page)

97. During your clinical examination, when considering a patient for a single toothimplant supported restoration, it is important to evaluate the status of the adjacent

teeth. What factors are important to consider before developing a definitive treatment

plan? (8 points- ½ page)

98. Why do implant sites in the anterior maxilla in partially edentulous patients frequentlyneed to be augmented with bone grafts? (4 points, 1/3 page)

99.

Do implants achieve the same degree of anchorage in grafted sites as in normal bone?Please explain your answer. (4 points, 1/3 page)

100. In partially edentulous patients, why do implants in grafted bone sites do better in the

anterior maxilla than they do in grafted sites in the posterior mandible? (4 points, 1/4 page)

101. There are several ways to supplement soft tissue contour of the peri-implant gingivaaround implants in the anterior maxilla. List the choices available and indicate which

would be your first choice. Explain your reason. (10 points, 1/2 page).

102.

When designing a surgical template for placement of an implant in #8 position, whatlandmarks or surfaces associated with the proposed definitive restoration need to be

incorporated within the design of the template? (4 points, 1/4 page)

103. What is a custom abutment? Why are custom abutments often necessary when

restoring anterior maxillary teeth with implants? (8 points, 1/2 page)

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