Perio2 Flashcards
Which of the following occlusal conditions would exert the lowest amount of biting force under normal conditions?
• complete dentures resting on soft tissue
• complete dentures supported by implants
• fully dentate occlusion
• maxillary complete denture opposing natural teeth
complete dentures resting on soft tissue (apply about one sixth of the occlusal force compared to the fully dentate occlusion or a complete denture opposing natural dentition.)
Occlusal forces produced by full arch dentures supported by implants produce ? force as fully dentate occlusal schemes
about the same
If the implant-to-abutment interface consists of a permanent extension on the top of an implant and a receptacle inside the abutment, the implant connection is categorized as: • an internal connection • an external connection • a cone in a socket connection • a nonengaging connection • a rotational element
an external connection
Which of the following is/are necessary for osseointegration to be successful • primary stability of the implant • limited micromotion during healing • minimization of surgical trauma • uncontaminated implant surfaces • all of the above
all of the above
Osseointegration can fail due to: • occlusal overload • bacterial plaque • micromotion during healing • excessive cantilevering of the prosthesis • all of the above
all of the above
The limit of heat is ? degrees C for less than ? minute
- 47
* 1
special drill for implant removing is called ?
a trephine drill
“Antirotational” element is added to an implant to:
• prevent rotation of multiunit restorations
• prevent rotation of the implant
• prevent rotation of the abutment in the implant
• prevent overtorquing of the abutment screw
• all of the above
prevent rotation of the abutment in the implant
Antirotational elements are also added to abutments to prevent the rotation of ?
attached single-unit restorations such as a single crown
Bisphosphonates are used to treat ?
osteoporosis and cancer (absolute contraindications for implant placement)
“Site development” for implants includes the following techniques. Select all that apply.
• guided tissue regeneration
• socket grafting
• bone grafting with cow bone
• bisphosphonate supplementation for bone density
• orthodontic tooth movement
- guided tissue regeneration
- socket grafting
- bone grafting with cow bone
- orthodontic tooth movement
technique for bone augmentation in edentulous areas?
guided bone regeneration technique
The hole that is surgically created in the bone to receive the implant body is called the: • osteotomy • bone channel • smokestack • callus core • chimney
osteotomy
? dictate how the osteotomy must be prepared
- The overall implant shape (macrostructure)
* the bone “quality” at any site
If the bone is very dense and a screw-shaped implant is being used, the osteotomy may be “tapped” meaning ?
that screw threads are created on the walls of the osteotomy to receive the screw threads on the implant
A radiograph should be exposed and interpreted at which of the following points during implant placement and restoration:
• at the end of the surgical procedure
• following the final torque application to an abutment
• anytime the fit or seating of a component must be verified
• intraoperatively to verify implant position
• all of the above
all of the above
The most common source of patient dissatisfaction with implants is: • pain • appearance • mobility • loss of osseointegration
appearance (since restoration of bone, gingival contours, and papillae is sometimes not possible)
? refers to an absence of one or more papillae, which creates an esthetic concern.
Black triangle disease
Which of the following was/were included in the 1986 Albrektsson et al criteria for functional implant success?
• implant is immobile and has no periimplant radiolucency
• bone loss is less than 0.02 mm/year after the first year of service
• absence of persistent and/or irreversible pain, infection, paresthesia or violation of the mandibular canal
• success rates of at least 85% at year 5 and 80% at year 10
• all of the above
all of the above
"Direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant" is the definition of: • a cold weld • ankylosis • osseointegration • metal callous formation
osseointegration
Epithelium does attach to titanium via ? structure comprised of ?
- a “junctional epithelium”
* hemidesmosomes and a basal lamina
Implants should not be treatment planned in young individuals until skeletal growth has been completed.
• true
• false
true
- do not erupt or move physiologically within bone
- prevent normal development of the jaws
The highest rate of implant failure occurs in: • type 1 bone • type 2 bone • type 3 bone • type 4 bone
type 4 bone
bone quality is categorized according to ?
- cortical plate thickness
* cancellous/trabecular density
Type I bone occurs in ?, for example, where the bone is mostly cortical bone
the anterior mandible
Type 2 bone is ?
a thick layer of cortical bone and the cancellous bone core is most dense
Type 3 bone is composed of ?
a thin layer of cortical bone surrounding a dense core of cancellous bone
Type 4 bone is characteristic of?
the posterior maxilla and has a typically thin cortical plate and low density cancellous bone core
In patients with normal bone and normal healing capabilities, one should anticipate dental implant success rates of: • 35% • 50% to 60% • 74% • 90% to 95% • 100%
90% to 95%
Implant failures are generally considered to be
• early due to?
• late due to ?
- surgical trauma and/or implant instability at the time of placement
- microbial plaque accumulation equivalent to periodontal disease and/or to excessive occlusal forces
• periimplant mucositis denotes ?
• periimplantitis refers to?
Both conditions require treatment
- inflammation of the soft tissues surrounding the implant
* this inflammation but with accompanying loss of implant-supporting bone
Implants are useful for orthodontic anchorage because implants:
• do not move in response to orthodontic forces
• do not have a periodontal ligament
• can be placed and later removed
• can be located to gain force advantage
• all of the above
all of the above
The greatest esthetic challenge for the restorative dentist occurs in the patient having a:
• high smile line, thick periodontal biotype
• low smile line, thin periodontal biotype
• low smile line, thick periodontal biotype
• high smile line, thin periodontal biotype
high smile line, thin periodontal biotype
? is responsible for proprioception around natural teeth. The lack of the periodontal ligament around implants results in a much reduced ? sense of where the implants are in relation to the opposing occlusion
- The periodontal ligament
* tactile
There is a phenomenon that develops with time called ?, which gives the patient a certain amount of tactile sense regarding the implants in the bone
osseoperception
The “anterior loop” is descriptive of the:
• circular course of the internal maxillary artery
• maxillary sinus extension toward the canine tooth
• course of the inferior alveolar nerve anterior to the mental foramen
• necessity for angled abutments
• none of the above
course of the inferior alveolar nerve anterior to the mental foramen (the implant location should be planned to be at least 5 mm or more anterior to the foramen)
When planning implant position, the osteotomy preparation should be planned to end a minimum of ? vertically away from the mandibular canal, and ? away from any other vital structure
- 2 mm
* 2 mm
Assessment of the potential implant patient should include:
• direct palpation of the bony ridges
• determination of any limitations of mouth opening
• cross-sectional imaging
• all of the above
all of the above
Where should the healing abutment be placed at the stage II (uncovering) surgery for a two-piece implant system? Select all that apply.
• approximately 1 to 2 mm “taller” then the height of the tissue
• out of occlusion
• radiographically confirmed as seated
• designed to shape or mold the tissue
- approximately 1 to 2 mm “taller” then the height of the tissue
- out of occlusion
- radiographically confirmed as seated
- designed to shape or mold the tissue
Although mobility of an implant is considered a sign of implant failure in other circumstances, the rotation of the implant at second stage surgery may possibly be overcome by ?
replacing the cover screw, covering the implant with soft tissue, and allowing the site to heal for an additional 3 months
At the conclusion of surgical placement of a titanium implant, complete soft tissue coverage of the implant is required for successful osseointegration to occur.
• true
• false
false (regarding one-stage or nonsubmerged systems also called transgingival placement)
The clinical examination of osseointegrated dental implants should include:
• soft tissue observation
• radiographic assessment
• probing
• visual inspection of implant components
• all of the above
all of the above
Cross-sectional imaging is produced by all of the following EXCEPT one. Which one is the EXCEPTION! • cone beam computed tomography • panoramic radiography • conventional linear tomography • computed tomography scans
panoramic radiography
The term “relative attachment level” is used when the attachment is calculated from ?
a landmark beside the CEJ
The use of plastic probes has been widely recommended to avoid ?
scratching of titanium components
Of the following factors, which determine(s) the abutment that the restorative dentist should select?
• soft tissue (mucosal or gingival) height
• interarch space
• implant angulation
• esthetic requirements
• all of the above
all of the above (interarch space means restorative space)
Which of the following dimensions is not part of routinely recommended space requirements for root form implants?
• a minimum of 3 mm of space between adjacent implants
• at least 2 mm of bone remaining between the implant and vital structures
• at least 1 mm of bone surrounding the implant in all dimensions
• a minimum of 16 mm of implant length for stability
• placement of the restorative platform apical to the CEJ’s of adjacent teeth
a minimum of 16 mm of implant length for stability (Implants of 10 to 14 mm length are routinely used successfully and achieve adequate primary stability)
A “polished collar,” or the smooth polished exterior surface of the implant closest to or in the oral cavity, is designed to:
• provide a location for epithelial attachment
• make the exposed surface cleansable
• keep plaque from gaining access to deeper structures
• inhibit biofilm formation
• all of the above
all of the above (Epithelium can also form an attachment on a roughened surfac)
The soft tissue interface can be ?, both seem clinically acceptable
keratinized gingiva or nonkeratinized mucosa
The interface between epithelial cells and titanium is composed of ?
hemidesmosomes and a basal lamina
A “Morse taper” is one of many designs for:
• the abutment to implant connection
• the shape of the abutment’s restorative part
• press-fit implants
• threads on a screw implant
• an implant milling machine
the abutment to implant connection (a cone-in-socket type of connection design for the fitting of the abutment into the implant)
Which of the following is NOT acceptable for cleaning of titanium surfaces, either by the patient or the dental clinician?
• powered toothbrushes
• end-tufted brushes
• plastic curettes
• conventional ultrasonic tips
• floss, especially multifilament varieties
conventional ultrasonic tips (Titanium as a metal is relatively “soft” and can be scratched on the surface fairly easily- specially designed ultrasonic tips having plastic or other softer coatings are available, and these are acceptable)
If the space available for the abutment and the crown is limited vertically, i.e., a small interarch space, which of the following abutment combinations would be least advantageous:
• cemented crown to the abutment
• screw-retained crown on the abutment
• restoration that fits to the implant with no abutment
• abutment with a ball extension for a removable prosthesis
cemented crown to the abutment
A suggested interval for implant maintenance appointments is ? for cleaning of the surfaces and inspection of the parts of the system which can become loose with function.
every 3 months
Platform switching refers to:
• replacing the implant to get a better abutment selection
• changing to a wider abutment for molar contours
• changing to a shorter abutment to hide margins
• matching a smaller diameter abutment with a wider diameter implant
• converting a round abutment to triangular
matching a smaller diameter abutment with a wider diameter implant (advantageous in terms of reducing the amount of bone remodeling and bone loss that normally occurs following placement of the abutment and the restoration on the implant.)
Dysmorphophobia ?
an extremely irrational fear of being disfigured by treatment.
Which of the following conditions is not a contraindication to dental implant placement?
• current chemotherapy for the treatment of cancer
• history of radiation therapy to the maxillofacial complex
• dysmorphophobia
• advanced patient age
advanced patient age
Which cells control all three stages of inflammation? • plasma cells • red blood cells • leukocytes • Sertoli cells
leukocytes