Quiz 16: Esthetic Risk Assessment

How many clinical factors are evaluated in the ITI Esthetic Risk Assessment table? Select the correct answer. 6 8 10 12

12

Multiple missing teeth ______ the challenge of esthetic planning. Select the correct answer. increase decrease do not change

increase

With regard to the esthetic risk factor "Infection at the Implant Site", which is low risk? none acute chronic

none

From an esthetic perspective, Camper's plane is most significant in the: Select the correct answer. sagittal view coronal view transverse view

sagittal view

Camper's plane is defined by the inferior border of the ala of the nose and the: Select the correct answer. superior aspect of the tragus of the ear inferior aspect of the tragus of the ear center of the external auditory meatus

superior aspect of the tragus of the ear

The White Esthetic Score (WES) was developed to assess: Select the correct answer. the visible part of the implant prosthesis the amount of available bone the soft tissue

the visible part of the implant prosthesis

Esthetic risk factors related to the gingival and peri-implant mucosal tissues include: Select all correct answers thin gingival phenotype triangular-shaped teeth thin facial bone plate high lip line

thin gingival phenotype triangular-shaped teeth thin facial bone plate

Dental and/or prosthesis factors that contribute to smile design include: Select all correct answers tooth axial inclinations interdental papillae levels interdental contact areas/points interincisal embrasures orientation of the dental midline with respect to the interpupillary line sagittal position of the incisors relative to Camper's plane

tooth axial inclinations interdental papillae levels interdental contact areas/points interincisal embrasures

Esthetic risk is greater with tooth crowns that are ___________ in shape. Select the correct answer. Ovoid Square Triangular

triangular

Which of the following statements define the esthetic zone? Select all correct answers The upper anterior teeth, including the upper incisors and the upper canines The upper incisor teeth and their surrounding soft tissues Any dentoalveolar segment that is visible upon full smile Any dentoalveolar area of esthetic importance to the patient

Any dentoalveolar segment that is visible upon full smile Any dentoalveolar area of esthetic importance to the patient

high

Based upon the Esthetic Risk Assessment, the lip line of this patient is __________. Select the correct answer. reversed low restricted medium high

What are the clinical characteristics of a thick periodontal phenotype (biotype)? Select all correct answers Highly scalloped papillae Broad bands of keratinized tissues Thin and friable soft tissue Prone to post-surgical scar formation

Broad bands of keratinized tissues Prone to post-surgical scar formation

ERA, defined by Buser and Martin in 2007, stands for: Select the correct answer. Esthetic Risk Assessment Esthetic Risk Analysis Esthetic Reproducibility Analysis

Esthetic Risk Assessment

Definitions of an esthetic implant-supported prosthesis should include considerations of which of the following factors? Select all correct answers Facial and perioral structures Peri-implant mucosal health Prosthesis-related factors such as tooth form, symmetry, color, and translucency The patient's occlusal scheme

Facial and perioral structures Peri-implant mucosal health Prosthesis-related factors such as tooth form, symmetry, color, and translucency

T/F: A smoking habit has little or no impact on the esthetic outcome of an implant treatment.

False

T/F: Benchmarks such as the White Esthetic Score (WES) and Pink Esthetic Score (PES) are designed as means of assessing treatment outcomes. As such, they cannot be used in planning esthetic implant-supported FDPs.

False

T/F: Horizontal bone deficiencies carry a higher level of esthetic risk when compared to vertical deficiencies.

False

T/F: In situations characterized by single missing teeth, the support for the interproximal dental papillae is related to the height of the bone crests on the implant.

False

T/F: To achieve esthetic prostheses, it is essential that the maxillary dental midline and facial midline are coincident.

False

A thin periodontal phenotype (biotype) is related to __________ esthetic risk. Select the correct answer. Low Medium High

High

Diagnostic set-up

In the clinical case shown here, which of the following investigations will be most useful in planning for an esthetic outcome? Select the correct answer. Diagnostic set-up Panoramic radiographs Digital photographs

It will increase difficulty

In the clinical case shown, the asymmetrical smile line exposes the flange on the diagnostic set-up used to plan for an implant-supported FDP. How will this affect the esthetic difficulty of this case? Select the correct answer. It will increase difficulty. It will decrease difficulty. It will not affect the difficulty of this case.

area 3

Indicate the area where an esthetic compromise is likely to occur if an implant-supported prosthesis is used to replace the missing central incisor. Select the correct answer. area 1 area 2 area 3

situation 2

Indicate the clinical situation that carries the highest level of esthetic risk with regard to the available vertical bone. Select the correct answer. situation 1 situation 2 situation 3

situation 1

Indicate the clinical situation that carries the highest level of esthetic risk with regard to the width of the edentulous span. Select the correct answer. situation 1 situation 2 situation 3

high

Indicate the level of esthetic risk associated with the shape of the tooth crowns in the clinical image. Select the correct answer. Low Moderate High

Which of the following situations are associated with reducing the quantity and quality of the bone and soft tissues at the proposed implant sites or adjacent to them? Select all correct answers Periodontal disease Dental caries Endodontic lesions Post-traumatic lesions Foreign bodies

Periodontal disease Endodontic lesions Post-traumatic lesions Foreign bodies

Health Height Volume Color Contours

Which clinical factors play a role in determining the esthetic outcome with regard to peri-implant tissue and the adjacent teeth? Select all correct answers Health Height Volume Color Contours

image 2

Which of the two images depicts a thin periodontal phenotype? Select the correct answer. image 1 image 2

7 mm

With regard to bone levels on adjacent teeth, which distance from the interproximal bone crest to the contact point results in a high level of esthetic risk? Select the correct answer. 4 mm 5 mm 6 mm 7 mm

With regard to the esthetic risk factor "Infection at the Implant Site", which is high risk? none acute chronic

acute

With regard to the esthetic risk factor "Infection at the Implant Site", which is medium risk? none acute chronic

chronic

To obtain an esthetically acceptable result, a patient may need both hard and soft tissue augmentation. To ensure informed consent, the patient must be informed about treatment _____________. Select all correct answers complexity duration cost

complexity duration cost

From an esthetic perspective, the smile line is most significant in the: Select the correct answer. sagittal view coronal view transverse view

coronal view

Prior to the initiation of therapy, the patient's wishes should be reviewed. The discussion on the rehabilitation should focus on three aspects: form, function and ________ as reported by Garber et al. in 1995. Select the correct answer. tooth shape tooth shade esthetics available bone soft tissue health

esthetics

Facial and perioral factors that contribute to smile design include: Select all correct answers facial and dental midlines that coincide or are parallel a dental midline that is perpendicular to the interpupillary line and the smile line central incisor incisal edges that are parallel to the interpupillary line and the smile line mucosal margin zeniths that are positioned appropriately for the tooth/teeth being replaced

facial and dental midlines that coincide or are parallel a dental midline that is perpendicular to the interpupillary line and the smile line central incisor incisal edges that are parallel to the interpupillary line and the smile line

The ______ smile line is the most difficult esthetic prosthodontic challenge and will always increase the complexity of treatment procedures involving implant-supported FDPs visible in the smile. Select the correct answer. high medium low

high

T/F: A prosthodontically driven approach should be used when planning hard and soft tissue augmentation to address esthetically significant contour deficiencies.

True

T/F: An esthetic assessment should consider the exposure of teeth when the lips are at rest and at full smile.

True

T/F: For esthetic balance, the interpupillary line and smile line should be parallel.

True

T/F: Horizontal bone deficiencies carry a lower level of esthetic risk when compared to vertical deficiencies.

True

T/F: Parafunctional habits such as bruxism can increase the risk of mechanical and technical complications of the implants and the prosthesis if not addressed.

True

T/F: Patients presenting with tissue deficiencies and high and/or asymmetric lip and smile lines may prove impossible to satisfy esthetically via fixed prostheses.

True

T/F: Patients who exhibit a medium lip line typically display most of their teeth and only very little, if any, of the supporting periodontal structures.

True

T/F: Patients who have a history of refractive periodontitis have an increased risk of a negative esthetic outcome.

True

T/F: Patients who report a history of an infection at or adjacent to the implant site have a greater risk of achieving a suboptimal esthetic outcome.

True

T/F: Since the esthetic outcome is strongly influenced by the final gingival architecture, the risk can be reduced in the presence of rectangular teeth.

True

T/F: Smile design principles use the shape of the face as a basis for tooth form design and tooth mould selection.

True

T/F: Soft-tissue deficiencies can be recognized when the tooth to be replaced is present by evaluating the position of the gingival margins on the tooth in question in relation to the adjacent teeth.

True

T/F: The addition of a pink porcelain component to an implant-supported prosthesis is an acceptable solution to a clinical situation where there is a significant hard and/or soft tissue contour deficiency.

True

T/F: The aim of smile design is to create harmony between facial and dental lines.

True

T/F: The risk of a sub-optimal esthetic outcome increases in proportion to the degree of vertical bone loss at the adjacent teeth.

True

T/F: Utilizing the Esthetic Risk Assessment prior to the initiation of implant therapy will assist the treatment team in identifying patients who carry a high risk of a negative esthetic outcome.

True

T/F: When examining the available soft tissue in an area that will receive a dental implant, the esthetic risk is elevated when there is a tissue deficiency.

True

T/F: When it is not possible or appropriate for the implant prosthesis to mimic the contralateral tooth, the clinician should instead seek to create esthetic harmony.

True

The width of the edentulous span is a significant esthetic risk factor. The highest risk category in the ERA is related to an edentulous span of: Select the correct answer. One tooth (>7mm). One tooth (<7mm). Two or more teeth.

Two or more teeth.

T/F: Utilizing the Esthetic Risk Assessment during the consultation phase of implant therapy will allow the treatment team to identify the esthetic risk of the proposed treatment. It allows the team to advise the patient on the likelihood of achieving an optimal esthetic result based upon the clinical findings.

True

Which of the following factors may impact on the esthetic risk of an implant treatment? Select all correct answers The patient's medical history The patient's esthetic expectations The patient's gingival phenotype The patient's smoking habit

The patient's medical history The patient's esthetic expectations The patient's gingival phenotype The patient's smoking habit

A conventional RDP with a flange

Achieving an acceptable esthetic result can be challenging when there are large defects in the hard and soft tissue contours, as demonstrated in this case. Which of the following treatment options is most likely to achieve an acceptable result in this case? Select the correct answer. Three individual implant-supported crowns A conventional RDP with a flange A five-unit conventional fixed dental prosthesis supported by the adjacent teeth

True

T/F: An esthetic implant-supported prosthesis is one that is in harmony with the dentofacial structures of the patient.

True

T/F: For an optimal esthetic outcome, the prosthesis should imitate the natural appearance of the missing dental unit(s) in color, form, texture, size, and optical properties.

False

T/F: Patients who smoke more than 10 cigarettes per day are the only patients at risk for surgical complications.

When a significant vertical discrepancy of the alveolar crest is present, an entirely tooth-colored prosthesis will result in ____________. Select the correct answer. very long teeth rather short teeth teeth with large diastemas

very long teeth