Quiz 9(a. b. & c.): Structured Assessment and Treatment Planning, Occlusion on Fixed Implant, Implant Configuration on Fixed Implant Prostheses Prosthesis
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In general, how many implants are required for replacement of 4 missing teeth in the posterior mandible with implant supported fixed dental prostheses? Select all correct answers 1 2 3 4
2 3
T/F: A reduced-diameter implant is always the most suitable solution for a single tooth space.
False
T/F: A structured patient assessment is only indicated for difficult or complex cases.
False
T/F: A wide-diameter implant is never suitable for a single tooth space.
False
T/F: At least 8 implants are needed to allow segmented prostheses in a full-arch restoration of an edentulous mandible.
False
T/F: During parafunctional activity, occlusal force is always the same.
False
T/F: Implant fracture is a frequent complication.
False
T/F: It is recommended that an implant-supported cantilever FDP (fixed dental prosthesis) be cement-retained.
False
T/F: Occlusal overload has been proven to prevent osseointegration.
False
T/F: Presenting one treatment option (treatment plan) to the patient is usually sufficient.
False
T/F: There is always conscious, protective feedback from teeth - even during sleep.
False
T/F: Reduced-diameter implants have unlimited indications.
False (limited)
Add complexity to maintaining recommended distances between implants
In the case illustrated below, replacement of the 4 posterior teeth in the maxilla with 4 implants and single-unit fixed dental prostheses will : Select the correct answer. Add complexity to maintaining recommended distances between implants Reduce overall cost Avoid anatomical limitations Avoid splinting of implants placed in grafted sites
just pull through
In the clinical situation pictured, shimstock should _________ between (3) 16 and (30) 46 when the patient bites together with light force. Select the correct answer. hold just pull through pull through easily
pull through easily
In the clinical situation pictured, shimstock should _________ between (3) 16 and (30) 46 when the patient bites together with light force. Select the correct answer. hold just pull through pull through easily
hold
In the clinical situation pictured, shimstock should _________ between 16 and 46 when the patient bites together with light force. Select the correct answer. hold just pull through pull through easily
16 (3)
Indicate which site shows the recommended contact positions for implant prostheses Select the correct answer. 16 (3) 26 (14)
24 (28)
Indicate which site shows the recommended contact positions for implant prostheses Select the correct answer. 24 (28) 25 (29)
An advantage of an anterior implant-supported FDP (fixed dental prosthesis) with a cantilever is: Select the correct answer. It is a segmented restoration It allows for the use of pink ceramic to replace the missing papilla There is no lever arm
It allows for the use of pink ceramic to replace the missing papilla
area 3
Which of the indicated areas at the planned upper right lateral incisor will most likely have a negative effect on the esthetic outcome? Select the correct answer. area 1 area 2 area 3
Occlusal guidelines are based on ______ concept of occlusion. Select the correct answer. an evidence-based a consensus opinion and empirical experience an implant-specific evidence-based
a consensus opinion and empirical experience
Design options for implant-supported fixed dental prostheses (FDPs) in an edentulous arch include: Select all correct answers single-unit prostheses Three or four short-span fixed dental prostheses (FDPs) A full-arch one-piece FDP A full-arch one-piece cantilever FDP
Three or four short-span fixed dental prostheses (FDPs) A full-arch one-piece FDP A full-arch one-piece cantilever FDP
T/F: 8 implants will allow segmented prostheses in a full-arch restoration of an edentulous maxilla.
True
T/F: A health history questionnaire is an important part of a structured patient assessment.
True
T/F: A one-piece implant design has an built-in prosthetic platform.
True
T/F: A patient's social history may reveal that an implant-supported overdenture is the best possible treatment option.
True
T/F: A structured assessment helps to avoid the possibility of missing relevant information.
True
T/F: A structured patient assessment is the basis for the best possible treatment.
True
T/F: A two-piece implant offers more prosthetic flexibility.
True
T/F: Complete medico-legal documentation is important for insurance purposes and legal concerns.
True
T/F: Identification of all existing oral pathology is an important part of any assessment process.
True
T/F: Implants, osseointegration, crestal bone levels, and implant components seem to withstand occlusal forces associated with normal function.
True
T/F: It is important to identify periodontal disease prior to implant placement as it is a risk factor in implant therapy.
True
T/F: Narrow diameter implants are available in stronger implant body alloys.
True
T/F: Obtaining informed patient consent is an important goal of a structured assessment and treatment planning process.
True
T/F: Occlusal feedback from implants is less than for teeth but more than from complete dentures.
True
T/F: Occlusal feedback from teeth arises from mechanoreceptors in the periodontal ligament.
True
T/F: Occlusal force varies.
True
T/F: Occlusal forces can present a risk to osseointegration.
True
T/F: Occlusal overload, in combination with peri-implant inflammation, may be detrimental to crestal bone levels.
True
T/F: Patient records can be in paper or digital form.
True
T/F: Patients should always be given different options for treatment of a dental problem.
True
T/F: Structured treatment planning is an organized and methodical approach to providing patients with different treatment options to address their needs.
True
T/F: The emergence profile on a two-piece implant design is established by the abutment.
True
T/F: The risk of technical complications affecting implant prostheses is significantly higher than that for teeth.
True
T/F: When 4 missing teeth are replaced in the anterior region, the appropriate number of implants are selected and placed according to prosthodontic planning.
True
T/F: When selecting the most suitable implant for a single tooth space, the implant diameter needs to be considered.
True
Compromised outcome
What does the image below represent (implant crown upper right lateral incisor)? Select the correct answer. Optimal outcome Compromised outcome Unacceptable outcome
Optimal outcome
What does the image below represent (implant crown upper right lateral incisor)? Select the correct answer. Optimal outcome Compromised outcome Unacceptable outcome
A structured treatment planning process should Select all correct answers include more than one treatment alternative. respect the patient's chief complaint and expectations. respect the patient's financial capabilities. recognize systemic risk factors.
include more than one treatment alternative. respect the patient's chief complaint and expectations. respect the patient's financial capabilities. recognize systemic risk factors.
The advantages of structured treatment planning include: Select all correct answers inclusion of different treatment options (and their cost) on the basis of a structured patient assessment. treatment planning is in line with the patient's chief complaint and expectations. informed patient consent and co-operation. complete medico-legal documentation. avoiding missing important diagnostic information.
inclusion of different treatment options (and their cost) on the basis of a structured patient assessment. treatment planning is in line with the patient's chief complaint and expectations. informed patient consent and co-operation. complete medico-legal documentation.
Occlusal feedback from implant prostheses is thought to arise from mechanoreceptors in Select all correct answers jaw joints. peri-oral musculature. periodontal ligaments.
jaw joints. peri-oral musculature.
Dynamic occlusion is when the Select the correct answer. teeth are apart. maxillary and mandibular teeth move against one another. teeth come together in static maximum contact.
maxillary and mandibular teeth move against one another.
Occlusal risk assessment using the ITI SAC Classification includes evaluation of: Select all correct answers occlusal scheme the number of implants the presence of cantilevers involvement of implant prostheses in occlusion occlusal parafunction
occlusal scheme involvement of implant prostheses in occlusion occlusal parafunction
Match the statements: Occlusal implant design requires
ongoing monitoring and maintenance
Structured patient assessment is a/an __________________ approach to obtaining a patient's medical, dental and social history and to comprehensively examining a patient. Select the correct answer. occasionally useful time consuming and unnecessary idealistic organized and methodical
organized and methodical
To allow for segmented FDPs (fixed dental prostheses) in the edentulous ridge, the implants are placed according to Select the correct answer. prosthodontic planning bone volume tooth volume surgeon's preference
prosthodontic planning
The indications for placing 1 implant with a cantilever FDP (fixed dental prosthesis) to replace 2 adjacent missing teeth in the posterior area include: Select all correct answers reduced mesiodistal space avoiding bone augmentation reduced coronoapical space for prosthesis
reduced mesiodistal space avoiding bone augmentation
Match the statements: Designing implant prostheses to limit the risk of complications from occlusal factors requires
specific attention to the intensity and pattern of static and functional contacts
Match the statements: A diagnosis of bruxism requires
specific implant and occlusal considerations
The prerequisite(s) for placing 2 neighboring implants in a short edentulous space (2 missing teeth) are Select all correct answers sufficient mucosal thickness sufficient mesiodistal space sufficient interimplant distance sufficient tooth-implant distance
sufficient mesiodistal space sufficient interimplant distance sufficient tooth-implant distance
Match the statements: For anterior guidance in dynamic occlusion
use adjacent teeth where possible for their proprioceptive feedback.
The design of an occlusal fossa on an implant prostheses should be ______ Select the correct answer. narrow. wider. steep.
wider
Regardless of implant type, the recommended minimal distance between a tooth and an implant is ______. Select the correct answer. < 1.0 mm ≥ 1.5 mm ≥ 3.0 mm
≥ 1.5 mm
To restore 3 missing teeth in the posterior region, the following restoration designs are possible: Select all correct answers 2 implants with a 3-unit FDP (fixed dental prosthesis) 3 short implants with single crowns 1 implant restored with an FDP incorporating a 2-unit cantilever 2 implants restored with an FDP incorporating a 1-unit cantilever
2 implants with a 3-unit FDP (fixed dental prosthesis) 3 short implants with single crowns 2 implants restored with an FDP incorporating a 1-unit cantilever
When the mesiodistal width is reduced in a short edentulous space (2 missing teeth), you should consider the following: Select all correct answers 2 reduced-diameter implants restored with splinted crowns a single implant with a cantilever fixed dental prosthesis (FDP) distraction osteogenesis a wide-diameter implant
2 reduced-diameter implants restored with splinted crowns a single implant with a cantilever fixed dental prosthesis (FDP)
The axial movement of a tooth is in the range of: Select the correct answer. 3 to 5 µm 10 to 50 µm 25 to 100 µm 56 to 108 µm 100 to 200 µm
25 to 100 µm
Regardless of implant type the recommended minimal distance between 2 adjacent implants is ______. Select the correct answer. 1.0 mm 1.5 mm 3.0 mm
3.0 mm
The technical complication rate of implant restorations is close to ______ over 5 years. Select the correct answer. 0% 5% 15% 25% 40%
40%
A one-piece implant design has the following characteristics: Select all correct answers A built-in prosthetic platform A built-in emergence profile Flexibility in sites with limited space The option of using a tooth-colored abutment close to bone level
A built-in prosthetic platform A built-in emergence profile
If only 4 implants can be placed in an edentulous ridge to support a fixed dental prosthesis, the prosthodontic design options include: Select all correct answers A shortened dental arch prosthesis Segmented prostheses A prosthesis with cantilevers
A shortened dental arch prosthesis A prosthesis with cantilevers
The advantages of a structured patient assessment include: Select all correct answers Avoiding missing relevant information Obtaining the patient's informed consent Recognizing potential systemic or local contraindications Recognizing risk factors Ensuring that all treatment options are discussed
Avoiding missing relevant information Recognizing potential systemic or local contraindications Recognizing risk factors
The components of a structured patient assessment are best sequenced in what order: Anamnesis/History Image Assessment Examination Additional Investigations Risk Assessment
Anamnesis/History Examination Image Assessment Additional Investigations Risk Assessment
Put the statements in the correct order: Respect the minimal distances between two implants and between an implant and a tooth Assess the width of the space Select the appropriate implant diameter
Assess the width of the space Respect the minimal distances between two implants and between an implant and a tooth Select the appropriate implant diameter
Indicate the preferred implant sites for a full-arch one-piece FDP (fixed dental prosthesis) with 6 implants in the edentulous mandible. Select all correct answers Central incisors Lateral incisors Canines First premolar Second premolar First molar Second molar
Canines First premolar First molar
Indicate the preferred implant sites for a full-arch one-piece FDP with 6 implants in the edentulous maxilla. Select all correct answers Canines or lateral incisors First premolars Second premolars First molar Second molar
Canines or lateral incisors First premolars First molar
In the presence of bruxism the following specific recommendations apply: Select all correct answers Choice of loading protocol is not relevant. Consider screw-retained design for retrievability. Use shorter implants. Use a protective splint. Avoid splinting implants.
Consider screw-retained design for retrievability. Use a protective splint
The goals of a structured treatment plan include: Select all correct answers Consideration of the evidence-based benefits/risks of treatment options Ensuring patients receive adequate information Obtaining Informed consent to treatment from the patient Finding the most expensive treatment option
Consideration of the evidence-based benefits/risks of treatment options Ensuring patients receive adequate information Obtaining Informed consent to treatment from the patient
Which of the following are part of an anamnesis: Select all correct answers Patient's social history Patient's medical history Patient's dental history Patient's gender and ethnicity
Patient's social history Patient's medical history Patient's dental history Patient's gender and ethnicity
What radiographs may be needed as part of a structured assessment of a patient for implant therapy? Select all correct answers Periapical Panoramic Computer tomograms True occlusal
Periapical Panoramic computer tomograms
Indicate the correct sequence in planning for implant prostheses: Select the number of implants Select the position of implants Prosthodontic planning
Prosthodontic planning Select the number of implants Select the position of implants
A two-piece implant design has the following characteristics: Select all correct answers Relative flexibility of the dimensions of the prosthodontic platform The option of an individual emergence profile Relative flexibility in sites with small dimensions The option of using a tooth-colored abutment closer to bone level A fixed neck design and prosthodontic platform
Relative flexibility of the dimensions of the prosthodontic platform The option of an individual emergence profile Relative flexibility in sites with small dimensions The option of using a tooth-colored abutment closer to bone level
True
T/F: According to the radiographic image below, an implant in the edentulous space appears to be contraindicated.
False
T/F: Implant-supported fixed dental prostheses in edentulous posterior areas should include replacements for all missing teeth up to, and including, second molars.
an implant-supported restoration a resin-bonded restoration. a conventional fixed dental prosthesis. a removable partial dental prosthesis.
The illustrated missing central incisor can be replaced in more than one way. Treatment options include Select all correct answers an implant-supported restoration a resin-bonded restoration. a conventional fixed dental prosthesis. a removable partial dental prosthesis.
Occlusal risk assessment for implant therapy includes: Select all correct answers choice of loading protocol accurate and complete information about the entire occlusion high-quality dental casts and accurate recording of occlusal relationship evaluation of occlusal case complexity using ITI SAC Classification occlusal equilibration of the remaining dentition
accurate and complete information about the entire occlusion high-quality dental casts and accurate recording of occlusal relationship evaluation of occlusal case complexity using ITI SAC Classification
In a clinical stuation where all 4 maxillary incisors are missing, which implant-supported FDP (fixed dental prosthesis) design options can be recommended? Select all correct answers 4 implant-supported single crowns an FDP with pontics an FDP with cantilevers an FDP with a pontic and a cantilever
an FDP with pontics an FDP with cantilevers an FDP with a pontic and a cantilever
Match the statements: Non-working side contacts
are on the opposite side to the side the mandible is moving towards in excursion
Match the statements: Working side contacts
are on the side the mandible is moving towards in excursion
Match the statements: For posterior implant restorations in dynamic occlusion
avoid lateral working and non-working contacts
The literature suggests that occlusal design for implant prostheses should include: Select all correct answers axial loading through centered contacts steeper cusps for reduced horizontal freedom simultaneous light contact for teeth and implants the use of adjacent teeth for guidance where possible avoidance of lateral working and non-working side contacts on posterior implant restorations
axial loading through centered contacts the use of adjacent teeth for guidance where possible avoidance of lateral working and non-working side contacts on posterior implant restorations
Occlusal forces during parafunction Select the correct answer. are in a physiological range. can reach considerable magnitude and duration. can lead to risk of disuse and loss of bone mass.
can reach considerable magnitude and duration.
Match the statements: Occlusal design and construction requires
complete and accurate dental casts and records
Match the statements: Mechanical complications refer to
complications involving implant components
Match the statements: Technical complications refer to
complications involving the implant prostheses
When designing the occlusion on posterior implant prostheses, cuspal inclines should be ______ Select the correct answer. steep. flattened. of no consequence.
flattened.
