Implantology questions

1- In cases of severe bleeding and lingual hematoma during the placement of the
implant in the lower incisor region, which artery do you think is injured:
a- submental
b- sublingual
c- inferior labial
d- transverse facial
e- mental

2- The path of the inferior dental canal inside the mandible is not straight and
deviates from the lingual to the buccal in the area of:
a- third molar tooth
b- second molar tooth
c- second premolar tooth
d- first molar tooth
e- none of the above

3- Implant placed in front of the mental foramen should be 6 mm from the foramen
to prevent the encroachment of:
a- mental foramen
b- submental artery
c- anterior loop of the inferior dental nerve
d- incisive canal
e- b&c

1
4- Severe bleeding and lingual hematoma that occur during implant placement in
the lower premolar area can be caused by severing the artery of:
a- lingual
b- submental artery
c- inferior alveolar artery
d- long buccal
e- none of the above

5- At an early age, the mandible blood supply is central, but over time, the blood
supply becomes peripheral:
a- inferior alveolar artery
b- lingual artery
c- endosteum
d- periosteum and attached muscle
e- mucosa

6- The anterior loop of an inferior dental nerve can be predicted when the nerve
comes:
a- above the mental foramen
b- below the mental foramen
c- above the mental foramen
d- same level with the mental foramen
e- disappear before the mental foramen

2
7- Dentoalveolar innervation and the periodontal ligament area of the innervation
are:
a- nerve endings with nociceptors
b- sympathetic
c- parasympathetic
d- nerve endings with mechanoreceptors
e- a&b

8-- The lateral wall of the maxillary sinus hosts the superior alveolar canal:
a- branches of the posterior superior alveolar and infraorbital arteries
b- branches of posterior and middle superior alveolar arteries
c- branches of posterior superior alveolar arteries only
d- branches of middle superior and infraorbital arteries
e- branches of posterior superior and greater palatine artery

9- The sensory innervation of the skin and mucous membranes of the lower lip:
a- mental nerve
b- incisive nerve
c- buccal branch of the facial nerve
d- long buccal
e- b&c

10- Regarding the temporomandibular joint articular disc, during mouth closure,
the anterior part of the disc is located:
A-just anterior to the condyle
b- along the articular eminence

3
c- superior to the condyle
d- along the articular tubercle
e- none of the above

11- Bone resorption is not a direct process, which means:

a- bone matrix attack before hydroxyapatite crystal
b- osteoclast get signals from the macrophage
c- osteoclast activated from the osteoblast
d- always there is external stimulation to start the resorption process
e- all of the above

12-Bone heating up to ____________________ for 1 minute is sufficient to impair

bone formation:
a- 32 ̊C
b- 37 ̊C
c- 44 ̊C
d- 47 ̊C
e- none of the above

13- To decrease the rate of implant failure, the required time interval between
radiotherapy and implant placement should be longer than:
a- 4 months
b- 6 months
c- 24 months
d- 3 months
e- none of the above

4
14-Osteogenesis can be defined as:
a- Process by which viable osteoblasts and precursor cells establish regions of bone
formation
b- Material surfaces act as scaffold for vascular ingrowth, cellular attachment, and
osteogenesis
c- Process of transformation of recruited precursor cells into osteoblastic cells
d- Directing bone formation at local osseous sites using membrane barrier
techniques

15- Osteoconduction can be defined as:

a- Process by which viable osteoblasts and precursor cells establish regions of bone
formation
b- Material surfaces act as scaffold for vascular ingrowth, cellular attachment, and
osteogenesis
c- Process of transformation of recruited precursor cells into osteoblastic cells
d- Directing bone formation at local osseous sites using membrane barrier
techniques
e- none of the above

16- Osteoinduction can be defined as:

a- Process by which viable osteoblasts and precursor cells establish regions of bone
formation
b- Material surfaces act as scaffold for vascular ingrowth, cellular attachment, and
osteogenesis
c- Process of transformation of recruited precursor cells into osteoblastic cells
d- Directing bone formation at local osseous sites using membrane barrier
techniques

5
17- Bone morphogenetic protein is one growth factor in a bone matrix that comes
from and has functions of:
A-osteoblast or bone matrix and act as osteoinductive, regulates osteogenesis
b- platelets/serum (osteoblast) and act as mitogenic
c-endothelial cells/bone matrix and act as mitogenic, angiogenic
d- osteoblast or bone matrix and act as regulates osteogenesis

18- Hydroxyapatite (HA) activity of the coated implant is considered:

a- osteoconductive
b- osteoinductive
c- osteogenesis
d- none of the above

19- The main biological difference between implants and natural teeth is:
a- periodontal ligament
b- vascular blood supply
c- connective tissue
d- junctional epithelium
e- all of the above

20- Cigarette and pipe smoking have adverse effects on wound healing and
integrity. All of the following are true except:
a- decrease tissue perfusion and oxygen delivery
B-create intraoral positive pressure causing a deleterious effect on wound healing
c- cause delayed wound healing and peri- implant infection
d- impaired gingival bleeding
e- increase oral cavity temperature

6
21- The difficulty with the peri- apical radiograph technique for implant
registration is:
a- periapical region does not show
b- parallelism
c- elongation
D-cone cut
E- a & b

22- In panoramic radiographs, the normal anatomy shadow can be divided into real
and ghost shadows. The ghost shadow is:
a- orbital rim
b- nasal septum and
c- cervical vertebrae
d- zygomatic arch
e- floor of the antrum

23- After tooth extraction, alveolar bone resorption will be:

a- Not affected
b- Increased progressively towards the apical level
c- Same rate at the apical and coronal level
D-decreased progressively towards the apical level
e- none of the above

24- When an implant is placed in the mandibular posterior area, the distance from
the inferior alveolar nerve should be 2 mm because:
a- mandibular jaw angulation make the nerve nearer to the crest
b- the apex of the drill (1.5) not estimated in most implant system

7
c- anatomical variation
d- allow the implant to be placed with angulation
e- a&c

25- The disadvantage of a tooth- supported surgical stent in a single anterior

implant is:
a- not stable enough
b- no sufficient space for the drills
c- difficult to determine the drilling depth
D-obscure the adjacent anatomical teeth structures
e- b&c

26- During a socket preservation procedure, the following should be considered:

a- no active infection
b- graft should be placed with layering
c- no condensation should be done to the graft material
d-no over grafting
e- all of the above

27- The main cause of cover screw exposure during the healing period is:
a- implant placed more buccally
b- crestal bone resorption
c- infection
d- thin gingival tissue
e- a&c

8
28- To increase the primary stability of an implant placed in soft bone, which of
the following should be considered:
a- undersize drilling
b- wide diameter implant
c- subcrestal placement implant
d- deep threaded implant, with the thread until the top
e- all of the above

29- To gain ridge width in the lower posterior area with minimum vertical bone
resorption, all of the following procedures can be performed except:
a- bone height reduction
b- later bone augmentation
c- ridge splitting
d- nerve lateralisation

30- Factors that can prevent placement of the implant in an ideal position include:
a- bone quality
b- anatomical factor
c- occlussion factor
d- implant position in the arch
e- none of the above

31- To avoid bone overheating during drilling, the following should be considered:
a- use internal irrigation
b- use sharp drills
c- incremental drilling procedure with increasing diameter drills

9
d- continuous drilling
e- b&c

32- Generally, the final bone preparation socket diameter is slightly smaller than
the implant diameter because:
a- 1mm
b- 0mm (same diameter)
c- 0.6mm
d- 0.2mm
e- none of the above

33- Implants placed in the mandible are exposed and loaded earlier than those in
the maxilla (approximately 3 months vs. 6 months) because:
a- poor bone quality of the maxilla
b- high bone density on the mandible
c- mandibular implant engage with more cortical bone that give more support
d- bone implant contact on the mandible is higher than the maxilla
e- all of the above

34- Placing an implant in soft bone is usually associate with an increased failure
rate. To reduce implant failure, which of the following should be considered:
a- increase implant length and width
b- increase the number of the implant
c- cantilevers should be omitted
d- reduce implant crown height and width
e- all of the above

10
35- A late implant failure usually occurs because of mechanical problems or an
overloaded implant. The best management approach in this case is:
a- trephine bur used to remove the implant, followed by immediate implant
placement with long implant
d- trephine bur used to remove the implant, followed by complete closure of the
soft tissue, fixed or removable prosthesis fabricate instead of implant after soft
tissue healing
c- trephine bur used to remove the implant, followed by bone grafting with GBR
procedure, late implant placement after bone grafting healing
d- trephine bur used to remove the implant, followed by immediate implant
placement with wide diameter implant
e- none of the above

36- Xenograft/alloplast graft material is typically:

a- osteoconductive
b- osteoinductive
c- osteogenesis
d- angiogenesis
e- none of the above

37- The disadvantages of xenografts include all of the following except:

a- increased risk of a host- immune response
b- high vertical and horizontal bone resorption when used as socket preservation
c- brittleness and easy migration
d- low resorption rate
e- need to mix to autogenous bone to regenerate bone

11
38- The disadvantages of resorbable membranes include all of the following
except:
a- fast resorption when exposed to the oral cavity
b- lack space- making ability
c- polymer membrane creates an acid environment during degradation which can
have a negative effect on bone formation
d- cross- linking membrane enhance sever inflammation
e- some types with faster degradation before healing

39- The resorption rate of allograft bone particles depends on:

a- particle size
b- shape of the particles
c- particle porosity
d- mineralization of the bone graft
e- all of the above

40- The limitation of preoperative ridge mapping is:

a- overestimate the bone width in thick mucosa site
b- underestimation of bone width when the area is totally cancellous bone
c- not enable accurate determination of bone levels in the anterior maxilla
(irregular bone
resorption/remodelling in this region)
d- not single assessment method, still need for radiograph
e- all of the above

12
41- The recommended thickness of free gingival grafts is:
a- 0.5- 1mm
b- 1- 2 mm
c- 2- 3mm
d- 3- 4mm
e- none of the above

42- From a surgical point of view, lower second molar implant placement is
difficult because of all of the following except:
a- limited access
b- inferior alveolar canal is near the alveolar crest at this area c- less dense bone
d- narrow occlusal table crown
e- high stress during occlusion

43- Vertical ridge augmentation is an unpredictable procedure because:

a- limited amount of bone growing in vertical direction with long healing period
b- difficulty in the soft tissue closure of the augmented site
c- special skill and material needed to create the vertical space
d- autogenous bone is needed in this procedure, means second surgical site
e- all of the above

44- Bone volume loss would be faster after tooth extraction in:
a- posterior of the mandible
b- posterior of the maxilla
c- anterior mandible
d- anterior of the maxilla
e- none of the above

13
45- The iliac crest is frequently used as a bone graft donor site for major jaw
reconstruction procedures. All of the following are true about this procedure
except:
a- there is a significant resorption of the bone graft
b- iliac bone has same histological origin of jaw bone (membranous)
c- altered ambulation
d- need for hospitalization
e- large volume of bone graft can be obtained

46- Factors that determine the fullness of the dental papillae in the embrasure area
include:
a- abutment design
b- implant diameter
c- hemidesmosomes attachment
d- the distance between the crestal bone and the crown contact area
e- all of the above

47- For a maxillary overdenture implant prosthesis, the minimum interarch space
is:
a- 14mm
b- 12mm
c- 10mm
d- 20mm
e- none of the above

14
48- The most common complication of a single- crown implant is:
a- implant fixture fracture
b- abutment screw fracture
c- progressive crestal bone resorption
d- abutment screw loosening
e- b&c

49- Immediate loading of an interforamina implant placed in the lower edentulous

is common, but the following should be considered:
a- implants should be connected together
b- achieve good primary implant stability
c- implant placed in dense bone
d- cantilever should minimized or eliminated
e- all of the above

50- A poor fit between the framework and the implant has been shown to cause
mechanical and biological complications, including:
a- loosening of the framework prosthetic and abutment screws b- marginal bone
loss
c- fracture of the various prosthetic components
d- pain and tenderness
e- all of the above

15
 Answers

Q1
b- sublingual

Q2
d- first molar tooth

Q3
c- anterior loop of the inferior dental nerve

Q4
b- submental artery

Q5
d- periosteum and attached muscle

Q6
b- below the mental foramen

Q7
c- parasympathetic

Q8
a- branches of the posterior superior alveolar and infraorbital arteries

16
Q9
A-mental nerve

Q10
A-just anterior to the condyle

Q11
c-osteoclast activated from the osteoblast

Q12
D- 47 ̊C

Q13
c- 24 months

Q14
a- Process by which viable osteoblasts and precursor cells establish regions of bone
formation

Q15
b- Material surfaces act as scaffold for vascular ingrowth, cellular attachment, and
osteogenesis

Q16
c- Process of transformation of recruited precursor cells into osteoblastic cells

17
Q17
a- Osteoblast or bone matrix and act as osteoinductive, regulates osteogenesis

Q18
A-osteoconductive

Q19
e- all of the above

Q20
B-create intraoral positive pressure causing a deleterious effect on wound healing

Q21
e- a & b (implant placed below tooth apex, located beyond muscle attachment)

Q22
c- cervical vertebrae

Q23
d- decreased progressively towards the apical level

Q24
b- the apex of the drill (1.5) not estimated in most implant system

Q25
d- obscure the adjacent anatomical teeth structures

18
Q26
e- all of the

Q27
b- crestal bone resorption

Q28
e- all of the above

Q29
d- nerve lateralisation

Q30
b- anatomical factor

Q31
e- b&c

Q32
c- 0.6mm

Q33
e- all of the above

Q34
e- all of the above

19
Q35
c- trephine bure used to remove the implant, followed by bone grafting with GBR
procedure, late implant placement after bone grafting healing

Q36
a- osteoconductive

Q37
b- high vertical and horizontal bone resorption when used as socket preservation

Q38
a- fast resorption when exposed to the oral cavity

Q39
e- all of the above

Q40
e- all of the above

Q41
b- 1- 2mm

Q42
d- narrow occlusal table crown

Q43
e- all of the above

20
Q44
b- posterior of the maxilla

Q45
b- iliac bone has same histological origin of jaw bone (membranous)

Q46
d- the distance between the crestal bone and the crown contact area

Q47
a- 14mm

Q48
d- abutment screw loosening

Q49
e- all of the above

Q50
e- all of the above

21