1) Ramus Frame Over dentures are retained by (main forms of retention: A) ERA attachment B) O-Rings C) Lew Attachment D) Hader Attachment

2) 510K FDA approval means:

A) The device is approved by for clinical trials only B) It is a new medical device C) It is similar to previously approved medical device

3) The head of a blade should be placed:

A) Crest of Ridge B) Widest bicortical area C) Where initial pilot holes are drilled

4) The shoulder of a blade should be placed:

A) Above the ridge B) Even with the ridge C) 1mm below the ridge D) 3mm below the ridge E) 2mm below the ridge

5) A posterior implant surgery in the mandible reveals a knife-edge ridge, You

should: Pg 361

A) Perform a osteotomy to flatten the ridge B) Place lmplant lingual to ridge C) Place implant buccal to the ridge

6) Fibrous Interface is found most often with: Pg 294

A) Ceramic B) Titanium C) Titanium Alloy

7) Severely reabsorbed Mx with existing CD. What is maximum angle of implants placement in Mx in this case:

A) 45 B) 35 C) 20 D) 15

8) A patient is to undergo radiation treatment and one of his recently placed implants

is failing. You removed the falling implant and make the patient wait how long to start radiation treatment:

A) 7 days B) 10 days C) 21 days D) 45 days

9) Screw form tapping is most necessary in: Pg375

A) Anterior Mnd B) Anterior Mx C) Posterior Mnd D) Posterior Mx

10) A single Mnd implant is removed 2-3 weeks after placement due to paresthesia.

What is the minimum time to wait for replacement of implant:

A) One year B) 6 Months C) 2 Months D) 1 month?

11) Titanium alloy consists of: Pg287

A) Titanium, Aluminum & Vanadium

12) Patient has Padgets disease, the best option to restore this edentulous patient with

the typical cotton wool radiographic appearance is by: Pg61

A) Subperiosteal B) Conventional removable appliance C) 5 Root forms.

13) A Subperiosteal implant gets its support from:

A) The crest of the mandible B) External oblique ridge C) Mylohyoid Ridge D) Suspensory Ligament

14) Patient has ectodermal displasia

Autosomal disease characterized as patients having thin dry hair, dry skin, partial anodontia and conical teeth. Patients have under developed alveolar arches, decreased salivary flow

15) First cell to appear in the inflammation response is: Pg 41 Neutrophils

16) Vicryl resorbs by:

A) Hydrolysis B) Proteolysis

17) The smallest suture size is:

A) 2-0 B) 5-0 C) Vicryl D) Chromigut

18) At the uncovering stage, there is a 3mm band of attached gingival lingual to implant. Your incision should be made: Pg 393

A) Buccal to implant B) Crest of ridge over the implant C) ½ way through the band of attached gingival

19) Intraoral donor site is preferred over the iliac crest site because:

1) More mesenchmal cells and less chondrocytes 2) Less osteoclasts 3) More rapid integration 4) Denser when integrated

Intaoral donar sites are intramembranous in orgin and are denser, have less resorption, and revascularize more rapidly then endochondral grafts such as found in the iliac crest.

20) A patient has 5 symphyseal implants in molar mastication (occlusion) the middle implants is in: Pg 311

A) Compression push masses together B) tension C) shear cause sliding forces D) Tensile (Pull objects apart)

21) For a single implant, the minimum acceptable length from soft tissue to opposing

occlusion is:

(Minimum inter-ach space for a fixed restorations?) Pg 137 7 mm in posterior 8 to 10 mm in anterior 12mm+ for removable

22) What is not true about the Trigeminal nerve. It has

A) Motor to muscles of mastication B) 8 cranial nuclei

The Trigeminal nerve innervates muscles of mastication with masseteric, posterior and deep temoral, medial pterygoid and lateral pterygoid nerves.

23) Non resorbable membrane is preferred when?

A) When you cant get primary closure. B) If you can obtaim primary closure

24) The advantage of resorbable membrane is?

A) No secondary surgery

25) When you can’t get primary closure the suture of choice is? A) Buccal everted Horizontal improves flap security B) Buccal everted verticle -useful in bone regeneration procedures C) Lingual everted Horizontal D) Lingual everted Vertical

26) In osteotomy preparation

A) Serial increments of increasing drill size is less traumatic.

27) The main consideration in 2nd molar implant placement

A) Position of inferior alveolar nerve B) Position of lingual nerve

28) A blocked airway caused by perforation of lingual undercut is caused by ? A) Blood moving through facial spaces.

29) A life threatening consideration in molar implant placement Is?

A) Perforation of the lingual artery B) Facial Artery

30) An example of an osteogenic material is? Osteogenesis refers to the growth of bone from viable cells transferred within the graft. Autogenous bone is the only graft material available with osteogenic properties. The most effective form is cancellous bone which provides bone cells in the greatest concentration.

31) An example of alloplastic material is? Ceramic, composites, polymers, Alluminum Oxide, Tricalcium phosphate (Augmen, CalciResorb, Synthograf) Natural HA (Bio-Oss, Osteograft N, Interpore 200) Synthetic HA ( Calcitite, Orthomatrix HA, Osteogen, Osteograft D, LD)

Biocompatible polymers ( Bioplant HTR) Bioactive glass ceramics ( Bioglass, Biogran, Perioglas) Calcium carbonate ( Biocoral)

32) Titanium is graded by :

A) The amount of impurities Grade 4 has the most impurities and is strongest B) Compression load strength

33) Contrainindications to using gold as a prosthesis is its:

A) Electrochemical properties (galvanic shock) ? B) Cost C) Modulus of elasticity

34) A woman has been on coumadine. A good test to determine if she is a good candidate for implants Is: Pg 43

A) Partial thrombin time PTT (Intrinsic Pathway) Aspirin inhibits platelet function because it interferes with hepatic production of prothrombin by blocking the use of K vitamins

B) PT (Extrinsic Pathway) associated with Liver damage Long term antibiotics International normalized Ratio (INR) Accepted PT are 2.0 to 2.5. Coumadin is a Vit K antagonist, it interferes with synthesis of Prothrombin.

The 3 phases necessary for hemostasis involve the vessels, the platelets, and coagulation both extrinsic ( outsite blood vessels) and intrinsic (inside the blood vessels) Vascular Phase occurs immediately and corresponds to the vasoconstriction of severed arteries responding to extravascular pressure Platelet phase begins a few seconds after vessels severed . Corresponds to formation of “ Platelet Plug” Blood coagulation phase is initiated by 2 mechanisms- extrinsic ( outsite blood vessels) and intrinsic (inside the blood vessels) Platelet Count Obtained in CBC –normal 200,000 and 300,000/ml Clinical manifestations below 80,000 Bleeding Time- measures both coagulation pathways as well as platelet function and capillary function Partial Thrombin Time used to determine ability of blood to cogaulate in the blood vessel Test the intrinsic and common pathways of coagulation ( factors VII through XII ) Prothrombin Time measres the ability of the blood to coagulate outside the vessels

35) 90% of all bleeding problems can be prevented by: A) Complete blood count B) PT C) PTT D) Medical History

36) CPR compressions breaths for a single and for dual rescuer are

A) 15:2 B) 5:1

37) The best way to determine if a patient has an or-ant fistula is:

A) The nose blowing test B) Put H20 in sinus and see if patient feels anything *

38) A patient returns to the clinic 2 weeks after an implant (2 stage) was placed and presents with an imflammed implant and a fistula around the top of the implant. Other than that this patient is asymptomatic. The implantologist should suspect?

A) An infection B) A loose cover screw

39) A patient presents to the clinic 2-3 weeks post op. The x-ray is WNL and the patient is asymptomatic, bone is exposed around the implant. The Implantologist should:

A) Freshen the edges of the gingival with a scalpel and resuture. B) Let it heal by secondary intention C) Prescribe antibiotic and resuture

40) After sinus surgery, patient has inflammation and swelling and a foul taste in his mouth with discharge. Patient is on Clindamycin you should:

C) Put patient on augmentin D) Put patient on Flagyl ,cleocin E) Refer to of ENT

41) 5 minutes into procedure patient starts gasping for air. Patient has no pulse and no respiration: CPR is started and now you should:

F) Administer Solu-Cortef G) Administer sublingual nitroglycerin H) Administer sublingual Epinephrine I) Administer IM -Epinepherine

42) Which describes a transient burst of localized remodeling following the

surgical wounding of cortical bone?

D) Rapid acceleratory phenomenon

43) In severely absorbed mandible the incision should be made:

A) Buccal B) Midcrestal to crest of the ridge C) Lingual

44) With the severely resorbed mandible, long-term prognosis is better if

struts are; A) Superior to mental bundle B) Away from mental nerve bundle *

45) There are 2 questions on allergic hazardous reaction to patients taking or about to take

Erythromycin

A) Seldane may cause ventricular arrhythmias in patients taking detoconzelon.

Erythromycin has a proclivity for elevating serum levels of Digoxin theophyline and Carbamazepine

46) There are 2 questions on epinephrine and when you should not take it?

A) One patient had blood pressure that was 150/95 and I believe the correct answer is not to use epinephrine.

47) Ca # channel blockers (procardia, Cardizem, Norvasc) cause gingival hyperplasia. * 48) 40% of new bone drilled is necessary in an immediate extraction site. 49) To achieve an everted closure you should use what suture technique?

Horizontal mattress 50) Pertinacious material maybe removed by

A) Steam Autoclaving B) Pressure Autoclaving C) Radio frequency Glow discharge PG295

51) A patient with cardiac disease can best be revealed by elevated levels of which;

A) Elevated levels of LDH, SGOT, Potassium B) Elevated levels of LDH, SGOT, Sodium.

52) Which antibiotic chelates calcium and arrests bone growth. Pg 458

A) Amoxicillin B) Penicillin C) Ceflaxin D) Tetracycline

53) The radiograph that shows the most immediate information is:

A) Panorex B) PA C) Digital radiograph D) Cephalametric

54) There were two questions on the position of the head in relation to the viewing of a

Panorex and the sinuses.

52) During the immediate placement of an implant, when the osteotmy extents into the sinus, the best long term prognosis in this case is:

A) You can maintain the integrity of the sinus membrane B) Add graft material

53) If the implant dentist wants to prophylactilly premeditates the patient he

should put the patient on:

One hour before procedure and no more than 24 hour after the surgery. 54) First leukocyte to the inflammation Site Is:

A) Neutrophil

55) One of the phases of wound healing is:

A) Inflammation ( the other are Maturation & Proliferation) Inflammation day 1-10 Platelet aggregation and activation. Clotting cascade activation, cytokine release, nonspecific cellular inflammatory response, Macrophage-mediated inflammation

B) Proliferation day 2-42 Neovascularization. Differentiation, proliferation, and activation of cells C) Maturation after day 21 connective tissue remodeling

56) The type of bacteria in the depth of the sulcus (pocket around an implant) are:

A) None motile rods, Strep Sanguis (Same as natural tooth) 57) The most important factor in the success of an implant: Quality of Bone 58) Beam’s Law dictates, flexure is calculated by:

A) Exponentially B) Linearly C) Variably D) Log linearly

59) Contraindications to implant surgery are Patients with:

A) Uncontrolled Diabetes Mellitus, Leucemia, Multiple Myeloma, Recent MI, CONNECTIVE TISSUE DISORDERS

60) To reduced shear forces use:

A) Square Screw Implant (Thread pattern) B) V-Screw Implant C) Round Implant

61) Patient has a white lesion on Buccal mucosa and white lacey pattern to it and it can’t be scraped off: Lichen Planus 62) To reduce lateral forces at the bone-implant surface: Pg 622

A) Place parallel implants B) Place staggered implants

More Implants Wider Implants

Splint Teeth 63) A patient comes in for a mid treatment check up & radiograph revels 30% of bone loss around top of implant, treatment:

A) Debride , irrigate & graft 64) For a single tooth implant replacing #8, the osteotomy should be placed:

A) In line with Incisal edge of #9 B) In line with the cingulum of #9 C) Forward to #9

65) On the vertical-horizontal aspect of reabsorbing Mand and Max and their relationship as they reabsorb are the crest of the ridge getting?

A) Wider B) Narrower C) Mx wider & Mand narrower D) Mand wider & Max narrower

66) The best impression material for making an implant supported overdenture is:

A) Polyethylene B) Poly Vinyl Siloxane C) Add-red silicone D) Alginate

67) Bone D1 has a module of elasticity most similar to: Pg 278

A) Ceramic Carbon B) Titanium C) Titanium Alloy D) Surgical Steel

68) Woven bone grows @ what rate in the Symph ysis:

A) 10-15 um/day B) 30-50 um/day C) 60-75 um/day D) 100-115 um/day

69) What is the optimal RPM for bone tapping;

A) 10-25 rpm (30 rpm is ideal) B) 50-75 rpm

C) 100-125 rpm 70) The best way to insure accurate coping placement is;

A) Proper placement of transfer pin into impression B) Rigid impression material

71) If a blade has a 50% sauceration and exudates what to do:

A) Take out Implant 72) After Successful bilateral mandibular blocks, patient still feels pain while drilling in symphysis, where is it coming from?

A) Mylohyoid B) C3- C2 C) Lingual D) Sub-lingual

73) After an implant is placed in the mandibular 1st molar area, buccal swelling, where did it come from?

A) Below buccinator attachment * B) Above buccinator attachment ?

After an implant is placed in the maxillary 1st molar area, buccal swelling, where did it come from? Pg 218

C) above buccinator attachment * D) Above buccinator attachment ?

74) Which has greatest affect on prognosis of root form implants of the same size, shape and cyclic loading?

A) Axial Relationship * 75) Which is true of Autogenous bone grafts?

A) Cancellous bone grafts heal differently than cortical bone grafts 76) Consider the first bacteria to colonize a new implant are set up Beneficial bacteria scergious and actinomyces viscosis. Which of the following statement is most true about the host response to this plaque.

A) There is no detectable response *

B) Immediate inflammatory response C) Gingival necrosis will be produced within two weeks D) Progressive perio implantitis will follow plaque formation

77) What do you do to reduce lateral forces?

A) Narrow occlusal table * B) Parallel placement of implants

78) Why shouldn’t you detach mentalis from symphysis?

A) It is hard to re-attach and causes Ptosis* B) It will never re-attach

79) Swelling of lateral face and tissue involves which anatomic space?

A) Massetor Space * B) Temporais space?

80) How do you treat a contaminated implant

A) Return to company * B) Autoclave C) Passivate in acid

81) Why would someone have difficulty swallowing after an implant supported overdenture is placed ?

A) Crown Ratio is incorrect B) Maxillary teeth placed to far palatally * C) Maxillary teeth placed to far buccally

82) If you have normal mucosa and the patient is complaining that her tongue is burning, the problem is?

A) Cardiac problem B) Diabetic problems C) Psychological problems* D) All the Above PG 61 0f study guide

Pernicious anemia can also have these symptoms.

83) Concerning the A-P distance for a cantilever, which palate shape gives the shortest A-P distance?

A) Tapered B) U-shaped C) Square D) V-shaped

84) Patient has anterior bar retained denture and has pain and bone resorption what would you do?

A) Decrease anterior bite force * B) Antibiotic treatment

85) To avoid galvanic corrosion you don’t want to place the following implant with a gold suprastructure? Pg 277

A) Ceramic B) Ti Alloy C) Nickel Cobalt D) Cr-Lo alloy

86) How do you passivate Ti and Ti Alloy

A) Air contact does it itself * 87) What does the Incisal guide table of the articulator mimic?

A) Anterior guidance of anterior teeth and vertical horizontal difference of incisors 88) To prevent suture line from opening

A) PTFE suture material B) Releasing incision on buccal to relieve tension

89) How soon can you load a Ramus Frame?

A) Immediately * 90) The best way to insure accurate coping placement

A) Proper placement of transfer pin into impression B) Rigid impression material C) Epoxy impression material

91) Flap should be big enough to see

A) All anatomical features * B) Just enough bone to drill

92) Vicryl resorbs by?

A) Hydrolysis B) Proleolysis

93) Non-resorbable membrane preferred when?

A) When you can’t get closure 94) Single mandibular implant is remove 2-3 weeks after placement because patient has parasthesia. What is the maximum time to wait for replacement of implant?

A) 1 year B) 6 months C) 3 months D) 2 months

95) 2mm bone loss around all 5 lower anterior implants and inflammation around one of them, what is happening

A) Bar flexes B) Bar doesn’t fit properly *

96) How do you stop bleeding from upper or lower lips?

A) Direct pressure on facial up against body of mandible * 97) In severely resorbed mandible incision should be made

A) Buccal B) Crest of Ridge C) Lingual *

98) Which describes transient burst of localized remodeling following surgical wounding of cortical bone?

A) Rapid accelerator phenomenon *

99) Patient with cardiac disease can be revealed by blood test with elevated levels of ?

A) LDH, SGOT, Potassium B) LDH, SGOT, Sodium

100) Which of the following categories of antibiotics are the strictest compliance due to their mechanism of?

A) Static * 101) 5 mandibular implant in edentulous area with a fixed bridge, what is the force applied?

A) Compression * B) Tension C) Shear

102) A patient develops a paresthesia following the insertion of an implant,. A referral to a doctor experienced in nerve injuries should be made within what time period?

A) 3months B) 1 month C) 6 months D) 1 year

102) Alloplast – They are the most common osteoconductive bone grafting material. Alloplastic materials are exclusively synthetic bicompatable products developed to cover a broad range of indications. Examples are ceramics, polymers and composites. The most frequently used are ceramics. Ceramics – They are characterized as bioinert. An example of bioinert is aluminum oxide and titanium oxide or bioactive ie. (Calcium phosphate) 103) Bioactive Ceramics- Which are calcium phosphate (an example is synthetic hydroxy appetite (HA) Calcium phosphate material displays a complete lack of toxicity. 104) Tri Calcium Phosphate- Is ceramic and is characterized as bioactive. Displays complete lack of toxicity and can bond with bone. Example- HA (hydroxy appetite) 105) Osteoconductive- Which is characterized bone growth by apposition from the surrounding bone. Therefore this process must occur in the presence of bone or differentiated menchymal cells. Osteoconductive materials are biocompatible. Bone or soft tissue can develop by apposititon without evidence of a toxic reaction. If

osteoconductive materials are placed in ectopic sites (ie. Subcutaneously) they do not initiate bone growth, the material remains the same or unchanged or resorbs. 106) An HA coated root form implant may have the most advantages in which type of bone? D4 bone has proven to be the one most at risk. Hence the benefits of hA are most required in this type of bone. Although it may have the greatest risk relative to bacteria, the benefits of gap healing, faster bone mineralization, and increased bone contact all favor HA. Higher success rates have been reported when HA coated implants have been used in soft bone. The HA should be added to an implant body with the most macroscopic load- bearing surface area to minimize crestal bone loss, larger diameter and an increased number of implants are also suggested in this very weak bone. 107) What about HA coating for D1 and D2 bone? D1 and D2 bone have the greatest strength and bone contact. Therefore is also increased risk of material flaking from the implant during insertion. The risk of implant failure, as a result of implant design is reduced, as in the incidence of crestal bone loss. Rather than a coating, D1 and D2 implants benefit from a roughened surface, sound biomechanical design and a minimum implant length of 10 to 11mm . D3 bone is approximately 50% weaker than D2 bone. As a result the advantages of TPS outweigh its disadvantages. The increased initial fixation, increased bone contact and greater strength of the interface all support its use. Care is taken to reduce crestal bone loss through sound design so the TPS does not become exposed and the increased plaque retention is not a concern. 108) What is an Osteocyte? Bone cells (example) This osteogenic process, referred to as Phase I bone, is related to the number of cells transplanted and dictates the amount of new bone that will form beyond the original dimension. It is directly proportional to the density of cells transplanted. 109) What is osteogenesis? Refers to the growth of bone from viable cells transferred within the graft. Autogenous bone is the onlay graft material available with osteogenic properties. The effective form is cancellous bone once harvested the should be used immediately. 110) Osteoinduction- Involves new bone formation from osteoprogenitor cells derived from primitive mesenchymal cells under the influence of one or more inducing agents that imitate

from the bone matrix. When placing subcutaneously in the absence ot bone, it has been shown to induce bone formation tn the ectopic site. Example is frozen bone, freeze dried bone and dimineralized freezed dried bone. 111) Osteoconduction- Characterizes bone growth by apposition from the surrounding bone. Therefore this process must occur in the presence of bone or differenciated mesenchymal cells. Osteoconductive materials are placed in ectopic sites. (example Subcutaneously) they do not iniciate bone growth. Instead the materials remain relatively unchanged or resorbed. The most common osteoconductive bone grafting materials used in implant dentistry are are alloplasts and xenografts. Alloplasts materials are synthetic. Most frequently used are ceramics ie. Alluminum Oxide and Titanium Oxide (bioinert) or (bioactive) which are calcium phosphate. Bioinert ceramics do not exhibit direct bonding with the host bone and are mechanically held in contact with the bone. 112) What is the difference of a press fit surface area compared to a screw form? Screw root forms are threaded into a bone site and have macroscopic retentive elements for initial bone fixation. Three basic screw thread implant is greater than a cylinder implant by a minimum of 30% and may exceed 500% depending on the thread geometry. This increase in functional implant surface area decreased the stress imposed on the bone implant surface and is also dependent on thread geometry. Most cylinder implants are essentially smooth sided and bullet shaped implants that require a bioactive or increased surface area coating for retention in the bone. If these same materials were placed on a threaded design the surface area of bone contact would be more than 30% higher compared with the smooth cylinder design. The greater the functional surface area of the bone implant contact, the better the support system for the prosthesis. In addition if bone loss occurs around a coated implant a biological smear layer attaches to the coating. The contaminated coating must often be removed from the bone. However once the coating is removed the cylinder implant primarily imposed shear loading to the bone implant interface. Bone is 65% weaker in shear force compared with compression. As a result future bone loss is even more likely. Once the surface is decontaminated and bone is regenerated next to the implant, the threaded implant can still transmit compression and tensile forces to bone. Hence surgical correction of bone loss has better prognosis with screw type implants. 113) If the patient has a bleeding disorder what tests would you order? PTT Test- It is used to determine the ability of the blood to coagulate within the vessels. Therefore it tests the intrinsic and common pathways of coagulation.

PT Test- It is used to determine the ability of the blood to coagulate outside the vessels therefore tests the extrinsic and common pathways of coagulation. Both systems are necessary for normal coagulation. 114) The patient has swelling and trismus (the ability of the patient to open his mouth) on the left side of his face due to surgical space infection, what muscle does this affect. Masseter muscle 115) What is the value of a Ceph? Cephalometric radiographs are oriented radiographs of the skull. The skull is oriented with respect to the x-ray device and the image receptor using a cephlometer, which physically fixes the position of the skull with projections into the external auditory canal. The geometry of cephalometric imaging devices results in a 10% magnification of the image with a 60 Inch focal object and 26 inch object to film distance. A lateral cephalometric radiograph is produced with the patients midagittal plane. It is demonstrated by this radiograph, With slight rotation of the cephalometer. A cross sectional Image ot the mandible or the maxilla. 116) When do you load D1 Bone? For complete regeneration of vital bone in this dense structure, 5 months healing time may be required. However because of the load bearing capability of the bone and the excellent bone implant contact and prosthetic loading of D1 bone may start at a very early stage. Conditions that contribute to no movement during healing are a primary factor for a direct bone to implant interface. D1 bone is stronger and often able to resist movement regardless of when a implant is loaded. As a result immediate implant loading is often possible when multiple implant are splinted together without compromise.

117) When placing an implant in #7 site with limited thickness and osteotomes the implant surgeon must be aware that? The facial mucoperiosteum is reflected to a minimum when bone expansion is planned. The facial cortex receives its blood supply from the overlying facial periosteum and complete facial soft tissue reflection compromises its blood supply.

118) There is a graft over an implant the membrane Is exposed there is slight inflammation what is the coarse of treatment? Use Chlorahexadine and AB 119) When an implant is exposed, tissue is sore and the patient is in a surgical denture what is the approach? Relieve Denture 120) Which of the following is the major difference between aspirin and the newest NSAID’s ?

D) Regulated be law (Aspirin causes GI problems and NSAID’S don’t) 121) Which of the following will cause an increase in eosinophils? Eosinophils- leukocytes (Immune Response) The normal total white blood cell (WBC) ranges from 5000 to 10,000/ML and often varies with each disease. WBC count are critical to the dental out-patient particularly for patients with immune diseases or undergoing chemotherapy. The counts can indicate infections, leukemic disease, immune disease and toxicity of drugs. parasitic 122) All of the following statements pertain to condition of the blood, which one is the exception?

E) Reduced uric levels are indicative of gout 123) What type of leukocyte is present in the greatest numbers during the inflammatory process? The determination of an inflammatory process is important for the implant dentist and may occur without leukocytosis. An increased count of band neutrophils indicates inflammation. 124) Which of these values in a blood chemistry exam will most likely be abnormal in a patient with alcoholic hepatic diseases? Primary hepatic disease is reflected in elevation of liver disease, biliruben measurement is of primary importance.and alkaline phosphatase

125) Which of these values in a chem. Exam would most likely be abnormal if the patient has cardiac disease? Lactic dehydrogenase (LDH) is an intracellular enzyme presented in all tissues. Normal is o-625 U/L. 126) Scientific studies about routine antimicrobial oral prophylaxis generally agree that a blood level of antibiotic be present at the time of wounding and there is no advantage to sustaining medications post operatively for which duration of time.

A) 1 Day 127) Which of the following penicillin is also specifically indicated for gram negative organisms? Amoxicillin- Ampicillin was developed in an attempt to extend penicillins spectrum of activity. Unlike Penicillin G & V Ampicillin is active against several gram negative organisms including H. Influenza and Escherichia coli, implicated respectively in sinus and urinary tract infections. Amoxicillin provides an identical antimicrobial spectrum and demonstrates an oral bioavailability greater than that of either Ampicillin or Penicillin V. 128) The accumulation of plaque around dental implants will initiate gingivitis in the same manner and the same rate as in natural dentition? Gingivitis is a bacteria. ( Induced inflammation around the region of the marginal gingival above the crest of the bone) it may be classified as 1) acute necrotizing 2) Ulcerative 3) Hormonal 4) drug induce 5) spontaneously occurring. These categories can also relate to the gingival tissue around an implant because the mode of attachement of the gingival to a tooth and implant have been reported to be similar. The bacteria in gingivitis around a tooth may affect the epithelial attachment but without loss of connective tissue attachment of a tooth extends an average of 1.07mm above the crestal bone, at least 1mm of protective barrier above the bone is left. In contrast there is no connective tissue attachment zone around an implant hence no connective tissue barrier exists to protect the crestal bone around an implant

A) This is a false statement it is faster in implants

129) The biological inertness of titanium is due to: Titanium oxidizes in air or oxygenated solutions. Titanium oxidizes upon contact with room temperatures air and normal tissue fluids. This relatively is favorable for dental implant devices in the absence of interfacial motion or adverse environmental conditions, passivated (oxidized surface_ condition minimizes biocorosion phenomena. In all cases titanium was selected as the material of choice because of its inert and biocompatible nature paired with excellent resistance to corrosion. 130) Hydroxyapatite coating- HA coating by plasma spraying was brought to the dental profession by de Groot, Kay et al, showed with scanning electron microscopy and spectrographic analysis that the plasma sprayed HA coating could be crystalline and could offer chemical and mechanical properties compatible with dental implant application. HA coating can also lower the corrosion rate of the same substrate alloys. Numerous histological studies have documented the greater surface area of bone apposition the the implant in comparison to uncoated implants which may enhance the biomechanics and initial load bearing capacity of the system. HA coating has been credited with enabling HA coated TI or TI alloy implants to improved bone to bone attachment compared with machined finished. 131) Coating applied most commonly to root form implants use the technique of? Plasma Spraying- Porous or rough titanium surfaces have been fabricated by plasma spraying a powder form of molten droplets at high temperatures. A temperature of 15,000 C, an argon plasma is associated with a nozzle to provide very high velocity 600m/sec partially molten particles of titanium powder (0.05 to 0.1mm diameter) projected with a 0.04 to 0.05 mm thickness.

132) Surface coated root form implants which do not have coatings extended to the very top have metallic collars that are?

C) Machine finished – Studies on osseous healing around implants suggest that crestal remodeling is limited to smooth region of the collar as a result of this remodeling the sulcar epithelium migrates to the bass of the implant collar. Besides the possible prevention of HA exposure an additional advantage of using a machined coronal portion is the potential for an improved interface at the abutment connection. Although the machined collar region may provide this advantage it contributes little to the bio mechanical support at the bony crest. Where stresses are most severe. Therefore the machined collar is limited in height to 0.5 to 1mm. It provides the biologic and abutment connection advantages and limits the bio-mechanical disadvantage.

Misch 340 highly polished on top, then machined Misch page 16

133) Gingival tissue can attach to metal . This can be seen by the presence of ? Muccopolysaccarides- also called glycosaminoglycans. There is a high content of the muccopolysaccarides in the linear body that coats the dental implant. With sufficient stickiness or glue like properties to form a biologically active and trauma resistant attachment at the base of the regenerated sulcus. The the biological seal around dental implants is a definitive entity that must be present to prevent external toxins and agents of the oral cavity from moving into internal enviroment of the jaw. Hemidemosomes-which are attachment plaques to hold epitheliam cells to the basil lamina. A series of events occur following implant surgery the attached gingival regenerates around the implant forming an epithelial cuff more appropriately termed the free gingival margin. Even though this area has been edentulous is some cases for long periods of time, the regenerating epithelium forms the free gingival margine complete with free gingival groove and a gingival sulcas. The epithelium regenerates into the sulcas and form nonderatinized sulcular epithelium and a zone of epithelium cells at the base of the sulcas that interface the implant surface these regenerated cells have the same morphology as the junctional epithelial cells seen around natural teeth. These epithelial cells at the base of the sulcas produce a series of biologic attachment structures that are recognized as part of normal cell biology and physiology.

Lamina- It is a potent chemoattractor. It has recently been associated with epithelial cell adhesion and prevention of connective tissue growth. In theory it could prevent epithelial cell migration 134) The time of healing after placement of maxillary posterior root form implants are? 4 to 8 months of healing time is required. 135) Which of the following are associated with the formation of the epithelial attachment complex to implants?

D) Hemiodemesomes and HA 136) Which of the following best describe the characteristics of osteocytes? Osteocyte- Bone cells. This osteogenic process referred to as phase I bone is related to the number of cells transplanted and dicatates the amount of new bone that will form beyond the original dimension. It is directly proportional to the density of cells transplanted. C) Osteoinductive and autogenious 137) Which of the following statements is true regarding the healing of autogenous grafts. The majority of bones in the skeleton are of endochondral origin (from a cartilaginous precurser the exception of alveolar bone, the maxilla and body of the mandible develop intremembranously while the Condyles develop by endochondral bone formation. Experimental evidence has shown that grafts from membraneous bone show less resorption than endochondral bone. Although cancellous grafts revascularise more rapidly than cortical grafts, cortical membraneous grafts have a thicker cancellous component. Mandibular donor bone grafts which are primarily cortical bone exhibit little volume loss and show good incorportion at short healing time.

E) membraneous grafts heal faster than endochondral bone around the implant.

138) What is Cortical bone? Cortical Bone (compacta) is dense skeletal tissue that is composed of lamellar and composite bone. Similar to the midshaft of long bones, The mandible is essentially a curved tube of compact bone. The mandible must be somewhat rigid because mastication involves substancial bending and torsion. 139) Prior to inserting a chrome alloy Subperiosteal casting it should be? The implant should be cleansed, passivated and sterilized before placement. 140) Which class of drugs are those that are non-contributory to gingival hyperplasis?

B) Beta blockers 141) Which of the following is the most important factor for the survival of grafts?

C) Vascularization- Vascularity of cortical bone has important physiologic ramifications. Diffusion through bone is effective only up to 100 NM. The vascular supply of compact bone is organized into haversian canals (aligned along the long axis of the bones long axis) and volkmans canals (aligned perpendicular to the bones long axis) cancentric bone lamellae form aroung neurovascular bundles resulting in a repetitive osteonal structure. Canaliculi processes and diffuses pathways for logistical support of osteocytes.

142) Which of the following statements as documented by studies of the flora associated with healthy stable implants? It has been demonstrated that the bacteria found in the implant crevice in the successful implant cases are basically the same flora as found in the natural tooth crevis/sulcus in a state of health. 143) The flora around implants in edentulous subjects is different from the flora around implants with teeth. Implants in partially edentulous cases/ patients appear to be at greater risk for periodontitis and perio implantitis than in completey or fully edentulous cases. There are few qualitive differences in the microflora surrounding implants and teeth in partially edentulous cases. However there are marked quantitative decreases in the umber of periodontal pathogens around implants in completely edentulous patients. It is possible that the natural teeth may serve as a resevoer for periodontal pathogens from which they may colonize implants in the same mouth.

144) All of the following are allografts except one?

A) Bovine bone is a xenograft (from species other than man) 145) How are the bacteria in the implant crevice correctly described?

A) Similar to those found in the state of health

146) Which of the following statements correctly describes the difference between the ailing and failing dental implant?

B) The ailing implant can be treated 147) Which of the following is the most recommended treatment of the failing dental implant?

C) Quickly remove the implant since bone loss is progressive 148) All of the terms are correctly associated with tri calcium phosphate except one?

B) Osteoinductive –involves new bone formation (tissue obtained from cadavers and processed)

149) All of the following terms are correctly associated with demineralized freeze- dried bone except one?

C) Alloplastic- synthetic materials (osteoconductive). They come in ceramics, polymers and composites.

Ament is non resorbable 150) What is the recommended therapy for perio-implantitis of an HA coated root form implant which is osseous integrated and demonstrates acute infection? If an implant is HA coated and the HA is undergoing resorption, has changed color and texture. Remove all the HA until the metallic surface is visible. It is best to use ultrasonics such as a cavitron or hand curette. 151) The synthetic suture material vicryl is made of : braided, white or dyed violet, polylactic acid.

152) Monochromatic Suture- Chromic gut Mono filament is non resorbable 153) Which statement is incorrect?

B) Metallic restorations in the jaw to be scanned must be taken out 154) Intra-oral bone grafts have been used for alveolar repair to allow implant placement with extremely favorable results. Block grafts can be harvested from the mandibular ? Symphysis or Ramus 155) Acceptable donor sites for autogenous bone grafting are The Zygoma, Femur, plateau, medial maleus and the bony orbit?

C) One of the Above (Zygoma) Smaller amounts of bone and autograft may be harvested from the maxillary tuberosity, zygoma, extrosseous tori, Residual ridge ostoplasty, extractin sites, implant osteotomy and bone collection devices.

156) When performing a sinus floor elevation at least how may mm of bone is required if implant are to be places at the same time?

A) 10-height 157) The minimum bone for blade implants is?

B) 3mm 158) the major components of a power implant system are?

C) Console, motor, handpiece 159) When Vancomycin IV is used for pre-operative prophylaxis, it should be administered successfully creates?

D) slowly over a time period of one hour before surgery?

160) Guided tissue regeneration membrane serves primarily to?

D) Discourage epithelial growth (The concept defining guided tissue regeneration is to exclude the rapidly generative tissues. Epithelium or connective tissue by use of a barrio allows differentiation and migration of pluri potential cells from the periodontal ligament and alveolus into the defect. This would be especially applicable to the dihised implant surface, in which endosteal implant surgical placement may result in facial or lingual osseous dihiscenses.

161) The anterior palatine second division block when administered successfully creates.

E) Anesthesia of the premolars and molars 162) If an implantologist intends to use several root form implant systems, he must be sure to arm himself with:

B) The specifically recommended drills and countersinks of that system. 163) A poorly fitted Subperiosteal implant:

A) Must be discarded 164) HA synthetic particulate bone grafting material is?

B) Osteoconductive 165) What are the characteristics of bactericidal antibiotics?

A) The ability to kill or destroy bacteria

166) What are the characteristics of bacteriostatic antibiotics?

B) Inhibiting or retarding the growth of bacteria 167) Which of the following conditions (May be caused) can be produces when prescribing sedatives for patients on anti hypertensive drugs?

A) Hypotension (subnormal arterial blood pressure) 168) Which of the following terms describes the transient burst of localized remodeling following the surgical wounding of cortical bone?

B) RAP (Regional acceleratory phenomenon) 169) Hypoxia is a concern with the administration of narcotics and may potentially trigger cardiac disease which of the following poses the least risk?

C) Increasing nitrous oxide supplementation