Oral Implantology Review

A Study Guide

Louie Al-Faraje

• Publisher: Quintessence Publishing Co, Inc
• Year: 2019
• ISBN:
  9780867158786
• Topic: Medicine
• Subtopic: Dentistry

This comprehensive exam study guide provides more than 700 practice questions on oral implantology. Topics include medical problems, biomedical sciences, radiology and computer-assisted technology, anatomy, biomechanics, patient data, treatment planning, principles of implantology, bone and soft tissue grafting, implant prosthodontics and occlusion, esthetics, maintenance, pharmacology, and complications. Because a true oral implantologist is involved in both the surgical and prosthetic phases of dental implant treatment, both aspects are covered extensively in this book.

An accurate and thorough medical evaluation is a critical component of implant therapy. This chapter discusses the many medical factors that must be considered when a patient presents for treatment, including pathologic conditions, bleeding risk, allergy, and medical contraindications. Implant therapy is not without risk, and medical emergencies can occur even when the proper precautions are followed; it is therefore imperative that all clinicians understand what to do in such situations, especially for individuals already compromised by certain medical conditions.

1. What key medical considerations must the clinician take into account when formulating a treatment plan for a dental implant patient?

a. Hemostasis

b. Drug actions and/or interactions

c. Predisposition to infection

d. All of the above

d: All of these could have a profound effect on the healing response and thereby compromise the treatment result. If there is a hemostasis problem, excessive bleeding may result. Drug actions may interfere with proper healing, and drug interactions may affect cardiovascular integrity. A compromised immune system could lead to postoperative infections.

2. The risk of a dental practitioner encountering a medical emergency during placement of a dental implant is related to:

a. The clinician’s medical training

b. The patient’s medical health

c. Staff training

d. Complexity of the procedure

e. All of the above

b: The patient’s systemic health will dictate how well he or she will be able to sustain the stress of the procedure and the response to administered medications.

3. Which of the following are essential components of a medical history? (MULTIPLE ANSWERS)

a. Medications

b. Previous hospitalizations, illnesses, and/or surgeries

c. Information regarding prosthetic joint replacements

d. Childhood immunizations

e. All of the above

a, b, c: A complete medical history should include an organ systems review, height, weight, exercise tolerance, present illnesses, as well as any medications the patient is taking, any previous hospitalizations or illnesses, and information regarding prosthetic joint replacements. The medical history can be done as an interview of the patient or as a printed questionnaire that the clinician reviews with the patient.

4. According to the ASA (American Society of Anesthesiologists) Physical Status (PS) classification, what would the classification be for a patient who can walk up a flight of stairs or the equivalent of two city blocks but has to stop along the way because of distress or shortness of breath?

a. ASA I

b. ASA II

c. ASA III

d. ASA IV

c: ASA III is defined as a patient with severe systemic disease. A consultation with this patient’s physician is recommended prior to initiating dental treatment for this individual. Perioperative sedation and special monitoring may be necessary in the treatment of ASA III patients.

5. What would the ASA classification be for a patient who is able to walk up a flight of stairs or the equivalent of two city blocks but has to rest at the end of the walk because of distress?

a. ASA I

b. ASA II

c. ASA III

d. ASA IV

b: ASA II is defined as a patient with mild systemic disease.

6. A healthy 38-year-old woman presents for a dental implant. She takes no medications and is not anxious about the treatment. What is her ASA classification?

a. ASA I

b. ASA II

c. ASA III

d. ASA IV

a: ASA I is defined as a normal healthy patient.

7. What would the ASA classification be for a patient with well-controlled diabetes who is insulin dependent?

a. ASA I

b. ASA II

c. ASA III

d. ASA IV

c: ASA III

8. What would the ASA classification be for a patient whose diabetes is well controlled with diet and oral hypoglycemic agents?

a. ASA I

b. ASA II

c. ASA III

d. ASA IV

b: ASA II

9. What percentage of patients, when asked “Are you in good health?”, respond “yes” but are actually found to be medically compromised on closer examination?

a. 10%

b. 20%

c. 30%

d. 40%

c: Studies reveal that 30% of patients who respond in the affirmative are actually deemed medically compromised by the treating clinician. (Source: Brady WF, Martinoff JT. Validity of health history data collected from dental patients and patient perception of health status. J Am Dent Assoc 1980;101:642–645.)

10. When a patient presents with a burning mouth or tongue, which of the following could be the possible medical cause?

a. Alcoholism

b. Neoplasm

c. Renal failure

d. Primary or secondary neuropathy

d: Patients with primary or secondary neuropathy often present with the symptom of a burning mouth or tongue.

11. When a patient presents with gingival overgrowth, which of the following could be a possible medical cause?

a. Leukemia

b. Gastroesophageal reflux disease (GERD)

c. Immune suppression from HIV

d. Mouth breathing

a: Gingival overgrowth can be a sign of leukemia.

12. When a patient presents with rampant dental caries, which of the following could be a possible medical cause?

a. Addison’s disease

b. Sjögren’s syndrome

c. Vitamin deficiency

d. Liver cirrhosis

b: Patients with Sjögren’s syndrome often present with a dry mouth that leads to rampant dental caries. In elderly patients, it often presents as root caries.

13. When a patient presents with ptosis of the chin, which of the following could be a possible medical cause?

a. Anemia

b. Use of skeletal muscle relaxants

c. Scleroderma

d. Myasthenia gravis

d: Myasthenia gravis is a neuromuscular disease that results in muscle fatigue and weakness. Patients with myasthenia gravis will have decreased muscle tone that can result in ptosis.

14. When a patient presents with a radiographic finding of reduced cortical bone density, which of the following could be a possible medical cause?

a. Primary hyperparathyroidism

b. Scleroderma

c. Osteoarthritis

d. Multiple myeloma

a: Hyperparathyroidism results in the secretion of excess parathyroid hormone, which stimulates osteoclast catabolic effects on bone, resulting in the loss of calcium and density.

15. When a patient presents with a radiographic finding of degenerative damage to the condyle or temporomandibular joint (TMJ), which of the following could be a possible medical cause?

a. Osteonecrosis

b. Paget disease

c. Hyperparathyroidism

d. Rheumatoid arthritis

d: Rheumatoid arthritis has an unknown etiology; however, genetic, environmental, hormonal, and immunologic factors as well as infection are possibly involved in the process. A genetic susceptibility may provoke an autoimmune reaction that leads to hypertrophy of the synovial lining of the TMJ and endothelial cell activation that results in an uncontrolled inflammatory response and destruction of the bone.

16. When a patient presents with a radiographic finding of carotid artery calcification, which of the fo...

Table of contents

• Cover
• Half Title Page
• Title Page
• Copyright Page
• Contents
• Dedication
• Preface
• Contributors
• 1 Medical Evaluation of the Implant Patient
• 2 Oral Evaluation and Treatment Planning
• 3 Head and Neck Anatomy
• 4 Surgical Procedures and Complications
• 5 Pharmacology
• 6 Biomechanics
• 7 Implant Prosthodontics
• Bibliography