Implant year6 2023

 
1. The primary goal to protect and maintain “tissue-integration"are :
Regularly scaling with hand scalers or ultrasonic scalers
Periodic recalls reinforcing regimen
Probing measurements closely approximate actual bone levels immediately after abutment connection
Good oral hygiene
Periodic recalls reinforcing regimen and Good oral hygiene
2. The primary goal of implant maintenance :
No Peri implantitis
Maintain and protect tissues integration
Marginal bone loss less then 0.1mm
Absence of mobility
Maintain and protect tissues integration and Absence of mobility
3. Which one is not Clinical Parameters of Evaluation:
Occlusion
Proper torque on screw joints
Bleeding
Radiographic assessment
Implant system
4. The Clinical signs of implantitis:
Pathogenic microorganisms is similar clinical presentation of Abscess
Poor oral hygiene; bacteria
Similar clinical presentation of periodontitis
Mobility and peri-implant radiolucency
Bone overheating, lack of initial stability
5. Criteria for the successful implant :
Radiographic radiolucency
no peri-implantitis
Marginal bone loss 1.0-1.5mm first year; then > 1mm annually thereafter
Progressive soft tissue changes or bone loss > 1.0-1.5mm
6. Success rate of implant varies with:
Bone quality
Loading dynamics
Location of implant placement
Case selection
All are correct
7. Which one is not recommended for maintenance of implant?:
Home-care regimen
Periodic recalls reinforcing regimen
Regularly scaling with ultrasonic scaler
Lifetime maintenance commitment
8. The Treatment for soft tissue reaction?:
Remove and replace with the same diameter fixture; or treat infection
Remove offending screw/reinforce oral hygiene
Reinforce oral hygiene with ultrasonic scaler
Soft-tissue graft
A and C are correct Remove and replace with the same diameter fixture; or treat infection
9. Which one is not recommended for Oral hygiene aids :
Regularly scaling with hand scalers or ultrasonic scalers
chlorhexidine - use during peri-surgical or as needed for acute soft tissue inflammation
Super-Floss - nylon fibers - thread for interproximal use between abutments and under extensions
Small interdental brushes (Proxibrushes) - for cleaning buccal & lingual abutment surfaces; all metal surfaces must be nylon coated
All is correct
10. The implant stability:
may be the key indicator of fixture health
marginal bone loss > 0.1mm
radiographic radiolucency
A and B are correct
All is wrong
11. We use radiographic assessment to:
Determine bone loss
Assess future mobility without FPD removal
Determine the landmarks
Monitor implant success
All is correct
12. Rapid bone loss seen if:
Occlusal trauma
Wrong size of implant
Often scaling
Fractured fixture
Occlusal trauma and Fractured fixture are correct
13. Dental Implant Prosthodontic procedure:
The same to prosthetic procedure for natural teeth
Learn new concepts of taking impressions
More meticulous occlusal adjustment to control biomechanical load on implant than on natural teeth.
The impression, lab-work, and delivery are the same of natural teeth procedure
Learn new concepts of taking impressions and More meticulous occlusal adjustment to control biomechanical load on implant than on natural teeth are correct
14. The new ideas for implant prosthodontics do not include:
The Impression taking
The abutment selections
The fitness of prosthodontics
The superstructure with cement or screw retained.
15. What factors do you consider for the section of implant abutment?:
Soft tissue levels & thickness
Marginal bone level
Implant type, diameter, angulation
Mesio-distal dimension
All is correct
16. We choose Screw retained due to :
Easy to solve prosthetic complication
More esthetic
Easier passive fit
Time efficient & low cost
17. One piece type of abutment:
Mainly use in fixture level impression
Opened tray impression taking
Mainly use for the front teeth only
Mainly use in abutment level impression
18. The disadvantage of Cement retained are:
Difficult to retrieve
Compromise esthetic
Problem due to residual cement
Difficult to obtain passive fit
Difficult to retrieve and Problem due to residual cement are correct
19. What are the 2 impression methods for implant impression?:
Open tray technic impression
Fixture level impression
Abutment level impression
Closed tray technic impression
Open tray technic impression and Closed tray technic impression are wrong
20. Generally we take impression after implant placing:
Maxillary 2 months later
Mandible 3 months later
Bone graft 5 months later
All is correct
21. The impression taking procedure for Esthetic case :
2nd Surgery + Impression +Healing abutment + final restoration
2nd Surgery +Healing abutment +impression + final restoration
2nSurgery +Healing abutment +impression +provisional restoration + impression + final restoration
2nSurgery +impression +Healing abutment +provisional restoration + impression + final restoration.
22. When do you select a fixture level impression?:
Posterior region with proper position and path of implant
A screw retained type restoration.
Proper position path and sufficient vertical space.
Full mouth fixed type implant restoration
A screw retained type restoration Full mouth fixed type implant restoration are correct
23. When do you select an abutment level impression ?:
On the anterior esthetic region
A screw retained type restoration.
Proper position path and sufficient vertical space
Full mouth fixed type implant restoration
24. What is the common problem with Plastic impression cap? :
Abutment height
Abutment collar height
Path of implant
Gingival or Alveolar bone interference
25. We can use transfer abutment as:
Abutment impression
Fixture level impression
Opened tray impression
Closed tray impression
All is correct
26. Bucco-lingual angulation of Posterior teeth:
Maxillary teethlingual tilting
Mandible teethbuccal tilting
Most of teeth tilted to mesial side
Distal curvature of natural teeth roots
All is not correct
27. What is the common error of beginner for Mandible posterior implant ?:
Implant system selection
The length of implant
The Angulation of implant
The diameter of implant
28. Firsrt Molar replacement with implant:
Two implants for one molar (one implant to one root)
Wide fixture for molar teeth
Easy site for implant
All is correct
29. When the patient has the limitation of opening, the common errors for #37, 47 implants are:
Possible lingual perforation
Suturing errors
Incorrect angle at drilling
Possible lingual perforation and Incorrect angle at drilling are correct
All are correct
30. The advantages of Panorama radiography :
Provide better solution
Produce anatomically truer images
Determine height of the bone
Minimize geometric distortion.
All are correct
31. The distortion of Panorama :
Vertical distortion 40-60% and Horizontal distortion 20-40%
Vertical distortion 50-70% and Horizontal distortion 20-40%
Horizontal distortion 50-70% and Vertical distortion 20-40%
Vertical distortion 40-60% and Horizontal distortion 20-40% and Horizontal distortion 50-70% and Vertical distortion 20-40% are correct
All answers are wrong .
32. The Periapical Radiography :
Produce anatomically truer images
Available for only 1 fixture
Poor resolution
Convenience and easy
Produce anatomically truer images and Available for only 1 fixture are correct
33. Radiology can :
Determine bone quality and quantity
Verify superstructure fitness
Identify diseases
All are correct
34. Risk factors of dental Implant for the Elderly person:
Xerostomia
Poor oral hygiene
Diabetes
Osteoporosis
All is correct
35. What are not the concerns about dental implants for geriatric person ?:
Longer healing time
Inadequate osseointegration of implants
The assisted implant
Loss of implants due to inadequate oral hygiene
36. Adequate Bone Volume for Implant by Spray JR et al. Ann periodontol 2000:
Thickness of 1 to 1.5mm buccal and lingual plate for ridge expansion
Favorable facial bone thickness 1.8 to 2.0mm.
At least 1mm buccal and lingual plate.
Minimum thickness of 1.5 to 2.5mm buccal and lingual plate
37. Surgery for Density 2:
Bone compaction
Larger final drill
Tapping – option
Bicortical installation
38. Density 1:
Thick cortical bone & dense sponge bone
Most preferred density
Posterior Mx
Almost cortical bone
39. Density 4:
Atrophic anterior Mx & Mn
Thin cortical bone with loose sponge bone
Almost cortical bone
Most preferred density
40. Density 2 :
Standard product protocol
Preservation of cortical bone
Reduce up and down during drilling
Almost cortical bone
41. Mandible posterior region :
Generally, good bone quality but esthetic demand is high.
Implant system can be selected carefully.
We can place sometimes, short implant (5~7mm length)
Immediate implantation is prohibited.
42. The angulation of Posterior teeth :
Maxillary teeth buccal tilting
Mandible teethlingual tilting
Most of teeth tilted to mesial side
Distal curvature of natural teeth roots
All are correct
43. Mesio-distal position of implant :
Natural tooth to implant at least 2-3mm and implant to implant 3-4mm
Center of restoration crown
Most of teeth tilted to distal side
Curvature of natural teeth root is buccally tilted
44. Firsrt mandible molar replacement with implant:
Two implants for one molar (one implant to one root)
Wide fixture for molar teeth
Easy site for implant
All are correct
45. Absolute Contraindications for Dental Implant:
Severe renal disorder
Myocardial infarction (MI)
Angina pectoris
Bacterial endocarditis
46. Risk factors of dental Implant for the Elderly person:
Xerostomia
Poor oral hygiene
Diabetes
Osteoporosis
All are correct
47. Relative Contraindications for Dental Implants:
Active periodontal disease
Renal/pancreatic disorders
Recent myocardial infarction (MI)
Heavy smoking
48. Dental Implant for Diabetes patients:
Patients are at greater risk of infection
Dental implant is contraindicated in diabetic patients.
The accumulation of periopathogenic bacteria could cause peri-implantitis.
The bone density is weak.
49. Implant Supported restorations are :
The denture support is derived from the implants or bar
The denture relies on edentulous arches and implants
The denture relies on implants and attached structures
The denture support is derived from the implants or bar and The denture relies on implants and attached structures are corrects
All is incorrect
50. What are the concerns about dental implants for geriatric person ?:
Longer healing time
Inadequate osseointegration of implants
Loss of implants due to inadequate oral hygiene.
All of them are incorrect.
51. The Success rate of healthy old person for implant:
Not comparable to young population
Much lower than young person
Better than healthy adults
Similar to young age group
52. Oral hygiene cannot predict when:
Adequate instruction and recall
Complicated design of implant abutment
Good oral heath aids
Simple design of abutments are utilized.
53. The group III of the residual ridge is:
Resorption of basal bone
minor ridge remodeling
basal bone ridge
sharp atrophic residual ridge
54. Adequate Bone Volume for Implant by Spray JR et al. Ann periodontol 2000:
Thickness of 1 to 1.5mm buccal and lingual plate for ridge expansion.
Favorable facial bone thickness 1.8 to 2.0mm
At least 1mm buccal and lingual plate.
Minimum thickness of 1.5 to 2.5mm buccal and lingual plate
55. The Solution of Insufficient Bone Width:
Alveoloplasty
GBR
Small diameter fixture
Ridge expansion / split
All are correct
56. The Rule 2 for mesio-distal position of implant is :
Implant to tooth: 2~3mm apart
Center of restorative crown
Implant to implant: 3~4mm apart
At least 1mm buccal and lingual plate
57. When the Bone Height is insufficient the solutions are:
Small diameter fixture
Short wide fixture
Alveoloplasty
Sinus lifting
Short wide fixture and Sinus lifting is correct
58. Bone density of D2 is:
A thin layer of cortical bone with low-density trabecular
A dense trabecular bone of favorable strength
A thick layer of compact bone surrounding a core of trabecular bone
Homogenous compact bone
59. We diagnose the bone density via:
Oral Examination
General health condition/ Age/sex of patient
Asking the patient
Model analysis
60. Surgery technique for D2 :
Bone compaction
Larger final drill
Tapping – option
Bicortical installation
61. Which one is not recommended for Surgery of D4?:
Bone compaction
Bicortical installation
Larger final drill
Finish with hand wrench
62. Surgery for D3:
Larger final drill
Bone tapping
Reduce final drill diameter
Fixture installation under 15N torque
63. Healing Period of Rough surface implant:
D1 4~5 months
D2 2~3 months
D3 6~8 months
D4 3~4 months
64. Surgical Technique for Various Bone Density:
Amount of torque during fixture installation
Drilling method
Size of final drill
A and B is correct
All are correct
65. Bone Density D1:
Thick cortical bone & dense sponge bone
Most preferred density
Posterior Mx
Almost cortical bone
66. Bone Density D4:
Atrophic anterior Mx & Mn
Thin cortical bone with loose sponge bone
Almost cortical bone
Most preferred density
67. Surgical technique for D2:
Standard product protocol
Preservation of cortical bone
Reduce up and down during drilling
Almost cortical bone
68. Ridge Expansion :
Possible fracture, resorption,
Loss of cortical bone
Maxilla is easier than mandible
Loss of bone height
Loss of cortical bone and Loss of bone height is wrong
69. Suggested Implant Diameter to Molar :
3.5~4.0
4.0~4.5
4.5~5.0
3.5~4.5
70. 34. What are the traditional BraneMark protocols?:
12 months period after tooth extraction.
Healing period of 3 to 4 months.
Total treatment time 16 months.
All of them are correct.
71. Attempt to shorten overall treatment length:
Immediate loading.
Immediate implant.
Implant surface design
All of them are correct.
72. Why immediate implant?:
No bone graft or membrane addition.
Initial stability.
Primary closure is fine.
Reduction of treatment time
73. What is the contraindications for immediate implant?:
Endodontic failure.
Insufficient apical bone.
Traumatically avulsed tooth.
Periodontal bone loss without purulent.
74. The measurements for the infected site :
Saline irrigation.
Antibiotic administration.
Stay clear of buccal plate.
All of them are incorrect.
75. Surgical procedure for Immediatethe implant :
Prohibited area buccal / labial
1mm of buccal bony wall for upper incisors.
Can not follow standard principal drilling.
Non of them is correct.
76. Choose the correct answer for immediate implant:
Reducing buccal retraction, flapless if no GBR.
Initial stability is not necessary.
Tooth mobility with chronic irritation is not a contraindications.
Site preparation followed MID B-L and MID M-D for maxillary incisors.
77. Choose the wrong answer for immediate provisional restoration:
Space maintenance.
Preserve ridge contour.
Promoting osseointegration.
Promote peri implant mucosal health.
78. Why delayed Implant placement ?:
Decreased patient's psychological stress.
Able to use longer implant.
Superior aesthetic result.
In the present of active infection.
79. Rule for mesio distal position of implant :
Implant to implant 2~3mm
Implant to tooth 3~4mm
Center of restoration crown :
All of them are wrong.
80. Antero posterior mandible :
Mandibular canal is 6mm below 2nd molar apex
12% patients, anterior loop of mandible canal exstends 5mm anterior to the mental foramen.
Mental foramen average 10-12mm from Mn interior border.
All of them are correct.
81. Influence of bone density on Implant success rate :
Lower success rate in anterior mandible.
Highest failure rate in posterior mandible.
Higher success rate in better bone quality.
These reported failure are primary related to surgery healing.
82. The maxilla has a thin cortical plate and fine trabecular bone due to :
The maxilla is a force absorption unit.
Any strain to the maxilla is transferred.
The maxilla is an independent structure.
All of them are wrong.
83. Bone density and Hounsfield Units:
D1 < 1250 HU
D2 550- 750 HU
D3 350- 850 HU
D4250 - 450 HU
D5 < 350 HU
84. Bone density quality:
D1has greatest BIC
D4 magnitude of the strain is further apical
D2 has 65 - 75 BIC
Ti - D4 interface : pathologic overload .
All of them are correct.
85. Implant Treatment plan :
Reducing stress when Bone density decreased.
D3 bone benefits from longer implant.
D4 bone one implant per one tooth.
All of them are correct.
86. Treatment modifier when low bone density :
Implant number
Prosthetic designs
Implant surface condition
Implant size .
All of them are correct.
87. What's the dental Implant ?:
medical device to replace and act as a missing biological structure.
The Implants for plastic surgery.
An artificial tooth root replacement.
An Implant is placed for joint , breast, eyes.
88. The top reason to choose a dental implant:
Hight success rate .
Safe for adjacent natural teeth.
Preventing bone loss.
All are correct .
89. The most successful and widely accepted dental implant :
Osseointegrated implant .
Endosseous implant .
Subperiosteal Implant.
Blade implant.
90. Osseointegration is:
A lack of mobility and ability of the implant to resist functional loading.
Bone ingrowth into a metal implant.
Direct structure and functional connection between living bone and surface of implant.
All are correct.
91. Interfering factors for osseointegration :
Traumatic surgery
Overloading
Implant movement
All of them are correct.
92. Progressive loading :
Functional loading within 48 hours after implant placement.
Stepwise, increased loading through primary restoration.
Prosthetic restoration after within 8 to 10 weeks after implant placement with temporary.
The prosthesis is attached in a second procedure after a healing period.
93. Evolution of surface technology:
2nd generation : RBM , SLA , HA coating , Fluoride.
3rd generation : peptides, growth factors.
Rough surfaces are better osseointegration but smooth surface is less bone resorption.
1st generation : machined, sintering
94. Choose the correct answer :
The reduced implant survival is more related to arch location not bone density.
Mandible is a force distribution unit.
The trabecular bone in mandible is more coarse compared to the maxilla.
All of them is incorrect.
95. Choose the incorrect answer:
D4 bone is more likely to cause implant mobility and failure.
Each bone density has a different strength.
Bone density doesn't affect elastic modulus
The diagnosis of the bone density in a implant site is a key determinant for clinical success.
96. The advantage of Implant :
Better longevity.
No alveolar bone resorption.
More esthetic and higher bite fore compared to dentures.
All of them are correct.
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97. The control of diabetes over time: HbA1c should not exceed 7%.
The prevention of infections
The implant surface and design
All are correct
98. Implant placement is indicated for diabetes patient if:
The wound healing is altered
HA1c not exceed 7%
The blood pressure is 180/80mmHg
Plasma glucose level is 126 to 200
All are correct
99. Dental Implant therapy for hypertensive patient is contra -indicated when:
Maximum Blood pressure is above 160/90mmHg and 150/80mmHg for diabetic patients.
Recent myocardial infarction
Unstable angina pectoris
Hypertensive patient with 180-209/110-119mmHg.
All are correct
100. Uncontrolled blood pressure increase the risk for cardiovascular during dental care or prolonged stressful:
Myocardial infarction
Angina pectoris
Cardiovascular accident
Blood pressure: 180-209/110-119mmHg
All are correct
101. Patient with acquired bleeding tendency:
Should stop using aspirin or other antiplatelet agents 2 days before surgery
Should stop using aspirin or other antiplatelet agents 1 week before surgery
Should prevent post operative bleeding
Should discontinue anticoagulant before dental treatment
Should not use local anesthesia contain with adrenaline.
102. The statement below is correct, Except:
Hyperglycemia impair the collagen metabolism and bind to monocyte and macrophage cell membranes, thus altering the wound healing.
Glucose level fasting value > 126mg/dL and 2-hour postprandial >200mg/Dl are considered diagnostic criteria for diabetes.
HbA1c value normal: 7%-7.5%
The longer duration diabetes, the higher the failure rate for implant treatment.
Implant placement is indicated for diabetes patient with HgA1C: 7%.
103. The statement below is true, Except:
Adrenaline in local anesthesia is not safe for hypertensive patients
Patients with recent myocardial infarction, unstable angina pectoris are not candidates for surgical treatment
IV bisphosphonate-treated patients have high incidence of ONJ.
Platelet Count lower than 100,000/mm3 are considered a contraindication for elective surgical procedure
INR is the most reliable test, its normal value is 1.
104. The statement below is true, Except:
The irradiation dose is the major limited factors which effects the osseintergration.
Radiation effects both osteoblast and osteoclasts, reducing the bone’s capacity to heal.
Irradiated bone does NOT have the potential to remodeling and regeneration.
Implant failure rate is low when irradiation dose below 45Gy.
ORN is one of major complications of radiation therapy
105. The statement below is true, Except:
Schneiderian membrane is very thin, yellowish and extremely friable for smokers.
Schneiderian membrane is elastic with the thickness: 0.45mm to 1.40 mm
15% of IAN is located in the middle of the mandibular ramus, posterior to the 2nd molar, then runs lingually to follow the lingual plate
15% of IAN canal follows the lingual cortical plate of the mandibular ramus and body
15% of IAN is located near the middle of the ramus and body
106. The statements below are correct, Except:
Certain areas of the implant surface are in direct contact with bone is called Primary bone contact.
+The remodeled bone and new bone contact with implant, termed secondary bone contact
Primary bone contact is increased when Secondary bone contact occurred.
Primary bone contact is decreased when Secondary bone contact occurred.
Immediate loading protocols were first described for the completely edentulous mandible
107. The concept of prosthetic-driven implant dentistry mean:
Implant selection is performed before prosthetic planning.
Perform prosthetic immediately after implant placement
Implant selection is performed after prosthetic planning
Immediate implantation into extraction socket.
108. Implant selection is involve:
clinical examination,
radiographic examination
surgical evaluation
prosthetic planning
All are correct
109. Implant characteristics include the following:
Length and diameter,
Shape and roughness,
Number
Position
All are correct
110. 1Guidelines for implant selection are based on:
Dimensions of the edentulous area
Adjacent teeth and Anatomical structures
Biomechanics
Bone volume and Bone quality
All are correct
111. Interdental distance for single tooth replacement using standard implant:
7mm
8mm
9mm
10mm
All are correct
112. Interdental and inter-occlussion distance for multi teeth replacement
7mm is required between the centers of two implants.
3mm is required between implant heads
1.5mm is required from implant to adjacent tooth
Vertical dimension of 6mm is required.
All are correct
113. A standard implant requires :
7mm mesiodistal distance,
10mm bone height,
6mm bone width.
7mm bone width at esthetic area.
All are correct
114. The role of the temporary prosthetic restoration:
Maintain esthetic
Provide stabilization
Function
Preview for future restoration
All are correct
115. The provisional prosthetic can be elaborated:
Prior to extraction
Before implant placement
After implant placement
After implant osseointergration
All are correct
116. General specifications of temporary prosthetic restorations:
Not traumatic to adjacent teeth and soft tissues
No negative interference with osseointergration
Easy to modify if necessary
Acceptable esthetics
All are correct
117. Minimal buccal –lingual bone volume for 4mm diameter implant is:
5mm in esthetic areas
5mm in non-esthetic areas
6mm in esthetic areas
7mm in esthetic area
All are correct
118. In term of biomechanics, implant should be placed in the direction of axial forces, because:
The bone/implant interface is well adapted to axial compressive forces.
To improves the mechanical strength of the implant body
To induce shear force
To improve esthetic
To get enough vertical dimension.
119. Wide diameter of implant should be use in strong occlusal forces because:
Increase primary stability
Improves the mechanical strength of the implant body.
Improve esthetic
Prevent implant fracture
Prevent loosening abutment
120. Prerequisite for success for immediate or early loading of implants is:
Implant brand
Implant SLA surface
Sufficient primary stability
All are correct
121. To improve primary stability in type 3 and 4 bone, surgeon may adapt with:
implant dimension
implant design
rough/bioactive surface
drill sequence
All are correct
122. Removable provisional may be unstable solution because :
Compressive on mucosa
Cause marginal bone loss
May loss of osseointergration
May not comfortable
All are correct
123. Implant placement in anterior single tooth is predictable treatment outcomes if:
Patient with high smile line
The sites without hard and soft tissue deficiency
Patient motivation
D.Patient with high smile line and The sites without hard and soft tissue deficiency
124. Dental implant therapy in the anterior is a complex procedure, which base on a comprehensive preoperative evaluation. An optimal esthetic result depends on
Patient selection
Implant selection
Correct three dimensional implant positioning
Soft tissue stability
All are correct
125. Single tooth implant in the anterior area is a surgical risk procedure if:
Buccal bone deficiencies
Soft tissue deficiencies
Distance between the proximal bone and CEJ of the adjacent teeth > 2mm
Buccal cortical bone plate < 1mm
All are correct
126. The provisional fixed restoration plays a major role in esthetic outcome because:
It can be modified to create emergence profile
It is easy to fabricate
It improve osseointergration
All are correct
127. Selection of the abutment depends on:
Peri-implant gingival margin and the longitudinal implant axis
Implant design
Implant surface
Mechanical strength of implant body
Bone implant contact
128. Implant-supported FPD, when possible, is the treatment of choice for partially edentulous patients in the situation:
Healthy adjacent teeth
Intact adjacent tooth restoration
Posterior reduced arch
Extended edentulous segments
All are correct
129. In cases of restoration of each los unit with an implant, when it is indicated to splinting the implant ?:
Narrow-diameter implants in the posterior area
Short implants
Bruxism
Poor bone quality
All are correct
130. There are some disadvantages of screw retain, Except:
Bacterial Colonization
More screw loosening
Cost
Retrievable
Esthetics
131. Immediate and early loading protocols should focus on:
The amount of primary bone contact.
The quantity of bone at the implant site.
The rapidity of bone formation around the implant
The quality of bone at the implant site.
All are correct
132. Cochrane reviews are recognized as a gold standard in evidence-based health care, Except:
Immediate loading was defined as implants in function within 1 week after their placement. No distinction was made between occlusal and nonocclusal loading.
Early loading was defined as putting implants in function between 1 week and 2 months after placement.
Conventional loading was defined as putting implants in function after 2 months
Immediate loading was defined as implants in function within 1 days after their placement
All are exceptional
133. What’s fibro-intergration?:
Implant is fully intergrated to the bone.
Implant is intergrated and attached via dense fibrous tissue.
Implant is 70% intergarted to the bone.
Implant is fallen out.
All are correct
134. To prevent implant from fibro-intergration, Must:
Curettage the osteotomy site before place implant
Drill with irrigation copiously
Drill slowly
Torque should not exceed 35Ncm.
Premedication
135. Clinician should be perform proper technique when placing implant in poor bone type IV, Except:
Drill sequence technique
Bone condensation technique
Bone splitting technique
All are corrects
136. There many reasons in implant failures, Except:
Implant design
Overheating bone
No primary stability
Contaminated osteotomy
Excessive force
137. Malposition of implant poses many complications, except:
Damage to adjacent teeth
Damage to important anatomic structure
Impossible to load
Fit for prosthetic restoration.
Poor esthetics
138. There are some pre -surgical steps to prevent implant from malposition. Except:
Proper pre-operative planning
Financial planning
Radiographic analysis
Surgical guide template
Soft or hard tissue augmentation procedure to obtain optimum anatomy.
139. Bleeding during and after implant surgery can be managed, Except:
Compression with plain gauze
Post operation mouth rinse with tranexamic acid (4-6 times daily x 3 days)
Incision in the mucosa to relieve the hematoma.
Ligation of vessel
Immediate referral to hospital
140. Nerve injury is due to occurred, Except:
Drill procedures or compression of implant body into canal.
Post surgical intra-alveolar oedema
Direct trauma
Prosthetic design
Mechanical, chemical and thermal
141. Infection is the most common cause for loss of implant. To prevent this occurrence, we have to respect the surgical protocol, Except:
Rule out medical history
Surgery under aseptic conditions
Pre-operative mouth rinse with clorhexidine
Prophylactic antibiotics 1 hr before surgery
Sedation
142. Pain after implant surgery is normal physiologic response to tissue damage. Pain intensity comes to the peak after:
3-5 hours
8 hours
12 hours
24 hours
72 hours
143. The statements below are true, Except:
The design of the restoration is a key factor for implant selection.
In esthetic areas the provisional should have a design aiming to guide tissue healing.
A standard implant requires 5mm mesiodistal distance, 10mm bone height, and 5mm bone width.
Wide implants are preferred for molars, and when high occlusal loading is expected.
Long implants (>10mm) are indicated when poor primary stability is expected with standard implants
144. The statements below are true, Except:
Cemented restorations are advisable used for the implant shoulder located deep under the mucosa in esthetic areas
Implant-supported FPD is the dominant strategy for partially edentulous patients.
There is no evidence to support the concept of one tooth, one implant.
Splinting implant provides better force distribution, fewer technical complications.
Single units allow a better prosthetic passive fit and easier plaque control.
145. The statements below are true, Except:
Autogenous graft is a graft from patient own bone.
Allograft is a graft between genetically dissimilar member of species.
Xenograft is a graft taken from a donor of another species
Alloplast graft is the combination of Autograft and other type of graft material.
Autogenous is a Gold standard for grated bone
146. There are some crestal approaches limitations, except:
Residual bone height >6mm
Oblique sinus floor
Present of septa
Inability to repair perforations
Inadequate ridge width
147. How do we prevent pressure necrosis of the cortical bone:
By under preparing the osteotomy
By using the 1 drill larger than the implant to be placed
By using the cortical drill and the drill tap to prepare the cortical bone.
By placing chlorhexidine in the saline
All are incorrect
148. What is important in the preparation of type 1 bone?:
Under-preparation of the osteotomy site
Use of osteotomes to prepare the osteotomy
Use of the cortical drills
Use of both the cortical and the drill taps where applicable.
By using the 1 drill larger than the implant to be placed.
149. Why is it important to take an X-ray after your pilot drill.:
To increase the profit margin of the procedure
To check vitality of the adjacent teeth
To make sure that you do not hit any vital structures with your initial drill.
To check the width of the osteotomy
All are correct
150. Why is the mid-crestal incision the most ideal incision type?:
Its the most aesthetic incision
Allows movement of palatal tissue to the buccal side
Improves your ability to move soft tissue around
Reduces risk of wound dehiscence by improving the blood flow to the wound edges
All are correct
151. Accessing the posterior wall of the Maxillary sinus through a vestibular incision may injure one or more of the following vital structures:
Origin of Buccinator muscle.
Posterior superior alveolar artery.
Posterior superior alveolar nerve.
All are incorrect
All are correct
152. Spontaneous recovery from nerve injury to the inferior alveolar nerve (IAN) is more frequently observed compared to the lingual nerve due to:
The position of the IAN in the bony canal serves as a conduit for nerve regeneration
]The IAN has a larger diameter
The IAN has better regenerative capability
The IAN is closer to the CNS at the point of injury
Wallerian degeneration is delayed for the lingual nerve
153. Which one of the following is not an acceptable complication of third molar surgery:
Mandible fracture
Tuberosity fracture
Fracture of adjacent teeth
TMJ pain
All are acceptable
154. Which of the following is most likely to result in implant failure:
Utilizing bovine derived augmentation material for sinus lift
A perforation of the Schnederrian membrane measuring 6 by 5 mm repaired with a PRP membrane prior to grafting
Placing implants in a patient with a 40 pack year smoking history who quit 4 weeks ago
Performing a sinus lift with simulataneous implant placement in a patient with chronic sinusitis without addressing the sinusitis preoperatively
All are correct
155. What is the minimum recommended distance between the most inferior aspect of an implant and the superior aspect of the mandibular canal:
3mm
2mm
4mm
1.5mm
1mm
156. A 30 year old male is one week status post placement of 3 right mandibular posterior implants. He is complaining of parasthesia of his right mental branch that has been present since the implants were placed. A panoramic radiograph demonstrates that all 3 implants are less than 0.5mm superior to the mandibular canal. What is the most appropriate next step:
Back up all 3 implants an additional 2 mm
Remove all implants
Reassure the patient and follow up again in 2 weeks
Schedule the patient for a IAN lateralization procedure
Obtain a CT scan to identify the exact relationship of each implant with the canal before proceeding with any treatment
157. In the aesthetic zone, the only place where two implants are acceptable is:
Between the central and lateral
Between the lateral and canine
Between the two centrals
None of all
All are acceptable
158. What are the advantages of the customized impression coping technique?:
It is an impression coping that is customized to the impression tray.
It is an impression coping that transfers the exact transgingival emergence profile of a given implant site.
It requires less time chair-side.
It reflects a more accurate spatial position of the implant
It helps to create stippling in the soft tissue
159. Which is the best material to use for the fabrication of a provisional restoration:
Bisacryl
PMMA
Composite
All of them
None of them
160. The most common problem following provisional restoration removal before impression making is?:
Expansion of the peri-implant mucosal tissues
Collapse of the peri-implant mucosal tissues
Bleeding of mucosal tissue
All of the above
None of the above
161. The arteries that are commonly found penetrating the lingual cortical bone of the mandibular symphysis and are liable to injury during implant surgery are branches of one or more of the following arteries:
Lingual profunda
Sublingual artery
Submental artery
Mental artery
Sublingual and Submental artery
162. The terminal branches of the lingual artery in the floor of the mouth are:
Lingual profunda artery
dorsal lingual artery
sublingual artery
Lingual profunda artery and sublingual artery
163. To stop hemorrhage from the lingual artery in the floor of the mouth one or more of the following maneuvers should be tried:
Pull the tongue forward to use the hyoglossi muscles contraction to pressure the artery against the hyoid bone
Pressure the artery as it crosses the tip of the greater horn of the hyoid bone
Pressure the external carotid artery against transverse process of C4 vertebra
All are corrects
164. Harvesting a ramus block may involve dissection below the external oblique ridge below the buccinator muscle attachment. The operator must be aware of the presence of one or more vital structures that may be injured
Facial artery
Marginal branch of facial nerve
Facial vein
All of the above
165. Lingual perforation during the insertion of mandibular second molar implant may injure one of the following arteries:
Lingual
Sublingual
Facial
Submental
All of the above
166. Which of the following is NOT considered a regenerative therapy:
Bone Grafting
Soft Tissue Grafting
Orthodontic Extrusion
Crown Preparation
Socket Preservation
167. Papilla regeneration can be best accomplished through:
Tunnel Technique
Onlay Bone Block Graft
Orthodonitc extrusion
BMP-2
None of the bove
168. In early implant placement, the implant is placed at:
The day of extraction
2-3 weeks after extraction
6-8 weeks after extraction
After 12 weeks
None of the above
169. Which factors are most related to recession and color changes around implants which are immediately placed into an anterior extraction socket.:
A thin biotype
An implant that is placed too labially.
Over-contoured restorative components
All of the above.
None of the above
170. The socket shield technique as published by Hurzeler et al., JCP 2010, is describing which technique?:
The use of a membrane to shield the socket.
The use of connective tissue graft to shield the socket
The use of a facial/buccal fragment of the root component of the tooth to be extracted in order to shield the labial plate of the socket.
The use of particle bone graft to shield the socket
All of the above
171. Why does every implant placed and restored should follow an Implant Maintenance Therapy?
To reduce the risk of an implant complication.
To prolong the results obtained with active implant therapy.
To increase the possibilities of implant success on a long term.
All of the above.
None of the above
172. The most common complication during sinus graft surgery is:
Bleeding
OMC obstruction
Membrane perforation
Graft contamination
Pain
173. Which of the following are factors that lead to peri-implantitis?:
Tissue thickness
History of Periodontitis
Excess Cement
All of the above
174. How does peri-implant tissue differ from that around teeth.:
There is no difference between the tissue surrounding implants and teeth
The tissue surrounding implants is more vascular
There are no sharpys fibers inserting into the body of the implant
The tissue surrounding implants is more resistant to probing forces
All of the above
175. What are the benefits of Immediate Implant Placement?:
Single procedure
Less traumatic for the patient
Less surgical time
Stabilizes the papillae
All of the above
176. Why does replacement of adjacent Central and Lateral Incisors pose an Esthetic Dilemma?:
Lack of Space for Two Implants
Anatomic Situation
Thin Labial Plate
Interproximal Bone Loss which occurs after extraction
All of the Above
177. Soft Tissue Thickness is important because:
It preserves crestal bone around implants
It improves the gingival margin stability of the final restoration
It maintains ideal color matching of the gingiva
All of the Above
None of the Above
178. The thickness of Gingiva on the Labial of Implants is best when:
Less than 0.5mm
Less than 1mm
Greater than 2mm
1.5mm
0.25mm
179. 84/ The sources of blood supply to the buccal plate of bone are:
The periodontal ligament
The buccal periostium
The endoseous marrow blood supply
All are corrects
180. Delaying placing an implant into a socket for 8 weeks:
Allows for soft tissue to grow over the socket
Allows for osteoid to fill in the base of the defect
Allows for any infections from the tooth to heal
All of the above
181. The proper placement of an implant into a maxillary central incisor is:
1 mm apically from the free gingival margin
3 mm apically from the free gingival margin
5 mm apically from the free gingival margin
7 mm apically from the free gingival margin
Immediate sockets should never be placed
182. Recession due to faulty implant positioning is typically due to placement too:
Apical
Palatal
Labial
All of the above
Apical and Labial
183. Soft tissue recession around implants can be due the following Physiological Factors:
Post extraction resorption
Post regenerative resorption
Post Flap resorption
Tissue Phenotype
All of the Above
184. The Goals of Therapy in Sinus Augmentation are;:
Create Bone in Posterior Maxilla
Achieve Osseointegration in that Bone
Maintain Occlusal Function under load
Achieve the above with predictability and low morbidity
All of the Above
185. What is the major concerns in One Stage Sinus Augmentation with simultaneous implant placement;:
Implant stability
Infection
Parallelism of multiple implants
Soft tissue recession
Implant stability and Parallelism of multiple implants
186. Surgical access of the maxillary sinus by creating a window through the posterior lateral wall of the maxilla may injure one or more of the following vital structures:
Posterior superior alveolar artery
Posterior superior alveolar nerve
Descending palatine nerve
Posterior superior alveolar artery and Posterior superior alveolar nerve
187. The vital structures that the dentist need to be aware of and protect during surgical access to the lateral wall of the maxillary sinus? 1. Caninus muscle 2. Infraorbital nerve 3. Infraorbital artery 4. Facial artery:
1, 2
2, 4
1, 2, 3
2 & 3
1, 2, 3 & 4
188. Maxillary siusitis caused by odontogenic infection was found to be ____ of all sinusitis;:
10%
20%
30%
40%
50%
189. The statements below are correct. Except:
In a patient with a thin gingival morphotype, a Delayed Implant Placement is recommended.
The utilization of Wide Diameter Implants in the anterior region will help to retain the Buccal Bone.
CBCT should be used for every Immediate Implant case in order to understand the patient's bone morphology and tooth position.
Good Primary Stability is a critically important factor to the success of Immediate Implant Placement.
Problems regarding Long Term Aesthetic Stability are more prevalent with Immediate Implant Placement as opposed to Delayed Implant Placement
190. In cases of severe bleeding and lingual hematoma during the placement of the implantin the lower incisor region, which artery do you think is injured:
Submental
Sublingual
Inferior labial
Transverse facial
Mental
191. 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:
Third molar tooth
Second molar tooth
Second premolar tooth
First molar tooth
None of the above
192. Implant placed in front of the mental foramen should be 6 mm from the foramen to prevent the encroachment of:
mental foramen
submental artery
anterior loop of the inferior dental nerve
incisive canal
193. During the procedure of autogenous bone grafting harvested from the area of symphysis, dysesthesia can occur because:
Damaging to the lower incisior teeth
Muscle detachment during flap raise
Incisive nerve damage
Hematoma formation postoperatively
Oedema formation postoperatively
194. Severe bleeding and lingual hematoma that occur during implant placement in the lower premolar area can be caused by severing the artery of:
Lingual
Submental artery
Inferior alveolar artery
Long buccal
None of the above
195. “Witch Chin” is a postoperative complication that occurs when a mucoperiosteal flap is raised in the symphyseal area because of:
Injury to the orbicularis oris
Detachment of mentalis muscle
Incisive nerve damage
Periosteal striping
Detachment of the platysma muscle
196. A mean distance between the mandibular canal and the inferior mandibular border measures approximately at:
10 mm
13mm
8mm
14mm
6mm
197. The incisive nerve is innervate:
lateral and central incisor
canine, lateral and central incisor
first bicuspid, canine, lateral and central incisors
canine and lateral incisor
central incisor
198. The anterior loop of an inferior dental nerve can be predicted when the nerve comes:
above the mental foramen
below the mental foramen
same level with the mental foramen
disappear before the mental foramen
199. Dentoalveolar innervation and the periodontal ligament area of the innervation are:
nerve endings with nociceptors
sympathetic
parasympathetic
nerve endings with mechanoreceptors
200. During implant placement and nerve injury, patients will feel numbness only when the injured nerve supply:
soft tissue
bony tissue
teeth
muscular tissue
201. Incisions on the buccal vestibules may cause severe edema and post- operative pain due to:
incision on loose tissue
plexus of blood vessels found in the vestibule
incision in non keratinized tissue
poor lymphatic drainage in this area
all of the above
202. The length of the inferior alveolar nerve’s anterior loop is:
<3 mm
<5 mm
<6 mm
<7 mm
8mm
203. The periosteum and both the lateral wall of the maxillary sinus and its Schneiderian membrane are supplied by two arterial branches:
middle and posterior superior alveolar artery
anterior and middle superior alveolar artery
posterior superior alveolar artery and the infraorbital artery
posterior superior and greater palatin artery
none of the above
204. The lateral wall of the maxillary sinus hosts the superior alveolar canal:
branches of the posterior superior alveolar and infraorbital arteries
branches of posterior and middle superior alveolar arteries
branches of posterior superior alveolar arteries only
branches of middle superior and infraorbital arteries
branches of posterior superior and greater palatine artery
205. The inferior border of the mandible receives most of its blood supply from:
periosteum
inferior alveolar artery
muscle attachment
mucosa
206. The gingiva and periosteum receive their blood supply mainly through the supraperiosteal vessels, which run ____________________ to the long axis of the teeth:
Angular
Perpendicular
Parallel
Circular
207. The lingual nerve provides a sensory supply to the:
lingual aspect of the mucosa, mandibular incisiors, anterior 2/3 of the tongue
lingual aspect of the mucosa, floor of the mouth, posterior 2/3 of the tongue
lingual aspect of the mucosa, floor of the mouth, lateral border of the tongue
lingual aspect of the mucosa, floor of the mouth, anterior 2/3 of the tongue
208. A Submandibular space infection can spread into:
sublingual space
lateral pharyngeal space
peritonsillar space
retropharyngeal space
sublingual space and lateral pharyngeal space
209. An anesthesia block to the long buccal nerve will anesthetize:
cheek mucosa
retromolar region
retromolar region and the buccal gingiva of the mandibular molars and premolars
retromolar region and the buccal gingiva of the mandibular molars
210. During mental nerve block anesthesia, the following structure is anesthetized:
buccal gingiva and mucosa from premolars to the midline
skin of the lower lip
lower anterior teeth
lower bicuspid teeth
buccal gingiva and mucosa from premolars to the midline and skin of the lower lip
211. Nontraumatic extraction followed by implant stabilization in the extraction socket is commonly achieved over:
the last 5 mm of the implant apical region
the last 3 mm of the implant apical region
the coronal half of the socket
apical half of the socket
the socket wall
212. For flap suturing, tissue trauma may be reduced by selecting:
finer suture diameters
thicker suture diameters
surgical knot to make the knot
matress suture technique
213. When an implant will be placed in hard, dense bone, which implant should be chosen to avoid pressure necrosis:
wide diameter implant
aggressive implant design
regular diameter implant
none tapered implant (parallel wall)
regular diameter implant and none tapered implant (parallel wall)
214. After implant placement, the most significant drop in implant stability occurs after:
6 weeks
1 week
3- 4 weeks
2 weeks
none of the above
215. The flapless punch technique is recommended for regular- size implants when the minimum ridge width:
7mm
8 mm
6 mm
5 mm
none of the above
216. When the lateral widow approach is used for maxillary sinus elevation, the operator relies on a 3- mm perforation of the Schneiderian membrane. The best management approach in this situation is:
autogenous cortical plate should be placed before particulate bone graft
collagen membrane barrier place underneath the membrane
suturing should be done to close the opening with resorbable suture
stop the operation and postponed to another time until the membrane healed
none of the above
217. Simultaneous implant placement and sinus augmentation is not recommended when:
using xenograft as a graft material
regular size implant is used
bone height underneath the maxillary sinus is < 5mm
soft bone
218. During a socket preservation procedure, the following should be considered:
no active infection
graft should be placed with layering
no condensation should be done to the graft material
no over grafting
all of the above
219. The treatment plan of choice for grossly decayed, unsolvable, upper central incisors with an optimal tissue condition is:
socket preservation with GBR procedure
the socket should be left for normal healing and delay implant placement
composite graft procedure needed
immediate implant placement with immediate provisional crown
none of the above
220. During a nonsubmerged procedure, there may be gingival overgrowth above the healing abutment during soft tissue healing. This can be treated with:
scalpel excision
laser excision
replace the healing abutment with longer one
replace the healing abutment with wider one
none of the above
221. The main cause of cover screw exposure during the healing period is:
implant placed more buccally
crestal bone resorption
infection
thin gingival tissue
222. Three weeks after submerged implant placement, you notice wound dehiscence and that part of the cover screw is exposed. What is the best management approach in this case?:
no treatment need, leave it for spontaneous healing
GBR procedure needed
full exposure of the cover screw and healing abutment placed
resuturing and complete closure
none of the above
223. A thorough investigation of the upper posterior edentulous area is needed to determine the bone volume availability before implant placement because:
difficult to determine the bone angulation in this area
thick gingival tissue can mask the bone volume
most of the time the soft tissue does not follow bone resorption
poor bone density can resorbed easily
thick gingival tissue can mask the bone volume and most of the time the soft tissue does not follow bone resorption
224. The implant should be submerged when:
poor primary implant stability
soft tissue grafting
bone grafting
poor oral hygiene
all of the above
225. The disadvantage of the punch flapless technique is:
keratinized tissue loss
blind technique
difficult to determine implant position in bone level implant
difficult to change drilling position or angulation
all of the above
226. The operator may be unable to place the implant level with bone or countersink it because:
underdrilling of the implant socket
debris at the apical part of the socket, failed to wash out
crestl preparation not done for the tapered implant
bone taping not used in hard bone
all of the above
227. Factors that can prevent placement of the implant in an ideal position include:
bone quality
anatomical factor
occlussion factor
implant position in the arch
none of the above
228. When placing an implant immediately after tooth extraction in the upper anterior area, there will be gap distance or jumping distance between the implant surface and the labial wall of the socket. This distance should be filled by bone graft particles to prevent:
soft tissue formation around the implant
implant tilting towards the labial side
collapse of the labial wall of the socket in towards the implant surface
gingival soft tissue collapse into the socket
none of the above
229. According to the Lechom and Zarb classification, which type of bone needs bone taping before implant placement:
type I
type II
type III
type IV
type I and type II
230. To avoid bone overheating during drilling, the following should be considered:
Irrigate copiously during drills
Use sharp drills
Incremental drilling procedure with increasing diameter drills
All of above
231. To achieve a proper emergence profile and to avoid a ridge overlap, an implant in the upper incisors should be placed bucco- lingually in:
underneath the cingulum
between the cingulum and the incisal edge
more palataly
slightly labial to the incisal edge
none of the above
232. Generally, the final bone preparation socket diameter is slightly smaller than the implant diameter :
1mm
0mm (same diameter)
0.6mm
0.2mm
none of the above
233. The best management for wound dehiscence after a GBR procedure and exposure of the resorbable collagen membrane to the oral cavity is:
antibiotic prescription, maintain good oral hygiene, special care to the exposed membrane by Chlorhexiden irrigation and removal of the plaque from the membrane
no management needed, just wait for wound to close spontaneously
remove the collagen membrane and replace by new one
resuturing the dehiscence with complete closure
none of the above
234. In cases of a GBR procedure, the best suturing technique to achieve complete closure and hold the wound in contact during soft tissue healing is:
figure 8
vertical mattress with simple interrupted suture in between
simple continuous
continuous block
none of the above
235. During implant placement in the upper first premolar area, special consideration should be given to:
curved apex of the adjacent canine
maxillary sinus
mesial curvature of the second premolar root
distal root angulation of the adjacent canine and curved apex of the adjacent canine
236. Underestimating the size of the incisive foramen in the upper central area during implant placement leads to implant engagement to the foramen, which in turn leads to:
numbness of the gingival premaxilla
soft tissue formation on the surface of the implant from the foramen
infection may spread to the nose
sever bleeding
237. Due to limited space in the upper central area, the implant may need to be placed in the incisive foramen. The best management approach in this case is:
enameloplasty with orthodontic movement to adjacent teeth to create space
evacuation of the foramen content then implant place in the foramen
evacuation of the foramen content, bone grafting then implant placed after graft healing
place the implant more labial with labial bone grafting
evacuation of the foramen content then implant place in the foramen and evacuation of the foramen content, bone grafting then implant placed after graft healing
238. When autogenous bone is needed for one implant, the intraoral harversian donor site is:
Symphysis
external oblique ridge
tuberosity
Exostosis
all of the above
239. 144/ Structural nerve damage without complete nerve cutting is called:
Neurotmesis
Neurapraxia
Axonotmesis
Neurogenesis
None of the above
240. A short implant should be avoided in which of the following cases:
dense bone
compromised patient
soft bone
bruxer patient and soft bone
241. For a patient with gingival recession on the adjacent teeth to the edentulous area, the best flap design is:
vestibular incision
papillae preservative incision
crestal with intrasulcular incision including the papillae
three sided flap including the papillae
none of the above
242. Immediate implant loading is determined when:
implant placed torque more than 35Ncm
implant placed in dense hard bone
resonance frequency analysis is 75 ISQ and above
when multiple implants splinted together
all of the above
243. The advantages of flapless punch implant placement include all of the following Except:
indicated when limited keratinized tissue found
less bleeding during surgery
time saving
less pain and oedema postoperatively
no suture needed
244. The advantages of the nonsubmerged over the submerged technique for implant placement include all of the following Except:
no need for second surgery
soft tissue maturation and formation around healing abutment
can be carried out with flap and flapless technique
more preferred in the aesthetic area
can transmit some of stress to the surrounding bone that enhance bone maturation
245. For a better emergent profile of an implant placed in the upper premolar area, the implant should be placed:
under the central fossa
under the buccal cusp
under the palatal cusp
subcrestal at least 1mm
none of the above
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