AAID Associate Fellow Written Examination
AAID – AMERICAN ACADEMY OF IMPLANT DENTISTRY | ASSOCIATE FELLOW
(AF) PART 1 WRITTEN EXAM | EXAM QUESTIONS AND CORRECT ANSWERS |
LATEST 2026/2027
AMERICAN ACADEMY OF IMPLANT DENTISTRY (AAID)
ASSOCIATE FELLOW WRITTEN
1. Which nerve is at greatest risk during implant placement in the posterior mandible?
A. Inferior alveolar nerve
B. Lingual nerve
C. Long buccal nerve
D. Mylohyoid nerve
ANSWER : A. Inferior alveolar nerve
The inferior alveolar nerve runs within the mandibular canal directly beneath the posterior
alveolar crest, making it the main structure to protect during osteotomy depth planning.
2. The anterior loop of the mental nerve is clinically significant because it:
A. Is absent in edentulous patients
B. Always lies distal to the second premolar
C. May extend mesial to the mental foramen before exiting
D. Runs superior to the alveolar crest
ANSWER : C. May extend mesial to the mental foramen before exiting
The nerve can loop forward before exiting the foramen, so a safety margin mesial to the
foramen is needed when placing implants in the premolar area.
Page 1 of 43
, AAID Associate Fellow Written Examination
3. A minimum safety distance commonly recommended between the apex of an implant
and the mandibular canal is:
A. 8 mm
B. 5 mm
C. 2 mm
D. 0.5 mm
ANSWER : C. 2 mm
A 2 mm margin allows for imaging error and drill tip overpreparation, reducing the risk of
nerve injury.
4. Life-threatening hemorrhage after perforation of the lingual cortex in the anterior
mandible most often involves branches of the:
A. Sublingual and submental arteries
B. Posterior superior alveolar artery
C. Inferior alveolar artery
D. Facial artery only
ANSWER : A. Sublingual and submental arteries
Perforation of the lingual plate can injure sublingual or submental vessels, producing a floor-
of-mouth hematoma that may compromise the airway.
5. The submandibular fossa is located:
A. Below the mylohyoid line on the lingual aspect of the posterior mandible
B. Above the mylohyoid line in the premolar region
C. On the buccal surface of the ramus
D. Within the symphysis midline
ANSWER : A. Below the mylohyoid line on the lingual aspect of the posterior
mandible
The fossa is a lingual undercut beneath the mylohyoid ridge; angled drilling here can
perforate the lingual cortex.
6. The posterior superior alveolar artery is clinically important during:
A. Palatal connective tissue harvest from the incisive region
B. Mandibular symphysis grafting
C. Lateral window sinus augmentation
D. Mandibular canal lateralization
ANSWER : C. Lateral window sinus augmentation
This artery often courses within the lateral sinus wall and may bleed when the bony window
is prepared.
Page 2 of 43
, AAID Associate Fellow Written Examination
7. The nasopalatine canal may complicate implant placement in which site?
A. Maxillary first molar
B. Maxillary central incisor
C. Mandibular canine
D. Mandibular first premolar
ANSWER : B. Maxillary central incisor
A wide incisive canal can occupy the bone needed for central incisor implants and may need
to be avoided or grafted.
8. Which type of bone has a thick cortex and dense trabecular core, according to Misch's
classification?
A. D1
B. D2
C. D3
D. D4
ANSWER : B. D2
D2 bone has a dense to porous cortical crest with coarse trabecular bone inside, commonly
seen in the anterior mandible.
9. D4 bone is most commonly found in the:
A. Ramus
B. Posterior maxilla
C. Mandibular symphysis
D. Anterior mandible
ANSWER : B. Posterior maxilla
The posterior maxilla often presents fine, low-density trabecular bone with little cortical
bone.
10. Underwood septa are best described as:
A. Accessory foramina in the symphysis
B. Bony partitions within the maxillary sinus floor
C. Fibrous bands in the floor of the mouth
D. Bony spurs on the mylohyoid ridge
ANSWER : B. Bony partitions within the maxillary sinus floor
These septa divide the sinus floor into recesses and can make window design and membrane
elevation more difficult.
Page 3 of 43
, AAID Associate Fellow Written Examination
11. The Schneiderian membrane lines the:
A. Nasal septum only
B. Mandibular canal
C. Maxillary sinus
D. Pterygomaxillary fissure
ANSWER : C. Maxillary sinus
It is the respiratory mucosa of the maxillary sinus that is elevated during sinus floor
augmentation.
12. Lingual concavity in the posterior mandible is best assessed with:
A. Cross-sectional CBCT images
B. Periapical radiograph
C. Bitewing radiograph
D. Panoramic radiograph
ANSWER : A. Cross-sectional CBCT images
Only cross-sectional 3D views show the true lingual undercut and its depth.
13. The ostium of the maxillary sinus drains into the:
A. Superior meatus
B. Sphenoethmoidal recess
C. Middle meatus
D. Inferior meatus
ANSWER : C. Middle meatus
Patency of the ostium in the middle meatus is important to avoid postoperative sinusitis after
augmentation.
14. Pneumatization of the maxillary sinus after posterior tooth loss results in:
A. Thickening of the sinus floor cortex
B. Reduced vertical bone height above the crest
C. Lowering of the alveolar crest only
D. Increased crestal bone width
ANSWER : B. Reduced vertical bone height above the crest
The sinus expands into the space once occupied by tooth roots, limiting available vertical
bone for implants.
15. The greater palatine foramen is usually located adjacent to the:
A. Maxillary first premolar
B. Maxillary second or third molar
C. Maxillary canine
D. Maxillary central incisor
ANSWER : B. Maxillary second or third molar
Knowledge of this foramen is needed to avoid the greater palatine artery during palatal tissue
harvest.
Page 4 of 43
AAID – AMERICAN ACADEMY OF IMPLANT DENTISTRY | ASSOCIATE FELLOW
(AF) PART 1 WRITTEN EXAM | EXAM QUESTIONS AND CORRECT ANSWERS |
LATEST 2026/2027
AMERICAN ACADEMY OF IMPLANT DENTISTRY (AAID)
ASSOCIATE FELLOW WRITTEN
1. Which nerve is at greatest risk during implant placement in the posterior mandible?
A. Inferior alveolar nerve
B. Lingual nerve
C. Long buccal nerve
D. Mylohyoid nerve
ANSWER : A. Inferior alveolar nerve
The inferior alveolar nerve runs within the mandibular canal directly beneath the posterior
alveolar crest, making it the main structure to protect during osteotomy depth planning.
2. The anterior loop of the mental nerve is clinically significant because it:
A. Is absent in edentulous patients
B. Always lies distal to the second premolar
C. May extend mesial to the mental foramen before exiting
D. Runs superior to the alveolar crest
ANSWER : C. May extend mesial to the mental foramen before exiting
The nerve can loop forward before exiting the foramen, so a safety margin mesial to the
foramen is needed when placing implants in the premolar area.
Page 1 of 43
, AAID Associate Fellow Written Examination
3. A minimum safety distance commonly recommended between the apex of an implant
and the mandibular canal is:
A. 8 mm
B. 5 mm
C. 2 mm
D. 0.5 mm
ANSWER : C. 2 mm
A 2 mm margin allows for imaging error and drill tip overpreparation, reducing the risk of
nerve injury.
4. Life-threatening hemorrhage after perforation of the lingual cortex in the anterior
mandible most often involves branches of the:
A. Sublingual and submental arteries
B. Posterior superior alveolar artery
C. Inferior alveolar artery
D. Facial artery only
ANSWER : A. Sublingual and submental arteries
Perforation of the lingual plate can injure sublingual or submental vessels, producing a floor-
of-mouth hematoma that may compromise the airway.
5. The submandibular fossa is located:
A. Below the mylohyoid line on the lingual aspect of the posterior mandible
B. Above the mylohyoid line in the premolar region
C. On the buccal surface of the ramus
D. Within the symphysis midline
ANSWER : A. Below the mylohyoid line on the lingual aspect of the posterior
mandible
The fossa is a lingual undercut beneath the mylohyoid ridge; angled drilling here can
perforate the lingual cortex.
6. The posterior superior alveolar artery is clinically important during:
A. Palatal connective tissue harvest from the incisive region
B. Mandibular symphysis grafting
C. Lateral window sinus augmentation
D. Mandibular canal lateralization
ANSWER : C. Lateral window sinus augmentation
This artery often courses within the lateral sinus wall and may bleed when the bony window
is prepared.
Page 2 of 43
, AAID Associate Fellow Written Examination
7. The nasopalatine canal may complicate implant placement in which site?
A. Maxillary first molar
B. Maxillary central incisor
C. Mandibular canine
D. Mandibular first premolar
ANSWER : B. Maxillary central incisor
A wide incisive canal can occupy the bone needed for central incisor implants and may need
to be avoided or grafted.
8. Which type of bone has a thick cortex and dense trabecular core, according to Misch's
classification?
A. D1
B. D2
C. D3
D. D4
ANSWER : B. D2
D2 bone has a dense to porous cortical crest with coarse trabecular bone inside, commonly
seen in the anterior mandible.
9. D4 bone is most commonly found in the:
A. Ramus
B. Posterior maxilla
C. Mandibular symphysis
D. Anterior mandible
ANSWER : B. Posterior maxilla
The posterior maxilla often presents fine, low-density trabecular bone with little cortical
bone.
10. Underwood septa are best described as:
A. Accessory foramina in the symphysis
B. Bony partitions within the maxillary sinus floor
C. Fibrous bands in the floor of the mouth
D. Bony spurs on the mylohyoid ridge
ANSWER : B. Bony partitions within the maxillary sinus floor
These septa divide the sinus floor into recesses and can make window design and membrane
elevation more difficult.
Page 3 of 43
, AAID Associate Fellow Written Examination
11. The Schneiderian membrane lines the:
A. Nasal septum only
B. Mandibular canal
C. Maxillary sinus
D. Pterygomaxillary fissure
ANSWER : C. Maxillary sinus
It is the respiratory mucosa of the maxillary sinus that is elevated during sinus floor
augmentation.
12. Lingual concavity in the posterior mandible is best assessed with:
A. Cross-sectional CBCT images
B. Periapical radiograph
C. Bitewing radiograph
D. Panoramic radiograph
ANSWER : A. Cross-sectional CBCT images
Only cross-sectional 3D views show the true lingual undercut and its depth.
13. The ostium of the maxillary sinus drains into the:
A. Superior meatus
B. Sphenoethmoidal recess
C. Middle meatus
D. Inferior meatus
ANSWER : C. Middle meatus
Patency of the ostium in the middle meatus is important to avoid postoperative sinusitis after
augmentation.
14. Pneumatization of the maxillary sinus after posterior tooth loss results in:
A. Thickening of the sinus floor cortex
B. Reduced vertical bone height above the crest
C. Lowering of the alveolar crest only
D. Increased crestal bone width
ANSWER : B. Reduced vertical bone height above the crest
The sinus expands into the space once occupied by tooth roots, limiting available vertical
bone for implants.
15. The greater palatine foramen is usually located adjacent to the:
A. Maxillary first premolar
B. Maxillary second or third molar
C. Maxillary canine
D. Maxillary central incisor
ANSWER : B. Maxillary second or third molar
Knowledge of this foramen is needed to avoid the greater palatine artery during palatal tissue
harvest.
Page 4 of 43
