AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
82. Fracture of alveolar process during the extraction of a tooth is usually due to:
A. use of excessive amounts of uncontrolled force.
B. presence of adjacent crowded teeth.
C. periapical infection.
D. expansion of surrounding alveolar bone. - (Answer)Answer: A
RA TIONALE:
If the alveolus is fractured, dissect the alveolus off the root, replace the periosteum and alveolus
which will act as a vascularized graft. If soft tissue is inadvertently dissected from the alveolus, the
segment of bone will likely undergo necrosis. If the maxillary tuberosity is fractured, and the tooth
cannot be dissected from the alveolus, replace and splint for 6 - 8 weeks. Later surgically extract the
tooth. If the tuberosity is completely avulsed without soft tissue pedicle, then smooth the remaining
bony edges and close, checking for oral antral communication.
83. If the lingual alveolar plate is fractured and mobile during removal of an erupted mandibular third
molar, the fractured segment should be:
A. stabilized to avoid damage to the lingual nerve.
B. left in place with minimal manipulation.
C. removed with careful subperiosteal dissection.
D. removed and the lingual nerve explored for evidence of injury. - (Answer)Answer: B
Rational:
Minimal manipulation of the segment will provide the greatest chance of maintaining the periosteal
attachment, and thus the blood supply to the segment. If soft tissue is inadvertently dissected from
the alveolus, the segment of bone will likely undergo necrosis. Removal of the segment is generally
not advised, dissection in this region would increase the risk of injury to the lingual nerve.
84. Thebiologicalwidthsurroundingnaturalteethandfreestandingosseointegratedrootform implants
demonstrate a relatively constant thickness of:
A. 1mm.
B. 3 mm.
,AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
C. 5 mm.
D. 7 mm - (Answer)Answer: B
Rationale:
An appreciation of biologic width is important in best determining implant positioning to allow for an
aesthetic result. Numerous studies document the dimensions of biological width for both natural
teeth and implants. Biologic width is comprised of the zone of supracrestal connective tissue that
measures approximately 1 mm and epithelial structures, including the junctional and sulcular
epithelium that measure about 2 mm in height.
85. Which of the following can cause premature loss of temporary implants used for the purpose of
providing orthodontic anchorage?
A. Non-keratinized surrounding mucosa
B. Type of intended tooth movement
C. Mini-plate implant configuration
D. Mini-screw implant configuration - (Answer)Answer: A
Rationale:
While success rates for mini-implants are high, studies like that of Chang and Tseng demonstrate that
implants placed through non-keratinized mucosa have a higher rate of failure. Another factor that
may have an adverse affect on success is placement in the posterior mandible. Implant type (mini-
screw of mini-plate) does not effect failure rates of rigid orthodontic anchorage.
86. The most important factor associated with the success of osteotome-mediated sinus floor
elevation technique is:
A. the height of the residual alveolar bone.
B. implant design.
C. type of graft material used.
D. method of sinus in-fracture. - (Answer)Answer: A
Rationale:
,AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
The ability to obtain primary implant stability is associated with the height of the residual alveolar
ridge, and is the primary factor related to success when implants are placed in conjunction with
osteotome mediated sinus floor elevation. Implant design graft material and method of sinus in-
fracture have minimal influence on survival; however, factors such as osteoporosis, type of final
prosthesis, and operator experience may also impact the success of this technique.
87. Whichofthefollowinghasafavorableaestheticimpactonanimplant-supportedrestoration?
A. Thick biotype
B. Thin biotype
C. Restorative table >6 mm apical to the contact point of the adjacent tooth.
D. Positive IL-1 genotype - (Answer)Answer: A
Rationale:
A thick biotype provides greater stability for the peri-implant soft tissues with more predictable
healing response following surgery and around restorations. Thin biotypes predispose not only to
unpredictable healing but also may allow titanium "show through". When implant restorative tables
are placed more than 5 mm below the contact point of an adjacent tooth, loss of the papilla is
common, having an adverse effect on the final aesthetic result. Finally, genetic testing utilizing a swab
has identified that positive intraleuken-1 (IL-1) genotype patients have an increased risk of developing
periodontitis with enhanced risk of peri-implant complications.
88. Which of the following is the best method to determine the completion of facial growth?
A. Use of hand/wrist films.
B. Completion of changes in skeletal height
C. Use of serial lateral cephalograms
D. Attainment of maturity by the Tanner classification - (Answer)Answer: C
Rationale:
Completion of skeletal height does not correspond to completion of facial growth. A hand- wrist
radiograph is inappropriate for assessing facial growth, because it is not specific enough for each
patient. The best method of evaluating the completion of facial growth is by superimposing
sequential cephalometric radiographs. Most boys do not complete their facial growth until the late
teenage years. A 14- or 15-year-old boy may not have gone through his adolescent growth spurt. It is
, AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
advisable to wait until an adolescent male has completed growth in height. At that point, a
cephalometric radiograph should be taken. Another radiograph should be taken at least 6 months to a
year later. If these radiographs are superimposed, and there are no changes in vertical facial height
(nasion to menton), this indicates that most of the facial growth has been completed. Achievement of
Tanner stage V indicates maturity in development of secondary sexual characteristics, but not skeletal
maturity.
89. Whichofthefollowingisanabsolutecontraindicationfordentalimplantplacement?
A. Oral lichen planus
B. Uncontrolled periodontal disease
C. Insulin dependent diabetes mellitus
D. Cigarette smoking - (Answer)Answer: B
Rationale:
Contraindications for the use of an implant restoration are in developing patients (particularly in the
maxilla, where vertical growth continues after permanent teeth are fully erupted), uncontrolled
periodontal disease, aesthetic areas with thin, highly scalloped gingiva, adjacent periapical pathology,
and non motivated patients. Relative contraindications where adjacent root flaring precludes
placement (correction needed with orthodontics), smokers (increased failure rate especially in type IV
bone), connective tissue diseases, and diabetes and autoimmune diseases.
91. In 75% of patients, in order for the dental papilla to fill the embrasure space of a single tooth
dental implant supported restoration, the maximum distance between the crestal bone and the
contact point is:
A. 6mm.
B. 5mm.
C. 4mm.
D. 3mm. - (Answer)Answer: A
Rationale:
The presence or absence of a peri-implant papilla mainly depends on the distance between the
alveolar crest and the contact point. In single-tooth gaps, the bone height at adjacent teeth
determines the status of the papilla. A clinical study by Dennis Tarnow , et al, demonstrated that a
82. Fracture of alveolar process during the extraction of a tooth is usually due to:
A. use of excessive amounts of uncontrolled force.
B. presence of adjacent crowded teeth.
C. periapical infection.
D. expansion of surrounding alveolar bone. - (Answer)Answer: A
RA TIONALE:
If the alveolus is fractured, dissect the alveolus off the root, replace the periosteum and alveolus
which will act as a vascularized graft. If soft tissue is inadvertently dissected from the alveolus, the
segment of bone will likely undergo necrosis. If the maxillary tuberosity is fractured, and the tooth
cannot be dissected from the alveolus, replace and splint for 6 - 8 weeks. Later surgically extract the
tooth. If the tuberosity is completely avulsed without soft tissue pedicle, then smooth the remaining
bony edges and close, checking for oral antral communication.
83. If the lingual alveolar plate is fractured and mobile during removal of an erupted mandibular third
molar, the fractured segment should be:
A. stabilized to avoid damage to the lingual nerve.
B. left in place with minimal manipulation.
C. removed with careful subperiosteal dissection.
D. removed and the lingual nerve explored for evidence of injury. - (Answer)Answer: B
Rational:
Minimal manipulation of the segment will provide the greatest chance of maintaining the periosteal
attachment, and thus the blood supply to the segment. If soft tissue is inadvertently dissected from
the alveolus, the segment of bone will likely undergo necrosis. Removal of the segment is generally
not advised, dissection in this region would increase the risk of injury to the lingual nerve.
84. Thebiologicalwidthsurroundingnaturalteethandfreestandingosseointegratedrootform implants
demonstrate a relatively constant thickness of:
A. 1mm.
B. 3 mm.
,AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
C. 5 mm.
D. 7 mm - (Answer)Answer: B
Rationale:
An appreciation of biologic width is important in best determining implant positioning to allow for an
aesthetic result. Numerous studies document the dimensions of biological width for both natural
teeth and implants. Biologic width is comprised of the zone of supracrestal connective tissue that
measures approximately 1 mm and epithelial structures, including the junctional and sulcular
epithelium that measure about 2 mm in height.
85. Which of the following can cause premature loss of temporary implants used for the purpose of
providing orthodontic anchorage?
A. Non-keratinized surrounding mucosa
B. Type of intended tooth movement
C. Mini-plate implant configuration
D. Mini-screw implant configuration - (Answer)Answer: A
Rationale:
While success rates for mini-implants are high, studies like that of Chang and Tseng demonstrate that
implants placed through non-keratinized mucosa have a higher rate of failure. Another factor that
may have an adverse affect on success is placement in the posterior mandible. Implant type (mini-
screw of mini-plate) does not effect failure rates of rigid orthodontic anchorage.
86. The most important factor associated with the success of osteotome-mediated sinus floor
elevation technique is:
A. the height of the residual alveolar bone.
B. implant design.
C. type of graft material used.
D. method of sinus in-fracture. - (Answer)Answer: A
Rationale:
,AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
The ability to obtain primary implant stability is associated with the height of the residual alveolar
ridge, and is the primary factor related to success when implants are placed in conjunction with
osteotome mediated sinus floor elevation. Implant design graft material and method of sinus in-
fracture have minimal influence on survival; however, factors such as osteoporosis, type of final
prosthesis, and operator experience may also impact the success of this technique.
87. Whichofthefollowinghasafavorableaestheticimpactonanimplant-supportedrestoration?
A. Thick biotype
B. Thin biotype
C. Restorative table >6 mm apical to the contact point of the adjacent tooth.
D. Positive IL-1 genotype - (Answer)Answer: A
Rationale:
A thick biotype provides greater stability for the peri-implant soft tissues with more predictable
healing response following surgery and around restorations. Thin biotypes predispose not only to
unpredictable healing but also may allow titanium "show through". When implant restorative tables
are placed more than 5 mm below the contact point of an adjacent tooth, loss of the papilla is
common, having an adverse effect on the final aesthetic result. Finally, genetic testing utilizing a swab
has identified that positive intraleuken-1 (IL-1) genotype patients have an increased risk of developing
periodontitis with enhanced risk of peri-implant complications.
88. Which of the following is the best method to determine the completion of facial growth?
A. Use of hand/wrist films.
B. Completion of changes in skeletal height
C. Use of serial lateral cephalograms
D. Attainment of maturity by the Tanner classification - (Answer)Answer: C
Rationale:
Completion of skeletal height does not correspond to completion of facial growth. A hand- wrist
radiograph is inappropriate for assessing facial growth, because it is not specific enough for each
patient. The best method of evaluating the completion of facial growth is by superimposing
sequential cephalometric radiographs. Most boys do not complete their facial growth until the late
teenage years. A 14- or 15-year-old boy may not have gone through his adolescent growth spurt. It is
, AAPD QE BOARD REVIEW QUESTIONS & ANSWERS RATED 100% CORRECT!!
advisable to wait until an adolescent male has completed growth in height. At that point, a
cephalometric radiograph should be taken. Another radiograph should be taken at least 6 months to a
year later. If these radiographs are superimposed, and there are no changes in vertical facial height
(nasion to menton), this indicates that most of the facial growth has been completed. Achievement of
Tanner stage V indicates maturity in development of secondary sexual characteristics, but not skeletal
maturity.
89. Whichofthefollowingisanabsolutecontraindicationfordentalimplantplacement?
A. Oral lichen planus
B. Uncontrolled periodontal disease
C. Insulin dependent diabetes mellitus
D. Cigarette smoking - (Answer)Answer: B
Rationale:
Contraindications for the use of an implant restoration are in developing patients (particularly in the
maxilla, where vertical growth continues after permanent teeth are fully erupted), uncontrolled
periodontal disease, aesthetic areas with thin, highly scalloped gingiva, adjacent periapical pathology,
and non motivated patients. Relative contraindications where adjacent root flaring precludes
placement (correction needed with orthodontics), smokers (increased failure rate especially in type IV
bone), connective tissue diseases, and diabetes and autoimmune diseases.
91. In 75% of patients, in order for the dental papilla to fill the embrasure space of a single tooth
dental implant supported restoration, the maximum distance between the crestal bone and the
contact point is:
A. 6mm.
B. 5mm.
C. 4mm.
D. 3mm. - (Answer)Answer: A
Rationale:
The presence or absence of a peri-implant papilla mainly depends on the distance between the
alveolar crest and the contact point. In single-tooth gaps, the bone height at adjacent teeth
determines the status of the papilla. A clinical study by Dennis Tarnow , et al, demonstrated that a
