Patient Assessment & Clinical Evaluation Flashcards

When assessing a patient's occlusal scheme for implant prosthetics, which concept describes the design that minimizes lateral forces on posterior implants by having only anterior teeth contact during excursive movements?

Answer: Canine-guided occlusion (mutual protection)

Canine-guided (mutually protected) occlusion uses the canines to disclude posterior teeth in excursions, protecting implants from harmful lateral forces.

A clinical photograph shows concavities on the palatal surfaces of maxillary anterior teeth in a patient seeking implant consultation. Which condition should be considered and investigated?

Answer: Bulimia nervosa with acid erosion

Perimolysis — acid erosion on palatal tooth surfaces — is a hallmark of chronic vomiting associated with bulimia, which impacts treatment planning and patient management.

Which patient factor is evaluated using the Periodontal Risk Assessment (PRA) before implant placement?

Answer: Multi-factorial risk profiling including bleeding on probing, bone loss pattern, and systemic factors

The PRA integrates multiple clinical and systemic risk factors to categorize a patient's overall risk of periodontal and peri-implant disease progression.

During assessment, a patient demonstrates a high lip line exposing the full crown and gingival margin when smiling. Why is this particularly important in anterior implant planning?

Answer: It raises the aesthetic demands, requiring precise tissue management and gingival architecture to avoid visible implant components

A high lip line exposes more gingival tissue, meaning any tissue recession, metallic show-through, or contour discrepancy will be aesthetically conspicuous.

Which of the following best describes the purpose of mounting diagnostic casts on a semi-adjustable articulator during pre-implant planning?

Answer: To analyze occlusion, arch relationships, and available restorative space in all excursive movements

Articulator-mounted casts allow dynamic analysis of occlusion, jaw relationships, and space in all mandibular movements, informing prosthetic and surgical decisions.

A patient's panoramic radiograph reveals a well-defined radiolucency at the apex of tooth #14 scheduled for extraction and immediate implant. What is the most appropriate action?

Answer: Investigate and treat the periapical pathology before or at the time of implant placement to avoid contaminating the implant site

Periapical pathology at an extraction site must be thoroughly debrided and ideally resolved before immediate implant placement to prevent infection and implant failure.

Which clinical sign during intraoral examination suggests the presence of parafunctional jaw activity in a patient being evaluated for implants?

Answer: Scalloped tongue margins (linea alba) and tooth wear on occlusal/incisal surfaces

Scalloped tongue borders from pressing against teeth and occlusal wear facets are classic intraoral signs of clenching and bruxism.