CIT Patient Assessment & Clinical Evaluation 2 — Questions and Answers
Question 1: Which systemic condition most significantly increases the risk of implant failure due to impaired osseointegration?
- Controlled hypertension
- Uncontrolled type 2 diabetes (HbA1c >10%) (Correct answer)
- Mild hyperlipidemia
- Seasonal allergies
Correct answer: Uncontrolled type 2 diabetes (HbA1c >10%)
Uncontrolled diabetes impairs immune function, wound healing, and bone metabolism, all of which compromise osseointegration.
Question 2: A patient presents with a probing depth of 6 mm and bleeding on probing at site #19. What does this finding most likely indicate?
- Healthy sulcus with normal variation
- Moderate to severe periodontitis requiring treatment before implant planning (Correct answer)
- Normal post-extraction remodeling
- Occlusal trauma only
Correct answer: Moderate to severe periodontitis requiring treatment before implant planning
Probing depths ≥6 mm with bleeding on probing indicate active periodontitis, which must be resolved before implant placement.
Question 3: Which imaging modality provides the most accurate three-dimensional assessment of bone volume and density prior to implant placement?
- Periapical radiograph
- Panoramic radiograph
- Cone beam computed tomography (CBCT) (Correct answer)
- Bitewing radiograph
Correct answer: Cone beam computed tomography (CBCT)
CBCT provides 3D volumetric data including bone height, width, and density that 2D radiographs cannot capture.
Question 4: When reviewing a patient's medication list, which drug class is most directly associated with medication-related osteonecrosis of the jaw (MRONJ)?
- ACE inhibitors
- Bisphosphonates (Correct answer)
- Beta-blockers
- Statins
Correct answer: Bisphosphonates
Bisphosphonates inhibit osteoclast activity and are the drug class most commonly implicated in MRONJ.
Question 5: During a clinical examination, a technician notes inadequate attached gingiva at a proposed implant site. Why is this clinically significant?
- It has no effect on implant longevity
- Adequate attached gingiva is needed for a stable peri-implant seal and hygiene maintenance (Correct answer)
- It only affects aesthetics in the posterior region
- It indicates the implant should be placed deeper
Correct answer: Adequate attached gingiva is needed for a stable peri-implant seal and hygiene maintenance
Adequate keratinized attached gingiva supports a stable peri-implant seal, resists inflammation, and facilitates effective plaque control.
Question 6: A patient reports smoking 1.5 packs per day. How does this most directly affect implant candidacy assessment?
- No effect if oral hygiene is good
- Smoking significantly increases the risk of implant failure and peri-implantitis (Correct answer)
- Only affects aesthetic outcomes
- Reduces the need for bone grafting
Correct answer: Smoking significantly increases the risk of implant failure and peri-implantitis
Smoking impairs vascularization and immune response, substantially increasing failure rates and peri-implant disease risk.
Question 7: What is the primary purpose of a diagnostic wax-up during the pre-implant assessment phase?
- To fabricate the final implant crown
- To visualize the planned prosthetic outcome and guide implant position (Correct answer)
- To measure crestal bone density
- To test the patient's bite force
Correct answer: To visualize the planned prosthetic outcome and guide implant position
A diagnostic wax-up allows the clinician to plan the prosthetic outcome first, ensuring implant placement is restorative-driven.
CIT Patient Assessment & Clinical Evaluation 2
Which systemic condition most significantly increases the risk of implant failure due to impaired osseointegration?