CIT Patient Care & Post-Operative Management 3 — Questions and Answers
Question 1: Which medication class is most commonly prescribed to manage post-operative pain following routine implant placement in a healthy adult?
- Opioid analgesics as first-line therapy
- Corticosteroids only
- NSAIDs such as ibuprofen (Correct answer)
- Muscle relaxants
Correct answer: NSAIDs such as ibuprofen
NSAIDs are first-line analgesics for implant post-operative pain due to their anti-inflammatory and analgesic properties with a favorable safety profile.
Question 2: During the osseointegration phase, a patient should be placed on what type of diet?
- Regular unrestricted diet immediately
- Soft, non-chewing diet on the implant side for 4–8 weeks (Correct answer)
- Liquid-only diet for 6 months
- High-protein hard foods to stimulate bone formation
Correct answer: Soft, non-chewing diet on the implant side for 4–8 weeks
A soft diet avoiding pressure on the implant site allows undisturbed bone apposition around the implant during the critical osseointegration window.
Question 3: What is the primary purpose of prescribing prophylactic antibiotics before implant surgery?
- To prevent peri-implant mucositis long-term
- To reduce the risk of early surgical site infection and implant failure (Correct answer)
- To eliminate the need for sterile technique
- To enhance osseointegration speed
Correct answer: To reduce the risk of early surgical site infection and implant failure
Pre-operative antibiotics reduce bacterial load at the surgical site, lowering the incidence of early post-operative infection and implant loss.
Question 4: A patient develops trismus (limited mouth opening) 48 hours after posterior mandibular implant placement. The most likely cause is:
- Implant thread exposure through the cortex
- Pterygoid muscle inflammation or hematoma from the local anesthetic injection (Correct answer)
- Allergic reaction to the titanium implant
- Early osseointegration causing jaw stiffness
Correct answer: Pterygoid muscle inflammation or hematoma from the local anesthetic injection
Trismus post-implant surgery is most commonly caused by muscle inflammation or hematoma at the injection site of the inferior alveolar block.
Question 5: Chlorhexidine gluconate mouth rinse is often prescribed post-operatively because it:
- Accelerates bone growth around the implant
- Provides broad-spectrum antimicrobial action to reduce surgical site infection (Correct answer)
- Whitens teeth adjacent to the implant
- Replaces mechanical brushing during healing
Correct answer: Provides broad-spectrum antimicrobial action to reduce surgical site infection
Chlorhexidine's substantivity and broad-spectrum activity make it effective at reducing oral biofilm and preventing post-surgical infection.
Question 6: Which finding at a 2-week post-operative visit is considered NORMAL and does not require intervention?
- Purulent discharge around the healing abutment
- Slight bruising (ecchymosis) on the cheek or neck (Correct answer)
- Severe throbbing pain unresponsive to NSAIDs
- Mobility of the implant when tested with finger pressure
Correct answer: Slight bruising (ecchymosis) on the cheek or neck
Ecchymosis from surgical trauma commonly appears in dependent areas of the face and neck within 2 weeks and resolves without treatment.
Question 7: A diabetic patient with HbA1c of 9.5% is scheduled for implant placement. Which post-operative consideration is MOST important?
- Prescribe a lower antibiotic dose to avoid nephrotoxicity
- Monitor more closely for delayed healing and infection due to impaired immune response (Correct answer)
- Avoid NSAIDs and use only acetaminophen
- No special considerations are needed if the patient takes insulin
Correct answer: Monitor more closely for delayed healing and infection due to impaired immune response
Poorly controlled diabetes impairs neutrophil function, wound healing, and bone metabolism, significantly increasing risk of peri-implant infection and failure.
CIT Patient Care & Post-Operative Management 3
Which medication class is most commonly prescribed to manage post-operative pain following routine implant placement in a healthy adult?