CIT Pharmacology & Medications in Implantology 1 — Questions and Answers
Question 1: Which local anesthetic is most commonly used during dental implant placement procedures?
- Bupivacaine 0.5%
- Lidocaine 2% with epinephrine 1:100,000 (Correct answer)
- Mepivacaine 3%
- Prilocaine 4%
Correct answer: Lidocaine 2% with epinephrine 1:100,000
Lidocaine 2% with epinephrine 1:100,000 is the gold standard in implant dentistry due to its reliable onset, adequate duration, and vasoconstrictive properties.
Question 2: What is the primary purpose of adding epinephrine to local anesthetics used in implant surgery?
- To increase the speed of anesthetic uptake
- To reduce the risk of allergic reactions
- To prolong anesthetic duration and reduce bleeding (Correct answer)
- To neutralize the pH of the anesthetic solution
Correct answer: To prolong anesthetic duration and reduce bleeding
Epinephrine acts as a vasoconstrictor, slowing systemic absorption of the local anesthetic to prolong its effect and reducing intraoperative bleeding.
Question 3: Which antibiotic is most commonly prescribed as prophylaxis before implant placement surgery?
- Metronidazole 500 mg
- Amoxicillin 2 g (Correct answer)
- Clindamycin 600 mg
- Ciprofloxacin 500 mg
Correct answer: Amoxicillin 2 g
Amoxicillin 2 g taken one hour before the procedure is the standard prophylactic antibiotic regimen for dental implant surgery in non-allergic patients.
Question 4: Chlorhexidine gluconate 0.12% oral rinse is prescribed after implant surgery primarily to:
- Reduce post-operative swelling
- Control bacterial plaque and reduce infection risk at the surgical site (Correct answer)
- Accelerate osseointegration of the implant
- Neutralize residual local anesthetic
Correct answer: Control bacterial plaque and reduce infection risk at the surgical site
Chlorhexidine gluconate is a broad-spectrum antimicrobial that reduces oral bacterial load, helping to prevent peri-implant infection during healing.
Question 5: Which drug class is most appropriate for managing mild to moderate post-operative pain and inflammation following implant placement?
- Opioid analgesics
- Non-steroidal anti-inflammatory drugs (NSAIDs) (Correct answer)
- Benzodiazepines
- Antihistamines
Correct answer: Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs such as ibuprofen address both pain and the inflammatory component of post-surgical discomfort without the dependency risks associated with opioids.
Question 6: What is the maximum recommended dose of lidocaine with epinephrine for a healthy adult patient during implant surgery?
- 3.3 mg/kg, not to exceed 300 mg
- 4.4 mg/kg, not to exceed 300 mg
- 7 mg/kg, not to exceed 500 mg (Correct answer)
- 10 mg/kg, not to exceed 600 mg
Correct answer: 7 mg/kg, not to exceed 500 mg
The maximum safe dose of lidocaine with epinephrine is 7 mg/kg up to 500 mg total; the vasoconstrictor slows absorption, allowing a higher ceiling than plain lidocaine.
Question 7: A patient is allergic to penicillin and requires antibiotic prophylaxis before implant surgery. Which antibiotic is the recommended alternative?
- Amoxicillin-clavulanate 875 mg
- Clindamycin 600 mg (Correct answer)
- Doxycycline 100 mg
- Azithromycin 500 mg
Correct answer: Clindamycin 600 mg
Clindamycin 600 mg one hour before the procedure is the standard alternative for penicillin-allergic patients undergoing dental implant surgery.
CIT Pharmacology & Medications in Implantology 1
Which local anesthetic is most commonly used during dental implant placement procedures?