CIT Surgical Assistance & Implant Placement 2 — Questions and Answers
Question 1: During implant osteotomy, which irrigation method best prevents bone overheating?
- Dry drilling at low speed
- External irrigation with saline at 50 mL/min
- Internal irrigation through the drill at adequate flow (Correct answer)
- Air cooling with the surgical handpiece
Correct answer: Internal irrigation through the drill at adequate flow
Internal irrigation delivers coolant directly to the cutting surface, most effectively preventing thermal necrosis during osteotomy.
Question 2: A patient presents with a Siebert Class III ridge defect. This describes:
- Horizontal bone loss only
- Vertical bone loss only
- Combined horizontal and vertical bone loss (Correct answer)
- Normal ridge anatomy with soft tissue deficit
Correct answer: Combined horizontal and vertical bone loss
Siebert Class III represents a combination of both horizontal and vertical bone deficiency, the most challenging defect for implant placement.
Question 3: The critical temperature threshold above which bone necrosis occurs during implant site preparation is:
- 37°C
- 42°C
- 47°C (Correct answer)
- 56°C
Correct answer: 47°C
Bone necrosis begins at approximately 47°C; maintaining bone temperature below this during drilling is essential for osseointegration.
Question 4: When placing a tissue-level implant versus a bone-level implant, the primary positional difference is:
- Tissue-level implants are placed sub-crestally
- Tissue-level implants have the abutment junction at the crestal bone
- Tissue-level implants have the implant-abutment junction at the soft tissue level (Correct answer)
- Bone-level implants protrude above the gingiva at placement
Correct answer: Tissue-level implants have the implant-abutment junction at the soft tissue level
Tissue-level implants are designed so the smooth collar and implant-abutment junction rest at or slightly above the mucosal level.
Question 5: Which retractor is most appropriate for providing lingual access while protecting the floor of the mouth during a mandibular implant procedure?
- Minnesota retractor (Correct answer)
- Weider tongue retractor
- Freer elevator
- Periosteal elevator used as a retractor
Correct answer: Minnesota retractor
The Minnesota retractor is specifically designed to retract the cheek and soft tissues while providing access and protecting adjacent structures in the mandible.
Question 6: During surgical site preparation, the assistant notices the surgeon is drilling without irrigation. The most appropriate immediate action is:
- Document the incident and report after surgery
- Verbally alert the surgeon and prepare irrigation immediately (Correct answer)
- Increase suction to compensate
- Continue without interruption as the surgeon leads the procedure
Correct answer: Verbally alert the surgeon and prepare irrigation immediately
Immediate verbal communication and preparation of irrigation is critical to prevent thermal bone damage, a time-sensitive complication.
Question 7: The 'torque wrench' used during implant placement is set to a specific value primarily to:
- Ensure the implant reaches the correct depth
- Prevent stripping of the implant fixture threads
- Achieve the target insertion torque without over-torquing (Correct answer)
- Measure bone density at the surgical site
Correct answer: Achieve the target insertion torque without over-torquing
The torque wrench is calibrated to a target value (commonly 25–35 Ncm) to achieve adequate primary stability without exceeding the bone's tolerance.
CIT Surgical Assistance & Implant Placement 2
During implant osteotomy, which irrigation method best prevents bone overheating?