CIT Surgical Assistance & Implant Placement 3 — Questions and Answers
Question 1: Which suture technique provides the best approximation of a flap over an extraction socket before implant placement?
- Simple interrupted suture
- Horizontal mattress suture
- Vertical mattress suture
- Figure-eight suture (Correct answer)
Correct answer: Figure-eight suture
A figure-eight suture effectively closes an extraction socket by crossing over the opening and providing tension-free closure across a wider gap.
Question 2: Implant primary stability is primarily determined by:
- Implant diameter alone
- Bone density and implant-bone contact at placement (Correct answer)
- Surface treatment of the implant
- Patient age and systemic health
Correct answer: Bone density and implant-bone contact at placement
Primary stability results from the mechanical engagement between the implant and the surrounding bone, directly related to bone density and fit.
Question 3: When a surgeon uses an expander technique instead of sequential drilling, it is most appropriate in:
- Dense cortical bone (D1)
- Soft cancellous bone (D4) (Correct answer)
- Normal trabecular bone (D2)
- Grafted bone sites
Correct answer: Soft cancellous bone (D4)
Bone expansion/condensing techniques are used in soft (D4) bone to compress trabecular bone laterally, increasing density and implant stability.
Question 4: A cover screw is placed at the end of a two-stage implant surgery primarily to:
- Transmit occlusal forces during healing
- Protect the internal connection and allow submerged healing (Correct answer)
- Attach the provisional prosthesis
- Guide soft tissue contour formation
Correct answer: Protect the internal connection and allow submerged healing
The cover screw seals the implant's internal connection and allows the implant to heal submerged under the mucosa, away from oral contaminants.
Question 5: The surgical assistant is responsible for maintaining the sterile field. If a sterile instrument falls below the level of the sterile drape, it should be:
- Retrieved if it touched only the floor momentarily
- Considered contaminated and replaced (Correct answer)
- Rinsed with sterile saline and returned to the field
- Used on the contralateral side of the mouth
Correct answer: Considered contaminated and replaced
Any sterile instrument that falls below the level of the sterile field or drape must be considered contaminated and cannot be returned to the sterile field.
Question 6: Guided bone regeneration (GBR) membranes are used during implant surgery to:
- Reduce post-operative pain
- Prevent epithelial and connective tissue ingrowth into the defect (Correct answer)
- Accelerate osseointegration of the implant surface
- Provide a scaffold for soft tissue augmentation only
Correct answer: Prevent epithelial and connective tissue ingrowth into the defect
GBR membranes create a secluded space that excludes fast-growing soft tissue cells, allowing slower-growing osteogenic cells to regenerate bone.
Question 7: Implant placement in the posterior maxilla is most challenging due to:
- Greater proximity to the inferior alveolar nerve
- Thin labial cortical plate and aesthetic demands
- Poor bone quality (D3/D4) and limited vertical bone height due to the sinus (Correct answer)
- Higher infection risk from the sublingual gland
Correct answer: Poor bone quality (D3/D4) and limited vertical bone height due to the sinus
The posterior maxilla typically has soft, poorly trabeculated bone and the maxillary sinus often limits available bone height, complicating standard implant placement.
CIT Surgical Assistance & Implant Placement 3
Which suture technique provides the best approximation of a flap over an extraction socket before implant placement?