CIT Treatment Protocols & Procedures 3 — Questions and Answers
Question 1: Which protocol defines placing a restoration in occlusion within 48 hours of implant surgery?
- Early loading
- Conventional loading
- Immediate loading (Correct answer)
- Delayed loading
Correct answer: Immediate loading
Immediate loading places a restoration in occlusion within 48 hours of implant placement, requiring high primary stability.
Question 2: A patient requires bilateral sinus augmentation. Which approach is preferred when residual bone height is less than 4 mm?
- Crestal (osteotome) sinus lift
- Lateral window sinus augmentation (Correct answer)
- Subantral augmentation via palatal approach
- Balloon sinus dilation
Correct answer: Lateral window sinus augmentation
The lateral window approach is indicated when residual bone height is insufficient (<4–5 mm) for the crestal technique.
Question 3: During a ridge split procedure, the primary instrument used to expand the thin alveolar ridge is:
- Rongeur forceps
- Piezoelectric osteotome or manual spreader osteotomes (Correct answer)
- Trephine bur
- Bone chisel and mallet only
Correct answer: Piezoelectric osteotome or manual spreader osteotomes
Piezoelectric tips or manual osteotomes are used to split and laterally expand the buccal and lingual cortical plates of a thin ridge.
Question 4: The 'platform switching' concept in implant prosthetics primarily serves to:
- Increase crown height for esthetic purposes
- Shift the abutment-implant junction inward to preserve crestal bone (Correct answer)
- Allow for easier torquing of the abutment screw
- Reduce the number of components needed
Correct answer: Shift the abutment-implant junction inward to preserve crestal bone
Platform switching uses a smaller-diameter abutment on a wider implant platform to move the microgap inward and reduce crestal bone resorption.
Question 5: A Schneiderian membrane perforation during lateral sinus augmentation that is small (<5 mm) is best managed by:
- Aborting the procedure entirely
- Placing a resorbable collagen membrane patch over the tear and continuing (Correct answer)
- Packing the sinus with iodoform gauze
- Converting to a crestal approach
Correct answer: Placing a resorbable collagen membrane patch over the tear and continuing
Small perforations can be managed by folding the membrane on itself or placing a resorbable collagen membrane patch before grafting.
Question 6: Which systemic condition represents an absolute contraindication to elective implant surgery?
- Well-controlled type 2 diabetes (HbA1c < 7%)
- Recent bisphosphonate IV therapy for malignancy (within 12 months) (Correct answer)
- Mild osteoporosis managed with calcium supplements
- Controlled hypertension on ACE inhibitors
Correct answer: Recent bisphosphonate IV therapy for malignancy (within 12 months)
IV bisphosphonate therapy for malignancy significantly raises the risk of medication-related osteonecrosis of the jaw (MRONJ), making elective implant surgery contraindicated.
Question 7: When suturing a flap following implant placement, which suture technique best achieves primary closure under tension?
- Simple interrupted sutures
- Continuous sling sutures
- Horizontal mattress sutures (Correct answer)
- Figure-of-eight sutures
Correct answer: Horizontal mattress sutures
Horizontal mattress sutures distribute tension over a wider area and evert wound edges, making them ideal for flap closure under tension.
CIT Treatment Protocols & Procedures 3
Which protocol defines placing a restoration in occlusion within 48 hours of implant surgery?