Accelerated treatment protocols: Full arch treatment with interim and definitive prostheses

Self Instruction Exercise No. 316
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Exercise No. 316
Subject Code: 616
Implant Restorations

The 15 questions for this exercise are based on the article Accelerated treatment protocols: Full arch treatment with interim and definitive prostheses on pages 480-491. This exercise was developed by Steven E. Holbrook, DMD, MAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • recognize the advantages of immediate occlusal loading of implants;
  • identify the principles associated with immediate occlusal loading of implants; and
  • understand the accelerated prosthodontics protocol for the restoration of edentulous and partially edentulous patients.

Answers for this exercise must be received by October 31, 2013.

  1. In the Agliardi study using the “All-on-4” protocol, the definitive prostheses were placed

    A. on the day of implant placement.
    B. one week following implant placement.
    C. one to three months following implant placement.
    D. four to six months following implant placement.

  2. The vertical space recommended by the author for implant restorative components and prosthesis is

    A. 5 to 8 mm.
    B. 9 to 11 mm.
    C. 12 to 15 mm.
    D. 16 to 19 mm.

  3. To ensure primary stability for immediate occlusal loading, the author recommends that implants are placed with a minimum insertion torque of ____ Ncm.

    A. 20
    B. 35
    C. 50
    D. 70

  4. Adequate space for restoration in this case was obtained by

    A. increasing the vertical dimension of occlusion (VDO) and alveolectomy of the maxilla and mandible.
    B. increasing the VDO and alveolectomy of the maxilla only.
    C. alveolectomy of the maxilla and mandible without increasing the VDO.
    D. increasing the VDO and alveolectomy of the mandible only.

  5. In this case, the fit of the final frameworks was checked using

    A. a verification jig.
    B. the one screw test.
    C. radiographic verification.
    D. abutment scanning.

  6. The accelerated protocol used in this case refers to

    A. the elimination of the interim prosthesis to shorten treatment time.
    B. the placement of an interim prosthesis to allow immediate occlusal loading.
    C. the use of a CAD/CAM generated stent to speed implant placement.
    D. longer prosthodontic visits that were well received by patients.

  7. The study by Ortorp & Jemt found a 10-year prosthesis cumulative survival rate (CSR) for the CAD/CAM group of 95.6% compared to a CSR of ____% for the casting group.

    A. 88.7
    B. 92.3
    C. 96.5
    D. 98.3

  8. The VDO was verified at the time of surgery by the use of a

    A. phonetic examination.
    B. CAD/CAM generated appliance.
    C. cotton tip applicator.
    D. prefabricated stent.

  9. According to Cooper et al, mandibular implants placed with high primary stability, immediately after extraction of periodontally compromised teeth, rigidly splinted together with acrylic resin prostheses, and placed into fully functional occlusion exhibited a post-implant placement CSR of _____% at 6 to 18 months.

    A. 100
    B. 98
    C. 88
    D. 50

  10. Strietzel reported that the median number of implants in their retrospective chart review for maxillary fixed implant prostheses was ____.

    A. 4
    B. 6
    C. 9
    D. 12

  11. One of the benefits of immediate occlusal loading is that the patient never has to wear a complete denture. Another benefit of immediate occlusal loading is that no patient adaptation is required.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  12. A clinically acceptable anterior-posterior spread was achieved in the mandible by

    A. placing two anterior implants, two implants in the canine areas, and two implants in the molar areas following nerve repositioning.
    B. the placement of six parallel implants anterior to the mental foramen.
    C. placing two distal tilted implants and two anterior implants relatively vertical.
    D. placing two short implants in the retromolar areas in addition to four implants anterior to the mental foramen.

  13. A laboratory study by Drago et al determined that the fit of CAD/CAM implant frameworks were significantly better than the fit of cast frameworks made from the same models. Eliasson et al measured the precision of fit of milled titanium frameworks and concluded that no framework actually had a passive fit.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  14. The treatment time to remove the teeth and to place the implants and the interim prostheses for the accelerated protocol used in this case was approximately ____ hours.

    A. two
    B. four
    C. six
    D. seven

  15. The benefits of immediately loaded prostheses placed with the accelerated prosthodontics protocol compared to conventional dentures include all of the following except one. Which is the exception?

    A. Minimal long-term bone loss
    B. No palatal coverage
    C. Improved masticatory function
    D. Removable by patient


Evaluation

Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent

Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
Did this exercise achieve its objectives? Yes No
Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins


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