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Participants must answer at least 12 of 15 questions correctly (80%) to earn CE credit.

AGD - Self-Instruction Exercise No. 403 - Implants
Timing of soft tissue management around dental implants: a suggested protocol

Self-Instruction Exercise No. 403
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Exercise No. 403
Subject Code: 690

The 15 questions for this exercise are based on the article Timing of soft tissue management around dental implants: a suggested protocol on pages 50-56. This exercise was developed by Thomas J. Boyle, DMD, MAGD, ABGD, in association with the General Dentistry Self-Instruction committee.

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

  • understand the factors involved in implant success as affected by soft tissue (ST) management around the implant;
  • appreciate the effect that sequencing of soft and hard tissue (HT) augmentations may have on implant esthetics and function; and
  • formulate a patient-centered protocol for organizing the sequence of tissue treatments for further research or individual treatment efficiency.

Answers for this exercise must be received by April 30, 2018.

  1. The objective of this article was to review _________________.

    A. esthetic concerns in implant protocols
    B. ST management timing
    C. ST grafting
    D. HT grafting

  2. Implant success depends mainly on _______________.

    A. ST grafting
    B. patient selection
    C. flap design
    D. HT grafting

  3. The best indicator of a favorable esthetic result is _______________.

    A. the smile line
    B. a thick biotype
    C. minimum keratinized tissue
    D. implant placement depth

  4. Kyllar & Witter demonstrated that variation in gingival thickness depends on _______.

    A. jaw site
    B. presence of natural teeth
    C. dental arch form
    D. patient health

  5. In a thin biotype environment, the implant must be positioned ___________ the bone crest.

    A. deeply apical to
    B. slightly apical to
    C. level with
    D. coronally to

  6. Bengazi et al reported that soft tissue loss is ___________.

    A. an inflammatory process
    B. due to trauma
    C. the result of biologic width stabilization
    D. related to oral hygiene

  7. What is the rationale for the use of an apically positioned flap (APF)?

    A. It prevents postoperative bone loss.
    B. It controls postoperative margin status.
    C. It is tolerated well by patients.
    D. It is less preferred than a connective tissue graft.

  8. According to Cardaropoli et al, what tissue condition existed 1 year after loading of implants?

    A. Buccal and lingual bone loss reached 1.3 mm.
    B. ST height loss was 1.0 mm.
    C. Keratinized tissue loss was 2.0 mm.
    D. Tissue was similar to the 2-week postoperative level.

  9. What technique is associated with increased surgical time and donor site morbidity?

    A. coronally advanced flap
    B. APF
    C. connective tissue graft
    D. vestibular graft

  10. Which method of keratinized tissue augmentation gives the greatest increase in gingival width?

    A. coronally positioned flap plus connective tissue graft
    B. APF plus free gingival graft
    C. APF only
    D. APF plus collagen matrix

  11. What were the results of the study by Basegmaz et al?

    A. Mucositis prevented successful increases in gingival height.
    B. Vestibuloplasty was more successful than free gingival graft.
    C. Primary keratinized tissue could only increase 1.5 mm.
    D. Free gingival grafts had lower relapse rates than vestibuloplasty.

  12. Throughout the majority of studies evaluated in this current review, when was soft tissue management performed?

    A. before implant placement
    B. at the time of implant placement
    C. after healing collar placement
    D. after implant loading

  13. In the protocol suggested by the authors, which tissue status should be evaluated first?

    A. height and thickness of ST
    B. vestibular depth
    C. height and width of bone
    D. gingival inflammation

  14. Mucosal collapse depends on the biotype of peri-implant mucosa. Converting the mucosal biotype to reinforce the keratinized tissue will have no effect on the ST dimensions.

    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.

  15. Two-dimensional radiographs can evaluate all of the following except one. Which is the exception?

    A. crest height
    B. mesiodistal site width
    C. buccolingual site width
    D. root proximity


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