DHA Implantology exam questions

6 worked Implantology practice questions

Original exam-style questions from the bank, spread across the blueprint domains. They are not real or recalled exam questions. Try each one, then open the answer for the rationale and reference. None of them appear in the free mock exam, so reading them will not spoil it.

1. Question 1 · Bone Augmentation and Sinus Surgery

   A patient asks how the ridge will change if an upper premolar is extracted with no grafting. Which statement best reflects the evidence?

   1. AVertical loss is greater than horizontal loss
   2. BNo measurable change occurs in the first 6 months
   3. CHorizontal width reduction exceeds vertical height loss
   4. DThe palatal wall resorbs more than the buccal wall
   Show answer and explanation

   Correct answer: C. Horizontal width reduction exceeds vertical height loss

   Systematic review data show greater horizontal than vertical reduction in the first 6 months after extraction, and most change occurs early. The thin buccal bundle bone resorbs more than the palatal wall, so the ridge moves palatally. Ridge preservation reduces but does not prevent these changes.

   Reference: Tan et al., Tissue alterations following tooth extraction in humans: a systematic review, Clin Oral Implants Res 2012

2. Question 2 · Diagnosis, Treatment Planning and Imaging

   A patient is being assessed for an implant in the lower first molar site. The clinician needs to measure bone width and the distance to the inferior alveolar canal in three dimensions. Which imaging is most appropriate?

   1. ABitewing radiograph
   2. BPanoramic radiograph
   3. CCone beam CT scan
   4. DOcclusal radiograph
   Show answer and explanation

   Correct answer: C. Cone beam CT scan

   Cone beam CT gives cross-sectional images that show bone width, height and the course of the canal, at a lower dose than medical CT. Panoramic and periapical images are two-dimensional, distorted to varying degrees and cannot show bone width. Bitewings do not show the canal at all.

   Reference: ITI Treatment Guide, Vol. 1: Implant Therapy in the Esthetic Zone

3. Question 3 · Diagnosis, Treatment Planning and Imaging

   A clinician plans implant positions in software using a digital wax-up and then fabricates a surgical guide. What is the main purpose of this approach?

   1. ATo remove the need for local anaesthesia
   2. BTo place implants in positions that suit the final restoration
   3. CTo allow implants to be placed without imaging
   4. DTo make primary stability unnecessary
   Show answer and explanation

   Correct answer: B. To place implants in positions that suit the final restoration

   Prosthetically driven planning places implants where the planned restoration needs them, and the guide transfers this plan to surgery. This improves angulation, emergence and hygiene access. Guides still depend on accurate imaging and do not remove the need for anaesthesia or stability.

   Reference: ITI Treatment Guide, Vol. 1: Implant Therapy in the Esthetic Zone

4. Question 4 · Implant Prosthodontics and Occlusion

   A screw-retained full arch framework on five implants is tried in. When one terminal screw is tightened, a gap is seen at the opposite end abutment. What does this indicate and what should be done?

   1. ALack of passive fit; section and re-join the framework
   2. BNormal settling; tighten all screws to full torque
   3. CLack of passive fit; add composite to close the gap
   4. DNormal play; cement the framework to the abutments
   Show answer and explanation

   Correct answer: A. Lack of passive fit; section and re-join the framework

   The one-screw test shows a misfit when tightening one screw lifts the framework elsewhere. Misfit causes strain in the implants, bone and screws, so the framework should be sectioned and re-joined from an accurate index or remade. Forcing it down by tightening screws hides the misfit and loads the components.

   Reference: Misch, Contemporary Implant Dentistry, 4th ed.

5. Question 5 · Implant Prosthodontics and Occlusion

   In a full arch protocol with four implants in the mandible, why are the posterior implants usually tilted distally?

   1. ATo engage the lingual cortex for stability
   2. BTo shorten the anterior-posterior spread
   3. CTo avoid the mental foramen and reduce cantilever length
   4. DTo allow cement retention of the prosthesis
   Show answer and explanation

   Correct answer: C. To avoid the mental foramen and reduce cantilever length

   Tilting the posterior implants distally lets them avoid the mental foramen while placing their platforms further back. This increases the anterior-posterior spread and shortens the distal cantilever. Tilted implants are usually restored with angled multi-unit abutments to a screw-retained bridge.

   Reference: Malo, Rangert and Nobre, All-on-Four immediate-function concept, Clin Implant Dent Relat Res 2003

6. Question 6 · Osseointegration and Implant Design

   A clinician considers loading an implant with moderate primary stability. At about what time after placement is total implant stability usually lowest?

   1. AImmediately after placement
   2. BAt about 2 to 4 weeks
   3. CAt about 3 to 4 months
   4. DAt about 12 months
   Show answer and explanation

   Correct answer: B. At about 2 to 4 weeks

   Primary mechanical stability falls as bone at the interface is resorbed and remodelled, while secondary biological stability rises with new bone formation. The two curves cross at about 2 to 4 weeks, when overall stability is lowest. This is why early loading during this window carries extra risk.

   Reference: Raghavendra, Wood and Taylor, Early wound healing around endosseous implants: a review of the literature, Int J Oral Maxillofac Implants 2005