Implantology Prometric exam questions with answers

1. Question 1Bone Augmentation and Sinus Surgerymedium

   A clinician is performing guided bone regeneration for a buccal dehiscence. Which set of principles is most important for success?

   1. APrimary closure, angiogenesis, space maintenance and stability
   2. BEarly loading, thin flaps, exposure of membrane and mobility
   3. CLarge particle grafts, open healing and early implant loading
   4. DSystemic steroids, flap tension and immediate provisional
   Show answer and explanation▾

   Answer: A. Primary closure, angiogenesis, space maintenance and stability

   The PASS principles of primary wound closure, angiogenesis, space maintenance and stability of the clot and graft underpin guided bone regeneration. Membrane exposure, flap tension and micromovement are common causes of failure. Tension-free flaps are essential for closure.

2. Question 2Complications and Peri-implant Diseasehard

   No baseline records exist for an implant placed elsewhere. It shows bleeding on probing, a probing depth of 7 mm and bone loss of 4 mm below the implant shoulder. According to the 2017 World Workshop, what is the diagnosis?

   1. APeri-implant health
   2. BPeri-implant mucositis
   3. CPeri-implant soft tissue recession
   4. DPeri-implantitis
   Show answer and explanation▾

   Answer: D. Peri-implantitis

   Without baseline data, peri-implantitis can be diagnosed with bleeding or suppuration on probing, probing depth of 6 mm or more and bone level 3 mm or more apical to the most coronal part of the intraosseous implant. Mucositis has bleeding without bone loss beyond initial remodelling. This implant meets all criteria.

3. Question 3Complications and Peri-implant Diseasemedium

   During placement of an implant in the upper first molar site with limited bone height, the implant suddenly disappears into the maxillary sinus. What is the most appropriate management?

   1. ALeave it in place and monitor yearly
   2. BPush it further in so it lodges posteriorly
   3. CPrescribe decongestants and close without imaging
   4. DPlan removal, usually via a lateral window or endoscopy
   Show answer and explanation▾

   Answer: D. Plan removal, usually via a lateral window or endoscopy

   A displaced implant acts as a foreign body and can cause sinusitis or migrate, so it should be located with imaging and removed, usually through a lateral window or endoscopically. Leaving it or pushing it further risks infection and migration. Imaging is essential to locate it.

4. Question 4Diagnosis, Treatment Planning and Imagingmedium

   A 4.0 mm diameter implant is planned in the lower premolar region. To keep at least 1 mm of bone on both the buccal and lingual sides, what is the minimum ridge width required?

   1. A6 mm
   2. B4 mm
   3. C5 mm
   4. D8 mm
   Show answer and explanation▾

   Answer: A. 6 mm

   With 1 mm of bone on each side, the minimum ridge width is 4 + 1 + 1 = 6 mm. Many clinicians prefer more buccal bone, particularly in the aesthetic zone, to resist resorption. If width is less, augmentation or a narrower implant is considered.

5. Question 5Peri-implant Soft Tissue Managementeasy

   An implant in the upper lateral incisor site has a thin buccal mucosa with a greyish show-through of the abutment. Which graft best increases soft tissue thickness?

   1. AFree gingival graft
   2. BConnective tissue graft
   3. CLateral pedicle flap
   4. DAutogenous block graft
   Show answer and explanation▾

   Answer: B. Connective tissue graft

   A subepithelial connective tissue graft from the palate increases mucosal thickness and masks the abutment colour, with a good colour match. A free gingival graft increases keratinised tissue but gives a poor colour match in the aesthetic zone. A block graft augments bone, not soft tissue.

6. Question 6Implant Prosthodontics and Occlusionmedium

   A posterior implant crown is being adjusted. Which occlusal scheme best limits overload on the implant?

   1. AHeavy contacts in centric and in excursions
   2. BLight centric contacts and no excursive contacts
   3. CWide occlusal table with steep cusps
   4. DDistal cantilever to increase chewing area
   Show answer and explanation▾

   Answer: B. Light centric contacts and no excursive contacts

   Implants lack a periodontal ligament, so implant-protected occlusion uses light centric contacts, a narrow occlusal table, shallow cusps and avoidance of contacts in lateral movements. These reduce lateral and bending forces. Steep cusps and cantilevers increase leverage on the implant and screw.

7. Question 7Surgical Procedures and Timinghard

   An implant is placed immediately into the socket of an upper central incisor with an intact thin buccal plate. Where should the implant be positioned within the socket?

   1. AAgainst the buccal wall to maximise width
   2. BIn the centre of the socket at the root apex
   3. CToward the palatal wall, leaving a buccal gap
   4. DTilted buccally to follow the original root
   Show answer and explanation▾

   Answer: C. Toward the palatal wall, leaving a buccal gap

   Placing the implant toward the palatal wall leaves a gap to the thin buccal plate that can be grafted, reducing the effect of buccal bone resorption and mucosal recession. Contact with the buccal plate increases the risk of resorption and recession. Following the root angle often places the screw access through the facial surface.

8. Question 8Surgical Procedures and Timingeasy

   During drilling in the upper molar region, the clinician feels a thin cortical layer over soft, low-density trabecular bone. Which Lekholm and Zarb bone quality type is this?

   1. AType 1
   2. BType 2
   3. CType 3
   4. DType 4
   Show answer and explanation▾

   Answer: D. Type 4

   Type 4 bone has a thin cortical layer over low-density trabecular bone and is typical of the posterior maxilla. Type 1 is almost entirely homogeneous compact bone, often in the anterior mandible. Type 4 bone gives lower primary stability and needs adapted drilling.

9. Question 9Medical Considerations, Infection Control and Ethicsmedium

   A 65-year-old woman has taken oral alendronate for osteoporosis for 3 years with no other risk factors and requests an implant. What is the most appropriate approach?

   1. ARefuse implants because of a high osteonecrosis risk
   2. BProceed only after a 2 year drug holiday
   3. CProceed with informed consent about a low osteonecrosis risk
   4. DRequire a serum CTX test before any treatment
   Show answer and explanation▾

   Answer: C. Proceed with informed consent about a low osteonecrosis risk

   The risk of medication-related osteonecrosis with oral bisphosphonates for osteoporosis is low, so implant surgery can proceed after discussing this risk and documenting consent. A drug holiday is not routinely required for this duration without other risk factors and should be decided with the prescriber. Serum CTX testing is not a reliable predictor.

10. Question 10Osseointegration and Implant Designmedium

    An implant is restored with an abutment narrower than the implant platform, moving the implant-abutment junction inward. What is the main intended benefit?

    1. AIncreased resistance to screw fracture
    2. BEasier impression taking
    3. CReduced crestal bone remodelling
    4. DIncreased implant length
    Show answer and explanation▾

    Answer: C. Reduced crestal bone remodelling

    Platform switching moves the implant-abutment junction and its inflammatory cell infiltrate away from the crestal bone, which is associated with less marginal bone loss. It does not change implant length or impression method. Its effect on screw mechanics is not its purpose.

11. Question 11Surgical Anatomymedium

    During drilling for an implant in the lower canine region, the drill perforates the lingual cortex. Minutes later the floor of the mouth swells and the tongue is pushed upwards. What is the main danger?

    1. ADamage to the lingual nerve causing numbness
    2. BInjury to the submandibular duct
    3. CInfection of the sublingual gland
    4. DObstruction of the airway by a haematoma
    Show answer and explanation▾

    Answer: D. Obstruction of the airway by a haematoma

    Perforating the lingual cortex in the anterior mandible can injure branches of the sublingual or submental arteries, producing an expanding floor of mouth haematoma that threatens the airway. Immediate airway assessment, pressure and emergency transfer are needed. Nerve or duct injury is less urgent.

12. Question 12Surgical Anatomymedium

    A CBCT for an implant in the lower second molar site shows a deep concavity below the mylohyoid ridge on the lingual side. What is the main risk if the drill follows the ridge crest at the planned angle?

    1. APerforation into the submandibular fossa
    2. BPerforation into the mental foramen
    3. CEntry into the maxillary sinus
    4. DFracture of the coronoid process
    Show answer and explanation▾

    Answer: A. Perforation into the submandibular fossa

    The submandibular fossa creates a lingual undercut in the posterior mandible, so a drill angled along the crest can perforate the lingual cortex and injure vessels or the lingual nerve. Cross-sectional imaging allows the angle to be adjusted or a shorter implant chosen. The mental foramen lies in the premolar region.

13. Question 13Surgical Anatomymedium

    Before a lateral window sinus floor elevation, CBCT shows a small canal running horizontally within the lateral wall of the maxillary sinus. What does it most likely contain?

    1. AThe infraorbital nerve
    2. BThe descending palatine artery
    3. CThe nasolacrimal duct
    4. DThe alveolar antral artery
    Show answer and explanation▾

    Answer: D. The alveolar antral artery

    An intraosseous anastomosis between the posterior superior alveolar artery and the infraorbital artery forms the alveolar antral artery in the lateral sinus wall and can bleed when the window is cut. Identifying it on CBCT allows the window to be placed to avoid it. The descending palatine artery runs in the greater palatine canal medially.

14. Question 14Surgical Procedures and Timingmedium

    An upper premolar is extracted and the implant is placed 6 weeks later, once the soft tissue has healed over the socket but before significant bone fill. Which placement category is this?

    1. AType 1, immediate placement
    2. BType 2, early placement with soft tissue healing
    3. CType 3, early placement with partial bone healing
    4. DType 4, late placement in a healed site
    Show answer and explanation▾

    Answer: B. Type 2, early placement with soft tissue healing

    Type 2 placement is done at about 4 to 8 weeks, when the soft tissue has healed, giving more mucosa for flap closure. Type 3 placement is at about 12 to 16 weeks with partial bone healing, and type 4 is after full healing, usually 6 months or more. Type 1 is placement on the day of extraction.

15. Question 15Surgical Procedures and Timingmedium

    An implant is planned in the posterior maxilla, where bone is soft with thin cortical bone. Which technique is most suitable to improve primary stability?

    1. AUnderprepare the osteotomy relative to implant size
    2. BUse a bone tap before placing the implant
    3. COverprepare the osteotomy by one drill size
    4. DCountersink the crest to widen the neck
    Show answer and explanation▾

    Answer: A. Underprepare the osteotomy relative to implant size

    In low-density bone, underpreparing the site or using osteotomes compresses the bone and increases primary stability. Tapping and countersinking are used in dense bone to reduce insertion torque and compression. Overpreparation would reduce stability further.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.