Implant Dentistry
Implant Dentistry tests whether you can select patients, plan safely in three dimensions and manage complications. The exam expects radiographic and anatomical reasoning, not just surgical steps.
Core rules
- Assess risk before planning: smoking, uncontrolled diabetes, previous radiotherapy to the jaws, antiresorptive medication, bruxism, oral hygiene and bone volume.
- Use CBCT with a radiographic guide to plan position. Respect safety distances: about 2 mm from adjacent roots, at least 1.5-2 mm from the inferior alveolar canal, and adequate buccal and lingual bone.
- Primary stability governs loading. Immediate loading suits high-torque, well-spaced single sites; delayed loading is safer in low-density bone or grafted sites.
- Do not prescribe routine antibiotic prophylaxis for implants unless the patient has a specific medical indication.
- Distinguish peri-implant mucositis (bleeding, no bone loss) from peri-implantitis (bleeding, suppuration, bone loss). Both need mechanical debridement; peri-implantitis may need surgical access.
Worked example
A missing 36 in a non-smoker with 8 mm of bone above the canal. Planning shows the crest is 4 mm wide with a buccal concavity. A 4.1 mm implant placed with a palatal-biased trajectory would leave under 1 mm of buccal bone, so either a narrower implant or simultaneous contour augmentation is required. The plan includes a healing period of about 3-4 months, a screw-retained provisional, and maintenance.
Traps
- Misjudging the inferior alveolar canal on a panoramic radiograph alone.
- Loading an implant with poor primary stability.
- Treating peri-implantitis with antibiotics and no debridement.