Part 2 (Oral/Case) Examination
- Can the patient's name and other personal information, e.g., telephone number, appear on the health history included in my case report?
Yes, the patient's name and telephone number can appear on the health history. However, the city, state and, when applicable, the country should not appear in the report.
- For cases that include a removable prosthesis, a post-completion photograph of the superstructure is required. Where should the superstructure be when the photo is made?
The superstructure should be in the mouth for this photograph. A photo on the model is not necessary.
- For cases that include a removable prosthesis, two additional photographs are required: (1) a post-completion photograph of the superstructure and (2) a photograph of the implants without the prosthesis in place. When should the photograph have been made?
The Board's preference is a photo that shows the implants before the superstructure was attached. However, if you did not make a photo of the case at that time and the bar is cemented or screw-retained, make a photo without the prosthesis in place.
- If the applicant did not place the implant(s), must the consent form for implant placement be included in the case report?
- What information should be included in the report with respect to pre- and post- diagnosis?
The pre-op diagnosis would include either partial edentulism or fully edentulous with a description of the ridge or implant site as to bone width height and density. The post op would be what was achieved with the procedure. The implant site should be presented in the context of the entire arch[s] as this will affect the final outcome, i.e., vertical dimension and inter-occlusal space as well as oral habits.
- What is the interpretation of the requirement that the pre- and post-operative diagnoses should be compared in the case report?
If something unforeseen surfaced during treatment, the post-operative diagnosis would be different and should be included in the report. If not, the pre- and post-operative diagnoses would be the same.
- If a removable prosthesis is placed on a subperiosteal implant, are two extra photographs required?
No, one photo showing the superstructure without the denture in place will suffice.
- Are health histories disclosing the patient's name and address to be included in the case reports?
The patient's health history is to be included in the case reports; however, his or her address should be blocked out.
- Is a photograph of a radiograph acceptable?
Yes. Since the Board accepts digital radiographs, a photograph of a radiograph is acceptable.
- What is the interpretation of "edentulous posterior maxilla?"
Free-ended - there is nothing distal to the tooth (teeth) replaced by the implant.
- Can I submit original radiographs in my case reports? It is not possible for me to get the radiographs duplicated in my area.
Original radiographs should not be submitted in your case reports since they are a part of your patient's permanent record. As noted in the Guidelines for Case Reports for Associate Fellow Membership, "The submitted reports become the property of the American Academy of Implant Dentistry and will not be returned."
An x-ray duplicator could probably be purchased where you buy dental supplies and a duplicator probably is not expensive. With a duplicator, you would use duplicating film that would be processed in the same way you regularly process radiographs, either with a processor or by hand.
Or you could place each radiograph on a view box, shoot a digital picture and then print the pictures on transparency film or photo paper.
- Is a panograph required for the case of an edentulous segment of two or more adjacent teeth?
No, a periapical radiograph is acceptable provided it shows both (or all) teeth.
- Must I be present for the entire examination period?
No. All candidates are given appointments that are within the examination period. Candidates are scheduled in groups of five. Each Associate Fellow candidate must be present for no more than 2 1/2 hours.
- May I request that my examination be scheduled on a specific day?
Yes, a specific day within the examination period can be requested at the time of application; the reason for the request must be specified. The Board will endeavor to honor the request but cannot guarantee that the candidate's examination will be scheduled on the day requested.
- Will my oral/case examination focus solely on my case reports?
No. Candidates demonstrate their knowledge of implant dentistry through five standardized cases as well as the reports that they submit to satisfy the case requirements for the examination. A team of two examiners is assigned to each station. For each of the five standardized cases, the candidates review a written description, a panograph and a photograph and then respond to questions related to treatment of the case. After a candidate completes the five stations, a team of two examiners conducts the case examination that is based on the cases submitted by the candidate. This examination follows a case presentation and discussion format. Before meeting with the candidate, this team of examiners evaluated the case reports that the candidate submitted to determine the degree to which the case reports met the Guidelines for Case Report Preparation.
- How are the oral/case examinations evaluated?
Each candidate receives a total of 88 ratings with input from ten different examiners, each of whom rates the candidate independently. These ratings are organized in ten areas: diagnosis, treatment planning, clinical judgment - surgical, clinical judgment - prosthetic; treatment, outcome, radiographs, photographs, medical history and narrative report. For the Associate Fellow examination, these ten areas are distributed among the various aspects of the examination as follows.
Each of the five standardized cases: diagnosis, treatment planning, clinical judgment; surgical, and clinical judgment: prosthetics
Written case reports: radiographs, photographs, medical history and narrative report
Defense of the three case reports: diagnosis, treatment plan, treatment, outcome
- If an oral surgeon placed the implants, what should the candidate submit for the surgical report section of the case report?
The candidate should submit the surgeon's report as well as his/her overview since it is assumed that the candidate had direct control about where the implants were placed and the number and brand of implants used.
- The insertion dates for the implants and the prosthesis for each of my cases were included in my application for the Part 2 examination. Therefore, do I need to include these dates in my case reports?
Yes. As specified in the Guidelines for Case Reports for the Associate Fellow Membership Examination, the dates of treatment must be included.
- From what date is the "one year in function" requirement calculated for an edentulous case in which one of the four root-form implants failed?
The prosthesis must have been in function for one year after the failed implant was replaced.
- What is the superstructure?
A prosthesis that attaches to an implant's abutments.
In the JOI Glossary of Terms, the definition of superstructure also states "or an intermediary casing called a mesostructure." The following definition for mesostructure was found on the internet: A mesostructure is an intermediate superstructure that is a series of splinted copings, each of which fits over an implant abutment or natural tooth and over which fits the completed prosthodontic appliance.
- Some years ago I placed an implant-supported overdenture for an elderly patient and followed the case for four years before she died. My clinical documentation includes all of the required photographs and radiographs except for a radiograph taken within 12 months of this year's examination period. Her family has authorized me to use her dental records for the examination. Can I use the case for the required edentulous arch case?
Yes, the case can be used provided the candidate has radiographs that document the the overdenture was in place for at least one year.
- Are examples of the photographs that must be included in my case reports available?
Yes. Three sets of the photographic views specified in the Guidelines for Case Reports are posted in this section of the web site. Single tooth case (click here); Edentulous Mand Arch Fixed(click here); Edentulous Max Arch Removable Prosthesis (click here)
- Is the "one-year-in-function" requirement calculated from the time that the temporary or permanent prosthesis was placed?
The "one-year-in-function" requirement is based on the time that the permanent prosthesis was placed.
- Can post-surgical periapical radiographs be submitted instead of an immediate post-surgical panograph for cases that include multiple implants?
If the periapical radiographs were made before the abutments were seated, they may be included in lieu of the photograph. Also include a panograph with the abutments in place. Note in your report why you did not submit the post-surgical panograph as specified.
- Should the denture be in place for the post-prosthetic radiograph?
No. For a removable overdenture, the post-prosthetic radiograph should show the bar, Locator®
or superstructure without the denture in place. As noted in the "Photographs" section of the case report guidelines, for cases that include a removable prosthesis, the following three photographs are required in addition to the either photographs required for all cases:
- An occlusal view of the superstructure without the removable prosthesis in place.
- A frontal view of the superstructure without the removable prosthesis in place.
- A view of the intaglio (tissue side) surface of the removable prosthesis.
The goal of these photographs is to show the tissue response to the removable prosthesis as well as the occlusion.
- Can the post-prosthetic and complete case x-ray be the same film as long as it is taken within twelve months of the exam?
Yes, the post-prosthetic and completed case x-ray can be the same film as long as it is taken within twelve months of the exam and the case has been in function for one year. However, two copies of the film should be provided: one labeled post-prosthetic and the other labeled completed case.
- For one of my cases I have a CT-scan but do not have a presurgical panograph or a full-mouth radiographic series. What should I submit?
Submit the 3-D rendering and a cross section of each of the implants.