1. What is the process of bone fusing with a dental implant called?

- This process is called osseointegration. It refers to the direct structural and

functional connection between living bone and the surface of a load-bearing implant.

2. The common cause of edentulism?

- The most common causes of edentulism are periodontal disease, tooth decay, and
trauma leading to the loss of natural teeth.

3. Which type of dental implant is most commonly used today?

- The most commonly used type of dental implant is the endosteal implant, which is
placed directly into the jawbone.

4. What is the main advantage of a single-piece implant over a two-piece implant?

- The main advantage of a single-piece implant is its simplified design, which
eliminates the need for a separate abutment, reducing the risk of screw loosening and
infection.

5. Advantages of dental implants?

- Advantages include improved function, aesthetic restoration, prevention of bone
loss, durability, and better patient satisfaction compared to dentures or bridges.

6. How do dental implants help preserve jawbone?

- Dental implants stimulate the bone during chewing, which helps maintain the
bone's integrity and prevents bone resorption, a common consequence of tooth loss.

---

### Data Collection

7. What are the common data collection methods in clinical research?
- Common methods include questionnaires, interviews, clinical examinations,
radiographic imaging, and histological analysis.
8. What is the primary goal of data collection in dental implant planning?
- The primary goal is to gather accurate information about the patient's oral health,
bone quality, medical history, and anatomical limitations to ensure successful implant
placement.

9. What diagnostic tools are essential for evaluating bone density and quality?
- Tools include CBCT (Cone Beam Computed Tomography), periapical radiographs,
and panoramic X-rays for assessing bone volume and density.

10. What factors should be considered when assessing the patient's medical history?
- Considerations include systemic health conditions (e.g., diabetes, osteoporosis),
medications, smoking history, and immune function.

11. What is the importance of assessing the patient's occlusion during data collection?
- Assessing occlusion is critical to ensure that the implant will function
harmoniously with the patient's natural bite, preventing undue stress on the implant
and surrounding tissues.

---

### Surgical Guide

12. The primary purpose of a surgical guide?
- The primary purpose is to ensure accurate placement of the implant by providing
precise guidance for the surgeon during the drilling process.

13. The type of material is commonly used to fabricate surgical guides?

- Surgical guides are typically made from resin-based materials, such as
biocompatible acrylic or 3D printed materials.

14. The most important factor to consider when designing a surgical guide?
- The most important factor is accurate patient-specific anatomical mapping,
ensuring that the implant is placed in the ideal position for both function and
aesthetics.
15. The role of the surgeon in the use of a surgical guide?
- The surgeon is responsible for ensuring the guide is properly placed and secured,
and the implant is positioned according to the guide’s instructions.

---

### Anatomical Limitations

16. The most common anatomical limitation encountered in implant dentistry?
- The most common limitation is insufficient bone volume, particularly in the
maxillary posterior region and mandibular anterior area.

17. How can anatomical limitations be addressed in implant dentistry?

- Strategies include bone grafting, sinus lifts, ridge augmentation, and the use of
shorter or angled implants.

---

### Misch Bone Density Classification

18. The Misch bone density classification system is used to assess:
- The Misch system assesses bone quality and density to determine the suitability of
a site for implant placement.

19. Type D1 bone in the Misch classification is characterized by:

- Type D1 bone is characterized by dense cortical bone with very little cancellous
bone, making it ideal for implant placement.

20. Type IV bone in the Misch classification is the most challenging for implant
placement due to:
- Type IV bone has low density and is primarily cancellous, which makes it more
prone to implant failure and requires special techniques to improve implant stability.
21. Which bone density type is most ideal for implant placement?
- Type D1 bone, with its dense cortical structure, is ideal for implant placement due
to its excellent primary stability.

---

### Ridge Description

22. A narrow ridge form is associated with:
- A narrow ridge form is often associated with compromised aesthetic outcomes and
may require bone grafting or sinus lift procedures.

23. Which ridge morphology is most ideal for implant placement?

- A wide, well-formed ridge is ideal as it allows for better implant placement, more
predictable outcomes, and greater stability.

---

### Patient Selection

24. Which of the following is NOT a contraindication for implant placement?
- Mild to moderate systemic health conditions, such as controlled diabetes, are not
absolute contraindications for implants, while conditions like uncontrolled diabetes or
radiation therapy in the head/neck area are.

25. What is the most important factor to consider when selecting a patient for implant
placement?
- The most important factor is overall health, particularly the absence of
contraindications such as uncontrolled systemic diseases.

26. What is the ideal inter-occlusal distance for implant placement?

- The ideal inter-occlusal distance is typically 7-10 mm to ensure adequate space
for the implant, abutment, and crown.
---

### Types of Dental Implants

27. Which of the following is NOT a type of dental implant?
- Subperiosteal implants (which sit on top of the bone) are not commonly used
today compared to endosteal implants.

28. Endosteal implants are the most common type of dental implant. They are placed:
- Endosteal implants are placed directly into the jawbone.

---

### Single-Piece vs. Two-Piece Implants

29. Understand single-piece dental implant.
- A single-piece implant is made from one solid piece, including both the fixture
and abutment, designed for simplicity and reduced risk of complications.

30. Understand two-piece dental implant.

- A two-piece implant consists of a separate fixture placed in the bone and a
separate abutment that connects to the crown.

---

### Dental Implant Components

31. Understand the part of a dental implant that is surgically placed into the jawbone.
- The implant fixture is the component that is surgically placed into the jawbone to
provide support for the abutment and restoration.
32. Understand the part of a dental implant that connects the crown to the fixture.
- The abutment is the connector between the implant fixture and the dental crown.

### Misch Bone Density Classification

33. The Misch bone density classification system categorizes bone quality into (D1-
D4).
- The Misch classification system categorizes bone into four types (D1-D4) based
on density, with D1 being the hardest and D4 the softest.

---

### Types of Bone

34. What does Cortical bone mean?
- Cortical bone is the dense, compact outer layer of bone that provides structural
strength.

35. What does the Cancellous bone mean?

- Cancellous bone (also known as spongy or trabecular bone) is the lighter, less
dense inner bone that provides elasticity.

---

### Integration of Bone in Dental Implants

36. Integration of Bone in Dental Implants:
- Successful osseointegration allows for the implant to fuse directly with the bone,
providing stability and function similar to natural teeth.

---

### Indications and Contraindications for Dental Implants

37. A good candidate (PATIENT) for dental implants generally has:
- A good candidate generally has adequate bone density, good oral hygiene,
controlled systemic health, and realistic expectations.

38. A contraindication for dental implant placement is:

 - A contraindication can include uncontrolled systemic conditions (e.g., diabetes or
cancer), active periodontal disease, or insufficient bone.

39. Ideal Distance Between Dental Implant and Surrounding Tissues:

- The ideal distance between a dental implant and surrounding tissues is typically
1.5-2 mm from the bone and 3 mm from adjacent teeth.

---

### Flap vs. Flapless Implant Surgeries

42. A flapless implant surgery involves:
- Flapless surgery involves no tissue incision, where the implant is placed through
the mucosa directly into the bone.

43. Flap surgery is typically used when there is a need for direct access to the
underlying bone or tissues for procedures such as bone grafting, dental
implants, or treatment of periodontal disease. It involves making an incision in
the soft tissues (gum) to lift a flap and expose the bone, allowing for a detailed
surgical intervention.

44. The primary causes of edentulism (tooth loss) include periodontal disease,
dental caries, and trauma. If a condition not related to these factors is listed,
such as "poor oral hygiene" (though it contributes, it's a risk factor rather than
a primary cause), it would be the incorrect option.

### Levels of Education in Dental Implant

45. What is the primary role of a dental technician in dental implant

procedures?

- The primary role of a dental technician is to fabricate the

implant-supported prostheses, including crowns, bridges, or
dentures, based on the impressions and specifications provided by
the dentist.
46. What is the primary purpose of continuing education courses for
dental professionals in the field of dental implants?

- Continuing education courses provide dental professionals with

the latest advancements in implant technology, surgical techniques,
and prosthetic solutions to improve patient outcomes and stay
current in the field.

---

### Innovation of Dental Implant Design

47. What is the primary advantage of using dental implants over

traditional dentures?

- The primary advantage is that dental implants offer a more

permanent solution, providing better functionality, aesthetic
appearance, and preventing bone loss compared to traditional
dentures.

48. Which type of dental implant material is most commonly used

today?

- Titanium is the most commonly used material for dental

implants due to its biocompatibility, strength, and ability to
osseointegrate with bone.

49. What is the primary goal of dental implant research and

development?

- The primary goal is to improve the longevity, safety, and

efficiency of dental implants, as well as to develop materials and
techniques that promote faster osseointegration and minimize
complications.

50. Which of the following is a leading brand in dental implants,

known for its premium quality and innovative solutions?

- Straumann is a leading brand recognized for its high-quality

implants and continuous innovation in the field.
---

### Dental Implant Complications

#### Section 1: Management of Dental Implant Complications

51. The most common cause of early dental implant failure?

- The most common cause of early implant failure is poor

osseointegration due to insufficient bone quality or infection at the
implant site.

52. The best management method of peri-implantitis in its initial

stages?

- The best management for peri-implantitis in the initial stages

includes debridement of the implant surface, antibiotic therapy, and
oral hygiene instructions to reduce inflammation.

---

#### Section 2: Implant Success

53. Which of the following is NOT a standard criterion for evaluating

implant success?

- Patient satisfaction is important but not a standard criterion for

implant success. Standard criteria include osseointegration,
functional restoration, and absence of infection.

54. The survival rate of dental implants is most significantly

influenced by which of the following factors?

- The most significant factor influencing implant survival is bone

quality and quantity, which impacts the primary stability and
osseointegration process.

#### Section 3: Implant Failure

55. Late implant failure is most commonly associated with which
factor?

- Peri-implantitis and progressive bone loss are the most common

causes of late implant failure, often due to poor oral hygiene or
excessive loading.

56. Which diagnostic tool is most useful in identifying peri-implant

bone loss?

- Radiographs, particularly cone beam computed tomography

(CBCT) and periapical X-rays, are essential in identifying peri-
implant bone loss.

---

#### Section 4: Framework for Management of Long-term

Complications

57. What is the first step in managing a fractured implant abutment

screw?

- The first step is to remove the implant prosthesis, followed by

securing the screw fragment and replacing the abutment or screw if
necessary.

58. Which of the following is a preventive measure to avoid peri-

implantitis?

- Preventive measures include maintaining good oral hygiene,

regular professional cleanings, and avoiding excessive smoking and
poor implant positioning.

---

#### Section 5: Case-Based Scenario

59. A patient presents with peri-implant probing depths of 7 mm and

bleeding on probing around an implant. Radiographic examination
shows 2 mm of bone loss. What is the most appropriate
management?

- The most appropriate management includes non-surgical

treatment, such as scaling and root planing, antibiotic therapy, and
improvement of oral hygiene. In more severe cases, surgical
intervention may be required.

60. What is the best approach for managing a mobile implant due to
severe bone loss?

- The best approach is to remove the implant and consider bone

grafting or sinus lift procedures for future implant placement.

"""""""""""""#################Advanced
##############"""""""""""""""

Here are detailed answers to the questions you provided based on

reliable sources, including PubMed, Google Scholar, and other
research databases in the fields of dentistry and dental technology:

### BENEX Atraumatic Extraction of Teeth

1. The primary goal of BENEX atraumatic dental extraction

The primary goal is to extract teeth with minimal damage to

surrounding tissues, especially the alveolar bone and soft tissue, to
preserve the integrity of the site for future procedures like implants.

2. The tools typically used in BENEX atraumatic dental extraction

The BENEX system uses specialized instruments like the BENEX

lever, elevator, and extraction forceps. These tools apply controlled,
gentle pressure to facilitate tooth removal without causing trauma.
3. The BENEX extraction system is primarily designed to minimize
damage to which structure?

The BENEX system primarily aims to minimize damage to the

alveolar bone to ensure it remains intact for future implant
placement.

4. In the context of BENEX atraumatic dental extraction, what is the

significance of preserving the alveolar bone?

Preserving the alveolar bone is crucial for ensuring adequate bone

volume and quality for future dental implant placement. Bone loss
during extraction can complicate or even prevent the placement of
implants.

5. BENEX atraumatic dental extraction is most commonly used for

which type of tooth?

It is most commonly used for teeth that are severely decayed,

broken, or have complicated root structures that are challenging to
extract using traditional methods.

6. Type of force used in BENEX atraumatic extraction?

BENEX extraction uses gentle, controlled, and precise force

compared to the often more forceful traditional extraction methods.

7. The advantages of BENEX over traditional extraction methods?

- Reduced trauma to surrounding tissues

- Faster recovery and reduced pain

- Preservation of bone for future implant placement

- Higher success rates for implants when extraction is followed by

implant surgery.

8. Which of the following is a potential complication associated with

conventional extractions that BENEX aims to reduce?

Bone fractures and excessive soft tissue damage are reduced with
BENEX extraction.
9. The BENEX extraction technique is especially beneficial for
patients who are considering what kind of future treatment?

It is particularly beneficial for patients planning for dental

implants.

10. In the BENEX atraumatic dental extraction system, what is the

function of the "lever" tool?

The lever is used to apply gentle mechanical pressure to loosen

the tooth from its socket, facilitating its extraction without trauma.

11. What is a key factor that distinguishes the BENEX system from
traditional tooth extraction methods?

The key factor is the atraumatic nature of the extraction, which

minimizes bone loss and soft tissue damage.

12. Which of the following is NOT an advantage of using the BENEX

atraumatic extraction method?

A disadvantage could be cost, as the BENEX system involves

specialized tools that may not be available in all dental practices.

13. The relationship between BENEX extraction and soft tissue

healing

Because BENEX extraction reduces trauma to the soft tissues, it

generally results in faster and more predictable soft tissue healing.

14. For patients who require tooth extraction and wish to proceed
with dental implants, the BENEX system is preferred because:

It preserves the alveolar bone, making it easier to place dental

implants with better outcomes.

### PET: Partial Extraction Therapy

15. What is the primary goal of Partial Extraction Therapy (PET) in
dentistry?

The goal of PET is to preserve as much of the tooth structure as

possible, especially the root, to promote healing and reduce the risk
of complications.

16. In Partial Extraction Therapy (PET), procedure mean?

PET involves selectively extracting part of a tooth, such as

performing a coronectomy (removal of the crown) while leaving the
roots intact to preserve the alveolar bone and prevent the need for
extensive bone grafting.

17. The most common indication for Partial Extraction Therapy (PET)

PET is commonly indicated for impacted third molars or teeth with

a high risk of damage during extraction, where preserving the root
and surrounding bone is important.

18. The key advantage of PET over conventional tooth extraction?

PET allows for bone preservation and minimizes the risk of

damage to the surrounding tissues, making future implant
placement more feasible.

19. During a coronectomy procedure in PET, which part of the tooth

is typically removed?

In a coronectomy, the crown of the tooth is removed, while the

roots are left intact.

20. In PET, why is the root typically left behind in procedures like
coronectomy?

The root is left intact to preserve the alveolar bone, which is

necessary for future implant placement or to avoid the need for
bone grafting.

21. The benefit of Partial Extraction Therapy (PET)?

PET offers the benefit of preserving alveolar bone, reducing the

need for bone grafts, and improving the outcomes for future implant
procedures.
22. Which radiographic techniques are essential for assessing the
tooth before performing Partial Extraction Therapy (PET)?

Cone-beam computed tomography (CBCT) is essential for

assessing the 3D anatomy of the tooth and surrounding bone
structures.

23. What is the most significant disadvantage of Partial Extraction

Therapy (PET)?

A potential disadvantage is the increased complexity of the

procedure, which may require more specialized skills and
technology.

24. What kind of advice should be given to the patient following a

Partial Extraction Therapy procedure?

Patients should be advised to follow post-operative care

instructions, including pain management, soft food intake, and
regular follow-up visits to monitor healing.

### Deceiving Mandibular Bone

25. What is the "deceiving bone" of the mandible?

The "deceiving bone" refers to the mental foramen area of the

mandible, which may appear differently on radiographs, leading to
potential misinterpretation of anatomical structures.

26. The mental foramen is typically located at which anatomical

position?

The mental foramen is typically located between the first and

second premolars on the mandibular body.

### Polyetheretherketone (PEEK)

27. The type of material of Polyetheretherketone (PEEK)?

PEEK is a high-performance polymer, known for its excellent

mechanical properties, biocompatibility, and resistance to chemical
and thermal degradation.

28. Advantages of using PEEK in dental and medical applications?

PEEK offers high strength, flexibility, biocompatibility, and

resistance to wear, making it suitable for both dental implants and
prosthetic components.

29. The properties make PEEK suitable for use in dental implants

PEEK is biocompatible, non-toxic, and exhibits low tissue reaction

and high strength, making it an ideal choice for dental implants and
other prosthodontic applications.

30. What is a key characteristic of Polyetheretherketone (PEEK)?

A key characteristic of PEEK is its radiolucency, which means it is

not visible on X-rays, making it useful in medical implants where
visibility on radiographs is not necessary.

31. PEEK is often used in combination with which material to

enhance its properties in dental applications?

PEEK is often combined with titanium or ceramic coatings to

enhance its biocompatibility and strength.

32. The disadvantage of using PEEK in medical applications?

A disadvantage is that PEEK does not exhibit radiopacity, which

can hinder its detection in X-ray images.

33. In which dental procedures is PEEK most commonly used?

PEEK is commonly used in dental implants, prosthetic

components, and temporary restorations.
34. What is the primary reason PEEK is not radiopaque and can be
problematic for some medical imaging applications?

PEEK is naturally radiolucent, which means it does not show up on

traditional X-rays, making it difficult to assess its position in
radiographic imaging.

### Caries Detection Device DEXIS CariVU

35. What is the primary function of the DEXIS CariVU Caries

Detection Device?

The primary function is to detect dental caries (cavities) early by

using transillumination technology.

36. Which technology does the DEXIS CariVU Caries Detection

Device use to identify dental caries?

The device uses near-infrared light to transilluminate the teeth,

revealing the presence of caries.

37. What is a key advantage of using the DEXIS CariVU device for
caries detection?

A key advantage is that it is non-invasive and provides

immediate, real-time results without radiation exposure.

38. How does the DEXIS CariVU device aid in the diagnosis of dental
caries?

By using near-infrared light, it allows for the detection of incipient

caries or early cavities that may not be visible on X-rays.

39. The DEXIS CariVU device is especially useful for detecting which
type of surface caries?

It is particularly useful for detecting interproximal caries (between

teeth), as well as occlusal and smooth surface caries
.

40. The position of DEXIS CariVU device during a caries detection

examination?

The device is typically positioned in the mouth near the tooth,

with the light directed at the tooth's surface to check for signs of
caries.

41. Is the DEXIS CariVU device emit radiation exposure?

No, the device does not emit radiation, making it safer compared
to traditional X-rays.

42. Which group of patients is especially beneficial for the DEXIS

CariVU system?

It is particularly beneficial for pediatric patients and those who

require frequent monitoring for caries detection.

43. The potential benefit of using the DEXIS CariVU for caries
detection in pediatric dentistry?

It offers a safe, non-invasive, and effective way to detect early

caries in pediatric patients, reducing the need for traditional X-rays.

---

### Advantages of Electric-Driven Handpieces Over Air

Turbine

44. The advantages of electric-driven handpieces over air turbine

handpieces

Electric-driven handpieces offer greater torque, precision, and

control compared to air turbines, making them better suited for
procedures requiring low speed and high torque, such as
endodontics.

45. In terms of control, how do electric-driven handpieces differ from

air turbine handpieces?

Electric-driven handpieces provide better control over speed and

torque, allowing for consistent power throughout the procedure.

46. Does the consistent torque provided by electric-driven

handpieces represent one advantage?

Yes, consistent torque is especially beneficial for low-speed

procedures, ensuring better accuracy and reduced vibration.

47. Which type of dental handpiece tends to produce more vibration

during use, potentially causing discomfort for the patient?

Air turbine handpieces tend to produce more vibration, which may

lead to discomfort during treatment.

48. Is the variable speed settings of electric-driven handpieces help

improve their efficiency in dental procedures?

Yes, the ability to adjust the speed allows for more efficient and
precise work during different phases of dental procedures.

49. How does the power source differ between electric-driven

handpieces and air turbine handpieces?

Electric-driven handpieces are powered by an electric motor, while

air turbine handpieces are powered by compressed air.

50. Which of the following is a potential disadvantage of air turbine

handpieces compared to electric-driven handpieces?

Air turbine handpieces can be less effective at low speeds due to

lack of consistent torque.
51. Why are electric-driven handpieces preferred for tasks requiring
low-speed precision?

They provide more consistent torque and better control during

low-speed procedures like endodontics.

52. How do electric-driven handpieces benefit patients in terms of

comfort?

Electric-driven handpieces generate less vibration and can offer

more precise control, leading to greater comfort during treatment.

---

### Clinical Technique for Repair of Porcelain-Fused-to-

Metal (PFM)

53. What is the first step in the clinical technique for repairing
porcelain-fused-to-metal (PFM)?

The first step is to clean and isolate the PFM restoration,

preparing the surface for repair.

54. What is the next step in repairing the Porcelain-Fused-to-Metal

process?

The next step is to etch the porcelain surface to improve bonding.

55. How long should the porcelain etchant be applied to the

porcelain surface in Step 2?

The etchant should be applied for 20-30 seconds.

56. What appearance should the etched porcelain surface have after
rinsing and drying in Step 3?

After rinsing and drying, the surface should appear matte and
roughened.
57. What is the purpose of Bisco’s Opaquer in Step 6?

Bisco’s Opaquer is applied to conceal discolorations and create a

uniform appearance for the repair.

58. How should the Opaquer be cured after application in Step 7?

It should be cured according to the manufacturer’s instructions,

typically using a light-curing unit.

59. What should be applied to the repair site in Step 8?

The repair site should be coated with bonding resin to ensure

proper adhesion.

60. What is the final step in the repair of porcelain-fused-to-metal in

this procedure?

The final step is to recontour and polish the repaired area for a
smooth finish.

### (DSD) Workflow of Visagismile + Rebel Software

61. What is the primary purpose of Visagismile/Rebel software in the

context of Digital Smile Design (DSD)?

The primary purpose of Visagismile/Rebel software in the context

of Digital Smile Design (DSD) is to assist in the visualization,
planning, and simulation of smile makeovers, using advanced
algorithms and 3D modeling to design a personalized treatment
plan that aligns with the patient's facial features.

62. What is the first step in the DSD workflow of Visagismile/Rebel

software?

The first step is to capture digital impressions or photographs of

the patient’s face and teeth, which will be used to create a digital
model of their smile and facial features.
63. What role does Visagismile/Rebel software play in treatment
planning for esthetic dentistry?

Visagismile/Rebel software plays a crucial role in esthetic dentistry

by providing accurate simulations of smile designs, enabling
dentists to preview how dental restorations (crowns, veneers, etc.)
will look and ensuring that the final design is in harmony with the
patient’s facial aesthetics.

64. What technology does Visagismile/Rebel software integrate with

to create detailed 3D models of a patient’s face and teeth?

The software integrates with 3D imaging technology, including

intraoral scanners and facial scanners (such as CBCT and 3D facial
scans), to create precise and detailed 3D models for smile design.

65. The role of algorithms in the Visagismile/Rebel software

customization in the design of a smile.

The algorithms in Visagismile/Rebel software analyze facial

proportions, tooth morphology, and symmetry to automatically
generate a personalized smile design that enhances the patient's
facial aesthetics and overall harmony.

66. In the DSD process using Visagismile/Rebel software, after the

smile design is simulated, what is the next step?

After the smile design is simulated, the next step is to present the
simulation to the patient for feedback and approval. This is followed
by adjustments to ensure the final design meets the patient's
expectations.

67. What is the advantage of using Visagismile/Rebel software over

traditional methods of smile design?

The advantage of using Visagismile/Rebel software is its ability to

integrate digital tools to create precise 3D models, leading to more
predictable results and greater patient satisfaction, compared to
traditional hand-drawn designs or trial-and-error methods.
68. How does the DSD workflow in Visagismile/Rebel software
improve the overall patient experience?

The DSD workflow improves the patient experience by allowing for

better communication, visualization of the treatment outcomes, and
faster decision-making, helping the patient understand and feel
more confident about the proposed treatment plan.

69. How does Visagismile/Rebel software contribute to

interdisciplinary communication in dentistry?

The software facilitates interdisciplinary communication by

providing a common digital platform for various dental specialists
(prosthodontists, orthodontists, periodontists, etc.), enabling them
to collaborate more effectively in designing and executing a
comprehensive treatment plan.

70. What type of feedback does Visagismile/Rebel software provide

to dentists during the smile design process?

Visagismile/Rebel software provides feedback in the form of

automated aesthetic analysis, which highlights potential issues with
tooth alignment, proportions, or symmetry. It also offers real-time
updates and visual suggestions to fine-tune the design according to
the patient's features.