ADC - Australian Dental Council Operative and Restorative Dentistry Questions and Answers

Question 1

A 45-year-old patient with a high caries risk presents with a Class II lesion on tooth 46. The distal marginal ridge is intact, but the caries extends gingivally below the cementoenamel junction (CEJ). Considering a minimally invasive approach and the patient's risk profile, which of the following is the most appropriate restorative technique for the Australian context?

Accepted Answer

An open 'sandwich' technique, using glass ionomer cement (GIC) to restore the gingival portion and layering composite resin occlusally.

Answer

The 'sandwich' technique is a well-established procedure in Australian dental practice, particularly for deep Class II cavities with subgingival margins. Using glass ionomer cement (GIC) at the gingival margin offers several advantages in a high-caries-risk patient: it chemically bonds to dentin and enamel, releases fluoride to inhibit recurrent caries, and has a coefficient of thermal expansion similar to that of tooth structure. The occlusal composite layer then provides superior aesthetics and wear resistance.

Question 2

A 7-year-old child presents for their first dental visit. Clinical examination reveals deep, sticky fissures on the permanent first molars (16, 26, 36, 46) with no radiographic evidence of caries. According to contemporary Australian caries management guidelines, what is the most appropriate initial management?

Accepted Answer

Applying a high-viscosity glass ionomer cement as a fissure sealant.

Answer

For a child with high-risk, deep fissures, a fissure sealant is the standard preventive measure. High-viscosity glass ionomer cements (GICs) are an excellent choice, especially in situations where moisture control can be challenging, as in a young child. GICs offer the significant advantage of fluoride release, which can help in the maturation of the enamel and provide protection against caries. Australian guidelines emphasize minimal intervention and prevention, making GIC sealants a preferred option over restorative intervention or simply observing.

Question 3

When preparing a moderate-sized Class I cavity for a direct composite resin restoration on a mandibular molar, which of the following cavity design principles is most consistent with modern adhesive dentistry practices in Australia?

Accepted Answer

Following the outline of the carious lesion, resulting in a conservative, 'scooped-out' preparation with rounded internal line angles.

Answer

Modern adhesive dentistry, as practiced in Australia, emphasizes minimal intervention and preservation of tooth structure. Cavity preparations for composite resin rely on micromechanical bonding, not macromechanical retention. Therefore, the design should be dictated by the extent of the caries, removing only the infected tooth structure. Rounded internal line angles help to reduce stress concentration within the restorative material and the tooth, improving the longevity of the restoration.

Question 4

A dentist in Australia is selecting a new composite resin for posterior restorations. To ensure the material is approved for use, which regulatory body's approval is essential?

Accepted Answer

The Therapeutic Goods Administration (TGA)

Answer

In Australia, all medical devices, including dental restorative materials, are regulated by the Therapeutic Goods Administration (TGA). The TGA's role is to safeguard public health and safety by ensuring that medical devices supplied in Australia meet stringent standards of safety, quality, and performance. A material must be listed on the Australian Register of Therapeutic Goods (ARTG) before it can be legally supplied and used.

Question 5

Which of the following statements best reflects the current evidence-based approach to managing an initial, non-cavitated carious lesion on the proximal surface of a posterior tooth in an adult patient with low caries risk in Australia?

Accepted Answer

Application of a professionally applied high-concentration fluoride varnish and radiographic monitoring.

Answer

Australian caries management protocols prioritize non-invasive strategies for initial lesions. For a non-cavitated lesion, the goal is to arrest and remineralize the tooth structure. This is best achieved through secondary prevention methods such as the professional application of fluoride varnish, coupled with dietary advice, oral hygiene instruction, and regular monitoring (e.g., with bitewing radiographs at appropriate intervals) to assess lesion activity. Operative treatment is reserved for cavitated lesions or lesions showing clear evidence of progression despite preventive efforts.

ADC - Australian Dental Council Practice Test

ADC - Australian Dental Council Practice Test

ADC - Australian Dental Council Operative and Restorative Dentistry Questions and Answers