Mixed Deck — All ADC Topics Flashcards

When is an immediate denture most indicated?

Answer: When anterior teeth are being extracted and the patient cannot be without teeth during healing

An immediate denture is fabricated before extraction and inserted at the time of anterior tooth removal so the patient is not edentulous during healing.

What is the purpose of a study cast (diagnostic model) in treatment planning?

Answer: To provide a three-dimensional record of the patient's dentition for diagnosis and planning

Study casts provide a three-dimensional, permanent record of the patient's occlusion and arch form, enabling detailed diagnosis and treatment planning outside the clinical environment.

Which permanent tooth has the longest root?

Answer: Maxillary canine

The maxillary canine has the longest root of all permanent teeth, contributing to its stability and longevity.

A 10-year-old child presents to your clinic 45 minutes after avulsing their maxillary central incisor (tooth 11) during a sports accident. The tooth has been kept in a dry handkerchief. The child is medically fit. What is the most appropriate immediate management step?

Answer: Gently rinse the tooth with saline, replant it immediately, and splint for 2 weeks.

According to the International Association of Dental Traumatology (IADT) guidelines, for an avulsed permanent tooth with an open or closed apex and an extra-oral dry time of less than 60 minutes, the tooth should be gently rinsed with a sterile solution like saline, replanted as soon as possible, and a flexible splint placed for up to 2 weeks. Scrubbing the root surface is contraindicated as it damages the periodontal ligament cells. Delaying replantation significantly worsens the prognosis. Extra-oral RCT is only considered if the extra-oral dry time is prolonged ( > 60 mins).

The recommended casting temperature for most dental gold alloys is:

Answer: Approximately 100–150°C above the liquidus temperature

Casting at 100–150°C above the liquidus provides enough superheat to ensure the alloy remains fully fluid, fills all mold details, and allows complete compensation for heat loss during casting without premature solidification.

When taking a final impression for multiple, non-parallel implants intended for a splinted, screw-retained bridge, which technique is generally considered more accurate for capturing the precise three-dimensional orientation of the implants?

Answer: Open-tray impression technique.

The open-tray (or pick-up) technique is generally more accurate for multiple, angulated (non-parallel) implants. The impression copings are directly connected to the impression material and are unscrewed from the implants while the tray is still in the mouth. This method minimizes errors from the potential malpositioning of copings when re-seating them into the impression, which is a risk with the closed-tray (transfer) technique, especially where implant angulation prevents a clear path of insertion.

What is the Bennett movement in mandibular kinematics?

Answer: Lateral bodily shift of the mandible during lateral excursion

The Bennett movement is the lateral bodily shift of the mandible toward the working side during lateral excursion.

Which index is used to assess the severity of periodontal disease in the ADC examination context?

Answer: Basic Periodontal Examination (BPE)

The Basic Periodontal Examination (BPE) uses a WHO probe to screen and record periodontal status using codes 0–4 plus an asterisk.

Case Scenario: A patient presents with malalignment of the upper and lower teeth, causing difficulty in chewing and speech. What is the most appropriate treatment option?

Answer: Referral to an orthodontist for braces

Explanation: Malalignment of teeth, also known as malocclusion, is best managed by an orthodontist who can assess the patient's bite and provide appropriate treatment such as braces.

How many cusps does a maxillary first molar typically have?

Answer: 4

The maxillary first molar typically has 4 major cusps: mesiobuccal, distobuccal, mesiolingual, and distolingual.

What is the most appropriate first step when a patient presents with acute irreversible pulpitis causing severe spontaneous pain?

Answer: Perform pulpectomy or extraction to relieve the pain

Acute irreversible pulpitis requires removal of the inflamed pulp tissue (pulpectomy or extraction) to provide definitive pain relief.

The canine guidance (cuspid protected occlusion) means:

Answer: The canines bear all lateral occlusal forces and disengage posterior teeth

In canine guidance, the canines bear lateral occlusal forces and cause disclusion of all posterior teeth during lateral excursions.

What does the term 'informed consent' require in Australian dental practice?

Answer: The patient is provided with sufficient information about the proposed treatment, risks, alternatives, and consequences of no treatment, to make a voluntary decision

Valid informed consent requires the patient to receive adequate information about the procedure, potential risks, alternatives, and outcomes of refusal, and to voluntarily agree without coercion.

A 60-year-old patient with an implant-supported crown on tooth 46, placed 5 years ago, presents for a routine check-up. Probing around the implant reveals a 6mm pocket with bleeding on probing. What is the most crucial additional diagnostic information required to differentiate between peri-mucositis and peri-implantitis?

Answer: Comparison with a baseline radiograph.

The key feature that distinguishes peri-implantitis from peri-mucositis is radiographic evidence of progressive bone loss beyond initial remodelling. Peri-mucositis is inflammation confined to the soft tissues without bone loss. While bleeding on probing indicates inflammation (present in both) and suppuration is a strong sign of infection, the definitive diagnosis of peri-implantitis requires confirmation of bone loss by comparing current radiographs to baseline or previous radiographs.

A 72-year-old patient received new complete maxillary and mandibular dentures one week ago. They return complaining that the lower denture lifts every time they move their tongue. Which of the following is the most likely cause?

Answer: The mandibular lingual flanges are overextended.

Overextension of the lingual flanges of a mandibular complete denture will impinge on the mylohyoid muscle and the floor of the mouth. When the patient lifts or moves their tongue, these muscles contract and dislodge the denture. An inadequate posterior palatal seal affects the maxillary denture, and incorrect vertical dimension or tooth position typically causes different issues like muscle fatigue or cheek biting.

Case Scenario: A patient reports a clicking sound and discomfort while opening their mouth. What is the most likely cause of this symptom?

Answer: Temporomandibular joint (TMJ) disorder

Explanation: Clicking sounds and discomfort while opening the mouth are common symptoms of temporomandibular joint (TMJ) disorders, which affect the jaw joint and surrounding muscles.

For a full-coverage all-ceramic posterior crown requiring maximum fracture resistance in a high-occlusal-load patient, the most appropriate ceramic system is:

Answer: Yttria-stabilized tetragonal zirconia (Y-TZP)

Y-TZP has the highest flexural strength (900–1200 MPa) of all dental ceramics, making it the best choice for posterior crowns under high occlusal loads, though its opacity may limit anterior esthetic use.

The most appropriate management for at tooth with a history of previous trauma that now exhibits apical resorption is:

Answer: complete instrumentation and medication with intra-canal calcium hydroxide.

Explanation: This option is the most appropriate management for a tooth with apical resorption following trauma. Complete instrumentation involves cleaning and shaping the root canal system to remove any necrotic or infected tissue. Medication with intracanal calcium hydroxide helps disinfect the canal and promote healing. Calcium hydroxide has antimicrobial properties and can also induce hard-tissue formation, aiding in the repair of apical resorption.

A 9-year-old child presents with an uncomplicated crown fracture of the maxillary right central incisor (tooth 11) following a fall. The fracture exposes a small area of vital dentine but not the pulp. The tooth is not mobile, and pulp vitality testing is positive. According to the International Association of Dental Traumatology (IADT) guidelines, what is the most appropriate immediate management?

Answer: Place a calcium hydroxide liner over the exposed dentine and restore with composite resin.

For an uncomplicated crown fracture with dentine exposure, the primary goal is to seal the dentinal tubules to prevent bacterial ingress and protect the pulp. Placing a calcium hydroxide liner or a glass ionomer base over the exposed dentine, followed by a definitive restoration with composite resin, is the standard of care. Direct pulp capping or pulpotomy is only indicated if there is a pulp exposure (complicated crown fracture). Extraction is not indicated as the tooth is restorable and vital.

Which investigation is most appropriate when suspecting a salivary gland obstruction by a calculus?

Answer: Ultrasound or sialography

Ultrasound or sialography is the preferred investigation for salivary gland ductal obstruction as they can visualise the gland, duct, and any calculi or strictures.