ADEX Patient Assessment and Diagnosis 4 — Questions and Answers
Question 1: A patient reports jaw pain, clicking on opening, and limited mouth opening of 28 mm. These findings are most consistent with:
- Masseteric hypertrophy
- Temporomandibular joint disorder (TMD) (Correct answer)
- Trigeminal neuralgia
- Eagle syndrome
Correct answer: Temporomandibular joint disorder (TMD)
Jaw pain, TMJ clicking, and restricted opening (<40 mm) are hallmark signs of temporomandibular disorder.
Question 2: During a periodontal assessment, the clinical attachment level (CAL) is calculated by:
- Subtracting probing depth from the gingival margin measurement
- Adding probing depth to recession or subtracting pseudopocket depth from probing depth (Correct answer)
- Measuring the distance from the CEJ to the base of the pocket only
- Averaging the six probing depths per tooth
Correct answer: Adding probing depth to recession or subtracting pseudopocket depth from probing depth
CAL = probing depth + recession when the gingival margin is apical to the CEJ, or CAL = probing depth − pseudopocket when the margin is coronal.
Question 3: A 45-year-old patient presents with smooth, shiny, cupped-out lesions on occlusal surfaces of mandibular molars and lingual erosion of maxillary anteriors. The most likely etiology is:
- Bruxism
- Bulimia nervosa with acid regurgitation (Correct answer)
- Fluorosis
- Amelogenesis imperfecta
Correct answer: Bulimia nervosa with acid regurgitation
Lingual erosion of maxillary teeth combined with cupped occlusal surfaces suggests chronic acid exposure from purging (perimolysis).
Question 4: When assessing salivary flow, hyposalivation is defined as an unstimulated whole saliva flow rate of less than:
- 0.5 mL/min
- 0.1 mL/min (Correct answer)
- 1.0 mL/min
- 0.3 mL/min
Correct answer: 0.1 mL/min
Hyposalivation is clinically defined as unstimulated whole saliva flow below 0.1 mL/min.
Question 5: Which of the following medications most commonly causes gingival enlargement that would be identified during a periodontal assessment?
- Metformin
- Amlodipine (calcium channel blocker) (Correct answer)
- Atorvastatin
- Lisinopril (ACE inhibitor)
Correct answer: Amlodipine (calcium channel blocker)
Calcium channel blockers such as amlodipine are among the drug classes most associated with drug-influenced gingival enlargement.
Question 6: A radiograph shows a radiolucent area at the apex of a non-vital tooth with an intact lamina dura elsewhere. This finding is most consistent with:
- Periapical cemental dysplasia (early stage)
- Periapical abscess or granuloma (Correct answer)
- Condensing osteitis
- Normal anatomical landmark
Correct answer: Periapical abscess or granuloma
A periapical radiolucency on a non-vital tooth with intact surrounding lamina dura is characteristic of a periapical abscess or granuloma.
Question 7: During a comprehensive periodontal assessment, mobility is graded as Class II. What does this indicate?
- Tooth moves slightly more than normal (up to 1 mm horizontally)
- Tooth moves 1-2 mm horizontally in any direction (Correct answer)
- Tooth is depressible in its socket (vertical mobility)
- Tooth is ankylosed with no mobility
Correct answer: Tooth moves 1-2 mm horizontally in any direction
Class II tooth mobility is defined as horizontal movement of 1-2 mm, indicating moderate periodontitis or bone loss.
ADEX Patient Assessment and Diagnosis 4
A patient reports jaw pain, clicking on opening, and limited mouth opening of 28 mm.
These findings are most consistent with: