AGD Diagnostic & Treatment Planning Techniques 5 — Questions and Answers
Question 1: A patient has a 5 mm diastema between teeth #8 and #9. Before recommending composite bonding, which diagnostic factor is MOST critical to evaluate?
- The patient's insurance coverage
- The occlusion and presence of fremitus on the anterior teeth (Correct answer)
- The shade of the patient's posterior teeth
- The patient's brushing frequency
Correct answer: The occlusion and presence of fremitus on the anterior teeth
Heavy anterior occlusal contacts and fremitus increase the risk of bonding failure and must be assessed before adding material.
Question 2: The ASA physical status classification system is used in dentistry primarily to:
- Determine the patient's dental insurance eligibility
- Assess medical risk and guide modifications to dental treatment (Correct answer)
- Classify the severity of periodontal disease
- Quantify caries risk based on dietary habits
Correct answer: Assess medical risk and guide modifications to dental treatment
The ASA classification (I–VI) stratifies a patient's medical risk level to inform treatment modifications and safety precautions.
Question 3: When mounted diagnostic casts are used for occlusal analysis, the articulator is programmed using which record?
- A bite registration in maximum intercuspation only
- A facebow transfer and centric relation record (Correct answer)
- An alginate impression of the maxillary arch
- A panoramic radiograph tracing
Correct answer: A facebow transfer and centric relation record
A facebow transfer locates the maxillary cast relative to the hinge axis, and a centric relation record positions the mandibular cast accurately.
Question 4: A 45-year-old patient has a 7 mm isolated probing depth on the distal of tooth #30 with 3 mm of recession. What is the clinical attachment level (CAL)?
- 7 mm
- 4 mm
- 10 mm (Correct answer)
- 3 mm
Correct answer: 10 mm
CAL = probing depth + recession = 7 mm + 3 mm = 10 mm.
Question 5: Which diagnostic test BEST differentiates a tooth with symptomatic irreversible pulpitis from one with acute apical periodontitis?
- Percussion test
- Palpation test
- Cold pulp vitality test (Correct answer)
- Periodontal probing
Correct answer: Cold pulp vitality test
A cold test assesses pulp vitality; a lingering positive response indicates irreversible pulpitis, while no response may suggest necrosis with apical periodontitis.
Question 6: According to evidence-based treatment planning principles, which caries lesion depth most consistently supports operative intervention over monitoring?
- Lesion confined to enamel (E1)
- Lesion at the enamel-dentin junction (E2/D0)
- Lesion extending into the inner half of dentin (D2) (Correct answer)
- Lesion limited to outer enamel (E1) in a low-risk patient
Correct answer: Lesion extending into the inner half of dentin (D2)
Lesions extending into the inner half of dentin (D2) are unlikely to arrest and typically require operative intervention.
Question 7: A patient presents with a chief complaint of 'my bite feels off' after a new crown was placed. The FIRST diagnostic step should be:
- Immediately remove and remake the crown
- Use articulating paper to identify premature contacts (Correct answer)
- Order a CBCT to evaluate bone levels
- Adjust the opposing teeth to compensate
Correct answer: Use articulating paper to identify premature contacts
Articulating paper is used first to precisely identify and locate the premature occlusal contacts causing the patient's discomfort.
AGD Diagnostic & Treatment Planning Techniques 5
A patient has a 5 mm diastema between teeth #8 and #9.
Before recommending composite bonding, which diagnostic factor is MOST critical to evaluate?