CDC Treatment Planning & Management 2 — Questions and Answers
Question 1: When treatment planning a patient with bruxism who requires ceramic restorations, which occlusal material consideration is most critical?
- Select the thinnest ceramic possible
- Choose a ceramic with high fracture toughness and wear resistance (Correct answer)
- Avoid all ceramic materials and use composite instead
- Use feldspathic porcelain exclusively for esthetic results
Correct answer: Choose a ceramic with high fracture toughness and wear resistance
Bruxist patients exert excessive occlusal forces, requiring ceramics with high fracture toughness such as zirconia or lithium disilicate to resist cracking.
Question 2: A treatment plan includes a fixed partial denture on a patient with a high caries risk. Which management step should the dental ceramist note as essential before fabrication begins?
- Begin wax-up immediately to save time
- Confirm caries has been controlled and teeth are stable (Correct answer)
- Use a fluoride-releasing luting cement as the sole caries strategy
- Fabricate provisionals first without informing the ceramist
Correct answer: Confirm caries has been controlled and teeth are stable
Active caries must be arrested before definitive restorations are placed to prevent recurrent decay under the prosthesis.
Question 3: Which radiographic finding would most significantly alter a ceramic crown treatment plan?
- Mild enamel hypocalcification
- Periapical pathology on the abutment tooth (Correct answer)
- Slight cervical abrasion at the CEJ
- Existing amalgam restoration in an adjacent tooth
Correct answer: Periapical pathology on the abutment tooth
Periapical pathology indicates endodontic compromise that must be resolved before placing a definitive ceramic restoration.
Question 4: During treatment planning, what is the purpose of a diagnostic wax-up for a patient requiring multiple ceramic veneers?
- To determine the shade of the ceramic
- To visualize the proposed final result and guide preparation depth (Correct answer)
- To select the luting cement type
- To evaluate the patient's bite force
Correct answer: To visualize the proposed final result and guide preparation depth
A diagnostic wax-up allows visualization of the planned esthetic outcome and serves as a template for minimal preparation guides and provisionals.
Question 5: A patient presents with a severely worn dentition and a collapsed vertical dimension of occlusion. What is the recommended treatment planning sequence?
- Restore posterior teeth first, then anterior
- Establish correct VDO with provisionals before definitive ceramic restorations (Correct answer)
- Place ceramic veneers on anterior teeth immediately
- Extract all teeth and plan implants
Correct answer: Establish correct VDO with provisionals before definitive ceramic restorations
The VDO must be re-established and verified with long-term provisionals before committing to irreversible definitive ceramic work.
Question 6: Which periodontal condition must be fully managed before a ceramic crown margin can be placed at or below the gingival crest?
- Minor gingival recession
- Active periodontitis with bleeding on probing (Correct answer)
- Physiologic sulcus depth of 1–2 mm
- Mild generalized erythema
Correct answer: Active periodontitis with bleeding on probing
Active periodontitis causes unstable gingival levels, making subgingival margin placement unpredictable and leading to recurrent disease under the restoration.
Question 7: When planning ceramic restorations for a patient with an anterior open bite, which occlusal scheme adjustment is most important to communicate to the ceramist?
- Canine-protected occlusion on posteriors only
- Group function with shared anterior contacts
- The absence of anterior guidance and its impact on incisal edge design (Correct answer)
- Immediate side shift in all excursions
Correct answer: The absence of anterior guidance and its impact on incisal edge design
An anterior open bite eliminates anterior guidance, placing potentially destructive lateral forces on posterior ceramics that must be accounted for in the design.
CDC Treatment Planning & Management 2
When treatment planning a patient with bruxism who requires ceramic restorations, which occlusal material consideration is most critical?