CDC Treatment Planning & Management 3 — Questions and Answers
Question 1: A ceramist receives a prescription for a full-arch implant-supported ceramic bridge. Which treatment planning factor is uniquely important compared to tooth-supported bridgework?
- The shade of opposing natural teeth
- The absence of periodontal ligament and proprioceptive feedback (Correct answer)
- The patient's age and cosmetic preferences
- The laboratory turnaround time
Correct answer: The absence of periodontal ligament and proprioceptive feedback
Implants lack a periodontal ligament, eliminating proprioceptive feedback and increasing the risk of overloading ceramic restorations with excessive occlusal forces.
Question 2: When treatment planning ceramic inlays versus full coverage crowns for posterior teeth, which factor most favors choosing an inlay?
- Severe cuspal fracture requiring cusp replacement
- Adequate remaining tooth structure with localized interproximal decay (Correct answer)
- Tooth with a large existing MOD amalgam
- Patient preference for a silver restoration
Correct answer: Adequate remaining tooth structure with localized interproximal decay
Ceramic inlays are indicated when sufficient healthy tooth structure remains to support the restoration, preserving more natural tooth than a crown preparation.
Question 3: Which smile design principle directly influences treatment planning for the number and size of ceramic veneers in the esthetic zone?
- Golden proportion and tooth width-to-height ratio (Correct answer)
- Incisal embrasure depth alone
- The patient's age only
- The facebow transfer angle
Correct answer: Golden proportion and tooth width-to-height ratio
The golden proportion (approximately 1:0.618) and ideal width-to-height ratios guide planning the number, width, and shape of veneers for a harmonious smile.
Question 4: A patient with a history of ceramic fracture in a previous restoration presents for a new crown. Which treatment planning adjustment is most appropriate?
- Prescribe the same ceramic system as before
- Investigate occlusal etiology, adjust occlusion, and select a higher-strength ceramic (Correct answer)
- Simply increase the porcelain thickness by 0.5 mm
- Place a metal crown regardless of esthetic concerns
Correct answer: Investigate occlusal etiology, adjust occlusion, and select a higher-strength ceramic
Recurrent ceramic fracture suggests an unaddressed occlusal problem; both the cause and the material selection must be addressed to prevent repeat failure.
Question 5: When planning ceramic restorations for a patient undergoing orthodontic treatment, when is the ideal time to take final impressions?
- During active tooth movement for efficiency
- Immediately after appliance removal before any retention period
- After a sufficient stabilization/retention period post-orthodontics (Correct answer)
- Only when the patient requests the restorations
Correct answer: After a sufficient stabilization/retention period post-orthodontics
Teeth continue to shift after orthodontic appliance removal; final impressions should be taken only after a retention period ensures tooth positions are stable.
Question 6: A treatment plan calls for ceramic veneers on teeth #8 and #9 to correct diastema closure. What pre-treatment planning consideration is essential?
- Confirm the diastema is of cosmetic concern only and not caused by a pathologic frenum or tongue thrust (Correct answer)
- Immediately schedule the preparation appointment
- Select shade A1 for both veneers
- Use a putty index for impression only
Correct answer: Confirm the diastema is of cosmetic concern only and not caused by a pathologic frenum or tongue thrust
Diastemas caused by a low frenal attachment or tongue thrust will recur unless the underlying cause is corrected before veneer placement.
Question 7: Which patient medical history finding requires a treatment planning modification when scheduling long ceramic restoration appointments?
- A history of mild seasonal allergies
- Controlled hypertension requiring scheduled medication timing (Correct answer)
- A prior history of a fractured ankle
- Social anxiety with no dental-specific component
Correct answer: Controlled hypertension requiring scheduled medication timing
Patients with hypertension may need appointments timed around medication schedules to maintain stable blood pressure during lengthy dental procedures.
CDC Treatment Planning & Management 3
A ceramist receives a prescription for a full-arch implant-supported ceramic bridge.
Which treatment planning factor is uniquely important compared to tooth-supported bridgework?