FREE ADC Scenario-Based Questions and Answers

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Case Scenario:
A patient presents with pain and swelling in the lower right jaw. On examination, you notice a draining sinus tract near the mandibular molars. What is the most likely diagnosis?

Correct! Wrong!

Explanation:
The presence of a draining sinus tract near the mandibular molars indicates an infection originating from the tooth's apex, known as a periapical abscess.

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

In addition to testing the pulp vitality with either a cold or an electric pulp tester, which of the following clinical tests or procedures would be the most appropriate to assist in making a diagnosis?

Correct! Wrong!

Explanation:
The percussion test involves tapping the tooth to assess for tenderness or discomfort, which can indicate inflammation or infection in the surrounding tissues or the tooth itself. In Alexander's case, since the tooth is occasionally sensitive to hot and cold, performing a percussion test can help determine if there is any underlying issue such as periapical inflammation or pulpitis.

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

In this case, what is most likely to cause the failure of the class II composite restorations of the posterior teeth?

Correct! Wrong!

Explanation:
Bonding to dentin, especially near the gingival margin, can be challenging and unpredictable due to factors like moisture control and the presence of dentinal tubules, which may affect the integrity of the restoration over time. Therefore, it is the most likely cause of failure for class II composite restorations in posterior teeth.

Case Scenario:
A patient presents with a fractured incisor tooth due to trauma. Which of the following is the most appropriate immediate management?

Correct! Wrong!

Explanation:
Trauma to the tooth can lead to pulp exposure or injury. Assessing for pulpal involvement is crucial to determine if root canal treatment is needed to preserve the tooth.

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

Correct! Wrong!

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.

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

After the removal of the 46, which prosthodontic options would be most appropriate for Alexander?

Correct! Wrong!

Explanation:
Waiting for the patient to assess their functional and aesthetic concerns before deciding on a replacement option is appropriate. It allows the patient time to consider their preferences and needs before proceeding with any prosthodontic treatment.

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?

Correct! Wrong!

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.

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

Given the history and radiographic evidence, what is the best description of the sensitivity to hot and cold you would expect Alexander to report?

Correct! Wrong!

Explanation:
"Dull and lingering for 1-2 minutes," is the most appropriate description of the sensitivity to hot and cold expected from Alexander. This description aligns with symptoms commonly associated with reversible pulpitis, indicating that the pulp is irritated but still viable.

Case Scenario:
During a routine dental examination, you notice redness and swelling around the gum line of a patient's tooth. What is the most likely diagnosis?

Correct! Wrong!

Explanation:
Redness and swelling around the gum line are characteristic signs of gingivitis, which is inflammation of the gums. It is often caused by poor oral hygiene.

Case scenario:
Alexander, a 64-year-old patient who is receiving warfarin as part of the management of his atrial fibrillation tells you that one of his lower right back teeth was restored three years ago by a dentist who has since retired from your practice.

The tooth is now occasionally sensitive to hot and cold. The clinical notes confirm the history and indicate that the tooth was restored using a resin composite material.

You obtain the periapical radiograph.

You decided to extract the tooth and in planning for the procedure you find that the patient’s International normalized ratio (INR) is 2.4. What is the most appropriate action to take at this time?

Correct! Wrong!

Explanation:
Since the INR is within the acceptable range for dental extractions, proceeding with the extraction and providing appropriate post-operative instructions would be the most appropriate action.

Case Scenario:
A patient complains of tooth sensitivity to colds and sweets. On examination, you notice a visible cavity in the tooth. What is the most appropriate initial treatment?

Correct! Wrong!

Explanation:
The visible cavity indicates dental caries. The most appropriate initial treatment is to restore the tooth with a filling to prevent further decay and alleviate sensitivity.

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