CCE Preliminary & Diagnostic Work Up 2 — Questions and Answers
Question 1: Which diagnostic record is most critical when evaluating a patient for full-mouth ceramic restorations?
- Panoramic radiograph only
- Mounted diagnostic casts with a facebow transfer (Correct answer)
- Intraoral photographs alone
- A single periapical radiograph of the anterior teeth
Correct answer: Mounted diagnostic casts with a facebow transfer
Mounted diagnostic casts with a facebow transfer allow accurate assessment of occlusal relationships and jaw movements essential for planning ceramic restorations.
Question 2: During a diagnostic wax-up for ceramic veneers, the ceramist discovers the patient has excessive incisal wear. What should be evaluated first?
- Shade selection for the restorations
- The etiology of the wear, such as bruxism or erosion (Correct answer)
- The number of veneers needed
- The patient's preference for tooth length
Correct answer: The etiology of the wear, such as bruxism or erosion
Identifying the cause of tooth wear is essential before fabricating any restoration to prevent premature failure.
Question 3: A facebow transfer is used in preliminary work-up primarily to:
- Record the shade of existing teeth
- Relate the maxillary arch to the hinge axis of the patient (Correct answer)
- Measure the vertical dimension of occlusion numerically
- Determine the periodontal health of the patient
Correct answer: Relate the maxillary arch to the hinge axis of the patient
The facebow records the spatial relationship of the maxillary arch to the transverse hinge axis so casts can be mounted accurately on an articulator.
Question 4: When evaluating the vertical dimension of occlusion (VDO) prior to ceramic reconstruction, which clinical sign suggests it may be collapsed?
- Increased overjet
- Angular cheilitis and reduced facial lower third height (Correct answer)
- Excessive tooth length
- Deep overbite with normal face height
Correct answer: Angular cheilitis and reduced facial lower third height
Angular cheilitis and a reduced lower facial third are classic clinical indicators of a collapsed vertical dimension of occlusion.
Question 5: Which articulator setting is most important when a ceramist receives casts for a full-mouth reconstruction case?
- Incisal pin setting
- Condylar inclination and Bennett angle (Correct answer)
- Mounting plaster brand used
- Color of the articulator frame
Correct answer: Condylar inclination and Bennett angle
Condylar inclination and Bennett angle settings govern the path of mandibular movement and directly affect occlusal morphology of ceramic restorations.
Question 6: A diagnostic wax-up is presented to the patient for approval before fabricating ceramic restorations. This step is important because it:
- Eliminates the need for provisional restorations
- Allows the patient to visualize and approve the planned esthetic outcome (Correct answer)
- Permanently sets the final shade
- Replaces the need for clinical photographs
Correct answer: Allows the patient to visualize and approve the planned esthetic outcome
The diagnostic wax-up serves as a communication tool between the ceramist, clinician, and patient to confirm esthetic and functional goals before irreversible tooth preparation.
Question 7: When reviewing pre-operative photographs during the diagnostic work-up, the ceramist notices the patient's midline is deviated 2mm to the left. The correct approach is to:
- Ignore it as 2mm is clinically insignificant
- Note it in the case documentation and discuss correction options with the dentist (Correct answer)
- Center the wax-up midline regardless of facial midline
- Delay fabrication until orthodontic treatment is complete
Correct answer: Note it in the case documentation and discuss correction options with the dentist
Midline deviations should be documented and discussed with the restorative dentist to determine whether correction is desired or feasible within the planned treatment.
Which diagnostic record is most critical when evaluating a patient for full-mouth ceramic restorations?