Diagnosis and Treatment Planning Flashcards

A radiograph of a mandibular molar shows a periapical radiolucency with the root apex appearing to project through the inferior alveolar canal. What is the most important diagnostic consideration?

Answer: Proximity of roots to the inferior alveolar nerve before endodontic surgery

When apices appear to overlap or project through the inferior alveolar canal, the dentist must assess the proximity to avoid neurovascular injury during endodontic or surgical procedures.

Which systemic condition most directly contraindicates elective dental treatment under local anesthesia alone, requiring medical clearance first?

Answer: Stable angina with recent myocardial infarction 3 weeks ago

Elective dental procedures should be deferred for at least 6 months after a myocardial infarction due to elevated risk of reinfarction under stress.

A patient presents with multiple missing posterior teeth and requests implants. Panoramic radiograph reveals inadequate vertical bone height in the posterior maxilla. What diagnostic imaging is most essential before treatment planning implants?

Answer: CBCT of the posterior maxilla to assess sinus floor proximity

CBCT provides three-dimensional assessment of residual bone height, width, and proximity to the maxillary sinus, which is critical for implant placement planning in this region.

A 12-year-old presents with a periapical abscess on a maxillary first permanent molar with an open apex. Which treatment approach best preserves the tooth's developmental potential?

Answer: Apexification with calcium hydroxide or MTA

Apexification with calcium hydroxide or MTA creates an apical barrier, allowing the dentist to obturate the canal while preserving the tooth until root development completes or is simulated.

During treatment planning for a full-arch fixed implant prosthesis, what is the most important occlusal consideration?

Answer: Minimizing lateral forces through mutually protected occlusion

Implant-supported prostheses lack periodontal ligament proprioception, so mutually protected occlusion minimizes destructive lateral forces on implants and prosthetic components.

A patient presents with a chief complaint of 'cracking sounds' in the jaw and difficulty opening widely. The maximum opening is 28 mm with deviation to the left. What is the most likely diagnosis?

Answer: Anterior disc displacement without reduction on the left

Limited opening with deflection (not deviation correcting at maximum opening) and absence of clicking suggests disc displacement without reduction (closed lock) on the ipsilateral side.

Which caries risk assessment factor most significantly elevates a patient's caries risk classification from moderate to high?

Answer: Salivary flow rate below 0.1 mL/min (hyposalivation)

Severe xerostomia (salivary flow < 0.1 mL/min) dramatically increases caries risk because saliva is the primary defense against acid demineralization.