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Arkansas Dentist — Requirements & Free Practice

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License to Practice Dentistry

Arkansas license to practice dentistry issued by the Arkansas State Board of Dental Examiners by examination or by credentials.

Licensing authority: Arkansas State Board of Dental Examiners · Application information

Licensure by credentials
Clinical Examination
Proof of successfully passing a clinical examination for licensure, with results sent directly from the state or regional testing agency that administered it (17 CAR § 115-901(a)(14)); no official source identifies which clinical examinations are accepted for this route.
Documents
Credentials application, transcript, verification from every state where licensed, comprehensive resume, letters from two licensed dentists, state and local peer review letters, DEA clearance and NPDB inquiry, CPR certificate, last two years of continuing education, letter of intent to practice in Arkansas within one year, fee, and continuing education at least equal to Arkansas licensees for the previous two years (17 CAR § 115-901(a)).
Jurisprudence And Interview
Pass the Arkansas Jurisprudence Examination with a score of 75% and appear before the Board for a jurisprudence examination and a personal interview (17 CAR § 115-901(a)(12), (c)).
National Board Card
National Board Exam Card sent from the JCNDE reflecting passage of the INBDE; photocopies not accepted (17 CAR § 115-901(a)(5)).
Practice
DDS or DMD from a CODA-accredited school; currently licensed in the state from which applying; continuous practice for five (5) years immediately before applying, meaning at least 1,000 hours per year for the two calendar years before application in the most current jurisdiction; postgraduate dental/medical education may count (17 CAR § 115-901(a)(1)).
Statutory Basis
Ark. Code § 17-82-308(a) permits a dentist practicing continuously for five years or more under a license of another state, territory, the District of Columbia or Canada to apply "without undergoing the examination required for licensing provided for in §§ 17-82-304-17-82-306"; the Board may in its discretion issue the license (§ 17-82-308(c)). The Board rule 17 CAR § 115-901 exercising that authority requires the INBDE and the Arkansas Jurisprudence Examination.
Licensure by examination

All of the following:

Age
At least twenty-one (21) years of age and proof of age and fitness on request (Ark. Code § 17-82-304(b) as amended by Act 170 of 2025).
Applicant Scope
The Board page applies this route to a dentist licensed and practicing for less than five (5) years; 17 CAR § 115-801 applies it to any dentist applying under Ark. Code § 17-82-304.
Application
Board application with photograph taken within the last six months, other forms as requested, and physician statement (17 CAR § 115-801(1), (6); application form).
Background Check
Authorization for a complete criminal background check (Board page; Ark. Code § 17-82-801 et seq.).
Clinical Examination
17 CAR § 115-801(5) requires a clinical examination administered by the Board or any regional testing agency whose examination the Board accepts, with at least 75% on each segment. The Board page names SRTA, WREB, CDCA, CITA and CRDTS; CDCA-WREB-CITA merged into the American Board of Dental Examiners (ADEX Dental Examination) and SRTA merged with CRDTS. A clinical examination administered by the Board itself or by another agency the Board accepts is not identified by any official source and is left to the Board.
Clinical Examination Content
The Board page states: "Effective January 1, 2020, the Arkansas State Board of Dental Examiners will only accept clinical dental examinations that consist of at least the following components: Restorative clinical examination section (anterior and posterior on a live patient), manikin prosthetic section, manikin endodontic section with posterior and interior access, treatment planning, and periodontal section." and "A clinical patient-based component of the examination must be administered by the testing agency and successfully completed by the candidate in order to be accepted." The currently registered ADEX and CRDTS dental examinations are manikin/simulated-patient examinations; applicants should confirm acceptance with the Board.
Clinical Score Validity
For licensure by examination, clinical examination scores are good for five (5) years from the date of successful passage (Board page).
Cpr
Current Basic Life Support / Healthcare Provider level CPR certificate; online CPR not accepted (17 CAR § 115-801(7); Board page).
Education
Graduate of a school for the education and training of dentists approved by the Board and accredited by the ADA Commission on Dental Accreditation, with a final transcript bearing the school seal and the degree sent directly from the school (17 CAR § 115-801(2)-(3)).
Jurisprudence Examination
Open-book Arkansas Jurisprudence Examination emailed to the applicant upon receipt of the application and fee (Board page).
National Board Results
INBDE results must be sent directly from the JCNDE; successful completion means at least 75% on each segment (17 CAR § 115-801(4)(B)-(D)). The Board page names this requirement "the National Board Examination for Dentistry, administered by the Joint Commission on National Dental Examinations (JCNDE)".
Other State Verification
Official verification from every state where licensed, sent directly by those boards (Board page).
Relicensing after forfeiture for non renewal
No examination is required for this applicant pathway.
Relicensing
License forfeited under Ark. Code § 17-82-311; apply in writing until January 1 of the year following the forfeiture, pay all accrued renewal fees plus a $200 penalty, and furnish proof of continuous ethical conduct and compliance (Ark. Code § 17-82-312(a)).

Official no-examination sources

Effective from 1955-01-27.

Biennial license renewal
No examination is required for this applicant pathway.
Renewal
Renew on January 1 of even-numbered years on Board forms with the renewal fee (Ark. Code § 17-82-310(a)); continuing education under 17 CAR Part 115, Subpart 14, including at least one hour of infection control (17 CAR § 115-1503(b)(1)).

Official no-examination sources

Effective from 1955-01-27.

ADEX Dental Examination

Provider
American Board of Dental Examiners (ADEX); DLOSCE administered at Prometric Test Centers under an exclusive license from the ADA; clinical examinations on simulated patient manikins at host clinical locations
Format
Examination series of one computer-based component (DLOSCE) and five clinical components (Periodontal, Endodontic, Fixed Prosthodontic, Anterior Restorative, Posterior Restorative), each scored and reported pass/fail as a separate part; all components must be passed within 18 months of the initial attempt of any component for an overall passing score; three successive failed attempts of the same part fail the entire series. Cohort form: registrations made prior to 6/1/2026 may make an initial attempt of the DSE OSCE in place of the DLOSCE by no later than December 31, 2026; failure of the DSE requires a subsequent attempt of the DLOSCE.
Time limit
DLOSCE approximately 6 hours 45 minutes seat time; Periodontal up to 90 minutes; Endodontic up to 3 hours; Fixed Prosthodontic up to 4 hours; Anterior Restorative up to 3 hours; Posterior Restorative up to 3.5 hours
Passing score
A score of 75 or greater is required to pass each part of the examination; results are reported as Pass/Fail for each part
Exam fee
$2,995 examination fee plus Facility Fee (varies by clinical location); includes one complimentary retake per clinical examination procedure; Typodont Fee $150 per procedure; DLOSCE second or third attempt $695
Examination outline
  • Dental Licensure Objective Structured Clinical Examination (DLOSCE) — computer-based component of the ADEX Dental Examination series (overseen by the Joint Commission on National Dental Examinations, owned by the ADA, used by ADEX under an exclusive license; administered at Prometric Test Centers). The examination includes questions involving patients of various types and backgrounds, including pediatric, geriatric, special needs, and medically complex patients.
    • DLOSCE topic area Restorative (24% of DLOSCE) — Diagnosis
    • DLOSCE topic area Restorative (24% of DLOSCE) — Preparations
    • DLOSCE topic area Restorative (24% of DLOSCE) — Restorations — Direct
    • DLOSCE topic area Restorative (24% of DLOSCE) — Restorations — Indirect
    • DLOSCE topic area Prosthodontics (19% of DLOSCE) — Removable
    • DLOSCE topic area Prosthodontics (19% of DLOSCE) — Fixed
    • DLOSCE topic area Prosthodontics (19% of DLOSCE) — Implants
    • DLOSCE topic area Oral Pathology, Pain Management, and Temporomandibular Dysfunction (13% of DLOSCE) — Oral Pathology/Oral Medicine
    • DLOSCE topic area Oral Pathology, Pain Management, and Temporomandibular Dysfunction (13% of DLOSCE) — Orofacial Pain and Temporomandibular Dysfunction
    • DLOSCE topic area Periodontics (10% of DLOSCE) — Diagnosis
    • DLOSCE topic area Periodontics (10% of DLOSCE) — Treatment Planning
    • DLOSCE topic area Periodontics (10% of DLOSCE) — Etiology
    • DLOSCE topic area Oral Surgery (9% of DLOSCE) — Diagnosis
    • DLOSCE topic area Oral Surgery (9% of DLOSCE) — Treatment Planning
    • DLOSCE topic area Oral Surgery (9% of DLOSCE) — Extractions
    • DLOSCE topic area Endodontics (8% of DLOSCE) — Diagnosis
    • DLOSCE topic area Endodontics (8% of DLOSCE) — Treatment Planning
    • DLOSCE topic area Endodontics (8% of DLOSCE) — Emergency Management
    • DLOSCE topic area Endodontics (8% of DLOSCE) — Post-treatment Evaluation
    • DLOSCE topic area Orthodontics (6% of DLOSCE) — Treatment Screening
    • DLOSCE topic area Orthodontics (6% of DLOSCE) — Space Management
    • DLOSCE topic area Medical Emergencies (6% of DLOSCE) — Diagnosis
    • DLOSCE topic area Medical Emergencies (6% of DLOSCE) — Management
    • DLOSCE topic area Prescriptions (5% of DLOSCE) — Antibiotic
    • DLOSCE topic area Prescriptions (5% of DLOSCE) — Analgesic
    • DLOSCE — Diagnosis and Treatment Planning – as well as Occlusion – are covered across the listed topic areas.
  • Periodontal Examination — clinical component on a simulated patient manikin, up to 90 minutes: 1. Calculus detection (maxillary); 2. Calculus removal on assigned quadrant (mandibular); 3. Periodontal probing depth measurements (mandibular). Scoring Rubric total 100 points; required component effective August 1, 2026.
    • Calculus Detection (16 points possible): 4 assigned maxillary teeth; 4 surfaces per tooth (M, D, F, L); 16 surfaces evaluated for presence or absence of subgingival calculus (1 point each).
    • Calculus Removal (66 points possible): One mandibular quadrant assigned; 12 assigned key surfaces evaluated for calculus removal (5.5 points each).
    • Complete Calculus Removal (6 points possible): Evaluation of calculus removal on all remaining surfaces within assigned quadrant. Calculus remaining: 1 surface (-3 points); 2 or more surfaces (-6 points).
    • Periodontal Probing Measurement (12 points possible): 2 assigned teeth (1 anterior; 1 posterior); 6 measurements per tooth (DF, F, MF, DL, L, ML); 12 measurements evaluated (1 point each). Periodontal probing measurement grading allows for ±1 mm leeway.
    • Treatment Management: Candidates must effectively complete periodontal treatment without causing unwarranted hard or soft tissue damage to the simulated dentition and gingiva. Penalty points will be assessed for each area of tissue damage and subtracted from the total points accrued during the grading process.
    • Soft Tissue Damage — penalty point assessment criteria: One point deducted for each site of minor soft tissue damage, up to three (3) sites. The presence of four (4) or more minor soft tissue damage sites, or one major soft tissue damage site results in automatic failure [critical error].
    • Minor Soft Tissue Damage: Slight soft tissue trauma that is inconsistent with the procedure, including: a laceration/abrasion that is ≤ 3 mm; a laceration or injury that would not result in the need for suturing, periodontal packing, or further follow-up treatment.
    • Major Soft Tissue Damage: a laceration/abrasion that is > 3 mm and that would require sutures, periodontal packing, or further follow-up treatment; a laceration/injury that would result in exposure of alveolar bone, flap, or amputation of papilla; an unreported broken instrument tip in the sulcus or soft tissue.
    • Hard Tissue Damage — penalty point assessment criteria: One point deducted for each site of minor hard tissue damage, up to three (3) sites. The presence of four (4) or more minor hard tissue damage sites, or one major hard tissue damage site results in automatic failure [critical error].
    • Minor Hard Tissue Damage: Slight hard tissue damage that is inconsistent with the procedure or a pre-existing condition; may include all hard tissue surfaces that would not require additional definitive treatment.
    • Major Hard Tissue Damage: Major damage to the hard tissue that is inconsistent with the procedure and a pre-existing condition; may include all hard tissue surfaces that would require additional definitive treatment (e.g. a restoration).
  • Endodontic Examination — clinical component on a simulated patient manikin, up to three (3) hours: 1. Anterior procedure; 2. Posterior procedure; the procedures are graded and reported as a singular exam part. Rating levels: ACC = Adheres to Criteria; SUB = Marginally Substandard; DEF = Critical Deficiency.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Critical errors: Procedure not challenged; Wrong tooth/surface treated; Crown of the tooth has been reduced; Any part of the tooth is fractured during instrumentation or obturation; Any part of the tooth is perforated
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Access Opening — Placement — ACC (Adheres to Criteria): Placement of the access opening is on the lingual surface directly over the pulp chamber and allows for pulp horns to be fully removed and complete debridement of the pulp chamber and straight-line access to the root canal system. | DEF (Critical Deficiency): Placement of the access opening is NOT over the pulp chamber and/or does NOT allow complete debridement of the pulp chamber or access to the root canal system.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Access Opening — Size — ACC (Adheres to Criteria): A. The incisal aspect of the access opening is ≥ 2.0 mm from the incisal edge which provides for a fully supported incisal edge. B. The cervical aspect of the access opening is ≥ 3.0 mm from the lingual CEJ which provides for a fully supported cingulum. C. The widest portion of the preparation mesio-distally is ≤ 1/2 of the lingual surface which provides for fully supported marginal ridges (approximately 1.0 mm). D. Size of the access opening allows for complete removal of pulp horns. | DEF (Critical Deficiency): A. The incisal aspect of the access opening is < 2.0 mm from the incisal edge which compromises the incisal edge. B. The cervical aspect of the opening is < 3.0 mm from the lingual CEJ which compromises the cingulum. C. The preparation compromises the mesial and/or distal marginal ridge(s) (≤ 1.0 mm). D. The size of the access opening does NOT allow for removal of pulp horns.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Access Opening — Internal Form — ACC (Adheres to Criteria): From the lingual surface to the cervical portion, the internal form tapers to the canal opening with slight ledges. | DEF (Critical Deficiency): Internal form exhibits excessive gouges, which compromise the integrity of the tooth.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Canal Instrumentation — Cervical Portion — ACC (Adheres to Criteria): Canal is shaped to a continuous taper to allow adequate debridement and obturation and the cervical portion of the canal is of appropriate location and size to allow access to the apical root canal system. | DEF (Critical Deficiency): Cervical portion of the canal is grossly over-prepared affecting the integrity of the tooth structure.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Canal Instrumentation — Mid-Root Portion — ACC (Adheres to Criteria): Mid-root portion of the canal blends smoothly with the cervical portion without ledges or shoulders. | DEF (Critical Deficiency): Mid-root portion of the canal has significant instrumentation irregularities that will compromise obturation.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Canal Instrumentation — Apical Portion — ACC (Adheres to Criteria): Apical portion of the canal is prepared to the anatomical apex of the tooth or ≤ 2.0 mm short of the anatomical apex. | DEF (Critical Deficiency): A. Apical portion of the canal is over-prepared beyond the anatomical apex. B. Apical portion of the canal is transported to the extent that the apical portion of the canal is not instrumented. C. Apical portion is under-prepared > 2.0 mm short of the anatomical apex.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Root Canal Obturation — Overfill/Underfill — ACC (Adheres to Criteria): Root canal is obturated with gutta percha at the anatomical apex or ≤ 2.0 mm short of the root apex. | DEF (Critical Deficiency): A. Root canal is obturated with gutta percha > 0.5 mm beyond the anatomical apex. B. Root canal is obturated with gutta percha > 2.0 mm short of the anatomical apex.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Root Canal Obturation — Voids in Gutta Percha — ACC (Adheres to Criteria): Apical third of the obturation in the root canal is dense and without voids. | DEF (Critical Deficiency): A. There are significant voids throughout the obturation of the root canal. B. There is no gutta percha present in the root canal. C. A material other than gutta percha was used to obturate the canal.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Root Canal Obturation — Filled above/below CEJ — ACC (Adheres to Criteria): A. Gutta percha in the root canal is ≤ 3.0 mm apical to the CEJ when measured from the facial. B. Gutta percha and/or sealer is/are evident in the pulp chamber extending ≤ 2.0 mm coronal to the CEJ when measured from the facial. | DEF (Critical Deficiency): A. Gutta percha in the root canal is > 3.0 mm apical to the CEJ when measured from the facial. B. Gutta percha and/or sealer is/are evident in the pulp chamber extending > 2.0 mm coronal to the CEJ when measured from the facial. C. There is restorative material present in the pulp chamber.
    • Anterior Endodontic Procedure (Tooth #8: access preparation, canal preparation, and obturation) — Root Canal Obturation — Separated File — ACC (Adheres to Criteria): File is not separated; or, file is separated in the root canal but does not affect obturation of the root canal. | DEF (Critical Deficiency): A file is separated in the root canal and either prevents the obturation or allows obturation at a critically deficient level.
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Critical errors: Procedure not challenged; Wrong tooth/surface treated; Crown of the tooth has been reduced; Any part of the tooth is fractured during instrumentation or obturation; Any part of the tooth is perforated
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Access Opening — Placement — ACC (Adheres to Criteria): Placement of the access opening is over the pulp chamber allowing for debridement of the pulp chamber and straight-line access to the three root canals located in the tooth. | DEF (Critical Deficiency): Placement of the access opening is not over the pulp chamber and/or does not allow complete debridement of the pulp chamber or access to the 3 root canals.
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Access Opening — Size — ACC (Adheres to Criteria): Access opening is in the mesial triangular pit and central fossa of the tooth and the following are true: A. The mesial extent of the access preparation is ≥ 2.0 mm from the mesial marginal ridge. B. The buccal extent of the access preparation is ≥ 1.0 mm from the line bisecting the mesio-buccal and disto-buccal cusp tips. C. The distal extent of the access preparation is ≥ 1.0 mm mesial to the distal oblique groove. D. The palatal extent of the access preparation is ≥ 1.0 mm from the mesiolingual cusp tip. | DEF (Critical Deficiency): A. The mesial extent of the access preparation is < 2.0 mm distal to the mesial marginal ridge. B. The buccal extent of the access preparation is < 1.0 mm from the line bisecting the mesio-buccal and disto-buccal cusp tips. C. The distal extent of the access preparation is < 1.0 mm mesial to the distal oblique groove. D. The palatal extent of the access preparation is < 1.0 mm from the mesio-lingual cusp tip. E. The access size is too small: <2.5 mm at its widest mesio-distally and/or < 2.5 mm at its widest bucco-lingually.
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Access Opening — Depth/Roof Removal — ACC (Adheres to Criteria): The depth of the access preparation removes the entire roof of the pulp chamber. | DEF (Critical Deficiency): A. The pulpal floor at the center of the floor is > 10.0 mm deep when measured from the buccal cavosurface margin of the access preparation. B. The depth of the access preparation does not remove the roof of the pulp chamber to the extent that all pulp tissue can be removed.
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Access Opening — Internal Form — ACC (Adheres to Criteria): The internal form of the access preparation leaves ≥ 1.0 mm of supported lateral tooth structure at any point of the preparation and tapers to the canal orifices with no or slight gouges. | DEF (Critical Deficiency): The internal form of the access preparation leaves < 1.0 mm of lateral supported tooth structure at any point of the preparation and/or tapers to the canal orifices with gross ledges that will inhibit access to the root canal orifices.
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Treatment Management — Condition of Adjacent Tooth/Teeth — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/ or contact. | DEF (Critical Deficiency): There is gross damage to adjacent tooth/teeth, requiring a restoration.
    • Posterior Endodontic Procedure (Tooth #14: access preparation and canal identification) — Treatment Management — Condition of Surrounding Tissue — ACC (Adheres to Criteria): There is slight damage to simulated gingiva and/or typodont consistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
  • Fixed Prosthodontic Examination — clinical component on a simulated patient manikin, up to four (4) hours: 1. All-Ceramic Crown preparation (Central Incisor); 2. Zirconia Crown preparation (Premolar); 3. Zirconia Crown preparation (Molar). Rating levels: ACC = Adheres to Criteria; SUB = Marginally Substandard; DEF = Critical Deficiency.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Critical errors: Wrong tooth/surface treated; Procedure not challenged
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Cervical Margin and Draw — Margin/Extension — ACC (Adheres to Criteria): The cervical margin is ≤ 0.5 mm below [apical to] the simulated free gingival margin to ≤ 1.5 mm above [incisal to] the simulated free gingival margin. | SUB (Marginally Substandard): The cervical margin is over-extended > 0.5 mm below the simulated free gingival margin. | DEF (Critical Deficiency): A. The cervical margin is over-extended > 0.5 mm below the simulated free gingival margin, causing visual damage to the typodont. B. The cervical margin is under-extended by > 1.5 mm above the simulated free gingival margin.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Cervical Margin and Draw — Margin/Definition/Unbeveled — ACC (Adheres to Criteria): The cervical margin is continuous but may be slightly rough and may lack some definition. | DEF (Critical Deficiency): A. The cervical margin has no continuity and/or definition. B. The margin is beveled. C. The margin is cupped or J-shaped.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Cervical Margin and Draw — Margin/Cervical Width — ACC (Adheres to Criteria): The cervical margin is ≥ 0.5 mm but ≤ 1.5 mm in width. | SUB (Marginally Substandard): The cervical margin is > 1.5 mm but ≤ 2.0 mm in width. | DEF (Critical Deficiency): A. The cervical margin is > 2.0 mm in width. B. The cervical margin is < 0.5 mm in width.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Cervical Margin and Draw — Line of Draw — ACC (Adheres to Criteria): The path of insertion/line of draw deviates < 20° from the long axis of the tooth. | SUB (Marginally Substandard): The path of insertion/line of draw deviates 20° to < 30° from the long axis of the tooth. | DEF (Critical Deficiency): The path of insertion/line of draw deviates ≥ 30° from the long axis of the tooth.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Walls, Taper and Line Angles — Axial/Lingual Tissue Reduction — ACC (Adheres to Criteria): The axial/lingual tissue reduction is ≥ 1.0 mm but ≤ 2.0 mm. | SUB (Marginally Substandard): The axial/lingual tissue reduction is > 2.0 mm but ≤ 2.5 mm. | DEF (Critical Deficiency): A. The axial/lingual tissue reduction is > 2.5 mm. B. The axial/lingual tissue reduction is < 1.0 mm.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Walls, Taper and Line Angles — Axial Walls Smoothness/Undercut — ACC (Adheres to Criteria): The walls may be slightly rough and may lack some definition. | DEF (Critical Deficiency): There is an undercut, which, when blocked out, would compromise margin width criteria and/or is > 0.5 mm deep.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Walls, Taper and Line Angles — Taper — ACC (Adheres to Criteria): Taper is present, from nearly parallel to ≤ 12° per wall. | SUB (Marginally Substandard): There is excessive taper that is > 12° but ≤ 16° per wall. | DEF (Critical Deficiency): The taper is grossly over-reduced > 16° per wall.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Walls, Taper and Line Angles — Incisal Reduction — ACC (Adheres to Criteria): The incisal reduction is ≥ 1.0 mm but ≤ 3.0 mm. | SUB (Marginally Substandard): The incisal reduction is > 3.0 mm but ≤ 3.5 mm. | DEF (Critical Deficiency): A. The incisal reduction is > 3.5 mm. B. The incisal reduction is < 1.0 mm.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Walls, Taper and Line Angles — External/Internal Line Angles — ACC (Adheres to Criteria): External and/or internal line angles may be rounded but irregular. | DEF (Critical Deficiency): The external and/or internal line angles are excessively sharp with no evidence of rounding.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Walls, Taper and Line Angles — Lingual Wall Height — ACC (Adheres to Criteria): The lingual wall height is ≥ 1.0 mm. | DEF (Critical Deficiency): The lingual wall height is < 1.0 mm.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Treatment Management — Condition of Adjacent/Opposing Teeth — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/ or contact. | SUB (Marginally Substandard): A. Damage to adjacent tooth/teeth requires recontouring that changes the shape and/or position of the contact. B. Opposing hard tissue shows minimal evidence of damage and/or alteration inconsistent with the procedure. | DEF (Critical Deficiency): A. There is gross damage to adjacent tooth/teeth, requiring a restoration. B. There is evidence of gross damage and/or alteration to opposing hard tissue inconsistent with the procedure.
    • Prosthodontic Crown Preparation — Ceramic Incisor (All-Ceramic Crown preparation on a central incisor, Tooth #9) — Treatment Management — Condition of Surrounding Tissue — ACC (Adheres to Criteria): There may be slight damage to the simulated gingiva and/or typodont consistent with the procedure. | SUB (Marginally Substandard): There is iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Critical errors: Procedure not challenged; Wrong tooth/surface treated
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Margin/Extension — ACC (Adheres to Criteria): The cervical margin is ≤ 0.5 mm below [apical to] the simulated free gingival margin to ≤ 1.5 mm above [occlusal to] the simulated free gingival margin. | SUB (Marginally Substandard): The cervical margin is over-extended > 0.5 mm below the simulated free gingival margin. | DEF (Critical Deficiency): A. The cervical margin is over-extended > 0.5 mm below the simulated free gingival margin, causing visual damage to the typodont. B. The cervical margin is under-extended > 1.5 mm above the simulated free gingival margin.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Margin/Definition/Unbeveled — ACC (Adheres to Criteria): The cervical margin is continuous but may be slightly rough and may lack some definition. | DEF (Critical Deficiency): A. The cervical margin has no continuity or definition. B. The cervical margin is beveled. C. The cervical margin is cupped or J-shaped.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Margin Width — ACC (Adheres to Criteria): The cervical margin is > 0.5 mm but ≤ 1.5 mm in width. | SUB (Marginally Substandard): The cervical margin is > 1.5 mm but ≤ 2.0 mm in width. | DEF (Critical Deficiency): A. The cervical margin is > 2.0 mm in width. B. The cervical margin is < 0.5 mm in width.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Line of Draw — ACC (Adheres to Criteria): The path of insertion/line of draw deviates < 20° from the long axis of the tooth. | SUB (Marginally Substandard): The path of insertion/line of draw deviates 20° to < 30° from the long axis of the tooth. | DEF (Critical Deficiency): The path of insertion/line of draw deviates ≥ 30° from the long axis of the tooth.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Axial Tissue Removal — ACC (Adheres to Criteria): The axial tissue removal is ≥ 1.0 mm but ≤ 2.0 mm. | SUB (Marginally Substandard): The axial tissue removal is > 2.0 mm but ≤ 2.5 mm. | DEF (Critical Deficiency): A. The axial tissue removal is > 2.5 mm. B. The axial tissue removal is < 1.0 mm.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Axial Walls Smoothness/Undercut — ACC (Adheres to Criteria): The walls may be slightly rough and may lack some definition. | DEF (Critical Deficiency): There is an undercut, which, when blocked out, would compromise margin width criteria and/or is > 0.5 mm deep.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Taper — ACC (Adheres to Criteria): Taper is present, from nearly parallel to ≤ 12° per wall. | SUB (Marginally Substandard): There is excessive taper that is > 12° and ≤ 16° per wall. | DEF (Critical Deficiency): Taper is grossly over-reduced > 16° per wall.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Occlusal Reduction — ACC (Adheres to Criteria): Occlusal reduction is ≥ 1.0 mm but ≤ 2.0 mm. | SUB (Marginally Substandard): Occlusal reduction is > 2.0 mm but ≤ 2.5 mm. | DEF (Critical Deficiency): A. Occlusal reduction is > 2.5 mm. B. Occlusal reduction is < 1.0 mm.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Internal Line Angles — ACC (Adheres to Criteria): Internal line angles and cusp tip areas may not be completely rounded and may show a slight tendency of being sharp. | DEF (Critical Deficiency): The internal line angles or cusp tip areas are excessively sharp with no evidence of rounding.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Treatment Management — Condition of Adjacent/Opposing Teeth — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | SUB (Marginally Substandard): A. Damage to adjacent tooth/teeth requires recontouring that changes the shape and/or position of the contact. B. Opposing hard tissue shows minimal evidence of damage and/or alteration inconsistent with the procedure. | DEF (Critical Deficiency): A. There is gross damage to adjacent tooth/teeth requiring a restoration. B. There is evidence of gross damage and/or alteration to opposing hard tissue inconsistent with the procedure.
    • Prosthodontic Crown Preparation — Zirconia Premolar (Zirconia Crown preparation, Tooth #5, as an anterior abutment for a 3-unit fixed dental prosthesis (bridge)) — Treatment Management — Condition of Surrounding Tissue — ACC (Adheres to Criteria): There may be slight damage to simulated gingiva and/or typodont consistent with the procedure. | SUB (Marginally Substandard): There is iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Critical errors: Procedure not challenged; Wrong tooth/surface treated
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Margin/Extension — ACC (Adheres to Criteria): The cervical margin is ≤ 0.5 mm below [apical to] the simulated free gingival margin to ≤ 1.5 mm above [occlusal to] the simulated free gingival margin. | SUB (Marginally Substandard): The cervical margin is over-extended > 0.5 mm below the simulated free gingival margin. | DEF (Critical Deficiency): A. The cervical margin is over-extended > 0.5 mm below the simulated free gingival margin, causing visual damage to the typodont. B. The cervical margin is under-extended > 1.5 mm above the simulated free gingival margin.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Margin/Definition/Unbeveled — ACC (Adheres to Criteria): The cervical margin is continuous but may be slightly rough and/or may lack some definition. | DEF (Critical Deficiency): A. The cervical margin has no continuity and/or definition. B. The cervical margin is beveled. C. The cervical margin is cupped or J-shaped.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Margin Width — ACC (Adheres to Criteria): The cervical margin is > 0.5 mm but ≤ 1.5 mm in width. | SUB (Marginally Substandard): The cervical margin is > 1.5 mm but ≤ 2.0 mm in width. | DEF (Critical Deficiency): A. The cervical margin is > 2.0 mm in width. B. The cervical margin is < 0.5 mm in width.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Cervical Margin and Draw — Line of Draw — ACC (Adheres to Criteria): The path of insertion/line of draw deviates < 20° from the long axis of the tooth. | SUB (Marginally Substandard): The path of insertion/line of draw deviates 20° to < 30° from the long axis of the tooth. | DEF (Critical Deficiency): The path of insertion/line of draw deviates ≥ 30° from the long axis of the tooth.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Axial Tissue Removal — ACC (Adheres to Criteria): The axial tissue removal is ≥ 1.0 mm but ≤ 2.0 mm. | SUB (Marginally Substandard): The axial tissue removal is > 2.0 mm but ≤ 2.5 mm. | DEF (Critical Deficiency): A. The axial tissue removal is > 2.5 mm. B. The axial tissue removal is < 1.0 mm.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Axial Walls Smoothness/Undercut — ACC (Adheres to Criteria): The walls may be slightly rough and may lack some definition. | DEF (Critical Deficiency): There is an undercut, which, when blocked out, would compromise margin width criteria and/or is > 0.5 mm deep.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Taper — ACC (Adheres to Criteria): Taper is present, from nearly parallel to ≤ 12°. | SUB (Marginally Substandard): There is excessive taper that is > 12° and ≤ 16°. | DEF (Critical Deficiency): The taper is grossly over-reduced > 16° per wall.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Occlusal Reduction — ACC (Adheres to Criteria): Occlusal reduction is ≥ 1.0 mm but ≤ 2.0 mm. | SUB (Marginally Substandard): Occlusal reduction is > 2.0 mm but ≤ 2.5 mm. | DEF (Critical Deficiency): A. Occlusal reduction is > 2.5 mm. B. Occlusal reduction is < 1.0 mm.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Walls, Taper and Line Angles — Internal Line Angles — ACC (Adheres to Criteria): Internal line angles and cusp tip areas may not be completely rounded and may show a slight tendency of being sharp. | DEF (Critical Deficiency): Internal line angles or cusp tip areas are excessively sharp with no evidence of rounding.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Bridge Factor — Path of Insertion/Line of Draw — ACC (Adheres to Criteria): The line of draw or path of insertion is direct or may require altering the path of insertion from a direct vertical axis to allow full seating. | DEF (Critical Deficiency): No line of draw or path of insertion exists through any plane of rotation without the removal of additional tooth structure in the apical 2/3 of either/both of the preparations.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Treatment Management — Condition of Adjacent/Opposing Teeth — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | SUB (Marginally Substandard): A. Damage to adjacent tooth/teeth requires recontouring that changes the shape and/or position of the contact. B. Opposing hard tissue shows minimal evidence of damage and/or alteration inconsistent with the procedure. | DEF (Critical Deficiency): A. There is gross damage to adjacent tooth/teeth, requiring a restoration. B. There is evidence of gross damage and/or alteration to opposing hard tissue inconsistent with the procedure.
    • Prosthodontic Crown Preparation — Zirconia Molar (Zirconia Crown preparation, Tooth #3, as the posterior abutment for same 3-unit fixed dental prosthesis (bridge)) — Treatment Management — Condition of Surrounding Tissue — ACC (Adheres to Criteria): There may be slight damage to simulated gingiva and/or typodont consistent with the procedure. | SUB (Marginally Substandard): There is iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
    • 3-SUB Rule: If examiners independently confirm three marginally substandard over-preparation criteria on the same procedure, then the procedure will be determined to be critically deficient, and the candidate will fail that procedure.
  • Anterior Restorative Examination — clinical component on a simulated patient manikin, up to three (3) hours: Class III preparation and restoration of carious lesion on a maxillary incisor; graded and reported as a separate exam part; preparation and restoration must be challenged together. Rating levels: ACC = Adheres to Criteria; SUB = Marginally Substandard; DEF = Critical Deficiency; 3-SUB rule applies to highlighted over-preparation criteria.
    • Preparation: Anterior Composite (Class III Composite Preparation) — Critical errors: Wrong tooth/surface treated; Unrecognized exposure
    • Preparation: Anterior Composite (Class III Composite Preparation) — External Outline Form — Outline Extension — ACC (Adheres to Criteria): The facial wall, if broken, may extend < 1.0 mm beyond the contact area. The outline form dimension is ≤ 3.0 mm incisal gingivally. | SUB (Marginally Substandard): A. The incisal cavosurface margin is over-extended so that the integrity of the incisal angle is compromised. B. The facial wall extends > 1.0 mm but ≤ 2.0 mm beyond the contact area. C. The outline form dimension is > 3.0 mm but ≤ 5.0 mm incisal gingivally. | DEF (Critical Deficiency): A. The incisal angle is unnecessarily removed or fractured. B. The facial wall extends > 2.0 mm beyond the contact area. C. The outline form dimension is > 5.0 mm incisal gingivally.
    • Preparation: Anterior Composite (Class III Composite Preparation) — External Outline Form — Gingival Clearance — ACC (Adheres to Criteria): The gingival clearance is ≤ 1.0 mm. | SUB (Marginally Substandard): The gingival clearance is > 1.0 mm but ≤ 2.0 mm. | DEF (Critical Deficiency): The gingival clearance is > 2.0 mm.
    • Preparation: Anterior Composite (Class III Composite Preparation) — External Outline Form — Margin Smoothness/Continuity/Bevels — ACC (Adheres to Criteria): The cavosurface margins may be slightly irregular. Enamel cavosurface margin bevels, if present, are ≤ 1.0 mm in width. | SUB (Marginally Substandard): The cavosurface margin is rough and severely irregular. Enamel cavosurface margin bevels, if present, are > 1.0 mm in width, are not uniform, or are inappropriate for the size of the restoration.
    • Preparation: Anterior Composite (Class III Composite Preparation) — External Outline Form — Sound Marginal Tooth Structure — ACC (Adheres to Criteria): There may be a small area of unsupported enamel which is not necessary to preserve facial aesthetics. | SUB (Marginally Substandard): The cavosurface margin does not terminate in sound natural tooth structure. | DEF (Critical Deficiency): A. There is explorer-penetrable decalcification remaining on the cavosurface margin. B. There are large or multiple areas of unsupported enamel which are not necessary to preserve facial aesthetics.
    • Preparation: Anterior Composite (Class III Composite Preparation) — Internal Form — Axial Walls — ACC (Adheres to Criteria): MAX CENTRALS: The depth of the axial wall extends ≤ 2.0 mm in depth from the cavosurface margin. MAX LATERALS: The depth of the axial wall extends ≤ 1.0 mm in depth from the cavosurface margin. | SUB (Marginally Substandard): MAX CENTRALS: The depth of the axial wall extends > 2.0 mm but ≤ 3.0 mm in depth from the cavosurface margin. MAX LATERALS: The depth of the axial wall extends > 1.0 mm but ≤ 2.0 mm in depth from the cavosurface margin. | DEF (Critical Deficiency): MAX CENTRALS: The depth of the axial wall extends > 3.0 mm in depth from the cavosurface margin. MAX LATERALS: The depth of the axial wall extends > 2.0 mm in depth from the cavosurface margin.
    • Preparation: Anterior Composite (Class III Composite Preparation) — Internal Form — Internal Retention — ACC (Adheres to Criteria): If used, rounded internal retention is placed in the dentin of the gingival and incisal walls just axial to the DEJ as dictated by cavity form. Retention is tactilely and visually present. | SUB (Marginally Substandard): When used, retention is excessive and undermines enamel, or jeopardizes the incisal angle, or encroaches on the pulp.
    • Preparation: Anterior Composite (Class III Composite Preparation) — Internal Form — Caries — ACC (Adheres to Criteria): All caries removed. | DEF (Critical Deficiency): Caries has not been accessed and/or remains in the preparation.
    • Preparation: Anterior Composite (Class III Composite Preparation) — Treatment Management — Adjacent Tooth Damage — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | SUB (Marginally Substandard): Damage to adjacent tooth/teeth requires re-contouring that changes the shape and/or contour and/or contact. | DEF (Critical Deficiency): There is gross damage to adjacent tooth/teeth which requires a restoration.
    • Preparation: Anterior Composite (Class III Composite Preparation) — Treatment Management — Soft Tissue Damage — ACC (Adheres to Criteria): The soft tissue is free from damage or there is tissue damage that is consistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the soft tissue inconsistent with the procedure and pre-existing condition of the soft tissue.
    • Restoration: Anterior Composite (Class III Composite Restoration) — Critical errors: Restoration is debonded and/or movable in the preparation; Restoration is fractured
    • Restoration: Anterior Composite (Class III Composite Restoration) — Margin Integrity and Surface Finish — Margin Excess/Deficiency — ACC (Adheres to Criteria): A. No marginal deficiency. There is no evidence of pits and/or voids at the cavosurface margin. B. The restoration-tooth interface may be detectable visually or with the tine of an explorer. | SUB (Marginally Substandard): A. DEFICIENCY: The restoration-tooth interface is detectable visually or with the tine of an explorer, and there is evidence of marginal deficiency ≤ 0.5 mm, which can include pits and/or voids at the cavosurface margin. B. EXCESS: There is evidence of marginal excess ≤ 1.0 mm in thickness perpendicular to the tooth surface (overhang) and/or extending laterally beyond the margin of the preparation ≥ 1.0 mm but ≤ 2.0mm. There is flash with or without contamination underneath, but it is not internal to the cavosurface margin and could be removed by polishing or finishing. | DEF (Critical Deficiency): A. There is evidence of marginal deficiency of > 0.5 mm, to include pits and voids at the cavosurface margin, and/or there is an open margin, and/or there is internal contamination at the interface between the restoration and the tooth. B. There is a marginal excess > 1.0 mm in thickness perpendicular to the tooth surface (overhang) and/or extending laterally beyond the margin of the preparation > 2.0 mm (excluding bonding agent or unfilled resin).
    • Restoration: Anterior Composite (Class III Composite Restoration) — Margin Integrity and Surface Finish — Adjacent Tooth Structure — ACC (Adheres to Criteria): There is no or minimal evidence of unwarranted or unnecessary removal, modification, or recontouring of tooth structure adjacent to the restoration (Enameloplasty). | DEF (Critical Deficiency): There is gross enameloplasty.
    • Restoration: Anterior Composite (Class III Composite Restoration) — Contour, Contact and Occlusion — Interproximal Contact — ACC (Adheres to Criteria): Interproximal contact is visually closed, and the contact is adequate in size, shape, or position but may demonstrate little resistance to dental floss. | DEF (Critical Deficiency): A. The interproximal contact is visually open or concave/irregular, allowing for food impaction. B. The interproximal contact will not allow floss to pass.
    • Restoration: Anterior Composite (Class III Composite Restoration) — Contour, Contact and Occlusion — Centric/Excursive Contacts — ACC (Adheres to Criteria): When checked with articulating paper, all centric and excursive contacts on the restoration are consistent in size, shape, and intensity with such contacts on other teeth in that quadrant. | SUB (Marginally Substandard): When checked with articulating paper, the restoration is in hyper-occlusion, making it inconsistent in size, shape, and intensity with the occlusal contacts on surrounding teeth, and it requires adjustment. | DEF (Critical Deficiency): There is gross hyper-occlusion so that the restoration is the only point of occlusion in that quadrant.
    • Restoration: Anterior Composite (Class III Composite Restoration) — Treatment Management — Adjacent Tooth Damage — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/ or contact. | DEF (Critical Deficiency): There is evidence of gross damage and/or alteration to adjacent and/or opposing hard tissue inconsistent with the procedure.
    • Restoration: Anterior Composite (Class III Composite Restoration) — Treatment Management — Soft Tissue Damage — ACC (Adheres to Criteria): The soft tissue is free from damage, or there is tissue damage that is consistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the soft tissue inconsistent with the procedure and pre-existing condition of the soft tissue. 1 of 1
  • Posterior Restorative Examination — clinical component on a simulated patient manikin, up to three and a half (3.5) hours: Class II preparation and restoration of carious lesion on a mandibular molar or premolar; all candidates complete a Composite Posterior Restorative procedure (amalgam is not an option); graded and reported as a separate exam part. Rating levels: ACC = Adheres to Criteria; SUB = Marginally Substandard; DEF = Critical Deficiency; 3-SUB rule applies to highlighted over-preparation criteria.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Critical errors: Wrong tooth/surface treated; Unrecognized exposure
    • Preparation: Posterior Composite (Class II Composite Preparation) — External Outline Form — Proximal Clearance — ACC (Adheres to Criteria): Proximal contact is either closed or visibly open, and, at the height of contour, proximal clearance may extend ≤ 1.0 mm beyond either one or both proximal walls. | SUB (Marginally Substandard): Proximal clearance at the height of contour extends > 1.0 mm but ≤ 2.0 mm beyond either one or both proximal walls. | DEF (Critical Deficiency): Proximal clearance at the height of contour extends > 2.0 mm beyond either one or both proximal walls.
    • Preparation: Posterior Composite (Class II Composite Preparation) — External Outline Form — Gingival Clearance — ACC (Adheres to Criteria): The gingival clearance is visually open but ≤ 1.0 mm. | SUB (Marginally Substandard): The gingival clearance is > 1.0 mm but ≤ 2.0 mm. | DEF (Critical Deficiency): A. The gingival clearance is > 2.0 mm. B. The gingival contact is not visually open.
    • Preparation: Posterior Composite (Class II Composite Preparation) — External Outline Form — Outline Shape/Continuity/Extension — ACC (Adheres to Criteria): The outline form may be sharp and irregular | SUB (Marginally Substandard): The outline form is inappropriately over-extended, compromising the remaining marginal ridge and/or cusp(s). | DEF (Critical Deficiency): The outline form is grossly over-extended, compromising and undermining the remaining marginal ridge to the extent that the cavosurface margin is unsupported by dentin and/or the width of the marginal ridge is ≤ 1.0 mm.
    • Preparation: Posterior Composite (Class II Composite Preparation) — External Outline Form — Isthmus — ACC (Adheres to Criteria): The isthmus may be between 1.0 mm - 2.0 mm in width but ≤ 1/3 the intercuspal width. | SUB (Marginally Substandard): The isthmus is > 1/3 the intercuspal width but ≤ 1/2 the intercuspal width. | DEF (Critical Deficiency): The isthmus is > 1/2 the intercuspal width or the isthmus width is < 1.0 mm.
    • Preparation: Posterior Composite (Class II Composite Preparation) — External Outline Form — Cavosurface Margin — ACC (Adheres to Criteria): The external cavosurface margin meets the enamel at 90°; The gingival floor is flat, smooth, and perpendicular to the long axis of the tooth. | SUB (Marginally Substandard): The proximal cavosurface margin deviates from 90° and is likely to jeopardize the longevity of the tooth or restoration. This would include unsupported enamel and/or excessive bevel(s).
    • Preparation: Posterior Composite (Class II Composite Preparation) — External Outline Form — Sound Marginal Tooth Structure — ACC (Adheres to Criteria): The cavosurface margin terminates in sound tooth structure. | SUB (Marginally Substandard): The cavosurface margin does not terminate in sound tooth structure. | DEF (Critical Deficiency): A. There is explorer-penetrable decalcification remaining on the cavosurface margin. B. There are large or multiple areas of unsupported enamel which are not necessary to preserve facial aesthetics.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Internal Form — Axial Walls — ACC (Adheres to Criteria): MOLARS: The depth of the axial wall extends ≤ 2.0 mm in depth from the cavosurface margin. PREMOLARS: The depth of the axial wall extends ≤ 1.5 mm in depth from the cavosurface margin. | SUB (Marginally Substandard): MOLARS: The depth of the axial wall extends > 2.0 mm but ≤ 3.0 mm in depth from the cavosurface margin. PREMOLARS: The depth of the axial wall extends > 1.5 mm but ≤ 2.0 mm in depth from the cavosurface margin. | DEF (Critical Deficiency): MOLARS: The depth of the axial wall extends > 3.0 mm in depth from the cavosurface margin. PREMOLARS: The depth of the axial wall extends > 2.0 mm in depth from the cavosurface margin. MOLARS & PREMOLARS: The depth of the axial wall is entirely in enamel.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Internal Form — Pulpal Floor — ACC (Adheres to Criteria): The pulpal floor depth is ≥ 1.0 mm but ≤ 3.0 mm in all areas; there may be remaining enamel. | SUB (Marginally Substandard): The pulpal floor depth is > 3.0 mm but ≤ 4.0 mm from the cavosurface margin. | DEF (Critical Deficiency): A. The pulpal floor is > 4.0 mm from the cavosurface margin. B. The pulpal floor depth is < 1.0 mm.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Internal Form — Caries — ACC (Adheres to Criteria): All caries removed. | DEF (Critical Deficiency): Caries has not been accessed and/or remains in the preparation.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Internal Form — Retention — ACC (Adheres to Criteria): Retention, when used, is well defined, in dentin, and does not undermine enamel. | SUB (Marginally Substandard): Retention, when used, undermines the enamel.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Internal Form — Proximal Box Walls — ACC (Adheres to Criteria): The proximal walls are parallel or convergent occlusally but may be slightly divergent and are not likely to jeopardize the longevity of the tooth or restoration. | SUB (Marginally Substandard): The proximal walls are too divergent.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Treatment Management — Adjacent Tooth Damage — ACC (Adheres to Criteria): Any damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/ or contact. | SUB (Marginally Substandard): Damage to adjacent tooth/teeth requires re-contouring that changes the shape and/or contour and/or contact. | DEF (Critical Deficiency): There is gross damage to adjacent tooth/teeth which requires a restoration.
    • Preparation: Posterior Composite (Class II Composite Preparation) — Treatment Management — Soft Tissue Damage — ACC (Adheres to Criteria): The soft tissue is free from damage, or there is tissue damage that is consistent with the procedure | DEF (Critical Deficiency): There is gross iatrogenic damage to the soft tissue inconsistent with the procedure and pre-existing condition of the soft tissue.
    • Restoration: Posterior Composite (Class II Composite Restoration) — Critical errors: Restoration is debonded and/or movable in the preparation; Restoration is fractured
    • Restoration: Posterior Composite (Class II Composite Restoration) — Margin Integrity and Surface Finish — Margin Excess/Deficiency — ACC (Adheres to Criteria): A. No marginal deficiency. There is no evidence of pits and/or voids at the cavosurface margin. B. The restoration-tooth interface may be detectable visually or with the tine of an explorer. | SUB (Marginally Substandard): A. DEFICIENCY: The restoration-tooth interface is detectable visually or with the tine of an explorer, and there is evidence of marginal deficiency ≤ 0.5 mm, which can include pits and/or voids at the cavosurface margin. B. EXCESS: There is evidence of marginal excess ≤ 1.0 mm in thickness perpendicular to the tooth surface (overhang) and/or extending laterally beyond the margin of the preparation ≥ 1.0 mm but ≤ 2.0mm. There is flash with or without contamination underneath, but it is not internal to the cavosurface margin and could be removed by polishing or finishing. | DEF (Critical Deficiency): A. There is evidence of marginal deficiency of > 0.5 mm, to include pits and voids at the cavosurface margin, and/or there is an open margin, and/or there is internal contamination at the interface between the restoration and the tooth. B. There is a marginal excess > 1.0 mm in thickness perpendicular to the tooth surface (overhang) and/or extending laterally beyond the margin of the preparation > 2.0 mm (excluding bonding agent or unfilled resin).
    • Restoration: Posterior Composite (Class II Composite Restoration) — Margin Integrity and Surface Finish — Adjacent Tooth Structure — ACC (Adheres to Criteria): There is no or minimal evidence of unwarranted or unnecessary removal, modification, or recontouring of tooth structure adjacent to the restoration. | DEF (Critical Deficiency): There is gross enameloplasty.
    • Restoration: Posterior Composite (Class II Composite Restoration) — Contour, Contact and Occlusion — Interproximal Contact — ACC (Adheres to Criteria): Interproximal contact is visually closed, and the contact appears adequate in size, shape, or position, but may demonstrate little resistance to dental floss. | DEF (Critical Deficiency): A. The interproximal contact is visually open or concave/irregular, allowing for food impaction. B. The interproximal contact will not allow floss to pass.
    • Restoration: Posterior Composite (Class II Composite Restoration) — Contour, Contact and Occlusion — Centric/Excursive Contacts — ACC (Adheres to Criteria): When checked with articulating paper, all centric and excursive contacts on the restoration are consistent in size, shape, and intensity with such contacts on other teeth in that quadrant. | SUB (Marginally Substandard): When checked with articulating paper, the restoration is in hyper-occlusion, making it inconsistent in size, shape, and inten- sity with the occlusal contacts on surrounding teeth, and it requires adjustment. | DEF (Critical Deficiency): There is gross hyper-occlusion so that the restoration is the only point of occlusion in that quadrant.
    • Restoration: Posterior Composite (Class II Composite Restoration) — Treatment Management — Adjacent Tooth Damage — ACC (Adheres to Criteria): Any minimal damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | DEF (Critical Deficiency): There is evidence of gross damage and/or alteration to adjacent and/or opposing hard tissue inconsistent with the procedure.
    • Restoration: Posterior Composite (Class II Composite Restoration) — Treatment Management — Soft Tissue Damage — ACC (Adheres to Criteria): The soft tissue is free from damage, or there is tissue damage that is consistent with the procedure. | DEF (Critical Deficiency): There is gross iatrogenic damage to the soft tissue inconsistent with the procedure.
Examination sources

Integrated National Board Dental Examination

Provider
Joint Commission on National Dental Examinations (JCNDE); administered at Prometric test centers
Format
Computer-based multiple-choice examination administered over two days; each item has at least three but not more than five response options, only one of which is the correct or best option
Exam questions
500 items: Sections 1-3 of 100 standalone items each, Section 4 of 60 case-based items, Sections 5 and 6 of 70 case-based items each
Time limit
12 hours 30 minutes total administration time over two days, including the optional tutorial, scheduled breaks, and post-examination survey
Passing score
Scale score of 75 (scale scores range from 49 to 99); results reported as pass or fail
Exam fee
$890 examination fee (purchased individually)
Examination outline
  • Diagnosis and Treatment Planning — includes all aspects of diagnosis, assessment, interpretation of laboratory results, physical evaluation of structure, appearance and function, as well as background, characteristics, circumstances, underlying conditions and psychological, social or behavioral influences to derive an accurate diagnosis and treatment plan, as well as identify reasonable and safe treatment alternatives for any patient (Clinical Content areas 1-15) (36%)
    • CC 1. Interpret patient information and medical data to assess and manage patients.
    • CC 2. Identify the chief complaint and understand the contributing factors.
    • CC 3. Perform head and neck and intraoral examinations, interpreting and evaluating the clinical findings.
    • CC 4. Use clinical and epidemiological data to diagnose and establish a prognosis for dental abnormalities and pathology.
    • CC 5. Recognize the normal range of clinical findings and distinguish significant deviations that require monitoring, treatment, or management.
    • CC 6. Predict the most likely diagnostic result given available patient information.
    • CC 7. Interpret diagnostic results to inform understanding of the patient’s condition.
    • CC 8. Recognize the manifestations of systemic disease and how the disease and its management may affect the delivery of dental care.
    • CC 9. Recognize the interrelationship between oral health and systemic disease, and implement strategies for improving overall health.
    • CC 10. Select the diagnostic tools most likely to establish or confirm the diagnosis.
    • CC 11. Collect information from diverse sources (patient, guardian, patient records, allied staff, and other healthcare professionals) to make informed decisions.
    • CC 12. Formulate a comprehensive diagnosis and treatment plan for patient management.
    • CC 13. Discuss etiologies, treatment alternatives, and prognoses with patients so they are educated and can make informed decisions concerning the management of their care.
    • CC 14. Understand how patient attributes (e.g., sex, age, race, ethnicity, and special needs), social background and values influence the provision of oral health care at all stages of life.
    • CC 15. Interact and communicate with patients using psychological, social, and behavioral principles.
  • Oral Health Management — includes all aspects of patient care delivery, including provision and modification of treatment, handling of complications, intervention outcomes assessment, and all developments that arise in the course of managing a patient’s oral health care (Clinical Content areas 16-38) (42%)
    • CC 16. Prevent, recognize, and manage medical emergencies (e.g., cardiac arrest).
    • CC 17. Prevent, recognize, and manage dental emergencies.
    • CC 18. Recognize and manage acute pain, hemorrhage, trauma, and infection of the orofacial complex.
    • CC 19. Prevent, diagnose, and manage pain during treatment.
    • CC 20. Prevent, diagnose, and manage pulpal and periradicular diseases.
    • CC 21. Prevent, diagnose, and manage caries.
    • CC 22. Prevent, diagnose, and manage periodontal diseases.
    • CC 23. Prevent, diagnose, and manage oral mucosal and osseous diseases.
    • CC 24. Recognize, manage, and report patient abuse and neglect.
    • CC 25. Recognize and manage substance abuse.
    • CC 26. Select and administer or prescribe pharmacological agents in the treatment of dental patients.
    • CC 27. Anticipate, prevent, and manage complications arising from the use of therapeutic and pharmacological agents in patient care.
    • CC 28. Diagnose endodontic conditions and perform endodontic procedures.
    • CC 29. Diagnose and manage the restorative needs of edentulous and partially edentulous patients.
    • CC 30. Restore tooth function, structure, and esthetics by replacing missing and defective tooth structure, while promoting soft and hard tissue health.
    • CC 31. Perform prosthetic restorations (fixed or removable) and implant procedures for edentulous and partially edentulous patients.
    • CC 32. Diagnose and manage oral surgical treatment needs.
    • CC 33. Perform oral surgical procedures.
    • CC 34. Prevent, diagnose, and manage developmental or acquired occlusal problems.
    • CC 35. Prevent, diagnose, and manage temporomandibular disorders.
    • CC 36. Diagnose and manage patients requiring modification of oral tissues to optimize form, function and esthetics.
    • CC 37. Evaluate outcomes of comprehensive dental care.
    • CC 38. Manage the oral esthetic needs of patients.
  • Practice and Profession — includes the understanding, implementation and monitoring of effective systems, procedures, and policies that support professional practice integrity, quality control and self or organizational performance assessment, as well as systems, procedures, and policies that enable skillful integration of new knowledge, products and technology, and that minimize risk and enhance the quality of care provided or improve community oral health (Clinical Content areas 39-56) (22%)
    • CC 39. Evaluate and integrate emerging trends in health care.
    • CC 40. Evaluate social and economic trends and adapt to accommodate their impact on oral health care.
    • CC 41. Evaluate scientific literature and integrate new knowledge and best research outcomes with patient values and other sources of information to make decisions about treatment.
    • CC 42. Practice within the general dentist’s scope of competence and consult with or refer to professional colleagues when indicated.
    • CC 43. Evaluate and utilize available and emerging resources (e.g., laboratory and clinical resources, information technology) to facilitate patient care, practice management, and professional development.
    • CC 44. Conduct practice activities in a manner that manages risk and is consistent with jurisprudence and ethical requirements in dentistry and healthcare.
    • CC 45. Recognize and respond to situations involving ethical and jurisprudence considerations.
    • CC 46. Maintain patient records in accordance with jurisprudence and ethical requirements.
    • CC 47. Conduct practice related business activities and financial operations in accordance with sound business practices and jurisprudence (e.g., OSHA and HIPAA).
    • CC 48. Develop a catastrophe preparedness plan for the dental practice.
    • CC 49. Manage, coordinate, and supervise the activity of allied dental health personnel.
    • CC 50. Assess one's personal level of skills and knowledge relative to dental practice.
    • CC 51. Adhere to standard precautions for infection control for all clinical procedures.
    • CC 52. Use prevention, intervention, and patient education strategies to maximize oral health.
    • CC 53. Collaborate with dental team members and other health care professionals to promote health and manage disease in communities.
    • CC 54. Evaluate and implement systems of oral health care management and delivery that will address the needs of patient populations served.
    • CC 55. Apply quality assurance, assessment, and improvement concepts to improve outcomes.
    • CC 56. Communicate case design to laboratory technicians and evaluate the resultant restoration or prosthesis.
Examination sources

Arkansas Jurisprudence Examination (Dental Licensure)

Provider
Arkansas State Board of Dental Examiners
Format
Open-book examination emailed to the applicant
Passing score
75%
Examination outline
  • Arkansas Dental Practice Act (Ark. Code Title 17, Chapter 82)
  • Dental Corporation Act (Ark. Code §§ 4-29-401 to 4-29-411)
  • Arkansas State Board of Dental Examiners Rules (17 CAR Part 115)
Examination sources

CRDTS Diagnosis and Comprehensive Treatment Planning (DCTP) Written Examination

Provider
Central Regional Dental Testing Service, Inc.
Format
Single-answer multiple-choice mini-cases; administered on-site on a computer tablet
Time limit
45 minutes
Passing score
75% or greater; 128 score points possible
Exam fee
Part I alone: $400; site or rental fees excluded
Examination outline
  • Diagnosis (30%)
    • Oral Pathology
    • Oral Medicine
    • Radiographic Assessment
    • Systemic Health
    • Medical and Dental Risk Factor Assessment
  • Comp. Treatment Planning/ Phasing of Treatment (50%)
    • Periodontics
    • Endodontics
    • Oral Surgery
    • Restorative Dentistry
    • Removable Prosthodontics
    • Fixed Prosthodontics
  • Treatment / Re-evaluation of Treatment (20%)
Examination sources

CRDTS Part II Endodontics Examination

This assessment does not have a question bank.

Provider
Central Regional Dental Testing Service, Inc. (CRDTS)
Format
Simulated-patient endodontic procedures on artificial teeth; scored by examiner performance criteria.
Time limit
2.5 hours
Passing score
75 or more on each procedure within the examination Part.
Examination outline
  • Part II: Endodontics Examination — simulated patient, 2.5 hours: endodontic access opening only on tooth #14, a multi-rooted artificial tooth (Posterior Access Opening, 9 criteria); endodontic access, canal instrumentation and obturation on tooth #8, a single-canal artificial tooth (Anterior Endodontics, 12 criteria). Rating levels: SAT = Satisfactory; ACC = Minimally Acceptable; SUB = Marginally Substandard; DEF = Critically Deficient.
    • Anterior Endodontic Procedure — Access Opening – Artificial Anterior #8 — PLACEMENT: SAT (Satisfactory): The placement of the access opening reflects the position of the pulp chamber and straight-line access to the root canal system. | ACC (Minimally Acceptable): The placement of the access opening is not directly over the pulp chamber but would allow for straight-line access to the root canal system. | SUB (Marginally Substandard): The placement of the access opening is not over the pulp chamber and would not allow straight-line access to the root canal system. | DEF (Critically Deficient): The placement of the access opening is not over the pulp chamber and would not allow access to the root canal system.
    • Anterior Endodontic Procedure — Access Opening – Artificial Anterior #8 — SIZE: SAT (Satisfactory): The access opening incorporates the middle one-third of the lingual surface mesiodistally and inciso-gingivally and allows for complete debridement of the pulp chamber. | ACC (Minimally Acceptable): The access opening is not less than ¼ or greater than ½ of the lingual surface, and does not weaken the marginal ridges or incisal edge. | SUB (Marginally Substandard): The access opening is [_] less than ¼ and allows for partial debridement of the pulp chamber or [_] greater than ½ the width of the lingual surface, or [_] the access opening weakens the marginal ridge(s). [_] The access encroaches on, but does not include the incisal edge. | DEF (Critically Deficient): The access opening includes the marginal ridge(s) and/or the incisal edge. The access opening is so small that debridement of the pulp chamber is impossible. The canal orifice is not accessed. The anterior crown is fractured due to excessive access preparation.
    • Anterior Endodontic Procedure — Access Opening – Artificial Anterior #8 — INTERNAL FORM: SAT (Satisfactory): From the lingual surface to the cervical portion, the internal form tapers to the canal opening with no ledges. | ACC (Minimally Acceptable): From the lingual surface to the cervical portion, the internal form tapers to the canal opening with slight ledges. | SUB (Marginally Substandard): The internal form lacks taper to the canal orifice(s), gouges are present that do not affect access to the canal orifice. | DEF (Critically Deficient): The internal form exhibits excessive ledging or gouges that do not allow access to the canal orifices and/or perforation.
    • Anterior Endodontic Procedure — Access Opening – Artificial Anterior #8 — PULP HORN REMOVAL: SAT (Satisfactory): All pulp horns are removed through the access opening. | ACC (Minimally Acceptable): Pulp horns are not fully removed through the access opening. | SUB (Marginally Substandard): Pulp horns are not entered.
    • Anterior Endodontic Procedure — Canal Instrumentation – Artificial Anterior #8 — CERVICAL PORTION: SAT (Satisfactory): The cervical portion of the canal is enlarged facial-lingually and mesio-distally to allow access to the apical portion of the canal. | ACC (Minimally Acceptable): The cervical portion of the canal is too small and makes access to the apical portion of the canal difficult. | SUB (Marginally Substandard): In the cervical portion, the canal is over or under prepared. | DEF (Critically Deficient): The cervical portion of the canal is grossly over prepared and/or perforated.
    • Anterior Endodontic Procedure — Canal Instrumentation – Artificial Anterior #8 — MID-ROOT PORTION: SAT (Satisfactory): The mid-root portion of the canal blends with the cervical portion and no ledges or shoulders are present. | ACC (Minimally Acceptable): The mid-root portion of the canal does not blend smoothly with the cervical portion, but no ledges or shoulders exist. | SUB (Marginally Substandard): The mid-root portion of the canal does not blend with the cervical region of the canal and/or ledging or shoulders are present that will inhibit canal obturation. The mid-root portion of the canal is transported. | DEF (Critically Deficient): The mid-root portion of the canal is perforated and/or has gross shoulders or ledges that will prevent canal obturation.
    • Anterior Endodontic Procedure — Canal Instrumentation – Artificial Anterior #8 — APICAL PORTION: SAT (Satisfactory): The apical portion is instrumented to within 0.5 to 1.0 mm of the anatomical apex. | SUB (Marginally Substandard): The apical portion of the canal is prepared more than 1.0 mm to 2.0 mm short of the anatomical apex. The apical portion is transported, but the apical portion still blends with the anatomical apex. | DEF (Critically Deficient): The apical portion of the canal is over prepared and instrumented beyond the anatomical apex, or is under prepared more than 2.0 mm from the anatomical apex. The apical portion of the canal is transported and does not blend with the anatomical apex and/or there is a perforation of the root.
    • Anterior Endodontic Procedure — Root Canal Obturation – Artificial Anterior #8 — OVERFILL/UNDERFILL: SAT (Satisfactory): The root canal is obturated with gutta percha to the apex or up to 1.0 mm or less from the apical foramen. | ACC (Minimally Acceptable): The root canal is obturated with gutta percha or extruded file up to 0.5 mm beyond the apical foramen. | SUB (Marginally Substandard): The root canal is obturated with gutta percha more than 1.0 mm up to 2.0 mm short of the apical foramen. The root canal is obturated with gutta percha or extruded file greater than 0.5 mm to 1.0 mm beyond the apical foramen. | DEF (Critically Deficient): The root canal is obturated with gutta percha more than 2.0 mm short of the apical foramen. The root canal is obturated with gutta percha or a file extruded greater than 1.0 mm beyond the apical foramen.
    • Anterior Endodontic Procedure — Root Canal Obturation – Artificial Anterior #8 — EXTRUDED SEALER: SAT (Satisfactory): There is 1.0 mm or less of sealer extruded beyond the apical foramen, measured in any direction. | SUB (Marginally Substandard): There is more than 1.0 mm of sealer extruded, beyond the apical foramen, measured in any direction.
    • Anterior Endodontic Procedure — Root Canal Obturation – Artificial Anterior #8 — VOIDS IN GUTTA PERCHA: SAT (Satisfactory): There are no voids in the gutta percha from the CEJ to the apical foramen. | ACC (Minimally Acceptable): The apical 1/3 of the gutta percha in the root canal is dense and without voids. | SUB (Marginally Substandard): There are voids present throughout the obturation of the root canal. | DEF (Critically Deficient): There are large voids throughout the obturation of the root canal, there is no gutta percha present in the root canal, or a material other than gutta percha was used to obturate the canal.
    • Anterior Endodontic Procedure — Root Canal Obturation – Artificial Anterior #8 — FILLED CORONAL/APICAL TO CEJ: SAT (Satisfactory): There is no gutta percha, restorative material, or sealer in the pulp chamber. | ACC (Minimally Acceptable): The gutta percha in the root canal is 1.0 mm to 2.0 mm short of the CEJ. Gutta percha and/or sealer is evident in the pulp chamber extending up to 1 mm coronal to the CEJ. | SUB (Marginally Substandard): The gutta percha in the root canal is more than 2.0 mm but less than 3.0 mm short of the CEJ. Gutta percha and/or sealer is evident in the pulp chamber extending greater than 1.0 mm, but no more than 2.0 mm coronal to the CEJ. | DEF (Critically Deficient): The gutta percha in the root canal is more than 3.0 mm short of the CEJ. Gutta percha and/or sealer is evident in the pulp chamber extending more than 2.0 mm coronal to the CEJ. There is restorative material in the pulp chamber.
    • Anterior Endodontic Procedure — Root Canal Obturation – Artificial Anterior #8 — SEPARATED FILE: SAT (Satisfactory): There is no evidence of a separated file. | ACC (Minimally Acceptable): A file is separated in the root canal, but does not prevent the obturation of the root canal. | DEF (Critically Deficient): A file is separated in the root canal, and prevents the obturation of the root canal.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — PLACEMENT: SAT (Satisfactory): The placement of the access opening is the mesial triangular pit and central fossa of the tooth and would allow for straight-line access to the root canal system. | ACC (Minimally Acceptable): The placement of the access opening is not directly over the pulp chamber, but would allow for straight-line access to the root canal system. | SUB (Marginally Substandard): The placement of the access opening is not over the pulp chamber and would not allow straight-line access to the root canal system. | DEF (Critically Deficient): The placement of the access opening is not over the pulp chamber, and would not allow access to the root canal system.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — SIZE: SAT (Satisfactory): The access opening is of optimal size and allows for complete debridement of the pulp chamber. | ACC (Minimally Acceptable): The access opening is underextended allowing for partial debridement of the pulp chamber. | DEF (Critically Deficient): The access opening is underextended so that debridement of the pulp chamber or access to one or more canal orifices is impossible.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — INTEGRITY OF OCCLUSAL ANATOMY: SAT (Satisfactory): The access opening preserves 2mm or more of the mesial marginal ridge and all cusp tips. | ACC (Minimally Acceptable): The access opening is overextended but preserves at least 1mm but less than 2mm of the mesial marginal ridge and/or any cusp tip. | DEF (Critically Deficient): The access opening is overextended but preserves less than 1mm of the mesial marginal ridge and/or any cusp tip.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — INTEGRITY OF OBLIQUE RIDGE: SAT (Satisfactory): Greater than or equal to 3.0mm as measured from the distal oblique groove | ACC (Minimally Acceptable): Greater than or equal to 2.0mm but less than 3.0mm as measured from the distal oblique groove | SUB (Marginally Substandard): Greater than or equal to 1.0mm but less than 2.0mm as measured from the distal oblique groove | DEF (Critically Deficient): Less than or equal to 1.0mm as measured from the distal oblique groove
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — INTERNAL FORM - LEDGING: SAT (Satisfactory): The internal form tapers to the canal opening with no ledges. | ACC (Minimally Acceptable): The internal form lacks taper to the canal orifice(s), gouges are present that do not affect access to the canal orifice(s). | DEF (Critically Deficient): The internal form exhibits excessive ledging or gouges that do not allow access to the canal orifices and/or there is a perforation of the crown or the floor of the pulp chamber.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — INTERNAL FORM - PULP CHAMBER ROOF: SAT (Satisfactory): The access opening completely removes the pulp chamber roof. | SUB (Marginally Substandard): The access opening partially removes the pulp chamber roof. | DEF (Critically Deficient): The pulp chamber roof has not been entered.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — PULP TISSUE DEBRIDEMENT: SAT (Satisfactory): All pulp tissue is removed. | ACC (Minimally Acceptable): Pulp tissue remains but is not on the floor or covering the orifice of the canals. | SUB (Marginally Substandard): Pulp tissue remains on the floor and covers 1 or more of the canal orifices. | DEF (Critically Deficient): All pulp tissue remains.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — CANAL ACCESS: SAT (Satisfactory): The access opening allows straight line access to three canal orifices. | ACC (Minimally Acceptable): The access opening allows straight line access to two canal orifices. | SUB (Marginally Substandard): The access opening allows straight line access to one canal orifice. | DEF (Critically Deficient): The access opening does not allow access to the canal orifices.
    • Posterior Endodontic Procedure — Access Opening ONLY – Artificial Posterior #14 — PULP HORN REMOVAL: SAT (Satisfactory): All pulp horns are removed through the access opening. | ACC (Minimally Acceptable): One or two of the pulp horns are not removed through the access opening. | DEF (Critically Deficient): All pulp horns have not been fully removed.
    • Endodontic Procedures — Penalty Points / Treatment Management (Penalty Points ONLY) — CONDITION OF ADJACENT TEETH: SAT (Satisfactory): The adjacent teeth and/or restorations are free from damage. | ACC (Minimally Acceptable): Damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | SUB (Marginally Substandard): Damage to adjacent tooth/teeth requires recontouring which changes the shape and/or position of the contact. | DEF (Critically Deficient): There is gross damage to adjacent tooth/teeth which requires a restoration.
    • Endodontic Procedures — Penalty Points / Treatment Management (Penalty Points ONLY) — CONDITION OF SOFT TISSUE: SAT (Satisfactory): The simulated gingiva and/or typodont is/are free from damage. | ACC (Minimally Acceptable): There is slight damage to simulated gingiva and/or typodont consistent with the procedure. | SUB (Marginally Substandard): There is iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure. | DEF (Critically Deficient): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
    • Endodontic Procedures — TYPODONT CONDITION (Penalty Points ONLY): 1. Rubber Dam remnants 2. Pencil marks on teeth 3. Uncleanliness of models when turned in
    • Endodontic Procedures — CRITICAL ERRORS: 1. Wrong Tooth/Surface Treated 2. Critical Lack of Clinical Judgment/Diagnostic Skills 3. ANTERIOR ENDODONTIC PROCEDURE - Root is fractured
Examination sources

CRDTS Part IV Periodontal Simulated Patient Examination

Provider
Central Regional Dental Testing Service, Inc. (CRDTS)
Format
One Part IV examination combining the tablet-based written Extra/Intra Oral Assessment OSCE and clinical skills performed on a typodont/manikin. Both components are reported as one comprehensive total score.
Exam questions
The written OSCE component contains 16 multiple-choice questions, worth 16 of 100 Part IV points. The remaining 84 points assess calculus detection (12), periodontal measurements (12), and scaling/subgingival calculus removal (60).
Time limit
The Part IV candidate manual specifies 15 minutes for the written OSCE and 1 hour 30 minutes for the clinical component.
Passing score
75 or more out of 100 for Part IV; no separate OSCE passing threshold.
Exam fee
$700 when taken as an individual Part IV; site or rental fees are excluded.
Examination outline
  • Part IV Extra/Intra Oral Assessment OSCE (written): The purpose of this part of the examination is to evaluate the level of a candidate’s competency in identifying gross head and neck anatomy, variations of normal anatomy, palpation techniques used to examine the head and neck extra and intraoral structures, and atypical or abnormal findings, whether pathologic or non-pathologic. The OSCE mirrors the Patient-Based Extra/Intra Oral Assessment Evaluation.
Examination sources

CRDTS Part III Fixed Prosthodontics Examination

This assessment does not have a question bank.

Provider
Central Regional Dental Testing Service, Inc. (CRDTS)
Format
Simulated-patient crown and bridge preparations; scored by examiner performance criteria.
Time limit
4 hours
Passing score
75 or more on each procedure within the examination Part.
Examination outline
  • Part III: Fixed Prosthodontics Examination — simulated patient, 4.0 hours: preparation of tooth #5 for a porcelain fused to zirconia crown (10 criteria) and of tooth #3 for a Monolithic Zirconia Ceramic Crown (9 criteria) as abutments for a 3-unit bridge, parallel to each other; Bridge Factor evaluating the line of draw for the bridge abutment preparations (2 criteria); preparation of tooth #9 for an Anterior Lithium Disilicate Ceramic Crown (11 criteria). Rating levels: SAT = Satisfactory; ACC = Minimally Acceptable; SUB = Marginally Substandard; DEF = Critically Deficient.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Cervical Margin and Draw — MARGIN/EXTENSION: SAT (Satisfactory): The margins should be 0.5 mm occlusal to the simulated free gingival margin. | ACC (Minimally Acceptable): The cervical margin is at the level of or no more than 1.0 mm occlusal to the simulated free gingival margin. | SUB (Marginally Substandard): The cervical margin is overextended 0.5 mm apical to the CEJ or the crest of the simulated free gingival margin, whichever is most occlusal. The cervical margin is underextended, more than 1.0 mm but no more than 1.5 mm occlusal to the crest of the simulated free gingival margin. | DEF (Critically Deficient): The cervical margin is overextended more than 0.5 mm apical to the simulated free gingival margin causing visual damage to the typodont. The cervical margin is underextended more than 1.5 mm occlusal to the simulated free gingival margin, thereby compromising esthetics, resistance and retention form.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Cervical Margin and Draw — MARGIN/DEFINITION: SAT (Satisfactory): The cervical margin is a smooth, continuous, well defined, 360 degree chamfer or rounded shoulder. | ACC (Minimally Acceptable): The cervical margin is continuous but slightly rough and lacks some definition. The cervical bevel, when used, is greater than 1.0 mm but does not exceed 1.5 mm, and lacks some definition. | SUB (Marginally Substandard): The cervical margin has some continuity, is significantly rough and is poorly defined. | DEF (Critically Deficient): The cervical margin has no continuity and/or definition or exhibits an indication of a lip or “J” design.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Cervical Margin and Draw — LINE OF DRAW: SAT (Satisfactory): The appropriate path of insertion varies less than 10° from parallel to the long axis of the tooth on all axial surfaces and a line of draw is established. | ACC (Minimally Acceptable): The path of insertion / line of draw deviates 10° to less than 20° from the long axis of the tooth. | SUB (Marginally Substandard): The path of insertion / line of draw deviates 20° to less than 30° from the long axis of the tooth. | DEF (Critically Deficient): The path of insertion / line of draw is grossly unacceptable, deviating 30° or more from the long axis of the tooth.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — AXIAL WALLS – SMOOTHNESS/UNDERCUT: SAT (Satisfactory): Walls are smooth and well-defined, no undercuts. | ACC (Minimally Acceptable): The walls are slightly rough and lack some definition. | SUB (Marginally Substandard): The axial walls are rough. | DEF (Critically Deficient): There is an undercut.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — TAPER: SAT (Satisfactory): There is full visual taper (6° - 16°). | ACC (Minimally Acceptable): Taper is present, but nearly parallel (less than 6°) or slightly excessive (greater than 16°, but less than 24°). | SUB (Marginally Substandard): There is no taper or excessive taper (greater than 24°). | DEF (Critically Deficient): The taper is grossly over-reduced (greater than 30°).
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — CERVICAL MARGIN WIDTH: SAT (Satisfactory): The cervical margin is 0.5 mm but no greater than 1.0 mm wide. | ACC (Minimally Acceptable): The cervical margin is greater than 1.0 mm, but is no greater than 1.5 mm in width. | SUB (Marginally Substandard): The cervical margin is [ ] greater than 1.5 mm. not to exceed 2.0 mm in width. | DEF (Critically Deficient): The cervical margin is [_] less than 0.5 mm or beveled or [_] greater than 2.0 mm in width.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — AXIAL REDUCTION: SAT (Satisfactory): The facial and palatal wall reduction follows the facial planes of contour and is optimally 1.5 mm when measured at any point between the original height of contour and the facial-occlusal line angle. | ACC (Minimally Acceptable): The facial and palatal wall reduction follows the facial planes of contour and is no less than 1.0 mm and no greater than 2 mm. | SUB (Marginally Substandard): The facial and palatal wall reduction no longer follows the facial/ planes of contour and is no less than 0.5 mm and no greater than 3.0 mm. | DEF (Critically Deficient): The facial and palatal wall axial reduction is less than 0.5 mm or greater than 3 mm.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — OCCLUSAL REDUCTION: SAT (Satisfactory): Reduction of the occlusal table, which includes secondary planes, is optimally 1.5 mm. | ACC (Minimally Acceptable): Reduction of the occlusal table, which includes secondary planes, is greater than 1.5 mm up to 2.0 mm. | SUB (Marginally Substandard): Reduction of the occlusal table, which includes secondary planes, is [ ] 1.0 mm to less than 1.5 mm or [ ] greater than 2.0 mm up to 2.5 mm. | DEF (Critically Deficient): Reduction of the occlusal table, which includes secondary planes, is grossly [_] over-reduced, greater than 2.5 mm, encroaching on the pulp and impacting resistance and retention form; or grossly [_] under- reduced, less than 1.0mm, resulting in insufficient occlusal clearance for adequate restorative material.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — INTERNAL LINE ANGLES: SAT (Satisfactory): Internal line angles and cusp tips are rounded. | ACC (Minimally Acceptable): Internal line angles and cusp tip areas not completely rounded and show a slight tendency of being sharp. | SUB (Marginally Substandard): The internal line angles and cusp tip areas show only minimal evidence of rounding with a greater tendency of being sharp. | DEF (Critically Deficient): The internal line angles or cusp tip areas are excessively sharp with no evidence of rounding.
    • Porcelain-Fused-to-Zirconia Crown Preparation — Tooth #5 - Walls, Taper and Finish Line — OCCLUSAL ANATOMY: SAT (Satisfactory): The general occlusal anatomy is maintained. | SUB (Marginally Substandard): The occlusal anatomy is flat.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Cervical Margin and Draw — MARGIN/EXTENSION: SAT (Satisfactory): The margins should be 0.5 mm occlusal to the simulated free gingival margin. | ACC (Minimally Acceptable): The cervical margin is at the level of or no more than 1.0 mm occlusal to the simulated free gingival margin. | SUB (Marginally Substandard): The cervical margin is overextended 0.5 mm apical to the crest of the simulated free gingival margin. The cervical margin is under-extended, more than 1.0 mm but no more than 1.5 mm occlusal to the crest of the simulated free gingival margin. | DEF (Critically Deficient): The cervical margin is overextended more than 0.5 mm apical to the simulated free gingival margin causing visual damage to the typodont. The cervical margin is under-extended more than 1.5 mm occlusal to the simulated free gingival margin, thereby compromising esthetics, resistance and retention form.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Cervical Margin and Draw — MARGIN DEFINITION: SAT (Satisfactory): The cervical margin is a smooth, continuous, well defined, 360 degree chamfer or rounded shoulder. | ACC (Minimally Acceptable): The cervical margin is continuous but slightly rough and lacks some definition. | SUB (Marginally Substandard): The cervical margin has some continuity, is significantly rough and is poorly defined. | DEF (Critically Deficient): The cervical margin has no continuity and/or definition or exhibits an indication of a lip or “J” design.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Cervical Margin and Draw — LINE OF DRAW: SAT (Satisfactory): The appropriate path of insertion varies less than 10° from parallel to the long axis of the tooth on all axial surfaces and a line of draw is established. | ACC (Minimally Acceptable): The path of insertion/line of draw deviates 10° to less than 20° from the long axis of the tooth. | SUB (Marginally Substandard): The path of insertion/line of draw deviates 20° to less than 30° from the long axis of the tooth. | DEF (Critically Deficient): The path of insertion/line of draw deviates 30° or more from the long axis of the tooth.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Walls, Taper and Finish Line — AXIAL WALL-SMOOTHNESS/UNDERCUT: SAT (Satisfactory): Walls are smooth and well-defined, no undercuts. | ACC (Minimally Acceptable): The walls are slightly rough and lack some definition. | SUB (Marginally Substandard): The axial walls are rough. | DEF (Critically Deficient): There is an undercut.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Walls, Taper and Finish Line — TAPER: SAT (Satisfactory): There is full visual taper (6°- 16°). | ACC (Minimally Acceptable): Taper is present, but nearly parallel (less than 6°) or slightly excessive (greater than 16°, but less than 24°). | SUB (Marginally Substandard): There is no taper or excessive taper (greater than 24°). | DEF (Critically Deficient): The taper is grossly over-reduced (greater than 30°).
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Walls, Taper and Finish Line — CERVICAL MARGIN WIDTH: SAT (Satisfactory): The cervical margin is 0.5 mm but no greater than 1.0 mm in width. | ACC (Minimally Acceptable): The cervical margin is greater than 1.0 mm, but is no greater than 1.5 mm in width. | SUB (Marginally Substandard): The cervical margin is [ ] less than 0.5 mm or [ ] greater than 1.5 mm, not to exceed 2.0 mm in width. | DEF (Critically Deficient): The cervical margin is [_] knife-edge/beveled or [ ] greater than 2.0 mm in width.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Walls, Taper and Finish Line — OCCLUSAL/AXIAL REDUCTION: SAT (Satisfactory): Reduction of the occlusal table, buccal, and palatal walls, which includes secondary planes, is optimally 1.5 mm. | ACC (Minimally Acceptable): Reduction of the occlusal table, buccal, and palatal walls, which includes secondary planes, is greater than 1.5 mm up to 2 mm. | SUB (Marginally Substandard): Reduction of the occlusal table, buccal, and palatal walls, which includes secondary planes, is [ ] 1.0 mm to less than 1.5mm or [ ] greater than 2.0mm up to 2.5 mm. | DEF (Critically Deficient): Reduction of the occlusal table, buccal, and palatal walls, which includes secondary planes, is grossly [_] over- reduced, greater than 2.5 mm; or grossly [_]under-reduced, less than 1.0 mm, resulting in insufficient occlusal clearance for adequate restorative material and/or [_] any axial surface on the preparation is in contact with the matrix.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Walls, Taper and Finish Line — INTERNAL LINE ANGLES: SAT (Satisfactory): Internal line angles and cusp tips are rounded. | ACC (Minimally Acceptable): Internal line angles and cusp tip areas are not completely rounded and show a slight tendency of being sharp. | SUB (Marginally Substandard): The internal line angles and cusp tip areas show only minimal evidence of rounding with a greater tendency of being sharp. | DEF (Critically Deficient): The internal line angles or cusp tip areas are excessively sharp with no evidence of rounding.
    • Monolithic Zirconia Ceramic Crown Preparation — Tooth #3 - Walls, Taper and Finish Line — OCCLUSAL ANATOMY: SAT (Satisfactory): The general occlusal anatomy is maintained. | SUB (Marginally Substandard): The occlusal anatomy is flat.
    • Bridge Factor — PATH OF INSERTION/LINE OF DRAW: SAT (Satisfactory): A line of draw or path of insertion that would allow for the full seating of a fixed prosthesis in a direct vertical plane without rotation either mesio-distally or bucco-lingually. | ACC (Minimally Acceptable): A line of draw or path of insertion that, due to angulations of the surface of the preparations, would require altering the path of insertion both mesio-distally and/or bucco-lingually from a direct vertical axis to allow full seating. | DEF (Critically Deficient): No line of draw or path of insertion exists through any plane of rotation without the removal of additional tooth structure of either/both of the preparations.
    • Bridge Factor — CONDITION OF SOFT TISSUE IN THE PONTIC AREA: SAT (Satisfactory): The simulated gingiva and/or typodont is/are free from damage. | ACC (Minimally Acceptable): There is slight damage to simulated gingiva and/or typodont consistent with the procedure. | DEF (Critically Deficient): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Cervical Margin and Draw — MARGIN/EXTENSION: SAT (Satisfactory): The cervical margin is placed 0.5 mm incisal to the simulated free gingival margin. | ACC (Minimally Acceptable): The cervical margin is at the level of or no more than 1.0 mm incisal to the simulated free gingival margin. | SUB (Marginally Substandard): The cervical margin is overextended 0.5 mm apical to the crest of the simulated free gingival margin. The cervical margin is under-extended, more than 1.0 mm but no more than 1.5 mm incisal to the crest of the simulated free gingival margin. | DEF (Critically Deficient): The cervical margin is overextended more than 0.5 mm apical to the simulated free gingival margin causing visual damage to the typodont. The cervical margin is under-extended more than 1.5 mm incisal to the simulated free gingival margin, thereby compromising esthetics, resistance and retention form.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Cervical Margin and Draw — MARGIN/DEFINITION: SAT (Satisfactory): The cervical margin is a smooth, continuous, 360 degree chamfer or rounded shoulder, well-defined on all axial surfaces. The cervical margin exhibits no bevel. | ACC (Minimally Acceptable): The cervical margin is continuous but slightly rough and lacks some definition. | SUB (Marginally Substandard): The cervical margin has some continuity, is significantly rough and is poorly defined. | DEF (Critically Deficient): The cervical margin is beveled, or exhibits an indication of a lip or “J” design or exhibits an external axial surface of 135º or greater (sloping shoulder).
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Cervical Margin and Draw — LINE OF DRAW: SAT (Satisfactory): The appropriate path of insertion varies less than 10° from parallel to the long axis of the tooth on all axial surfaces and a line of draw is established. | ACC (Minimally Acceptable): The path of insertion / line of draw deviates 10° to less than 20° from the long axis of the tooth. | SUB (Marginally Substandard): The path of insertion / line of draw deviates 20° to less than 30° from the long axis of the tooth. | DEF (Critically Deficient): The path of insertion / line of draw is grossly unacceptable, deviating 30° or more from the long axis of the tooth.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — AXIAL WALLS – SMOOTHNESS/UNDERCUT: SAT (Satisfactory): Walls are smooth and well-defined, no undercuts. | ACC (Minimally Acceptable): The walls are slightly rough and lack some definition. | SUB (Marginally Substandard): The axial walls are rough. | DEF (Critically Deficient): There is an undercut.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — TAPER: SAT (Satisfactory): There is full visual taper (6° - 16°). | ACC (Minimally Acceptable): Taper is present, but nearly parallel (less than 6°) or slightly excessive (greater than 16°, but less than 24°). | SUB (Marginally Substandard): There is no taper or excessive taper (greater than 24°). | DEF (Critically Deficient): The taper is grossly over-reduced (greater than 30°).
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — CERVICAL MARGIN WIDTH: SAT (Satisfactory): The cervical margin is optimally 1.0 mm in width. | ACC (Minimally Acceptable): The cervical margin is greater than 1.0 mm, but not more than 1.5 mm in width. | SUB (Marginally Substandard): The cervical margin is [_]0.5 mm to less than 1.0 mm or [_] greater than 1.5 mm, not to exceed 2.0 mm in width. | DEF (Critically Deficient): The cervical margin is less than 0.5 mm or more than 2.0 mm in width.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — INCISAL REDUCTION: SAT (Satisfactory): The optimal incisal reduction is 3.0 mm. | ACC (Minimally Acceptable): The incisal reduction is not less than 2.5 mm or not more than 3.5 mm. | SUB (Marginally Substandard): The incisal reduction is less than 2.5 mm or up to 4.0 mm. | DEF (Critically Deficient): The incisal reduction is less than 2.0 mm or more than 4.0 mm.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — LINGUAL FOSSA REDUCTION: SAT (Satisfactory): The lingual reduction is ideally 1.0 mm. | ACC (Minimally Acceptable): The lingual reduction is greater than 1.00 mm up to 1.5 mm. | SUB (Marginally Substandard): The lingual reduction is [ ] 0.5 mm or greater but less than 1.00 mm or [ ] greater than 1.5 mm but less than 2.0 mm. | DEF (Critically Deficient): The lingual reduction is less than .5 mm or 2.0 mm or greater.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — LINGUAL WALL HEIGHT: SAT (Satisfactory): The lingual wall height is optimally 1.0 mm or more. | ACC (Minimally Acceptable): The lingual wall height is 0.5-1.0 mm. | SUB (Marginally Substandard): The lingual wall height is less than .5mm | DEF (Critically Deficient): There is no lingual wall.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — FACIAL AXIAL REDUCTION: SAT (Satisfactory): The facial reduction follows the facial planes of contour and is optimally 1.5 mm when measured at any point between the original height of contour and the incisal edge. | ACC (Minimally Acceptable): The facial reduction follows the facial planes of contour and is no less than 1.0 mm and no greater than 2 mm. | SUB (Marginally Substandard): The facial reduction no longer follows the facial planes of contour and is no less than 0.5 mm and no greater than 3.0 mm. | DEF (Critically Deficient): The facial axial reduction is less than 0.5 mm or greater than 3 mm.
    • Anterior Lithium Disilicate Ceramic Crown Preparation — Tooth #9 - Walls, Taper and Finish Line — EXTERNAL/INTERNAL LINE ANGLES: SAT (Satisfactory): Internal line angles and external line angles are rounded and smooth. | ACC (Minimally Acceptable): External and/or internal line angles are rounded, but irregular. | SUB (Marginally Substandard): External and internal line angles are sharp. | DEF (Critically Deficient): The external and/or internal line angles are excessively sharp with no evidence of rounding.
    • Fixed Prosthodontic Simulated Patient Procedures — Treatment Management (Penalty Points ONLY) — CONDITION OF ADJACENT TEETH: SAT (Satisfactory): The adjacent teeth and/or restorations are free from damage. | ACC (Minimally Acceptable): Damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | SUB (Marginally Substandard): Damage to adjacent tooth/teeth requires recontouring which changes the shape and/or position of the contact. | DEF (Critically Deficient): There is gross damage to adjacent tooth/teeth which requires a restoration.
    • Fixed Prosthodontic Simulated Patient Procedures — Treatment Management (Penalty Points ONLY) — CONDITION OF SOFT TISSUE: SAT (Satisfactory): The simulated gingiva and/or typodont is/are free from damage. | ACC (Minimally Acceptable): There is slight damage to simulated gingiva and/or typodont consistent with the procedure. | SUB (Marginally Substandard): There is iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure. | DEF (Critically Deficient): There is gross iatrogenic damage to the simulated gingiva and/or typodont inconsistent with the procedure.
    • Fixed Prosthodontic Simulated Patient Procedures — Typodont Condition (Penalty Points ONLY): 1. Pencil marks on teeth 2. Uncleanliness of models when turned in
    • Fixed Prosthodontic Simulated Patient Procedures — CRITICAL ERRORS: 1. Wrong Tooth/Surface Treated 2. Critical Lack of Clinical Judgment/Diagnostic Skills
Examination sources

CRDTS Part V Restorative Examination

This assessment does not have a question bank.

Provider
Central Regional Dental Testing Service, Inc. (CRDTS)
Format
Simulated-patient restorative preparations and restorations; scored by examiner performance criteria.
Time limit
4 hours
Passing score
75 or more on each procedure within the examination Part.
Examination outline
  • Part V: Restorative Simulated Patient Examination — 4-hour clinical exam: prepare 2 teeth with simulated decay on 8 DL, 3 MO or 13 DO and place restorations in 2 pre-prepped teeth on 26 DL, 20 DO or 31 MO — one Class II Composite or Amalgam Preparation and Restoration (candidate’s choice) and one Class III Composite Preparation and Restoration. Rating levels: SAT = Satisfactory; ACC = Minimally Acceptable; SUB = Marginally Substandard; DEF = Critically Deficient.
    • Amalgam Preparation — External Outline Form — PROXIMAL CLEARANCE: SAT (Satisfactory): Contact is visibly open proximally. | ACC (Minimally Acceptable): Proximal contact is visibly open, and proximal clearance at the height of contour extends beyond 0.5 mm but not more than 1.0 mm on either one or both proximal walls. | SUB (Marginally Substandard): Proximal contact is [_] not visually open; or proximal clearance at the height of contour [_] extends beyond 1.0 mm but not more than 2.0 mm on either one or both proximal walls. | DEF (Critically Deficient): The proximal clearance at the height of contour extends beyond 2.0 mm on either one or both proximal walls.
    • Amalgam Preparation — External Outline Form — GINGIVAL CLEARANCE: SAT (Satisfactory): Contact is open gingivally up to 1.0 mm. | ACC (Minimally Acceptable): The gingival clearance is greater than 1.0 mm but not greater than 1.5 mm. | SUB (Marginally Substandard): The gingival clearance is greater than 1.5 mm but not greater than 2.0 mm. | DEF (Critically Deficient): The gingival clearance is greater than 2.0 mm or is not open.
    • Amalgam Preparation — External Outline Form — OUTLINE SHAPE/CONTINUITY/EXTENSION: SAT (Satisfactory): The outline form is smooth, rounded and flowing with no sharp curves or angles. The cavosurface margin terminates such that the width of the marginal ridge/oblique ridge, is 1.5 mm or greater. | SUB (Marginally Substandard): The outline form is inappropriately overextended so that it compromises the remaining marginal ridge/oblique ridge and/or cusp(s). The cavosurface margin terminates such that the width of the marginal ridge/oblique ridge is 1.0 mm to less than 1.5 mm. The outline form is underextended and does not incorporate occlusal pits and grooves. | DEF (Critically Deficient): The outline form is inappropriately overextended so that it compromises, undermines and leaves unsupported the remaining marginal ridge/oblique ridge to the extent that the cavosurface margin is unsupported by dentin or the width of the marginal ridge/oblique ridge is less than 1.0 mm.
    • Amalgam Preparation — External Outline Form — ISTHMUS: SAT (Satisfactory): The isthmus is 1.5 mm wide. | ACC (Minimally Acceptable): The isthmus is greater than 1.5 mm and not greater than 2.0 mm. | SUB (Marginally Substandard): The isthmus is greater than 2.0 mm and not greater than 2.5 mm, or less than 1.5mm and greater than or equal to 1.0 mm. | DEF (Critically Deficient): The isthmus is greater than 2.5 mm or less than 1.0 mm.
    • Amalgam Preparation — External Outline Form — CAVOSURFACE MARGIN: SAT (Satisfactory): The external cavosurface margin meets the enamel at 90°. There are no gingival bevels. The proximal gingival point angles may be rounded or sharp. | ACC (Minimally Acceptable): The proximal cavosurface margin deviates from 90° but is unlikely to jeopardize the longevity of the tooth or restoration; this would include small areas of unsupported enamel. | SUB (Marginally Substandard): The proximal cavosurface margin deviates from 90° and is likely to jeopardize the longevity of the tooth or restoration. This would include unsupported enamel and/or excessive bevel(s).
    • Amalgam Preparation — External Outline Form — SOUND MARGINAL TOOTH STRUCTURE: SAT (Satisfactory): The cavosurface margin terminates in sound natural tooth structure. *There is no previous restorative material, including sealants, at the cavosurface margin. *There is no decalcification on the gingival margin. | SUB (Marginally Substandard): The cavosurface margin does not terminate in sound natural tooth structure; *or there is explorer penetrable decalcification remaining on any cavosurface margin, or the cavosurface margin terminates in a previously placed pit and fissure sealant.
    • Amalgam Preparation — Internal Form — AXIAL WALLS: SAT (Satisfactory): The axial wall follows the external contours of the tooth, and is entirely in dentin, .5 mm to 1.0 mm from the DEJ. | ACC (Minimally Acceptable): The depth of the axial wall is greater than 1.0 mm but no more than 1.5 mm beyond the DEJ. | SUB (Marginally Substandard): The axial wall is more than 1.5 mm beyond the DEJ, but no more than 2.5 mm or the axial wall depth does not include the DEJ. | DEF (Critically Deficient): The axial wall is [_] more than 2.5 mm beyond the DEJ or [_] gingival floor less than 1.0 mm.
    • Amalgam Preparation — Internal Form — PULPAL FLOOR: SAT (Satisfactory): The pulpal floor is optimally 1.5 to 2.0 mm from the cavosurface margin at its shallowest point. | SUB (Marginally Substandard): The pulpal floor is less than 1.5 mm at its shallowest point or greater than 2.0 mm but not greater than 3.0 mm from the cavosurface margin. | DEF (Critically Deficient): The pulpal floor is more than 3.0 mm from the cavosurface margin or is 0.5 mm or less at its shallowest point.
    • Amalgam Preparation — Internal Form — PULPAL-AXIAL LINE ANGLE: SAT (Satisfactory): The pulpal-axial line angle is rounded. | SUB (Marginally Substandard): The pulpal-axial line angle is sharp.
    • Amalgam Preparation — Internal Form — CARIES/REMAINING MATERIAL: SAT (Satisfactory): All caries and/or previous restorative material are removed. | DEF (Critically Deficient): Caries or previous restorative material remains in the preparation or preparation is not extended to include caries.
    • Amalgam Preparation — Internal Form — PROXIMAL BOX WALLS: SAT (Satisfactory): The walls of the proximal box should be convergent occlusally and meet the external surface at a 90º angle. | ACC (Minimally Acceptable): The walls of the proximal box are parallel, but appropriate internal retention is present. | DEF (Critically Deficient): The walls of the proximal box diverge occlusally which offers no retention and will jeopardize the longevity of the tooth or restoration.
    • Amalgam Preparation — Internal Form — PREPARED SURFACES: SAT (Satisfactory): All prepared surfaces are smooth and well-defined, and the gingival floor is perpendicular to the long axis of the tooth. | SUB (Marginally Substandard): The prepared surfaces are irregular or ill-defined.
    • Amalgam Preparation — Critical Errors: 1. Wrong Tooth/Surface Treated 2. Retention, when used, grossly compromises the tooth or restoration 3. Unrecognized Exposure 4. Critical Lack of Clinical Judgment/Diagnostic Skills
    • Amalgam Finished Restoration — Margin Integrity and Surface Finish — MARGIN DEFICIENCY: SAT (Satisfactory): There is no marginal deficiency. There is no evidence of voids or open margins. | ACC (Minimally Acceptable): There is a detectable marginal deficiency at the restoration-tooth interface either visually or with the tine of an explorer, but it is less than 0.5 mm. | SUB (Marginally Substandard): The restoration-tooth interface is detectable visually or with the tine of an explorer. There is evidence of marginal deficiency, 0.5 mm up to 1 mm, which can include pits and voids at the cavosurface margin | DEF (Critically Deficient): There is evidence of marginal deficiency of more than 1 mm, to include pits and voids at the cavosurface margin, and/or there is an open margin.
    • Amalgam Finished Restoration — Margin Integrity and Surface Finish — MARGIN EXCESS: SAT (Satisfactory): There is no detectable excess at the cavosurface margin either visually or with the tine of an explorer. | ACC (Minimally Acceptable): There is a detectable marginal excess at the cavosurface margin either visually or with the tine of an explorer, but it is no greater than 1.0 mm. | SUB (Marginally Substandard): The cavosurface margin is detectable visually or with the tine of an explorer. There is evidence of marginal excess of more than 1.0 mm and up to 2.0 mm. | DEF (Critically Deficient): There is evidence of marginal excess at the cavosurface margin of more than 2.0 mm.
    • Amalgam Finished Restoration — Margin Integrity and Surface Finish — GINGIVAL OVERHANG: SAT (Satisfactory): The restoration exhibits no gingival overhang. | ACC (Minimally Acceptable): The restoration exhibits a slight gingival overhang but would not be expected to adversely affect the tissue health. | DEF (Critically Deficient): The restoration exhibits a significant gingival overhang and would be expected to adversely affect the tissue health.
    • Amalgam Finished Restoration — Margin Integrity and Surface Finish — SURFACE FINISH: SAT (Satisfactory): The surface of the restoration is uniformly smooth and free of pits and voids. | ACC (Minimally Acceptable): The surface of the restoration is slightly grainy or rough, but it is free of significant pits and voids. | SUB (Marginally Substandard): The surface of the restoration is rough and exhibits surface significant irregularities, pits or voids.
    • Amalgam Finished Restoration — Margin Integrity and Surface Finish — CONTIGUOUS TOOTH STRUCTURE: SAT (Satisfactory): There is no evidence of unwarranted or unnecessary removal or recontouring of tooth structure contiguous to the restoration. There is no excess restorative material present that is not contiguous with the restoration. | ACC (Minimally Acceptable): There is evidence of unwarranted or unnecessary removal, or recontouring of tooth structure contiguous to the restoration that is no greater than 0.5 mm. (Enameloplasty) Excess present that is not contiguous with the restoration no greater than 0.5mm. | SUB (Marginally Substandard): There is evidence of unwarranted or unnecessary removal or recontouring of tooth structure contiguous to the restoration that is greater than 0.5 mm up to 1 mm. (Enameloplasty) Excess present that is not contiguous with the restoration greater than 0.5mm up to 1 mm. | DEF (Critically Deficient): There is greater than 1.0 mm of Enameloplasty. There is excess present that is not contiguous with the restoration greater than 1 mm.
    • Amalgam Finished Restoration — Contour, Contact and Occlusion — INTERPROXIMAL CONTACT: SAT (Satisfactory): Interproximal contact is present, the contact is visually closed and is properly shaped and positioned; and there is definite, but not excessive, resistance to dental floss when passed through the interproximal contact area. | ACC (Minimally Acceptable): Interproximal contact is visually closed, and the contact is adequate in size, shape, or position but demonstrates little resistance to dental floss. | SUB (Marginally Substandard): Interproximal contact is visually closed, but the contact is deficient in size, shape, or position and demonstrates little resistance to dental floss or shreds the floss. | DEF (Critically Deficient): The interproximal contact is visually open or will not allow floss to pass through the contact area.
    • Amalgam Finished Restoration — Contour, Contact and Occlusion — CENTRIC/EXCURSIVE CONTACTS: SAT (Satisfactory): When checked with articulating ribbon or paper, all centric and excursive contacts on the restoration are consistent in size, shape and intensity with such contacts on other teeth, in that quadrant. | SUB (Marginally Substandard): When checked with articulating ribbon or paper, the restoration is in hyper-occlusion inconsistent in size, shape and intensity with the occlusal contacts on surrounding teeth, and requires adjustment. | DEF (Critically Deficient): There is gross hyperocclusion so that the restoration is the only point of occlusion in that quadrant.
    • Amalgam Finished Restoration — Contour, Contact and Occlusion — ANATOMY/CONTOUR: SAT (Satisfactory): The restoration reproduces the normal physiological proximal contours of the tooth, occlusal and marginal ridge anatomy. | ACC (Minimally Acceptable): The restoration does not reproduce the normal occlusal anatomy, proximal contours of the tooth or marginal ridge anatomy, but would not be expected to adversely affect the tissue health. | DEF (Critically Deficient): The restoration does not reproduce the normal occlusal anatomy, proximal contours of the tooth or marginal ridge anatomy, and would be expected to adversely affect the tissue health.
    • Amalgam Finished Restoration — Critical Errors: 1. Fractured Restoration 2. Critical Lack of Clinical Judgment/Diagnostic Skills
    • Class II Composite Preparation — External Outline Form — PROXIMAL CLEARANCE: SAT (Satisfactory): Proximal contact is visibly open up to 0.5 mm. | ACC (Minimally Acceptable): Proximal contact is visibly open, and proximal clearance at the height of contour extends beyond 0.5 mm but not more than 1.0 mm on either one or both proximal walls. | SUB (Marginally Substandard): Proximal contact is [_] not visually open; or proximal clearance at the height of contour [_] extends beyond 1.0 mm but not more than 2.0 mm on either one or both proximal walls. | DEF (Critically Deficient): The proximal clearance at the height of contour extends beyond 2.0 mm on either one or both proximal walls.
    • Class II Composite Preparation — External Outline Form — GINGIVAL CLEARANCE: SAT (Satisfactory): Contact is open gingivally up to 1.0 mm. | ACC (Minimally Acceptable): The gingival clearance is greater than 1.0 mm but not greater than 1.5 mm. | SUB (Marginally Substandard): The gingival clearance is greater than 1.5 mm but not greater than 2.0 mm. | DEF (Critically Deficient): The gingival clearance is greater than 2.0 mm or is not open.
    • Class II Composite Preparation — External Outline Form — OUTLINE SHAPE/CONTINUITY/EXTENSION: SAT (Satisfactory): The outline form is smooth, rounded and flowing with no sharp curves or angles. The cavosurface margin terminates such that the width of the marginal ridge/oblique ridge, is 1.5 mm or greater. | SUB (Marginally Substandard): The outline form is inappropriately overextended so that it compromises the remaining marginal ridge/oblique ridge and/or cusp(s). The cavosurface margin terminates such that the width of the marginal ridge/oblique ridge is 1.0 mm to less than 1.5 mm. The outline form is underextended and does not incorporate occlusal pits and grooves. | DEF (Critically Deficient): The outline form is inappropriately overextended so that it compromises, undermines and leaves unsupported the remaining marginal ridge/oblique ridge to the extent that the cavosurface margin is unsupported by dentin or the width of the marginal ridge/oblique ridge is less than 1.0 mm.
    • Class II Composite Preparation — External Outline Form — ISTHMUS: SAT (Satisfactory): The isthmus is 1.5 mm wide. | ACC (Minimally Acceptable): The isthmus is greater than 1.5 mm and not greater than 2.0 mm. | SUB (Marginally Substandard): The isthmus is greater than 2.0 mm and not greater than 2.5 mm, or less than 1.5mm and greater than or equal to 1.0 mm. | DEF (Critically Deficient): The isthmus is greater than 2.5 mm or less than 1.0 mm.
    • Class II Composite Preparation — External Outline Form — CAVOSURFACE MARGIN: SAT (Satisfactory): The external cavosurface margin meets the enamel at 90°. | SUB (Marginally Substandard): The proximal cavosurface margin deviates from 90° and is likely to jeopardize the longevity of the tooth or restoration. This would include unsupported enamel and/or excessive bevel(s).
    • Class II Composite Preparation — External Outline Form — SOUND MARGINAL TOOTH STRUCTURE: SAT (Satisfactory): The cavosurface margin terminates in sound natural tooth structure. *There is no previous restorative material, including sealants, at the cavosurface margin. *There is no decalcification on the gingival margin. | SUB (Marginally Substandard): The cavosurface margin does not terminate in sound natural tooth structure; *or there is explorer penetrable decalcification remaining on any cavosurface margin, or the cavosurface margin terminates in a previously placed pit and fissure sealant.
    • Class II Composite Preparation — Internal Form — AXIAL WALLS: SAT (Satisfactory): The axial wall follows the external contours of the tooth, and is entirely in dentin, 0.5 mm to 1.0 mm from the DEJ. | ACC (Minimally Acceptable): The depth of the axial wall is greater than 1.0 mm but no more than 1.5 mm beyond the DEJ. | SUB (Marginally Substandard): The axial wall is [_] more than 1.5 mm beyond the DEJ, but no more than 2.5 mm or the axial wall depth does not include the DEJ. | DEF (Critically Deficient): The axial wall is more than 2.5 mm beyond the DEJ or [_] gingival floor less than 1.0 mm.
    • Class II Composite Preparation — Internal Form — PULPAL FLOOR: SAT (Satisfactory): The pulpal floor depth must be at 1.5—2.0 mm in all areas; there may be remaining enamel. | SUB (Marginally Substandard): The pulpal floor depth is greater than 0.5 mm but less than 1.5 mm or up to 3.0 mm. | DEF (Critically Deficient): The pulpal floor is [_] less than 0.5 mm or [_] is more than 3.0 mm from the cavosurface margin.
    • Class II Composite Preparation — Internal Form — CARIES/REMAINING MATERIAL: SAT (Satisfactory): All caries and/or previous restorative material are removed. | DEF (Critically Deficient): Caries or previous restorative material remains in the preparation or preparation is not extended to include caries.
    • Class II Composite Preparation — Internal Form — PROXIMAL BOX WALLS: SAT (Satisfactory): The walls of the proximal box should be parallel or converge occlusally. | SUB (Marginally Substandard): The walls of the proximal box are divergent. | DEF (Critically Deficient): The walls of the proximal box are grossly [_] convergent so that the buccal-lingual gingival floor width is greater than two times the buccal-lingual width of the occlusal access or [_] divergent so that the occlusal access is greater than two times the width of the buccal-lingual gingival floor.
    • Class II Composite Preparation — Internal Form — PREPARED SURFACES: SAT (Satisfactory): All prepared surfaces are smooth and well-defined, and the gingival floor is perpendicular to the long axis of the tooth. | SUB (Marginally Substandard): The prepared surfaces are irregular or ill-defined.
    • Class II Composite Preparation — Critical Errors: 1. Wrong Tooth/Surface Treated 2. Unrecognized Exposure 3. Critical Lack of Clinical Judgment/Diagnostic Skills
    • Class II Composite Finished Restoration — Margin Integrity and Surface Finish — MARGIN DEFICIENCY: SAT (Satisfactory): There is no marginal deficiency. There is no evidence of voids or open margins. | ACC (Minimally Acceptable): There is a detectable marginal deficiency at the restoration-tooth interface either visually or with the tine of an explorer, but it is less than 0.5 mm. | SUB (Marginally Substandard): The restoration-tooth interface is detectable visually or with the tine of an explorer. There is evidence of marginal deficiency, 0.5 mm up to 1 mm, which can include pits and voids at the cavosurface margin | DEF (Critically Deficient): There is evidence of marginal deficiency of more than 1 mm, to include pits and voids at the cavosurface margin, and/or there is an open margin.
    • Class II Composite Finished Restoration — Margin Integrity and Surface Finish — MARGIN EXCESS: SAT (Satisfactory): There is no detectable marginal excess at the cavosurface margin either visually or with the tine of an explorer. | ACC (Minimally Acceptable): There is a detectable marginal excess at the cavosurface margin either visually or with the tine of an explorer, but it is no greater than 1.0 mm. | SUB (Marginally Substandard): The cavosurface margin is detectable visually or with the tine of an explorer. There is evidence of marginal excess of more than 1.0 mm and up to 2.0 mm. | DEF (Critically Deficient): There is evidence of marginal excess at the cavosurface margin of more than 2.0 mm.
    • Class II Composite Finished Restoration — Margin Integrity and Surface Finish — GINGIVAL OVERHANG: SAT (Satisfactory): The restoration exhibits no gingival overhang. | ACC (Minimally Acceptable): The restoration exhibits a slight gingival overhang but would not be expected to adversely affect the tissue health. | DEF (Critically Deficient): The restoration exhibits a significant gingival overhang and would be expected to adversely affect the tissue health.
    • Class II Composite Finished Restoration — Margin Integrity and Surface Finish — SURFACE FINISH: SAT (Satisfactory): The surface of the restoration is uniformly smooth and free of pits and voids. | ACC (Minimally Acceptable): The surface of the restoration is slightly grainy or rough, but it is free of significant pits and voids. | SUB (Marginally Substandard): The surface of the restoration is rough and exhibits significant irregularities, pits or voids.
    • Class II Composite Finished Restoration — Margin Integrity and Surface Finish — CONTIGUOUS TOOTH STRUCTURE: SAT (Satisfactory): There is no evidence of unwarranted or unnecessary removal or recontouring of tooth structure contiguous to the restoration. There is no excess restorative material present that is not contiguous with the restoration. | ACC (Minimally Acceptable): There is evidence of unwarranted or unnecessary removal, or recontouring of tooth structure contiguous to the restoration that is no greater than 0.5 mm. (Enameloplasty) Excess present that is not contiguous with the restoration no greater than 0.5mm. | SUB (Marginally Substandard): There is evidence of unwarranted or unnecessary removal or recontouring of tooth structure contiguous to the restoration that is greater than 0.5 mm up to 1 mm. (Enameloplasty) Excess present that is not contiguous with the restoration greater than 0.5mm up to 1 mm. | DEF (Critically Deficient): There is greater than 1.0 mm of Enameloplasty. There is excess present that is not contiguous with the restoration greater than 1 mm.
    • Class II Composite Finished Restoration — Contour, Contact and Occlusion — INTERPROXIMAL CONTACT: SAT (Satisfactory): Interproximal contact is present, the contact is visually closed and is properly shaped and positioned; and there is definite, but not excessive, resistance to dental floss when passed through the interproximal contact area. | ACC (Minimally Acceptable): Interproximal contact is visually closed, and the contact is adequate in size, shape, or position but demonstrates little resistance to dental floss. | SUB (Marginally Substandard): Interproximal contact is visually closed, but the contact is deficient in size, shape, or position and demonstrates little resistance to dental floss or shreds the floss. | DEF (Critically Deficient): The interproximal contact is visually open or will not allow floss to pass through the contact area.
    • Class II Composite Finished Restoration — Contour, Contact and Occlusion — CENTRIC/EXCURSIVE CONTACTS: SAT (Satisfactory): When checked with articulating ribbon or paper, all centric and excursive contacts on the restoration are consistent in size, shape and intensity with such contacts on other teeth, in that quadrant. | SUB (Marginally Substandard): When checked with articulating ribbon or paper, the restoration is in hyper-occlusion inconsistent in size, shape and intensity with the occlusal contacts on surrounding teeth, and requires adjustment. | DEF (Critically Deficient): There is gross hyperocclusion so that the restoration is the only point of occlusion in that quadrant.
    • Class II Composite Finished Restoration — Contour, Contact and Occlusion — ANATOMY/CONTOUR: SAT (Satisfactory): The restoration reproduces the normal physiological proximal contours of the tooth, occlusal and marginal ridge anatomy. | ACC (Minimally Acceptable): The restoration does not reproduce the normal occlusal anatomy, proximal contours of the tooth or marginal ridge anatomy, but would not be expected to adversely affect the tissue health. | DEF (Critically Deficient): The restoration does not reproduce the normal occlusal anatomy, proximal contours of the tooth or marginal ridge anatomy, and would be expected to adversely affect the tissue health.
    • Class II Composite Finished Restoration — Critical Errors: 1. Fractured Restoration 2. The restoration is debonded and/or movable in the preparation. 3. Critical Lack of Clinical Judgment/Diagnostic Skills
    • Class III Composite Preparation — External Outline Form — OUTLINE EXTENSION: SAT (Satisfactory): Outline form provides adequate access for complete removal of caries and/or previous restorative material and insertion of composite resin. Access entry is appropriate to the location of caries and tooth position. If a lingual approach is initiated, facial contact may or may not be broken as long as the margin terminates in sound tooth structure. | ACC (Minimally Acceptable): The wall opposite the access, if broken, may extend no more than 1.0 mm beyond the contact area. The outline form is overextended mesiodistally 0.5-1 mm beyond what is necessary for complete removal of caries and/or previous restorative material. | SUB (Marginally Substandard): The outline form is underextended making caries removal or insertion of restorative material questionable. The outline form is overextended mesiodistally more than 1mm, but no more than 2 mm beyond what is necessary for complete removal of caries and/or previous restorative material. The incisal cavosurface margin is overextended so that the integrity of the incisal angle is compromised. The wall opposite the access opening extends more than 1 mm beyond the contact area. | DEF (Critically Deficient): The outline form is underextended making it impossible to manipulate and finish the restorative material. The outline form is overextended mesiodistally more than 2.0 mm beyond what is necessary for complete removal of caries and/or previous restorative material. The incisal cavosurface margin is overextended so that the incisal angle is removed or fractured. A Class IV restoration is now necessary without justification. The wall opposite the access opening extends more than 2.5 mm beyond the contact area.
    • Class III Composite Preparation — External Outline Form — GINGIVAL CONTACT BROKEN: SAT (Satisfactory): The gingival contact must be broken, with gingival clearance up to 1.0 mm. The incisal contact need not be broken, unless indicated by the location of the caries. If a lingual approach is initiated, facial contact may or may not be broken as long as the margin terminates in sound tooth structure. | ACC (Minimally Acceptable): The gingival clearance is greater than 1.0 mm but not greater than 1.5 mm. | SUB (Marginally Substandard): The gingival clearance is greater than 1.5 mm but not more than 2.0 mm. The gingival contact is not visibly broken. | DEF (Critically Deficient): The gingival clearance is greater than 2.0 mm.
    • Class III Composite Preparation — External Outline Form — MARGIN SMOOTHNESS/CONTINUITY/BEVELS: SAT (Satisfactory): Cavosurface margins form a smooth continuous curve with no sharp angles. Enamel cavosurface margins may be beveled. | ACC (Minimally Acceptable): The cavosurface margins are slightly irregular. Enamel cavosurface margin bevels, if present, do not exceed 1.0 mm in width. | SUB (Marginally Substandard): The cavosurface margin is rough and severely irregular. Enamel cavosurface margin bevels, if present, exceed 1.0 mm in width, are not uniform or are inappropriate for the size of the restoration.
    • Class III Composite Preparation — External Outline Form — SOUND MARGINAL TOOTH STRUCTURE: SAT (Satisfactory): The cavosurface margin terminates in sound natural tooth structure. *There is no previous restorative material, including sealants, at the cavosurface margin. All unsupported enamel is removed unless it compromises facial esthetics. | ACC (Minimally Acceptable): There is a small area of unsupported enamel which is not necessary to preserve facial esthetics. | SUB (Marginally Substandard): There are large or multiple areas of unsupported enamel which are not necessary to preserve facial esthetics. The cavosurface margin does not terminate in sound natural tooth structure; *or the cavosurface margin terminates in previous restorative material.
    • Class III Composite Preparation — Internal Form — AXIAL WALLS: SAT (Satisfactory): The axial wall follows the external contours of the tooth, and is entirely in dentin, 0.5 mm to 1.0 mm from the DEJ. | ACC (Minimally Acceptable): The depth of the axial wall is greater than 1.0 mm but no more than 1.5 mm beyond the DEJ. | SUB (Marginally Substandard): The axial wall is [_] more than 1.5 mm beyond the DEJ, but no more than 2.5 mm or the axial wall depth does not include the DEJ. | DEF (Critically Deficient): The axial wall is more than 2.5 mm beyond the DEJ.
    • Class III Composite Preparation — Internal Form — INTERNAL RETENTION: SAT (Satisfactory): If used, rounded internal retention is placed in the dentin of the gingival and incisal walls just axial to the DEJ as dictated by cavity form. Retention is tactilely and visually present. | SUB (Marginally Substandard): When used, retention is excessive and undermines enamel or jeopardizes the incisal angle or encroaches on the pulp.
    • Class III Composite Preparation — Internal Form — CARIES/REMAINING MATERIAL: SAT (Satisfactory): All caries and/or previous restorative material are removed. | DEF (Critically Deficient): Caries or previous restorative material remains in the preparation or preparation is not extended to include caries.
    • Class III Composite Preparation — Critical Errors: 1. Wrong Tooth/Surface Treated 2. Unrecognized Exposure 3. Critical Lack of Clinical Judgment/Diagnostic Skills
    • Class III Composite Restoration — Margin Integrity and Surface Finish — MARGIN DEFICIENCY: SAT (Satisfactory): There is no marginal deficiency. No marginal deficiency is detectable at the restoration-tooth interface either visually or with the tine of an explorer. There is no evidence of voids or open margins. | ACC (Minimally Acceptable): There is a detectable marginal deficiency at the facial or lingual restoration-tooth interface either visually or with the tine of an explorer, but it is less than 0.5 mm. | SUB (Marginally Substandard): The restoration-tooth interface is detectable visually or with the tine of an explorer. There is evidence of marginal deficiency, 0.5 mm up to 1 mm, which can include pits and voids at the cavosurface margin | DEF (Critically Deficient): There is evidence of marginal deficiency of more than 1 mm, to include pits and voids at the cavosurface margin, and/or there is an open margin.
    • Class III Composite Restoration — Margin Integrity and Surface Finish — MARGIN EXCESS: SAT (Satisfactory): No marginal excess is detectable at the cavosurface margin either visually or with the tine of an explorer. | ACC (Minimally Acceptable): There is a detectable marginal excess at the cavosurface margin either visually or with the tine of an explorer, but it is no greater than 1.0 mm.. | SUB (Marginally Substandard): The cavosurface margin is detectable visually or with the tine of an explorer. There is evidence of lingual marginal excess, more than 1.0 mm and up to 2 mm. There is facial and/or lingual flash with contamination underneath, but it is not internal to the cavosurface margin, and could be removed by polishing or finishing. | DEF (Critically Deficient): There is evidence of marginal excess at the cavosurface margin of more than 2 mm, and/or there is internal contamination at the facial and/or lingual interface between the restoration and the tooth.
    • Class III Composite Restoration — Margin Integrity and Surface Finish — GINGIVAL OVERHANG: SAT (Satisfactory): The restoration exhibits no gingival overhang. | ACC (Minimally Acceptable): The restoration exhibits a slight gingival overhang but would not be expected to adversely affect the tissue health. | DEF (Critically Deficient): The restoration exhibits a significant gingival overhang and would be expected to adversely affect the tissue health.
    • Class III Composite Restoration — Margin Integrity and Surface Finish — SURFACE FINISH: SAT (Satisfactory): The surface of the restoration is uniformly smooth and free of pits and voids. | ACC (Minimally Acceptable): The surface of the restoration is slightly grainy or rough, but it is free of significant pits and voids. | SUB (Marginally Substandard): The surface of the restoration is rough and exhibits significant irregularities, pits or voids.
    • Class III Composite Restoration — Margin Integrity and Surface Finish — CONTIGUOUS TOOTH STRUCTURE: SAT (Satisfactory): There is no evidence of unwarranted or unnecessary removal or recontouring of tooth structure contiguous to the restoration. There is no excess restorative material present that is not contiguous with the restoration. | ACC (Minimally Acceptable): There is evidence of unwarranted or unnecessary removal, or recontouring of tooth structure contiguous to the restoration that is no greater than 0.5 mm. (Enameloplasty) Excess present that is not contiguous with the restoration no greater than 0.5mm. | SUB (Marginally Substandard): There is evidence of unwarranted or unnecessary removal or recontouring of tooth structure contiguous to the restoration that is greater than 0.5 mm up to 1 mm. (Enameloplasty) Excess present that is not contiguous with the restoration greater than 0.5mm up to 1 mm. | DEF (Critically Deficient): There is greater than 1.0 mm of Enameloplasty. There is excess present that is not contiguous with the restoration greater than 1 mm.
    • Class III Composite Restoration — Contour, Contact and Occlusion — INTERPROXIMAL CONTACT: SAT (Satisfactory): Interproximal contact is present, the contact is visually closed and is properly shaped and positioned; and there is definite, but not excessive, resistance to dental floss when passed through the interproximal contact area. | ACC (Minimally Acceptable): Interproximal contact is visually closed, and the contact is adequate in size, shape, or position but demonstrates little resistance to dental floss. | SUB (Marginally Substandard): Interproximal contact is visually closed, but the contact is deficient in size, shape, or position and/or demonstrates little resistance to dental floss, shreds the floss or is visually open but deflects floss. | DEF (Critically Deficient): The interproximal contact allows standardized dental floss to pass without deflection or resistance or will not allow dental floss to pass through the contact area.
    • Class III Composite Restoration — Contour, Contact and Occlusion — CENTRIC/EXCURSIVE CONTACTS: SAT (Satisfactory): When checked with articulating ribbon or paper, all centric and excursive contacts on the restoration are consistent in size, shape and intensity with such contacts on other teeth, in that quadrant. | SUB (Marginally Substandard): When checked with articulating ribbon or paper, the restoration is in hyper-occlusion inconsistent in size, shape and intensity with the occlusal contacts on surrounding teeth, and requires adjustment. | DEF (Critically Deficient): There is gross hyperocclusion so that the restoration is the only point of occlusion in that quadrant.
    • Class III Composite Restoration — Contour, Contact and Occlusion — ANATOMY/CONTOUR: SAT (Satisfactory): The restoration reproduces the normal anatomical contours of the tooth, including facial, lingual, proximal and marginal ridge anatomy when compared to contiguous tooth structure. | ACC (Minimally Acceptable): The restoration deviates slightly from the normal anatomical contours of the tooth, when compared to contiguous tooth structure but would not be expected to adversely affect the tissue health. | DEF (Critically Deficient): The restoration deviates significantly from the normal anatomical contours of the tooth, including facial, lingual, proximal or marginal ridge anatomy, and/or would be expected to adversely affect the tissue health.
    • Class III Composite Restoration — Critical Errors: 1. Restoration is debonded. 2. Critical Lack of Clinical Judgment/Diagnostic Skills
    • Restorative Procedures — Treatment Management / Typodont Condition (Penalty Points Only) — CONDITION OF ADJACENT TEETH: SAT (Satisfactory): The adjacent teeth and/or restorations are free from damage. | ACC (Minimally Acceptable): Damage to adjacent tooth/teeth can be removed with polishing without adversely altering the shape of the contour and/or contact. | SUB (Marginally Substandard): Damage to adjacent tooth/teeth requires recontouring which changes the shape and/or position of the contact. | DEF (Critically Deficient): There is gross damage to adjacent tooth/teeth which requires a restoration.
    • Restorative Procedures — Treatment Management / Typodont Condition (Penalty Points Only) — CONDITION OF SOFT TISSUE: SAT (Satisfactory): The soft tissue is free from damage or there is tissue damage that is consistent with the procedure. | SUB (Marginally Substandard): There is iatrogenic soft tissue damage that is inconsistent with the procedure. | DEF (Critically Deficient): There is gross iatrogenic damage to the soft tissue inconsistent with the procedure and pre-existing condition of the soft tissue.
    • Restorative Procedures — TYPODONT CONDITION (Penalty Points Only): 1. Rubber Dam remnants 2. Pencil marks on teeth 3. Uncleanliness of models when turned in 4. Bonding agent
Examination sources