Restorative Dentistry Prometric exam questions with answers

1. Question 1Cariology and Minimally Invasive Dentistrymedium

   On a cleaned and dried occlusal surface, a lesion shows localised enamel breakdown with no visible dentine and no underlying shadow. What is the ICDAS code?

   1. ACode 1
   2. BCode 2
   3. CCode 3
   4. DCode 5
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   Answer: C. Code 3

   ICDAS code 3 is localised enamel breakdown due to caries with no visible dentine or underlying shadow. Code 2 is a distinct visual change visible when wet without breakdown, and code 5 is a distinct cavity with visible dentine.

2. Question 2Cariology and Minimally Invasive Dentistryhard

   A 16-year-old has a non-cavitated occlusal lesion on tooth 47 with radiographic extension into the outer third of dentine. The patient attends regularly. What is the most appropriate management?

   1. APlace a resin-based sealant and monitor
   2. BPrepare a conventional amalgam restoration
   3. CNo treatment and review in 2 years
   4. DCrown the tooth to prevent fracture
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   Answer: A. Place a resin-based sealant and monitor

   Non-cavitated occlusal lesions, including those into the outer dentine, can be arrested by sealing with a resin-based sealant and monitoring, which avoids removal of sound tooth structure. Leaving an active lesion untreated risks progression.

3. Question 3Dental Materials and Adhesionmedium

   When using an etch-and-rinse adhesive, why should etched dentine be left visibly moist rather than air-dried until desiccated?

   1. ATo dissolve the remaining smear plugs fully
   2. BTo activate the photoinitiator in the primer
   3. CTo prevent collapse of the exposed collagen network
   4. DTo increase fluoride uptake by the dentine
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   Answer: C. To prevent collapse of the exposed collagen network

   Acid etching demineralises dentine and exposes a collagen network that collapses when dried, preventing resin infiltration and creating a poor hybrid layer. Keeping dentine moist maintains interfibrillar spaces for the primer to penetrate.

4. Question 4Dental Materials and Adhesionmedium

   By what mechanism does conventional glass ionomer cement adhere to tooth structure?

   1. AMicromechanical resin tags in etched enamel
   2. BIonic bonding of carboxylate groups to calcium
   3. CCovalent bonding to exposed collagen fibrils
   4. DFrictional retention within the cavity only
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   Answer: B. Ionic bonding of carboxylate groups to calcium

   Polyacrylic acid in glass ionomer forms ionic bonds between carboxylate groups and calcium in hydroxyapatite, giving true chemical adhesion. Resin tags in etched enamel are the mechanism for resin-based adhesives.

5. Question 5Periodontal and Endodontic Considerations in Restorationeasy

   A patient with generalised periodontitis with 6-7 mm pockets and bleeding wants new crowns on several teeth. What should be done first?

   1. APrepare the crowns and treat the gums later
   2. BPlace provisional crowns and then scale
   3. CPrescribe systemic antibiotics and prepare crowns
   4. DComplete cause-related periodontal therapy and reassess
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   Answer: D. Complete cause-related periodontal therapy and reassess

   Active periodontitis must be controlled with cause-related therapy and reassessment before definitive restorations, because inflamed tissues compromise margins, impressions and abutment prognosis. Antibiotics are not a substitute for mechanical periodontal therapy.

6. Question 6Fixed Prosthodonticsmedium

   A patient needs a three-unit bridge. According to Ante's law, what should the combined periodontal ligament area of the abutments be?

   1. AAt least half that of the teeth replaced
   2. BAt least twice that of the teeth replaced
   3. CUnrelated to the teeth replaced
   4. DEqual to or greater than that of the teeth replaced
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   Answer: D. Equal to or greater than that of the teeth replaced

   Ante's law states that the root surface area of the abutment teeth should equal or exceed that of the teeth being replaced. It is a guideline for judging whether abutments can tolerate the extra load of a fixed partial denture.

7. Question 7Periodontal and Endodontic Considerations in Restorationhard

   Tooth 46 does not respond to cold or electric testing and has a single narrow 8 mm pocket on the distal with a periapical radiolucency. Other sites probe 2-3 mm. What should be done first?

   1. ARoot canal treatment and reassessment
   2. BPeriodontal flap surgery and debridement
   3. CExtraction and implant placement
   4. DGuided tissue regeneration surgery
   Show answer and explanation▾

   Answer: A. Root canal treatment and reassessment

   A necrotic pulp with a narrow isolated pocket and otherwise healthy periodontium suggests a lesion of endodontic origin draining through the periodontal ligament, which often heals after root canal treatment. Periodontal surgery first would not remove the intracanal source of infection.

8. Question 8Removable Prosthodonticseasy

   A 70-year-old complete denture wearer has diffuse erythema of the palate under the upper denture. She wears the dentures day and night. What is the most important management step?

   1. AReline the denture with a hard acrylic
   2. BLeave the denture out overnight and clean it daily
   3. CPrescribe a 2-week course of amoxicillin
   4. DConstruct a new denture immediately
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   Answer: B. Leave the denture out overnight and clean it daily

   Denture stomatitis is mainly associated with Candida and poor denture hygiene, so removing dentures at night and cleaning them daily, with antifungal treatment if needed, is central. Antibacterial antibiotics do not treat this fungal-associated condition.

9. Question 9Fixed Prosthodonticsmedium

   An addition silicone (polyvinyl siloxane) impression shows unset, sticky material around the prepared tooth. The assistant had handled the gingival retraction cord with latex gloves. What is the most likely cause?

   1. AExcess catalyst in the mix
   2. BSulfur compounds from latex inhibiting setting
   3. CHydrophobic material repelling saliva
   4. DUse of a rigid custom tray
   Show answer and explanation▾

   Answer: B. Sulfur compounds from latex inhibiting setting

   Sulfur compounds from latex gloves poison the platinum catalyst of addition silicones and inhibit setting where contamination occurs. Hydrophobicity causes voids and poor detail in wet areas but does not stop the material from setting.

10. Question 10Implant Dentistrymedium

    A 64-year-old woman receives monthly IV zoledronic acid for bone metastases from breast cancer and requests implants. What is the most appropriate advice?

    1. AImplants can proceed as normal
    2. BImplants are generally avoided because of high MRONJ risk
    3. CStop zoledronic acid for 1 week before surgery
    4. DPlace implants only in the maxilla
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    Answer: B. Implants are generally avoided because of high MRONJ risk

    High-dose IV antiresorptive therapy for cancer carries a substantially higher risk of medication-related osteonecrosis of the jaw, and elective implant surgery is generally avoided. Brief drug holidays do not remove the risk because bisphosphonates persist in bone for years.

11. Question 11Occlusion, Tooth Wear and TMDmedium

    In a mutually protected occlusion, what happens to the posterior teeth during a lateral excursion of the mandible?

    1. AThey contact on the working side
    2. BThey contact on the non-working side
    3. CThey are discluded by canine guidance
    4. DThey guide the movement with group function
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    Answer: C. They are discluded by canine guidance

    In mutually protected occlusion the canines guide lateral excursions and disclude the posterior teeth on both sides, while the posterior teeth protect the anterior teeth in intercuspal position. Group function, where posterior teeth contact on the working side, is a different scheme.

12. Question 12Occlusion, Tooth Wear and TMDmedium

    A 50-year-old has localised wear of the upper anterior teeth with no interocclusal space to restore them. Composite restorations are added at an increased vertical dimension anteriorly, leaving the posterior teeth temporarily out of contact. What is this approach called?

    1. ADahl concept
    2. BPankey-Mann-Schuyler philosophy
    3. CBennett movement
    4. DBonwill triangle
    Show answer and explanation▾

    Answer: A. Dahl concept

    The Dahl concept creates space for anterior restorations by placing them at an increased vertical dimension, with posterior occlusion re-establishing through a combination of intrusion and eruption over months. Pankey-Mann-Schuyler is a full-mouth rehabilitation philosophy.

13. Question 13Periodontal and Endodontic Considerations in Restorationmedium

    A root-filled premolar needs a post. What is the main advantage of a glass-fibre post over a cast metal post?

    1. AHigher stiffness than the surrounding dentine
    2. BModulus closer to dentine, reducing root fractures
    3. CBetter radiopacity than a cast metal post
    4. DNo need for adhesive or resin cementation
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    Answer: B. Modulus closer to dentine, reducing root fractures

    Fibre posts have an elastic modulus closer to dentine, so stress is distributed more evenly and failures tend to be restorable rather than catastrophic root fractures. Stiff metal posts concentrate stress in the root.

14. Question 14Removable Prosthodonticsmedium

    In an RPI clasp assembly for a distal extension partial denture, why is the occlusal rest placed on the mesial of the terminal abutment?

    1. ATo increase the retention of the I-bar clasp
    2. BTo improve the aesthetics of the clasp arm
    3. CTo reduce distal tipping force on the abutment
    4. DTo allow a shorter, simpler major connector
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    Answer: C. To reduce distal tipping force on the abutment

    A mesial rest moves the fulcrum forward so that when the distal extension base is loaded the abutment is pushed mesially against adjacent teeth rather than tipped distally. The I-bar then disengages from the undercut instead of torquing the tooth.

15. Question 15Removable Prosthodonticsmedium

    After receiving new complete dentures, a patient reports that the teeth click together when speaking and the ridges feel sore and tired. What is the most likely cause?

    1. AExcessive occlusal vertical dimension
    2. BInsufficient occlusal vertical dimension
    3. CIncorrect shade of the teeth
    4. DOverextended lingual flange
    Show answer and explanation▾

    Answer: A. Excessive occlusal vertical dimension

    Teeth clicking during speech, loss of freeway space and generalised ridge soreness suggest the occlusal vertical dimension is too great. Reduced vertical dimension instead produces angular cheilitis, a collapsed facial appearance and reduced chewing efficiency.

Last reviewed September 2026. Questions are original and written to the published exam blueprint; they are not taken from any real paper.