Prosthodontics Quiz 1 Prosthodontics Quiz 1 1. Scenario 1: Complete Denture Fit A 70-year-old edentulous patient complains of a loose mandibular denture 2 weeks post-delivery. What’s the most likely cause? Overextended buccal flange Underextended buccal flange Overextended lingual flange Underextended lingual flange Overextended retromolar pad 2. 2. Next step to confirm diagnosis? Check occlusion with articulating paper Apply pressure indicator paste Take new impressions Adjust occlusal vertical dimension Relieve retromolar area 3. Scenario 2: Bridge Failure A 45-year-old has a 3-unit bridge (35-37, 36 missing) that debonded after 6 months. 3. Most likely reason for failure? Inadequate retention form Insufficient resistance form Over-contoured pontic Under-contoured pontic Excessive occlusal load 4. 4. Best immediate action? Recement with temporary cement Recement with resin cement Fabricate new bridge Adjust occlusion then recement Relieve pontic and recement 5. Scenario 3: Partial Denture Design A 55-year-old needs an RPD for missing 14, 15, 16; 17 present. 5. Best clasp for 17? Cast circumferential clasp Wrought wire clasp I-bar clasp Ring clasp Reverse action clasp 6. 6. Rest placement for stability? Mesial rest on 17 Distal rest on 17 Mesial rest on 13 Distal rest on 13 Cingulum rest on 13 7. Scenario 4: Crown Prep Issue A 30-year-old’s crown on 21 keeps coming off despite good margins. 7. Most likely prep flaw? Inadequate taper (4°) Excessive taper (12°) Insufficient occlusal reduction Over-reduced occlusal surface Lack of proximal grooves 8. 8. Best fix before recementing? Increase taper to 10° Add retention grooves Reduce occlusal more Shorten prep height Smooth axial walls 9. Scenario 5: Denture Sore Spot A 62-year-old with new complete dentures has soreness in the buccal vestibule. 9. Most likely cause? Overextended flange Overextended flange Occlusal prematurity Insufficient freeway space Overclosed vertical dimension 10. Adjustment method? Grind occlusal contacts Relieve flange with bur Increase vertical dimension Add wax to flange Remake denture 11. Scenario 6: Bridge Pontic Design A 50-year-old needs a bridge 24-26 (25 missing). 11. Best pontic design? Ridge lap pontic Modified ridge lap pontic Sanitary pontic Ovate pontic Conical pontic 12. 12. Why choose this design? Best aesthetics Easiest to clean Least tissue pressure Most stable retention Matches occlusion 13. Scenario 7: Veneer Failure A 28-year-old’s veneer on 11 fractures after 1 year. 13. Most likely cause? Insufficient enamel etch Excessive incisal reduction Inadequate incisal reduction Poor shade selection Over-contoured restoration 14. 14.Next step? Replace with new veneer Repair with composite Adjust occlusion Smooth fracture site Monitor for 6 months 15. Scenario 8: Denture Occlusion A 68-year-old’s maxillary denture rocks during chewing. 15. Most likely occlusal issue? Premature contact on right Premature contact on left Excessive vertical dimension Insufficient vertical dimension Bilateral balanced occlusion 16. 16. Correction method? Reduce vertical dimension Grind premature contacts Increase vertical dimension Remake with new occlusion Adjust freeway space 17. Scenario 9: Implant Overdenture A 72-year-old has a loose mandibular overdenture on 2 implants. 17. Most likely cause? Worn locator attachments Overextended denture base Underextended denture base Implant angulation mismatch Occlusal overload 18. 18. Immediate fix? Replace locator inserts Relieve denture base Adjust occlusal contacts Take new impressions Tighten implant screws 19. Scenario 10: Bridge Material A 40-year-old needs a 3-unit posterior bridge. 19. Best material for strength? Porcelain-fused-to-metal (PFM) All-ceramic zirconia All-ceramic lithium disilicate Gold alloy Composite resin 20. 20. Why this material? Best aesthetics Highest fracture resistance Easiest to adjust Least wear on opposing teeth Most cost-effective 21. Scenario 11: Crown Margin Gap A 38-year-old’s PFM crown on 36 shows a 1mm gap at the distal margin on a bitewing. 21. Most likely cause? Open margin from poor prep Over-contoured crown design Inadequate cement thickness Distal caries undermining margin Excessive occlusal adjustment 22. 22. Best next step? Recement with temporary cement Adjust margin and recement Remake the crown Monitor for 6 months Relieve distal contact 23. Scenario 12: Partial Denture Clasp Breaks A 60-year-old’s maxillary RPD has a wrought wire clasp on 14 that snapped after 1 year. 23. Most likely reason? Overflexing beyond elastic limit Fatigue from repeated insertion Corrosion from poor hygiene Inadequate clasp thickness Excessive undercut engagement 24. 24. Best replacement option? Cast circumferential clasp Another wrought wire clasp I-bar clasp Ring clasp Reverse action clasp 25. Scenario 13: Overdenture Sore Spot A 65-year-old with a mandibular overdenture on 4 implants reports pain near the left canine area. 25. Most likely cause? Overextended denture flange Underextended denture flange Implant abutment pressure Occlusal prematurity Insufficient relief over implant 26. 26. How to adjust? Increase vertical dimension Relieve flange with a bur Adjust occlusal contacts Tighten implant abutments Remake denture base 27. Scenario 14: Bridge Debonds Repeatedly A 50-year-old’s 3-unit bridge (44-46, 45 missing) debonds for the second time in 9 months. 27. Most likely prep issue? Inadequate abutment height Insufficient retention form Excessive pontic span Over-tapered abutments Poor occlusal reduction 28. 28. Next step after evaluation? Recement with resin cement Adjust occlusion and recement Redesign and remake bridge Add retention grooves Monitor with temporary cement 29. Scenario 15: Denture Patient Gags A 58-year-old with new maxillary complete dentures gags constantly. 29. Most likely cause? Overextended posterior border Underextended posterior border Excessive vertical dimension Insufficient freeway space Over-contoured palate 30. 30. Best solution? Increase vertical dimension Shorten posterior flange Reduce palatal thickness Remake with new impressions Adjust freeway space 31. Scenario 16: Veneer Shade Mismatch A 32-year-old’s veneer on 21 looks too dark 1 month post-placement. 31. Most likely reason? Poor lab shade communication Inadequate enamel reduction Excessive composite lute Wrong cement shade Underlying tooth discoloration 32. 32. Best corrective action? Replace with new veneer Polish and adjust shade Bleach adjacent teeth Apply surface stain Monitor for 3 months 33. Scenario 17: Crown Cement Failure A 42-year-old’s zirconia crown on 16 dislodges after 4 months. 33. Most likely cement issue? Weak cement (zinc phosphate) Inadequate surface prep Excessive cement thickness Poor moisture control Over-etched zirconia 34. 34. Retry with what? Zinc phosphate cement Resin cement Glass ionomer cement Polycarboxylate cement Temporary cement 35. Scenario 18: Partial Denture Unstable A 55-year-old’s mandibular RPD (missing 34-36) rocks during function. 35. Most likely design flaw? Mesial rest on 33 misplaced Distal rest on 37 not seating Insufficient clasp retention Overextended major connector Underextended minor connector 36. How to redesign? Add distal rest on 37 Extend major connector Replace clasp with I-bar Adjust rest to mesial Remake with new framework 37. Scenario 19: Bridge Pontic Traps Food A 48-year-old’s 3-unit bridge (13-15, 14 missing) traps food underneath. 37. Most likely design flaw? Ridge lap pontic Sanitary pontic Ovate pontic Modified ridge lap pontic Conical pontic 38. How to correct? Remake with ridge lap Remake with sanitary pontic Adjust pontic contour Relieve tissue contact Add proximal grooves 39. Scenario 20: Denture Vertical Dimension Off A 67-year-old with new complete dentures complains of cheek biting. 39. Most likely issue? Excessive vertical dimension Insufficient vertical dimension Overextended buccal flange Underextended buccal flange Poor occlusal plane alignment 40. How to adjust? Increase vertical dimension Reduce vertical dimension Relieve buccal flange Remake denture Adjust occlusion 41. Scenario 21: Implant Crown Loose A 60-year-old’s implant crown on 26 feels loose 6 months post-placement. 41. Most likely cause? Loose abutment screw Fractured implant fixture Inadequate cement bond Excessive occlusal load Poor osseointegration 42. Immediate action? Tighten abutment screw Recement crown Adjust occlusion Remove and replace crown Monitor with radiograph 43. Scenario 22: Crown Prep Overheats A 35-year-old’s crown prep on 11 caused patient discomfort from heat. 43. Most likely damage? Pulpal necrosis risk Enamel microcracks Dentin hypersensitivity Gingival recession Cement failure risk 44. How to manage? Immediate RCT Monitor, RCT if symptomatic Apply desensitizer Reduce prep further Remake impression 45. Scenario 23: Partial Denture Clasp Deforms A 62-year-old’s RPD clasp on 24 deforms after 8 months. 45. Most likely material issue? Cast clasp too brittle Wrought wire fatigue Corrosion from alloy Inadequate clasp length Over-polished clasp 46. Best replacement? Cast circumferential clasp Wrought wire clasp I-bar clasp Ring clasp Reverse action clasp 47. Scenario 24: Bridge Occlusion Off A 52-year-old’s 3-unit bridge (23-25) feels high when biting. 47. Most likely cause? Premature occlusal contact Insufficient occlusal reduction Over-contoured pontic Underextended pontic Excessive vertical dimension 48. How to fix? Increase vertical dimension Grind premature contacts Remake bridge Adjust pontic contour Relieve abutment margins 49. Scenario 25: Denture Flange Irritates A 70-year-old’s mandibular denture causes redness along the buccal mucosa. 49. Most likely issue? Overextended buccal flange Underextended buccal flange Occlusal prematurity Insufficient vertical dimension Overclosed freeway space 50. Best adjustment? Extend flange further Relieve flange with bur Adjust occlusal contacts Increase vertical dimension Remake denture base Loading …
