CDA PRACTICE TEST EXAM VERIFIED
QUESTIONS AND ANSWERS ALREADY GRADED
A+ 2026-2027.
1. A 45-year-old patient presents with a deep carious lesion on tooth #19. Radiographs reveal the
caries extends to the pulp chamber with a periapical radiolucency. The tooth has a large amalgam
restoration and a fractured mesial marginal ridge. Periodontal probing depths are within normal
limits. The patient has a history of controlled hypertension (medicated) and reports no allergies.
Which of the following is the most appropriate initial treatment plan?
A. Extraction followed by implant placement after 4 months
B. Root canal therapy followed by composite restoration and crown
C. Pulpectomy and placement of a stainless steel crown
D. Direct pulp cap with calcium hydroxide and composite restoration
Answer: B
Rationale: Root canal therapy is indicated because the caries has reached the pulp and there is
periapical pathology. After endodontic treatment, the tooth requires a crown due to the large existing
restoration and fractured marginal ridge. Extraction is not first-line as the tooth is restorable.
Pulpectomy with SSC is appropriate for primary teeth, not permanent. Direct pulp cap is
contraindicated when pulp necrosis is present.
2. A patient with a history of infective endocarditis requires a dental extraction. According to the
2021 AHA guidelines, which of the following antibiotic regimens is recommended for prophylaxis?
A. Amoxicillin 2 g orally 30-60 minutes before procedure
B. Clindamycin 600 mg orally 1 hour before procedure
C. Cephalexin 2 g orally 30-60 minutes before procedure
D. Azithromycin 500 mg orally 1 hour before procedure
Answer: A
Rationale: Amoxicillin 2 g orally is the first-line recommended regimen for dental procedures in patients
with indications for prophylaxis. Clindamycin is an alternative for patients with penicillin allergy.
Cephalexin is not recommended due to cross-reactivity concerns. Azithromycin is not a standard
recommendation.
3. Which of the following periodontal conditions is most strongly associated with an increased risk
of adverse pregnancy outcomes such as preterm birth and low birth weight?
A. Gingivitis associated with dental plaque only
B. Chronic periodontitis with localized probing depths of 5-6 mm
C. Necrotizing ulcerative periodontitis
D. Periodontal abscess
Page 1
,Answer: B
Rationale: Chronic periodontitis, characterized by moderate to severe attachment loss and inflammation,
has been consistently linked to adverse pregnancy outcomes. Gingivitis alone is not strongly associated.
Necrotizing conditions are acute but less common. A periodontal abscess is a localized infection and not
typically linked to systemic pregnancy outcomes.
4. A patient presents with a painful, erythematous, and erosive lesion on the buccal mucosa
bilaterally. The lesions have a lacy white pattern at the periphery. The patient reports a history of
hepatitis C. Which of the following is the most likely diagnosis?
A. Lichen planus
B. Lupus erythematosus
C. Erythema multiforme
D. Pemphigus vulgaris
Answer: A
Rationale: Oral lichen planus typically presents with bilateral, reticular, white striae (Wickham striae)
and can be erosive. It is associated with hepatitis C infection. Lupus erythematosus often has discoid
lesions and is photosensitive. Erythema multiforme is acute with target lesions. Pemphigus vulgaris
presents with flaccid bullae and positive Nikolsky sign.
5. In a patient with a Class II Division 1 malocclusion, which of the following cephalometric
measurements is most likely to be increased?
A. ANB angle
B. SNB angle
C. FMA (Frankfort-mandibular plane angle)
D. IMPA (incisor mandibular plane angle)
Answer: A
Rationale: Class II Division 1 malocclusion is characterized by a retrognathic mandible or prognathic
maxilla, leading to an increased ANB angle (normal ~2°). SNB angle is decreased. FMA may be normal
or increased depending on vertical growth pattern. IMPA is often increased due to proclined incisors but
is not the most direct cephalometric indicator of the skeletal discrepancy.
6. A 6-year-old child presents with a fractured incisal edge of tooth #8 involving enamel and dentin,
with no pulpal exposure. Radiographs show no root fracture or periapical pathology. The tooth is
asymptomatic. Which of the following is the most appropriate management?
A. Place a stainless steel crown
B. Perform a pulpectomy and place a composite restoration
C. Restore with composite resin using adhesive techniques
D. Extract the tooth and place a space maintainer
Answer: C
Rationale: For a complicated crown fracture involving dentin without pulp exposure, composite resin
restoration is the standard of care in a primary or young permanent tooth. Stainless steel crowns are
used for posterior teeth or extensive caries. Pulpectomy is not indicated as pulp is not exposed.
Extraction is too aggressive for a restorable tooth.
Page 2
,7. A patient presents with a solitary radiolucency in the mandibular premolar region that is
well-defined with a sclerotic border. The lesion is asymptomatic and discovered on routine
panoramic radiograph. Vitality testing of adjacent teeth is normal. Which of the following is the
most likely diagnosis?
A. Odontogenic keratocyst
B. Ameloblastoma
C. Stafne bone cyst
D. Periapical cyst
Answer: C
Rationale: Stafne bone cyst (static bone cavity) is a developmental depression on the lingual surface of
the mandible, often in the premolar/molar region, appearing as a well-defined radiolucency with a
sclerotic border. It is asymptomatic and does not involve teeth. Odontogenic keratocyst and
ameloblastoma are more aggressive and may cause root resorption. Periapical cyst is associated with
nonvital teeth.
8. Which of the following local anesthetics has the longest duration of action when used for inferior
alveolar nerve block?
A. Lidocaine 2% with epinephrine 1:100,000
B. Mepivacaine 3% plain
C. Bupivacaine 0.5% with epinephrine 1:200,000
D. Articaine 4% with epinephrine 1:100,000
Answer: C
Rationale: Bupivacaine is a long-acting amide anesthetic with a duration of up to 6-8 hours for nerve
blocks. Lidocaine and articaine are intermediate-acting (2-4 hours). Mepivacaine plain is short-acting
(1-2 hours). Epinephrine prolongs duration but bupivacaine's inherent properties make it the longest.
9. A patient requires extraction of a mandibular third molar with a high risk of inferior alveolar
nerve injury due to root proximity. The surgeon decides to perform a coronectomy. Which of the
following is a contraindication to this procedure?
A. Presence of periapical pathology
B. Patient age over 40
C. Tooth is completely bony impacted
D. Roots are divergent
Answer: A
Rationale: Coronectomy (removal of crown only) is contraindicated when there is periapical infection, as
the retained roots may become a nidus for infection. Age over 40 is not a contraindication. Complete
bony impaction is often an indication. Divergent roots do not preclude coronectomy.
10. A dentist discovers that a patient has been receiving treatment from another dentist for the
same condition without the patient's disclosure. The dentist considers continuing treatment. Which
ethical principle is most directly challenged in this scenario?
A. Beneficence
Page 3
, B. Nonmaleficence
C. Patient autonomy
D. Veracity
Answer: C
Rationale: Patient autonomy involves the right to make informed decisions about their care, including the
choice of provider. The patient's failure to disclose concurrent treatment undermines the dentist's ability
to provide informed care and respects the patient's autonomy. Beneficence and nonmaleficence are also
relevant but the core issue is the patient's right to choose and the dentist's need for full information to
avoid harm.
11. In the context of dental caries risk assessment for an adult patient with xerostomia due to
medication, which combination of factors most robustly predicts future caries incidence according
to the Caries Management by Risk Assessment (CAMBRA) model?
A. Low salivary flow, high Streptococcus mutans count, and frequent sugar intake
B. Exposed root surfaces, low fluoride exposure, and poor oral hygiene
C. High Lactobacillus count, visible plaque, and previous restorations
D. Low socioeconomic status, infrequent dental visits, and high DMFT index
Answer: A
Rationale: CAMBRA emphasizes that the combination of biological risk factors (low salivary flow, high
mutans streptococci) and behavioral factors (frequent sugar intake) provides the strongest predictive
power for caries progression. Option B omits microbial factors, C omits salivary and sugar factors, and
D focuses on historical and demographic factors rather than modifiable risk indicators.
12. A 45-year-old patient presents with a well-defined radiolucency at the apex of tooth #19 that is
associated with a sinus tract. The patient reports no pain. Histological examination of the
periapical tissue shows granulation tissue with cholesterol clefts and hemosiderin deposition.
Which of the following is the most likely diagnosis?
A. Periapical granuloma
B. Radicular cyst
C. Periapical abscess
D. Focal cemento-osseous dysplasia
Answer: A
Rationale: Periapical granuloma is characterized by granulation tissue with cholesterol clefts and
hemosiderin, often asymptomatic with a sinus tract. Radicular cyst would show an epithelial lining;
abscess shows acute inflammation; cemento-osseous dysplasia is not associated with sinus tract and has
mixed radiolucent/radiopaque appearance.
13. Which of the following periodontal pathogens is most strongly associated with the pathogenesis
of aggressive periodontitis in systemically healthy individuals, and its presence is considered a
major diagnostic criterion?
A. Porphyromonas gingivalis
B. Aggregatibacter actinomycetemcomitans
C. Tannerella forsythia
Page 4
QUESTIONS AND ANSWERS ALREADY GRADED
A+ 2026-2027.
1. A 45-year-old patient presents with a deep carious lesion on tooth #19. Radiographs reveal the
caries extends to the pulp chamber with a periapical radiolucency. The tooth has a large amalgam
restoration and a fractured mesial marginal ridge. Periodontal probing depths are within normal
limits. The patient has a history of controlled hypertension (medicated) and reports no allergies.
Which of the following is the most appropriate initial treatment plan?
A. Extraction followed by implant placement after 4 months
B. Root canal therapy followed by composite restoration and crown
C. Pulpectomy and placement of a stainless steel crown
D. Direct pulp cap with calcium hydroxide and composite restoration
Answer: B
Rationale: Root canal therapy is indicated because the caries has reached the pulp and there is
periapical pathology. After endodontic treatment, the tooth requires a crown due to the large existing
restoration and fractured marginal ridge. Extraction is not first-line as the tooth is restorable.
Pulpectomy with SSC is appropriate for primary teeth, not permanent. Direct pulp cap is
contraindicated when pulp necrosis is present.
2. A patient with a history of infective endocarditis requires a dental extraction. According to the
2021 AHA guidelines, which of the following antibiotic regimens is recommended for prophylaxis?
A. Amoxicillin 2 g orally 30-60 minutes before procedure
B. Clindamycin 600 mg orally 1 hour before procedure
C. Cephalexin 2 g orally 30-60 minutes before procedure
D. Azithromycin 500 mg orally 1 hour before procedure
Answer: A
Rationale: Amoxicillin 2 g orally is the first-line recommended regimen for dental procedures in patients
with indications for prophylaxis. Clindamycin is an alternative for patients with penicillin allergy.
Cephalexin is not recommended due to cross-reactivity concerns. Azithromycin is not a standard
recommendation.
3. Which of the following periodontal conditions is most strongly associated with an increased risk
of adverse pregnancy outcomes such as preterm birth and low birth weight?
A. Gingivitis associated with dental plaque only
B. Chronic periodontitis with localized probing depths of 5-6 mm
C. Necrotizing ulcerative periodontitis
D. Periodontal abscess
Page 1
,Answer: B
Rationale: Chronic periodontitis, characterized by moderate to severe attachment loss and inflammation,
has been consistently linked to adverse pregnancy outcomes. Gingivitis alone is not strongly associated.
Necrotizing conditions are acute but less common. A periodontal abscess is a localized infection and not
typically linked to systemic pregnancy outcomes.
4. A patient presents with a painful, erythematous, and erosive lesion on the buccal mucosa
bilaterally. The lesions have a lacy white pattern at the periphery. The patient reports a history of
hepatitis C. Which of the following is the most likely diagnosis?
A. Lichen planus
B. Lupus erythematosus
C. Erythema multiforme
D. Pemphigus vulgaris
Answer: A
Rationale: Oral lichen planus typically presents with bilateral, reticular, white striae (Wickham striae)
and can be erosive. It is associated with hepatitis C infection. Lupus erythematosus often has discoid
lesions and is photosensitive. Erythema multiforme is acute with target lesions. Pemphigus vulgaris
presents with flaccid bullae and positive Nikolsky sign.
5. In a patient with a Class II Division 1 malocclusion, which of the following cephalometric
measurements is most likely to be increased?
A. ANB angle
B. SNB angle
C. FMA (Frankfort-mandibular plane angle)
D. IMPA (incisor mandibular plane angle)
Answer: A
Rationale: Class II Division 1 malocclusion is characterized by a retrognathic mandible or prognathic
maxilla, leading to an increased ANB angle (normal ~2°). SNB angle is decreased. FMA may be normal
or increased depending on vertical growth pattern. IMPA is often increased due to proclined incisors but
is not the most direct cephalometric indicator of the skeletal discrepancy.
6. A 6-year-old child presents with a fractured incisal edge of tooth #8 involving enamel and dentin,
with no pulpal exposure. Radiographs show no root fracture or periapical pathology. The tooth is
asymptomatic. Which of the following is the most appropriate management?
A. Place a stainless steel crown
B. Perform a pulpectomy and place a composite restoration
C. Restore with composite resin using adhesive techniques
D. Extract the tooth and place a space maintainer
Answer: C
Rationale: For a complicated crown fracture involving dentin without pulp exposure, composite resin
restoration is the standard of care in a primary or young permanent tooth. Stainless steel crowns are
used for posterior teeth or extensive caries. Pulpectomy is not indicated as pulp is not exposed.
Extraction is too aggressive for a restorable tooth.
Page 2
,7. A patient presents with a solitary radiolucency in the mandibular premolar region that is
well-defined with a sclerotic border. The lesion is asymptomatic and discovered on routine
panoramic radiograph. Vitality testing of adjacent teeth is normal. Which of the following is the
most likely diagnosis?
A. Odontogenic keratocyst
B. Ameloblastoma
C. Stafne bone cyst
D. Periapical cyst
Answer: C
Rationale: Stafne bone cyst (static bone cavity) is a developmental depression on the lingual surface of
the mandible, often in the premolar/molar region, appearing as a well-defined radiolucency with a
sclerotic border. It is asymptomatic and does not involve teeth. Odontogenic keratocyst and
ameloblastoma are more aggressive and may cause root resorption. Periapical cyst is associated with
nonvital teeth.
8. Which of the following local anesthetics has the longest duration of action when used for inferior
alveolar nerve block?
A. Lidocaine 2% with epinephrine 1:100,000
B. Mepivacaine 3% plain
C. Bupivacaine 0.5% with epinephrine 1:200,000
D. Articaine 4% with epinephrine 1:100,000
Answer: C
Rationale: Bupivacaine is a long-acting amide anesthetic with a duration of up to 6-8 hours for nerve
blocks. Lidocaine and articaine are intermediate-acting (2-4 hours). Mepivacaine plain is short-acting
(1-2 hours). Epinephrine prolongs duration but bupivacaine's inherent properties make it the longest.
9. A patient requires extraction of a mandibular third molar with a high risk of inferior alveolar
nerve injury due to root proximity. The surgeon decides to perform a coronectomy. Which of the
following is a contraindication to this procedure?
A. Presence of periapical pathology
B. Patient age over 40
C. Tooth is completely bony impacted
D. Roots are divergent
Answer: A
Rationale: Coronectomy (removal of crown only) is contraindicated when there is periapical infection, as
the retained roots may become a nidus for infection. Age over 40 is not a contraindication. Complete
bony impaction is often an indication. Divergent roots do not preclude coronectomy.
10. A dentist discovers that a patient has been receiving treatment from another dentist for the
same condition without the patient's disclosure. The dentist considers continuing treatment. Which
ethical principle is most directly challenged in this scenario?
A. Beneficence
Page 3
, B. Nonmaleficence
C. Patient autonomy
D. Veracity
Answer: C
Rationale: Patient autonomy involves the right to make informed decisions about their care, including the
choice of provider. The patient's failure to disclose concurrent treatment undermines the dentist's ability
to provide informed care and respects the patient's autonomy. Beneficence and nonmaleficence are also
relevant but the core issue is the patient's right to choose and the dentist's need for full information to
avoid harm.
11. In the context of dental caries risk assessment for an adult patient with xerostomia due to
medication, which combination of factors most robustly predicts future caries incidence according
to the Caries Management by Risk Assessment (CAMBRA) model?
A. Low salivary flow, high Streptococcus mutans count, and frequent sugar intake
B. Exposed root surfaces, low fluoride exposure, and poor oral hygiene
C. High Lactobacillus count, visible plaque, and previous restorations
D. Low socioeconomic status, infrequent dental visits, and high DMFT index
Answer: A
Rationale: CAMBRA emphasizes that the combination of biological risk factors (low salivary flow, high
mutans streptococci) and behavioral factors (frequent sugar intake) provides the strongest predictive
power for caries progression. Option B omits microbial factors, C omits salivary and sugar factors, and
D focuses on historical and demographic factors rather than modifiable risk indicators.
12. A 45-year-old patient presents with a well-defined radiolucency at the apex of tooth #19 that is
associated with a sinus tract. The patient reports no pain. Histological examination of the
periapical tissue shows granulation tissue with cholesterol clefts and hemosiderin deposition.
Which of the following is the most likely diagnosis?
A. Periapical granuloma
B. Radicular cyst
C. Periapical abscess
D. Focal cemento-osseous dysplasia
Answer: A
Rationale: Periapical granuloma is characterized by granulation tissue with cholesterol clefts and
hemosiderin, often asymptomatic with a sinus tract. Radicular cyst would show an epithelial lining;
abscess shows acute inflammation; cemento-osseous dysplasia is not associated with sinus tract and has
mixed radiolucent/radiopaque appearance.
13. Which of the following periodontal pathogens is most strongly associated with the pathogenesis
of aggressive periodontitis in systemically healthy individuals, and its presence is considered a
major diagnostic criterion?
A. Porphyromonas gingivalis
B. Aggregatibacter actinomycetemcomitans
C. Tannerella forsythia
Page 4
