2026 | 100 Advanced Questions &
Answers with Detailed Rationales |
CITA Dental Licensing Exam Prep &
Study Guide
1. A patient presents for a Class II composite restoration on a mandibular first
molar. After caries removal, the remaining dentin is very thin over the pulp,
but there is no pulpal exposure and the tooth is asymptomatic. Which
approach is most appropriate?
A. Complete removal of all affected dentin until hard dentin is present
everywhere
B. Place calcium hydroxide over the entire preparation and restore with amalgam
C. Use selective caries removal near the pulp and place an appropriate protective
liner/base only when indicated
D. Perform an immediate pulpectomy before restoration
Answer: Use selective caries removal near the pulp and place an appropriate
protective liner/base only when indicated.
,Rationale: Selective caries removal can reduce the risk of pulp exposure in a
deep lesion while preserving tooth structure. Modern adhesive restorations
generally do not require routine placement of calcium hydroxide or bases
throughout deep preparations.
2. During preparation for an indirect posterior restoration, the operator
creates an excessively sharp internal line angle. What is the principal
concern?
A. Increased enamel rod orientation
B. Stress concentration within the restoration and tooth
C. Increased fluoride uptake
D. Improved retention
Answer: Stress concentration within the restoration and tooth.
Rationale: Rounded internal line angles reduce stress concentration and
improve the adaptation and fracture resistance of many indirect restorations.
3. A patient has a deep carious lesion with spontaneous lingering pain to cold
and a history of nocturnal pain. Percussion is mildly positive. Which pulpal
diagnosis is most likely?
A. Normal pulp
B. Reversible pulpitis
C. Symptomatic irreversible pulpitis
D. Pulpal necrosis without apical disease
Answer: Symptomatic irreversible pulpitis.
Rationale: Spontaneous, lingering, and nocturnal pain are classic findings
associated with irreversible pulpal inflammation. Percussion indicates possible
associated apical periodontal inflammation.
4. A mandibular molar requires a full-coverage crown. Which finish-line design
generally provides appropriate space for a metal-ceramic restoration while
preserving tooth structure?
,A. Knife-edge margin in all areas
B. Deep chamfer or rounded shoulder appropriate to the restorative material
C. Flat horizontal butt joint without reduction
D. Reverse bevel only
Answer: Deep chamfer or rounded shoulder appropriate to the restorative
material.
Rationale: The finish line must provide adequate restorative material thickness
while minimizing unnecessary tooth reduction. The exact design depends on the
restorative material and location.
5. A patient develops sensitivity after placement of a posterior composite
restoration. Occlusion is normal, and the sensitivity occurs primarily with
cold and resolves quickly. What is the most likely explanation?
A. Immediate pulpal necrosis
B. Postoperative dentin sensitivity
C. Acute apical abscess
D. Vertical root fracture
Answer: Postoperative dentin sensitivity.
Rationale: Short, nonlingering sensitivity after adhesive restoration may result
from dentinal fluid movement, polymerization stress, marginal leakage, or
technique-related factors. Persistent or spontaneous symptoms warrant further
evaluation.
6. During crown preparation, the occlusal reduction is inadequate for a
ceramic restoration. What is the most likely consequence?
A. Improved fracture resistance
B. Increased risk of restoration fracture or excessive occlusal anatomy
C. Increased periodontal attachment
D. Reduced need for retention
Answer: Increased risk of restoration fracture or excessive occlusal anatomy.
, Rationale: Restorative materials require sufficient thickness for strength and
proper anatomy. Inadequate reduction can result in thin material or
overcontoured restoration.
7. A patient has a mandibular first molar with a large existing restoration and
a visible crack extending toward the pulp. The tooth has pain on biting and
release. Which condition should be strongly considered?
A. Cracked tooth syndrome
B. Dentinogenesis imperfecta
C. External cervical resorption
D. Hypercementosis
Answer: Cracked tooth syndrome.
Rationale: Pain on biting or, particularly, release of biting pressure is
characteristic of a cracked tooth. Diagnosis may require transillumination, bite
testing, magnification, and periodontal probing.
8. Which radiographic finding most strongly suggests chronic apical
periodontitis associated with pulpal necrosis?
A. Intact lamina dura with normal PDL width
B. Well-defined periapical radiolucency
C. Generalized horizontal bone loss
D. Enlarged coronal pulp chamber
Answer: Well-defined periapical radiolucency.
Rationale: A persistent periapical radiolucency associated with a nonvital tooth
is strongly suggestive of apical periodontitis resulting from pulpal necrosis.
9. When placing a rubber dam for a mandibular molar restoration, which is a
major advantage?
A. It eliminates the need for local anesthesia
B. It provides moisture control and protects the airway