ADAT Practice Test: Study Notes

• These study notes are based on the Advanced Dental Admission Test (ADAT) Practice Test from the American Dental Association (ADA).
• The practice test includes sample questions covering various topics relevant to the ADAT.
• The ADA recommends textbooks and lecture notes as primary study sources.
• The included practice items are copyrighted property of the ADA, intended for educational purposes only.

Patient History & Organ Function

• A 45-year-old male patient with loose teeth and prolonged gingival bleeding, recent job loss, heavy drinking, and homelessness, may have compromised Liver function.

Surgical Risks - Parotid Gland

• Surgical procedures involving the parotid gland pose the greatest risk of damage to the retromandibular vein.

Epidermis Layers

• The stratum basale layer of the epidermis contains stem cells undergoing mitosis.

Chronic Sialadenitis

• Lymphocytes are the predominant inflammatory cells in chronic sialadenitis.

Bone Cells

• Osteoclasts secrete collagenase.

Hepatotoxicity

• Chloroform is highly toxic to hepatocytes.

Glucose & Protein Glycation

• The linear unbranched form of glucose is responsible for the glycation of proteins.

Small Intestine

• Circular folds, intestinal villi, and brush border in the small intestine maximize the surface area to aid digestion and absorption.

Diabetes & Stress

• In a 20-year-old male with uncontrolled type 1 diabetes who was recently hospitalized after an automobile accident and currently has aggressive periodontitis, elevated HbA1c, and radiographic evidence of alveolar bone loss, the stress of the accident might have decreased glucose control due to cortisol release.

Addison’s Disease

• Addison’s disease is characterized by hypofunction of the adrenal cortex.

Metabolic Defects

• High levels of fumarate, succinate, α-ketoglutarate citrate, and malate in a 3-month-old female with neurological defects indicates Fumarase deficiency.

Loose Teeth in Young Children

• In a 3-year-old female with normal dental root morphology, but with anterior teeth mobility and no history of facial injury, points to Hypophosphatasia.

Genetics

• Offspring of a genotypically normal mother and a father with an X-linked recessive disease will produce 100% carrier daughters.

Hemostasis

• During the hemostasis coagulation cascade, exposure of Factor III, a pericytes membrane protein, results in the initiation of the extrinsic pathway.

Cell Communication

• Proteins cannot be transported through gap junctions in the cell membrane.

Analgesia

• The analgesic effect of nitrous oxide results from activation of the opioid receptors.

Central Nervous System

• Oligodendrocytes produce myelin in the central nervous system.

Muscular Dystrophy

• Loss of muscle function in the jaw and shoulders is characteristic of facioscapulohumeral muscular dystrophy.

Antibodies Acting

• The presence of antibodies that act against acetylcholine receptors is characteristic of myasthenia gravis.

Myocardial Infarcts

• A common complication of large acute myocardial infarcts is pump or congestive heart failure.

Sickle Cell Anemia

• High oxygen tension does NOT exacerbate polymerization of hemoglobin in a patient with sickle cell anemia.

Allergic Reaction

• The following may provoke symptoms of nausea, dyspnea, and tingling around the lips, which are edematous: Increase in capillary permeability, Release of immunoglobulin E-mediated histamine, Type I allergic hypersensitivity reaction, but NOT Bronchodilation.

Maxillary Sinus Involvement

• Mucormycosis is known for its propensity for maxillary sinus involvement.

Gram-Negative Bacteria

• Endotoxin is the component of the outer membrane of gram-negative bacteria that stimulates the host immune response and causes tissue damage.

Hepatocyte Degeneration

• Hydropic degeneration of hepatocytes involves fluid and metabolite accumulation within the cell and water displacement of the endoplasmic reticulum.

Lip Biopsy

• Histological examination of a biopsy from a cyst taken from a lower lip reveals a cystic cavity filled with mucus and surrounded by a layer of granulation tissue is likely due to trauma to the minor salivary glands.

Inflammation

• C-reactive protein is the most reliable marker of inflammation.

Tuberculin Injection

• Cell-mediated (type IV) hypersensitivity is the underlying mechanism responsible for the development of an indurated area following a tuberculin injection.

Marfan Syndrome

• Marfan syndrome is caused by a mutation in the gene coding for the Fibrillin protein.

Systemic Sclerosis

• A 46-year-old female with sensitive teeth and bleeding gums, arthritis, multiple joint pain, pulmonary arterial hypertension and a systemic sclerosis diagnosis is at the highest risk for Secondary Sjögren.

Crohn's Disease

• Thickening of the bowel wall due to inflammation is a common complication of Crohn's disease.

Transverse Ridge

• Maxillary incisor does not have a transverse ridge.

Cingula Offset

• Maxillary central incisors and mandibular lateral incisors have their cingula offset to the distal.

Pulp Canal Space

• The best anatomical landmark to identify the location of the pulp canal space on tooth #6 is the cusp tip.

Retained Tooth

• In a 16-year-old female taking oral contraceptives with a retained tooth C and excellent home care, is likely due to impaction of tooth #6.

Pulpal Calcification

• Calcification within the pulpal space due to trauma or irritation follows a pattern from the coronal to the apex.

Class I Occlusion

• Tooth 19 usually occludes with teeth 13 and 14 in a Class I occlusion.

Malocclusion Type

• The malocclusion type is II when the facial cusp of tooth 28 contacts the mesial marginal ridge of tooth 4.

Maxillary Third Molars

• A small, calcified radiopaque mass distal to the maxillary third molar is most likely a distodens.

TMJ Clicking

• For an 18-year-old male with a non-painful clicking of the right TMJ, no history of prior symptoms, and stable occlusion, and reports the clicking is gone when seen at a recall appointment two weeks later, recommend advising gradual return to normal function.

Avulsed Tooth

• For a 12-year-old male with a complicated fracture of tooth #8 and avulsion of tooth #9, where the tooth is in water and the patient presents within 25 minutes of the incident, the priority is to reimplant and splint tooth 9.

Composite Resin

• A composite resin material with a lower viscosity would likely also have a higher polymerization shrinkage.

Gold Casting Alloy

• The addition of less than 50 atomic percent of copper to gold in the production of a gold casting alloy will achieve a decrease in the melting temperature.

Cervical Caries

• A 20-year-old female with a history of periodic pain associated with tooth #8 and a fistula in the buccal maxillary vestibule, with a current finding of a large cervical caries on tooth 8, large periapical radiolucency and biopsy revealed epithelium-lined cavity is likely a periapical cyst.

Denture Lesion

• For an 85-year-old female with well-fitting dentures, not disliking how her dentures look with moderate hypertension controlled with a calcium channel blocker and osteoarthritis as well as a right hip replacement, and has a lesion attached to the palatal tissue through a 10mm pedunculated base that has been manipulated and bled, the first step in management is to perform an excisional biopsy. The provisional diagnosis is inflammatory hyperplasia, and the dentist should fabricate a new denture following definitive removal of the lesion.

Oral Lesion

• A single, well-documented, circular, 4mm, brown, flat, non-palpable lesion on soft palate means the patient most likely has an oral melanotic macule.

Cranial Measurement

• A 12-year-old female with a cranial base length two standard deviations shorter than normal and all other cephalometric measurements within normal limits, is most likely to have Angle's Class III classification.

Erosive Lichen Planus

• Symptomatic erosive lichen planus is best treated with Topical Steroids

Pain Relief

• A 14-year-old female prescribed hydrocodone/acetaminophen for analgesia, but the patient reports inadequate relief after getting a molar pulled a week prior due to Juvenile rheumatoid arthritis and is currently taking Methotrexate (Rheumatrex ®) and Adalimumab (Humira ®) and also has Indundated swelling of submandibular space on the right side, Oral temp of 100.7 ° F, BP: 125/83 Heart Rate: 92 BPM, and Difficulty swallowing.. A generic polymorphism in drug-metabolizing enzymes is the most likely explanation.

Denture Fit

• A 65-year-old male taking a daily tricyclic antidepressant medication may be suffering from xerostomia, which may be contributing to the feeling like his dentures aren't fitting right.

Dental Implant Distance

• The ideal distance between the superior surface of the implant and the inferior portion of the gingival emergence position of the planned restoration is 2.5 to 3.0 mm.

Denture Fabrication

• Regarding occlusal plane establishment in complete denture fabrication, the mandibular first molar is usually at a level two-thirds of the way up the retromolar pad.

Randomized Controlled Trial

• For a study to be considered a randomized controlled trial, participants must be randomly assigned to experimental conditions.

Meta-Analysis Goal

• The goal of a meta-analysis is to summarize the results of multiple studies.

Crossover Trial

• For a study to be considered a crossover trial, each participant must experience multiple experimental conditions.

Power Analyses

• Power analyses are used to determine the number of participants needed for a study.

Diastolic Blood Pressure

• The first quartile of the distribution of diastolic blood pressure in a sample of 400 dental patients at 73.

Coronal Surfaces Statistic

• Based on the graph, the mean will have the highest value of number of coronal surfaces with active caries in a sample of 300 seniors.

Diagnostic Saliva Test

• The sensitivity of a diagnostic saliva test is 4/5.

Relative Risk

• Based on the table, the relative risk (RR) of dental implant failure associated with smoking is 2.0.

Hypothesis Testing

• The reader can conclude that the result was not statistically significant when the results of a hypothesis test indicate that the p-value is greater than the alpha level of 0.05.

Smoking and Implant Failure

• A study examined the relationship between smoking and dental implant failure in a sample of 300 patients and suggest that there is a relationship between smoking and implant failure.

Absolute Risk

• The absolute risk increase associated with diabetes is 5%, when the results indicated that the risk of periodontal disease was 10% for those with diabetes, and 5% for those without diabetes.

Hypothesis Plot

• Based on the plot, the relationship between diastolic blood pressure and mean pocked depth is nonlinear and gets stronger as diastolic blood pressure increases.

Causality

• Establishment of a causal relationship is NOT required in statistical hypothesis testing.

Confidence Interval

• A confidence interval for a treatment effect represents an interval estimate of the effect in the population.

Point Estimate

• Determination of a p-value is NOT required for confidence intervals.

Study Association

• None of the four studies found a statistically significant association; the overall association is not statistically significant.

Ethical Violations

• Beneficence is the ethical principle is involved in the dentist's decision to contact child protective services. Nonmaleficence is the ethical principle that has been violated when a dentist extracts the tooth of a patient with hemophilia A without obtaining a medical consultation because the extraction site immediately starts to bleed profusely and the bleeding cannot be stopped. Beneficence and autonomy are in conflict, when a patient wants a fractured tooth extracted but the dentist tells the patient that the tooth is restorable.

Manage Dental Anxiety

• Modeling is best exemplified when you allow the patient to observe another patient who is coping successfully with the procedure in managing a child patient's dental anxiety.

Prevention Success

• Patient success rates with preventive oral health behaviors, such as flossing, usually declines over time.

Antibiotic Regimen

• If initiation of endodontic therapy on tooth #30 provides no drainage, the dentist should prescribe an antibiotic regimen of Clindamycin (Cleocin ®).

Medicatios

• Metronidazole (Flagyl ®) should be avoided in a well-managed patient with bipolar disorder who is taking lithium because lithium toxicity and kidney damage can occur. A dentist should call the patient's physician to discuss the consultation and current guidelines, and then proceed with the extraction because the patient presents with a letter from her physician saying that she should discontinue use of clopidogrel for two days prior to extraction, but she has not stopped taking this medication. The patient has a history of atrial fibrillation and requires simple extraction of carious non-restorable tooth.

Hypothyroidism

• Risk of thyroid storm is NOT a concern related to treatment of a patient with hypothyroidism. Another concern is risk of bleeding.

Index

• df is the index that should be used for children only.

Infection Control

• Treat an HIV-positive and hepatitis C patient following universal precautions prior to extracting a tooth. Standard or universal precautions apply to infection control measures in the treatment of all patients in the dental office. Remove clothing and jewelry from the affected area if skin is exposed to a hazardous material, as this is the first thing you should do. As the capacity of a hazardous waste container approaches the fill line, it should be immediately exchanged, properly labeled, dated, and replaced.

Dental Care

• When a patient refuses scaling and root planing because insurance won't cover it and agrees to return in six months for an examination and prophylaxis with the hygienist, the dentist should refer the patient to a more cost-effective treatment facility.

Pulpal, Periapical Diagnosis

• Tooth 10 is asymptomatic and does not respond to pulp testing. It is necrotic pulp with chronic apical periodontitis for the pulpal and periapical diagnoses.

Pulpal Diagnosis

• The patient desires a tooth-colored restoration for tooth 3. Closed sandwich technique with glass ionomer on the gingival floor is the best method to restore this tooth.
• Tooth 3 approximates the pulp, responds normally to pulpal testing so the pulpal diagnosis is asymptomatic irreversible pulpitis .

Mandibular Incisal Cupping

• Clinical examination reveals mandibular incisal dentinal cupping. The likely cause of this finding is dietary acidic erosion.

Suspected Myopathy.

• During the examination if the patient complains of muscle pain, tenderness, and weakness, the most appropriate response is to refer the patient to her primary care physician for suspected myopathy.

Extraction of Tooth

• After extraction of tooth 11, the Kennedy classification is Class II modification I.

Trigeminal Neuralgia

• The patient reports an intense, unilateral, "electric" pain in his lower lip when shaving is trigeminal neuralgia.

Apex of Implant

• The minimum distance required between the apex of the implant and the inferior alveolar canal when placing an implant at site #19, is 2 mm.

Medication

• For the patient's pain, the referral to a pain specialist most likely lead to a Carbamazepine (Tegretol ®) prescription.

Radioloecent Lesion.

• A periapical abscess is NOT a possible differential diagnosis fo a radiolucent lesion apical to a vital tooth 30.

Angle's Class

• The Angle's classification of malocclusion for the patient is Class II division 2 malocclusion.

Bone Extraction

• The expected time-frame is 3 months for the majority of resorption to have occurred after an uncomplicated dental extraction in the absence of ridge preservation therapy.

Alveolar Bone Resporption

• The extraction will result in more bone resporption Buccally than lingually.

Bone Graft

• Lingualized crestal incision during healing abutment placement surgery is the best approach to provide adequate keratinized tissue for an implant restoration of site #19.

Approach to Implant Sugery

• The correct sequence of events to plan the implant surgery after the clinical examination is: working cast, cone beam computerized tomography, surgical guide.

Implant Considerations

• The mandibular posterior region doesn't have a cement-retained restoration is indicated for limited inter-arch distance and the minimal mesio-distal distance is 8 mm for a regular-diameter 4 mm implant, because it's most important to note that there is no benefit to platform switching.