ADEX CSCE OSCE Examination 2026/2027 –
Complete 150-Questions Actual Exam With Verified
Answers, Clinical Rationales, And Pass Guarantee
(Graded A+)
1. Periodontics – Staging/Grading
A 52-year-old patient with type 2 diabetes (HbA1c 8.2%) has probing depths of 5–
7 mm, clinical attachment loss of 4–5 mm, and radiographic bone loss of 30–50%
on six teeth. Three teeth have been lost due to periodontitis. What is the most
appropriate AAP/ADA periodontitis diagnosis?
A) Stage II, Grade B
B) Stage III, Grade C
C) Stage IV, Grade C
D) Stage III, Grade B
Answer: B
Rationale: Stage III is defined by CAL ≥5 mm, bone loss extending to middle third
of root, and possibility of tooth loss (≤4 teeth). Grade C indicates rapid
progression, associated with HbA1c >7% (uncontrolled diabetes). Stage IV would
involve more extensive tooth loss or masticatory dysfunction.
2. Ethics – Informed Consent
During a crown preparation, the patient asks, “Will this treatment definitely work
for 20 years?” The most appropriate ethical response is:
A) “Yes, with modern materials, crowns last a lifetime.”
B) “No dental procedure can be guaranteed, but crowns have a high success rate
if you maintain good oral hygiene.”
C) “I guarantee 20 years if you sign this waiver.”
D) “Let’s discuss that after the procedure is done.”
1|Page
,Answer: B
Rationale: Informed consent requires truthfulness and avoiding unrealistic
guarantees. Option B provides realistic expectations while acknowledging
individual variability. Guarantees (A, C) are unethical and legally problematic.
Delaying (D) violates patient autonomy.
3. Pharmacology – Anticoagulation
A patient on rivaroxaban 20 mg daily needs a simple extraction of a mobile tooth.
According to 2026 guidelines, what is the recommended management?
A) Stop rivaroxaban 48 hours before extraction.
B) Continue rivaroxaban; use local hemostatic measures.
C) Bridge with enoxaparin.
D) Check INR; if >1.5, postpone.
Answer: B
Rationale: Direct oral anticoagulants (DOACs) like rivaroxaban do not require
interruption for simple extractions when used at standard doses. Local measures
(gauze, tranexamic acid, sutures) are sufficient. INR is not relevant for DOACs.
Bridging increases bleeding risk without benefit.
4. Operative – Cavity Preparation
Which bur is specifically designed to create a reverse curve for a dovetail in a
Class II amalgam preparation?
A) 330
B) 245
C) 557
D) 701
Answer: A
Rationale: The #330 bur, with its conical shape and rounded end, is ideal for
creating the occlusal dovetail and reverse S-curve in a traditional Class II amalgam
preparation. #245 is for proximal box divergence; #557 is a straight fissure bur;
#701 is for slot preparations.
2|Page
,5. Rubber Dam – Isolation
You are placing a rubber dam for endodontic treatment on tooth #3. How many
teeth mesial to the clamp should be exposed to maintain stability and retraction?
A) 0
B) 1
C) 2
D) 3
Answer: C
Rationale: Standard rubber dam technique recommends exposing at least two
teeth on each side of the clamp when possible. For posterior teeth, exposing two
teeth mesial to the clamp provides better dam stability, prevents leakage, and
improves access.
6. Radiology – Pregnancy
A 28-week pregnant patient needs a periapical radiograph for a symptomatic
tooth #20. Which statement is correct regarding safety?
A) Any dental radiograph is contraindicated during pregnancy.
B) A single PA with a lead apron and thyroid collar is acceptable.
C) Panoramic radiography is preferred because it has lower fetal dose.
D) Delay radiography until postpartum regardless of symptoms.
Answer: B
Rationale: Dental radiographs are safe during pregnancy when proper shielding
(lead apron, thyroid collar) and collimation are used. Fetal exposure from a single
PA is negligible (<0.005 mGy). Panoramic has higher scatter. Delaying could lead
to infection or emergency.
7. Pulp Testing – Diagnosis
Cold test on tooth #14 produces a sharp pain that lingers for 45 seconds after
stimulus removal. The most likely pulpal diagnosis is:
3|Page
, A) Normal pulp
B) Reversible pulpitis
C) Irreversible pulpitis
D) Pulp necrosis
Answer: C
Rationale: Irreversible pulpitis is characterized by lingering pain (typically >10–30
seconds) after stimulus removal. Reversible pulpitis pain ceases immediately.
Normal pulp has mild/no pain. Necrosis gives no response.
8. Restorative – NCCL
A patient has multiple non-carious cervical lesions (NCCLs) with minimal dentin
exposure and high esthetic demand. Which material offers the best combination
of adhesion, fluoride release, and esthetics?
A) Amalgam
B) Resin-modified glass ionomer (RMGI)
C) Conventional glass ionomer
D) Composite resin without adhesive
Answer: B
Rationale: RMGI bonds chemically to tooth structure, releases fluoride, has
acceptable esthetics, and requires minimal preparation. Conventional GI has
poorer esthetics and wear resistance. Composite requires etching and bonding
but lacks fluoride release. Amalgam is unaesthetic.
9. Oral Pathology – Periapical Radiolucency
A 35-year-old has a 1.5 cm well-defined unilocular radiolucency at the apex of
#19. The tooth tests vital. The patient is asymptomatic. Most likely diagnosis:
A) Periapical granuloma
B) Radicular cyst
C) Periapical cemento-osseous dysplasia (PCOD)
D) Traumatic bone cyst
4|Page
Complete 150-Questions Actual Exam With Verified
Answers, Clinical Rationales, And Pass Guarantee
(Graded A+)
1. Periodontics – Staging/Grading
A 52-year-old patient with type 2 diabetes (HbA1c 8.2%) has probing depths of 5–
7 mm, clinical attachment loss of 4–5 mm, and radiographic bone loss of 30–50%
on six teeth. Three teeth have been lost due to periodontitis. What is the most
appropriate AAP/ADA periodontitis diagnosis?
A) Stage II, Grade B
B) Stage III, Grade C
C) Stage IV, Grade C
D) Stage III, Grade B
Answer: B
Rationale: Stage III is defined by CAL ≥5 mm, bone loss extending to middle third
of root, and possibility of tooth loss (≤4 teeth). Grade C indicates rapid
progression, associated with HbA1c >7% (uncontrolled diabetes). Stage IV would
involve more extensive tooth loss or masticatory dysfunction.
2. Ethics – Informed Consent
During a crown preparation, the patient asks, “Will this treatment definitely work
for 20 years?” The most appropriate ethical response is:
A) “Yes, with modern materials, crowns last a lifetime.”
B) “No dental procedure can be guaranteed, but crowns have a high success rate
if you maintain good oral hygiene.”
C) “I guarantee 20 years if you sign this waiver.”
D) “Let’s discuss that after the procedure is done.”
1|Page
,Answer: B
Rationale: Informed consent requires truthfulness and avoiding unrealistic
guarantees. Option B provides realistic expectations while acknowledging
individual variability. Guarantees (A, C) are unethical and legally problematic.
Delaying (D) violates patient autonomy.
3. Pharmacology – Anticoagulation
A patient on rivaroxaban 20 mg daily needs a simple extraction of a mobile tooth.
According to 2026 guidelines, what is the recommended management?
A) Stop rivaroxaban 48 hours before extraction.
B) Continue rivaroxaban; use local hemostatic measures.
C) Bridge with enoxaparin.
D) Check INR; if >1.5, postpone.
Answer: B
Rationale: Direct oral anticoagulants (DOACs) like rivaroxaban do not require
interruption for simple extractions when used at standard doses. Local measures
(gauze, tranexamic acid, sutures) are sufficient. INR is not relevant for DOACs.
Bridging increases bleeding risk without benefit.
4. Operative – Cavity Preparation
Which bur is specifically designed to create a reverse curve for a dovetail in a
Class II amalgam preparation?
A) 330
B) 245
C) 557
D) 701
Answer: A
Rationale: The #330 bur, with its conical shape and rounded end, is ideal for
creating the occlusal dovetail and reverse S-curve in a traditional Class II amalgam
preparation. #245 is for proximal box divergence; #557 is a straight fissure bur;
#701 is for slot preparations.
2|Page
,5. Rubber Dam – Isolation
You are placing a rubber dam for endodontic treatment on tooth #3. How many
teeth mesial to the clamp should be exposed to maintain stability and retraction?
A) 0
B) 1
C) 2
D) 3
Answer: C
Rationale: Standard rubber dam technique recommends exposing at least two
teeth on each side of the clamp when possible. For posterior teeth, exposing two
teeth mesial to the clamp provides better dam stability, prevents leakage, and
improves access.
6. Radiology – Pregnancy
A 28-week pregnant patient needs a periapical radiograph for a symptomatic
tooth #20. Which statement is correct regarding safety?
A) Any dental radiograph is contraindicated during pregnancy.
B) A single PA with a lead apron and thyroid collar is acceptable.
C) Panoramic radiography is preferred because it has lower fetal dose.
D) Delay radiography until postpartum regardless of symptoms.
Answer: B
Rationale: Dental radiographs are safe during pregnancy when proper shielding
(lead apron, thyroid collar) and collimation are used. Fetal exposure from a single
PA is negligible (<0.005 mGy). Panoramic has higher scatter. Delaying could lead
to infection or emergency.
7. Pulp Testing – Diagnosis
Cold test on tooth #14 produces a sharp pain that lingers for 45 seconds after
stimulus removal. The most likely pulpal diagnosis is:
3|Page
, A) Normal pulp
B) Reversible pulpitis
C) Irreversible pulpitis
D) Pulp necrosis
Answer: C
Rationale: Irreversible pulpitis is characterized by lingering pain (typically >10–30
seconds) after stimulus removal. Reversible pulpitis pain ceases immediately.
Normal pulp has mild/no pain. Necrosis gives no response.
8. Restorative – NCCL
A patient has multiple non-carious cervical lesions (NCCLs) with minimal dentin
exposure and high esthetic demand. Which material offers the best combination
of adhesion, fluoride release, and esthetics?
A) Amalgam
B) Resin-modified glass ionomer (RMGI)
C) Conventional glass ionomer
D) Composite resin without adhesive
Answer: B
Rationale: RMGI bonds chemically to tooth structure, releases fluoride, has
acceptable esthetics, and requires minimal preparation. Conventional GI has
poorer esthetics and wear resistance. Composite requires etching and bonding
but lacks fluoride release. Amalgam is unaesthetic.
9. Oral Pathology – Periapical Radiolucency
A 35-year-old has a 1.5 cm well-defined unilocular radiolucency at the apex of
#19. The tooth tests vital. The patient is asymptomatic. Most likely diagnosis:
A) Periapical granuloma
B) Radicular cyst
C) Periapical cemento-osseous dysplasia (PCOD)
D) Traumatic bone cyst
4|Page
