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ADEX CSCE OSCE Exam 2026/2027 Actual Exam |
100 Actual Exam Questions with 100% Verified
Answers | Graded A+ & Updated to Latest Clinical
Standards | Pass Guaranteed - A+ Graded
Section 1: Patient Assessment and Diagnosis (20 Questions)
Q1: A 55-year-old patient presents for a comprehensive dental examination. The medical history
reveals hypertension controlled with lisinopril and type 2 diabetes managed with metformin. The
patient's blood pressure is 148/92 mmHg, and random blood glucose is 180 mg/dL. Which of the
following actions is MOST appropriate?
A. Proceed with dental treatment as planned
B. Defer elective dental treatment and refer for medical evaluation of blood pressure and glucose
control [CORRECT]
C. Administer local anesthesia with epinephrine and proceed
D. Prescribe antibiotics before any dental treatment
Correct Answer: B
Rationale: Uncontrolled hypertension (BP >140/90) and elevated blood glucose indicate poor
medical management. Elective dental treatment should be deferred until medical optimization.
Option A ignores medical risks. Option C could exacerbate hypertension. Option D is not
indicated without infection.
Q2: A 65-year-old patient reports taking bisphosphonates orally for osteoporosis for the past 3
years. The patient requires a tooth extraction. Which of the following is the MOST important
consideration?
A. The patient should stop bisphosphonates 1 week before extraction
B. Risk of medication-related osteonecrosis of the jaw (MRONJ) [CORRECT]
C. Bisphosphonates have no effect on dental treatment
D. Antibiotic prophylaxis is required for all extractions
Correct Answer: B
Rationale: Oral bisphosphonates increase the risk of MRONJ, though risk is lower than with IV
bisphosphonates. Option A is incorrect—discontinuing oral bisphosphonates does not eliminate
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risk and should be discussed with the physician. Option C is false. Option D is not routinely
indicated.
Q3: A panoramic radiograph reveals a well-defined, corticated radiolucency surrounding the
crown of an unerupted mandibular third molar. This finding is consistent with:
A. Periapical cyst (radicular cyst)
B. Dentigerous cyst [CORRECT]
C. Odontogenic keratocyst
D. Ameloblastoma
Correct Answer: B
Rationale: A dentigerous cyst (follicular cyst) surrounds the crown of an unerupted tooth,
attached at the cementoenamel junction. Option A (periapical cyst) is at the apex of a non-vital
tooth. Option C (OKC) may be multilocular. Option D (ameloblastoma) is often multilocular and
aggressive.
Q4: A patient presents with a 3-day history of swelling, pain, and purulent drainage from the
gingival margin of tooth #19. Probing depths are 8 mm with bleeding on probing. Radiograph
shows moderate bone loss. The MOST likely diagnosis is:
A. Periapical abscess
B. Periodontal abscess [CORRECT]
C. Pericoronitis
D. Gingival abscess
Correct Answer: B
Rationale: Periodontal abscess presents with localized swelling, purulent drainage, deep probing
depths, and bone loss associated with periodontitis. Option A (periapical) would show periapical
radiolucency. Option C (pericoronitis) involves an operculum over a partially erupted tooth.
Option D (gingival) is confined to gingiva without attachment loss.
Q5: A 42-year-old patient presents with a painless, slowly growing swelling in the floor of the
mouth. The swelling is fluctuant and moves with tongue protrusion. The MOST likely diagnosis
is:
A. Sialolithiasis with secondary infection
B. Ranula [CORRECT]
C. Ludwig's angina
,3
D. Squamous cell carcinoma
Correct Answer: B
Rationale: A ranula is a mucous extravasation phenomenon from the sublingual gland, presenting
as a painless, fluctuant swelling in the floor of mouth that moves with tongue protrusion. Option
A (sialolithiasis) typically presents with pain during eating. Option C (Ludwig's angina) is a
bilateral, painful cellulitis. Option D would present with ulceration or induration.
Q6: During an extraoral examination, a firm, non-tender lymph node is palpated in the left
submandibular region. The patient has a non-vital maxillary left first molar with a periapical
radiolucency. The MOST appropriate management is:
A. Observation of the lymph node
B. Antibiotic therapy only
C. Endodontic treatment or extraction of the associated tooth [CORRECT]
D. Biopsy of the lymph node
Correct Answer: C
Rationale: A reactive lymph node secondary to dental infection requires treatment of the source
(the non-vital tooth). Option A ignores the source of infection. Option B provides temporary
relief but not definitive treatment. Option D is unnecessary for a reactive node.
Q7: A patient presents with burning mouth sensation, xerostomia, and angular cheilitis.
Laboratory tests reveal low hemoglobin and elevated MCV. The MOST likely systemic condition
is:
A. Diabetes mellitus
B. Vitamin B12 deficiency or pernicious anemia [CORRECT]
C. Hyperthyroidism
D. Hypertension
Correct Answer: B
Rationale: Burning mouth, xerostomia, angular cheilitis, macrocytic anemia (elevated MCV),
and low hemoglobin are classic for vitamin B12 deficiency. Option A presents with different oral
findings (periodontal disease, candidiasis). Option C causes different symptoms. Option D has
minimal oral manifestations.
Q8: A panoramic radiograph shows a multilocular radiolucency extending from the mandibular
left first molar to the angle of the mandible, with "soap bubble" or "honeycomb" internal
structure. The MOST likely diagnosis is:
, 4
A. Dentigerous cyst
B. Odontogenic keratocyst
C. Ameloblastoma [CORRECT]
D. Central giant cell granuloma
Correct Answer: C
Rationale: Ameloblastoma characteristically presents as a multilocular radiolucency with "soap
bubble" or "honeycomb" appearance, often in the posterior mandible. Option A is unilocular and
associated with impacted teeth. Option B can be multilocular but less commonly shows the
classic soap bubble pattern. Option D occurs in younger patients.
Q9: A patient reports taking warfarin (Coumadin) 5 mg daily for atrial fibrillation. The patient's
INR is 3.2. Which dental procedure can be safely performed without altering the anticoagulant
regimen?
A. Multiple surgical extractions with flap elevation
B. Simple extraction of a single tooth with local hemostatic measures [CORRECT]
C. Full-mouth periodontal surgery
D. Alveoloplasty
Correct Answer: B
Rationale: Simple dental extractions can be performed safely with INR up to 3.5-4.0 with local
hemostatic measures (sutures, gauze pressure, hemostatic agents). Options A, C, and D involve
more extensive surgery and may require consultation with the physician.
Q10: A 35-year-old patient presents with generalized gingival inflammation, bleeding on
probing, and pseudomembrane formation. The patient reports severe pain and "metallic taste."
Necrosis of the interdental papillae is observed. The MOST likely diagnosis is:
A. Chronic gingivitis
B. Necrotizing ulcerative gingivitis (NUG) [CORRECT]
C. Periodontitis
D. Desquamative gingivitis
Correct Answer: B
Rationale: NUG (trench mouth) is characterized by necrosis of interdental papillae,
pseudomembrane, severe pain, metallic taste, and bleeding. Option A lacks necrosis and severe
ADEX CSCE OSCE Exam 2026/2027 Actual Exam |
100 Actual Exam Questions with 100% Verified
Answers | Graded A+ & Updated to Latest Clinical
Standards | Pass Guaranteed - A+ Graded
Section 1: Patient Assessment and Diagnosis (20 Questions)
Q1: A 55-year-old patient presents for a comprehensive dental examination. The medical history
reveals hypertension controlled with lisinopril and type 2 diabetes managed with metformin. The
patient's blood pressure is 148/92 mmHg, and random blood glucose is 180 mg/dL. Which of the
following actions is MOST appropriate?
A. Proceed with dental treatment as planned
B. Defer elective dental treatment and refer for medical evaluation of blood pressure and glucose
control [CORRECT]
C. Administer local anesthesia with epinephrine and proceed
D. Prescribe antibiotics before any dental treatment
Correct Answer: B
Rationale: Uncontrolled hypertension (BP >140/90) and elevated blood glucose indicate poor
medical management. Elective dental treatment should be deferred until medical optimization.
Option A ignores medical risks. Option C could exacerbate hypertension. Option D is not
indicated without infection.
Q2: A 65-year-old patient reports taking bisphosphonates orally for osteoporosis for the past 3
years. The patient requires a tooth extraction. Which of the following is the MOST important
consideration?
A. The patient should stop bisphosphonates 1 week before extraction
B. Risk of medication-related osteonecrosis of the jaw (MRONJ) [CORRECT]
C. Bisphosphonates have no effect on dental treatment
D. Antibiotic prophylaxis is required for all extractions
Correct Answer: B
Rationale: Oral bisphosphonates increase the risk of MRONJ, though risk is lower than with IV
bisphosphonates. Option A is incorrect—discontinuing oral bisphosphonates does not eliminate
,2
risk and should be discussed with the physician. Option C is false. Option D is not routinely
indicated.
Q3: A panoramic radiograph reveals a well-defined, corticated radiolucency surrounding the
crown of an unerupted mandibular third molar. This finding is consistent with:
A. Periapical cyst (radicular cyst)
B. Dentigerous cyst [CORRECT]
C. Odontogenic keratocyst
D. Ameloblastoma
Correct Answer: B
Rationale: A dentigerous cyst (follicular cyst) surrounds the crown of an unerupted tooth,
attached at the cementoenamel junction. Option A (periapical cyst) is at the apex of a non-vital
tooth. Option C (OKC) may be multilocular. Option D (ameloblastoma) is often multilocular and
aggressive.
Q4: A patient presents with a 3-day history of swelling, pain, and purulent drainage from the
gingival margin of tooth #19. Probing depths are 8 mm with bleeding on probing. Radiograph
shows moderate bone loss. The MOST likely diagnosis is:
A. Periapical abscess
B. Periodontal abscess [CORRECT]
C. Pericoronitis
D. Gingival abscess
Correct Answer: B
Rationale: Periodontal abscess presents with localized swelling, purulent drainage, deep probing
depths, and bone loss associated with periodontitis. Option A (periapical) would show periapical
radiolucency. Option C (pericoronitis) involves an operculum over a partially erupted tooth.
Option D (gingival) is confined to gingiva without attachment loss.
Q5: A 42-year-old patient presents with a painless, slowly growing swelling in the floor of the
mouth. The swelling is fluctuant and moves with tongue protrusion. The MOST likely diagnosis
is:
A. Sialolithiasis with secondary infection
B. Ranula [CORRECT]
C. Ludwig's angina
,3
D. Squamous cell carcinoma
Correct Answer: B
Rationale: A ranula is a mucous extravasation phenomenon from the sublingual gland, presenting
as a painless, fluctuant swelling in the floor of mouth that moves with tongue protrusion. Option
A (sialolithiasis) typically presents with pain during eating. Option C (Ludwig's angina) is a
bilateral, painful cellulitis. Option D would present with ulceration or induration.
Q6: During an extraoral examination, a firm, non-tender lymph node is palpated in the left
submandibular region. The patient has a non-vital maxillary left first molar with a periapical
radiolucency. The MOST appropriate management is:
A. Observation of the lymph node
B. Antibiotic therapy only
C. Endodontic treatment or extraction of the associated tooth [CORRECT]
D. Biopsy of the lymph node
Correct Answer: C
Rationale: A reactive lymph node secondary to dental infection requires treatment of the source
(the non-vital tooth). Option A ignores the source of infection. Option B provides temporary
relief but not definitive treatment. Option D is unnecessary for a reactive node.
Q7: A patient presents with burning mouth sensation, xerostomia, and angular cheilitis.
Laboratory tests reveal low hemoglobin and elevated MCV. The MOST likely systemic condition
is:
A. Diabetes mellitus
B. Vitamin B12 deficiency or pernicious anemia [CORRECT]
C. Hyperthyroidism
D. Hypertension
Correct Answer: B
Rationale: Burning mouth, xerostomia, angular cheilitis, macrocytic anemia (elevated MCV),
and low hemoglobin are classic for vitamin B12 deficiency. Option A presents with different oral
findings (periodontal disease, candidiasis). Option C causes different symptoms. Option D has
minimal oral manifestations.
Q8: A panoramic radiograph shows a multilocular radiolucency extending from the mandibular
left first molar to the angle of the mandible, with "soap bubble" or "honeycomb" internal
structure. The MOST likely diagnosis is:
, 4
A. Dentigerous cyst
B. Odontogenic keratocyst
C. Ameloblastoma [CORRECT]
D. Central giant cell granuloma
Correct Answer: C
Rationale: Ameloblastoma characteristically presents as a multilocular radiolucency with "soap
bubble" or "honeycomb" appearance, often in the posterior mandible. Option A is unilocular and
associated with impacted teeth. Option B can be multilocular but less commonly shows the
classic soap bubble pattern. Option D occurs in younger patients.
Q9: A patient reports taking warfarin (Coumadin) 5 mg daily for atrial fibrillation. The patient's
INR is 3.2. Which dental procedure can be safely performed without altering the anticoagulant
regimen?
A. Multiple surgical extractions with flap elevation
B. Simple extraction of a single tooth with local hemostatic measures [CORRECT]
C. Full-mouth periodontal surgery
D. Alveoloplasty
Correct Answer: B
Rationale: Simple dental extractions can be performed safely with INR up to 3.5-4.0 with local
hemostatic measures (sutures, gauze pressure, hemostatic agents). Options A, C, and D involve
more extensive surgery and may require consultation with the physician.
Q10: A 35-year-old patient presents with generalized gingival inflammation, bleeding on
probing, and pseudomembrane formation. The patient reports severe pain and "metallic taste."
Necrosis of the interdental papillae is observed. The MOST likely diagnosis is:
A. Chronic gingivitis
B. Necrotizing ulcerative gingivitis (NUG) [CORRECT]
C. Periodontitis
D. Desquamative gingivitis
Correct Answer: B
Rationale: NUG (trench mouth) is characterized by necrosis of interdental papillae,
pseudomembrane, severe pain, metallic taste, and bleeding. Option A lacks necrosis and severe
