Practical Exam Handbook 2014

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Practical Examination Handbook 2014


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Copyright 2012

This work is copyright 2012. Copyright isheld by the Australian Dental Council Ltd.

It may not be reproduced for commercialuse or sale. Reproduction requires a licenceor written permission which may be obtainedfrom:

Australian Dental Council LtdPo Box 13278Law Courts Victoria 8010

Australia

Tel +61 (0) 3 9657 1777www.adc.org.au
http://www.adc.org.au/http://www.adc.org.au/http://www.adc.org.au/


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Australian Dental Council

Contents

PAGE

INTRODUCTION................................................................................................... 5VENUE ALLOCATIONS AND REQUIREMENTS............................................... 5REGISTRATION AND OTHER DENTAL BOARD REQUIREMENTS.............. 6CANDIDATE CONTACT INFORMATION........................................................... 6WITHDRAWING FROM AN EXAMINATION...................................................... 6CONTENT AND FORMAT.................................................................................... 7EXAMINATION SCHEDULE................................................................................ 7EXAMINATION REGISTRATION......................................................................... 8EQUIPMENT, INSTRUMENTS AND SUPPLIES .................................................... 8EXAMINATION INSTRUCTIONS......................................................................... 8EXAMINATION CONDUCT POLICY................................................................. 11TIME EXTENSION POLICY................................................................................ 12ADVERSE INCIDENT POLICY.......................................................................... 12ASSESSMENT TASKS....................................................................................... 13ASSESSMENT CRITERIA .................................................................................... 13

Grade Derivation Grid ........................................................................................................ 14Final Result Grade Derivation Grid (12 requirements) ................................................... 14

ASSESSMENT CRITERIA .................................................................................... 15Class II Amalgam Cavity Preparation ............................................................................... 15Class III Composite Cavity Preparation ........................................................................... 16Full Metal Crown Preparation............................................................................................ 17Metal-ceramic Crown Preparation .................................................................................... 18Endodontic Access Preparation ....................................................................................... 19


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Provisional Crown Restoration ......................................................................................... 20Class II Composite Resin Restoration ............................................................................. 21Class IV Composite Resin Restoration ............................................................................ 22Class II Amalgam Restoration........................................................................................... 23Radiographic exercise ....................................................................................................... 24Rubber Dam Application ................................................................................................... 25Record of Procedures ........................................................................................................ 26Infection Control ................................................................................................................. 27

RESULTS.............................................................................................................. 29VERIFICATION, REVIEW AND APPEAL ............................................................. 29REPEATS ............................................................................................................. 29


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Introduction

This information has been prepared for candidates of the Australian Dental Council (ADC)Practical Examination. The information booklet should be used in conjunction with theinformation on the ADC website.

Under the provisions of the Health Practitioner Regulation National Law Act 2009 the

Australian Dental Council (ADC) has been assigned the accreditation functions for theDental Board of Australia.One of the key accreditation functions is the assessment of theknowledge, judgement, clinical skills and professional attributes of overseas qualifieddentists who are seeking registration with the Dental Board of Australia to practise in

Australia and whose qualifications are not otherwise approved for registration.

ADC is the national assessment authority by the Department of Immigration And Citizenshipto assess professional skills for migration purposes.

The ADC assessment and examination procedure consists of the following steps:

1. Initial Assessment of Professional Qualifications in Dentistry

2. Written Examination

3. Practical Examination

The format of the ADC examination process has been approved for the purposes ofregistration in Australia. The ADC cannot vary the format of the examination, or grantexemptions from the requirements of the examinations.

Venue Allocations and Requirements

The Practical Examination is held over two days at various venues in Australia. They areheld twice per year, in June and November. To be eligible to sit the Practical Examination,candidates must have a valid and current English language test results at the required leveland have passed the Written Examination within the three years prior to the examinationclosing date.

Candidates can apply to sit either the June or the November Practical Examination.Candidates will select the venue that they wish to sit the examination using the online portalon the ADC website (www.adc.org.au), and then must submit an application form andthe relevant examination fee before the venue booking is confirmed.

After successful submission of an application form, candidates will receive confirmation oftheir allocation to the examination, and also receive an information pack relevant to their

particular venue. The venues in which the ADC examinations are held are usually clinicswithin dental hospitals or university dental schools. Each venue has its own requirementsthat must be met by ADC candidates.
http://www.dentalboard.gov.au/http://www.adc.org.au/http://www.adc.org.au/http://www.adc.org.au/http://www.adc.org.au/http://www.dentalboard.gov.au/


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Registration and other Dental Board of Australia Requirements

Previously, the Dental Board of Australia (DBA) required all candidates to be registered inorder to undertake an ADC Practical Examination. Since the examination no longer involvesthe treatment of patients, this is no longer a requirement for candidates. Similarly,

candidates are no longer required to provide evidence of immune status but will berequired to have ascertained this before being registered.

The ADC and the DBA will share candidate information where it is necessary for the properfunctioning of the examination. This may include: candidate contact details, names ofcandidates listed for particular examination sessions, information relating to professionalindemnity insurance, names of candidates with limited registration for examinationpurposes.

Following the examinations, the ADC provides the DBA with the name and details ofcandidates who have successfully completed the Practical Examination and been awardedtheADC Certificate (General Dentist).

Candidate Contact Information

Candidates must notify the ADC of any change in mailing address immediately in writing.Information may not be reissued to candidates who fail to advise the ADC or employ asuitable mail redirection service from their previous address.

Timetables and urgent information may be communicated to you via your nominated emailaddress. Please ensure the email address you provide is reliable and checked regularly.Candidates who use free webmail services (Gmail, Yahoo, Hotmail, etc) should properlymaintain their mailboxes. The ADC will not accept responsibility for non-receipt of correctlyaddressed emails.

Withdrawing from an Examination

Candidates withdrawing from an examination should contact the ADC in writing. Anintention to withdraw can be sent by email if the date of the examination is imminent and awithdrawal letter, together with any supporting documentation, has been posted to the ADC.Withdrawal notification will not be accepted by telephone.

The ADCs response will be madeto the candidate in writing.

Candidates will forfeit 20% of their examination fees if their withdrawal from an examinationis received before the closing date for that examination series.

Those candidates whose withdrawal is received after the closing date for the examinationseries will forfeit 50% of their examination fees.

Candidates who withdraw within four weeks of the examination date will forfeit the wholefee unless their withdrawal is due to acceptable medical grounds, supported by a medicalcertificatein which case they forfeit 40% of the fee.

Failure to undertake the examination because of an inability to obtain necessary visas or toarrange travel, etc will be considered a withdrawal and fees will be forfeited.


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Content and Format

During the two day Practical Examination, participants will be evaluated on theirperformance of dental procedures on simulated patients (manikins) in a clinical setting.Each day participants will be issued a:

1. Typodont model mounted in a manikin on a dental chair. The typodont will belabelled with the participants ID number.

2. Selected teeth for practice preparations.

3. Detailed list of required procedures for that day specifying tooth numbers andsurfaces.

4. Scheduled time to perform the Rubber Dam, Communication and/or Radiologytasks.

Examination Schedule

The following is an indicative schedule for the Practical Examination. More detailedinformation will be provided to candidates who enrol for the examination.

TRANSITIONAL WRITTEN EXAM (Friday before the Practical Examination)

For those candidates who have passed the Written (Preliminary) Examination prior to2014.

Validation of registration 8:30 a.m. - 9:00 a.m.

Transitional exam 10:00 a.m. - 12:00 noon

ORIENTATION (Friday before the Saturday examinations commence)

Orientation lecture 2:00 p.m.3:00 p.m.

Hand-in sterilised instruments 3:00 p.m. - 4:00 p.m.

DAY 1


Orientation and instructions 8:00 a.m. - 8:30 a.m.

Set up 8:30 a.m. - 9:00 a.m.

Clinical procedures on simulated patients 9:00 a.m. - 4:30 p.m.

DAY 2


Set up 8:30 a.m.9:00 a.m.

Clinical procedures on simulated patients 9:00 a.m. - 4:30 p.m.


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Examination Registration

During the validation of registration participants will be issued an Identification (ID) badge.To receive the ID badge, participants will be required to show current government photoidentification (i.e. a current passport or drivers licence) for comparison to the ID badge.The participants name on the government photo identification must match the name usedby the participant to register with the ADC for the Practical Examination. Participants who

do not provide government photo identification will not be admitted into the examination.

Participants must have their ID badge visible at all times and must submit them as directedat the end of the Assessment. Participants who fail to submit their ID badge may receive afail grade for all requirements in the Assessment.

Equipment, Instruments and Supplies

Standard equipment and materials will be provided for these exercises, howevercandidates may supply their own items of appropriate equipment if they prefer.

Information regarding hand-piece configuration (connectors) at each centre will beforwarded to participants prior to the Assessment. Candidates are personally responsiblefor any damage to the fittings and couplings that occur as a result of providing andattempting to use poorly fitting attachments and candidates will be liable to meet allassociated repair costs.

Please note that dental burs will not be provided. Candidates are required to bring allrelevant burs to the exam.

The dental clinic at the Assessment Centre will NOT be accessible prior to theAssessment.

Examination Instructions

1. At the beginning of each day, the list of tasks for the day will be distributed. Therewill be three timetabled assessment tasksRubber Dam, Radiographs andCommunication. Candidates will be allocated 30 minutes for the Rubber Dam taskon one day, and will be allocated 15 minutes each for the Radiograph task and theCommunication task on the other day. Candidates may perform the otherrequirements for the day in any order.

2. Participants are not permitted to remove teeth from typodonts, nor are they permittedto remove typodonts from the manikins.

3. If there are problems with any of the teeth, typodonts or manikins, candidates should

bring this to the attention of the examination convenor to rectify if necessary.

If a candidate experiences an adverse incident during the examination, it is theirresponsibility to bring it to the attention of one of the invigilators immediately. Theinvigilator can then complete an Adverse Incident form. The ADC will not be able totake into consideration any adverse incidents that are reported to the ADC after theexamination.

4. Participants are not permitted to have extra typodont teeth in the Assessment area.


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5. Participants must wear eye protection, masks and gloves whilst undertaking anysimulated clinical activity.

6. Participants may use magnification aids and may take breaks whenever needed.

7. Participants who start or complete a procedure other than an identified requirementon an identified tooth or practice tooth will receive a fail grade for that requirement.

8. Participants are responsible for their own instruments and supplies. The ADC andthe Assessment Centre will not be held responsible for instruments or personalsupplies left unattended.

9. Participants are financially responsible for any damage caused to any suppliedequipment.

10. During the Assessment, participants must demonstrate competency in performingprocedures in a clinical environment. Although there are no criteria for evaluatingthe posture of a participant, procedures must be performed in anatomicallyacceptable positions. Invigilators will direct participants to correct unacceptablepositions. Any participant who continues to work with the manikin in anunacceptable position may be dismissed from the Assessment. Examples ofunacceptable positions include:

the manikinshead positioned so that a patient would be uncomfortable

the manikins neck extended so that a patient would be uncomfortable

the participant inappropriately leaning on or contacting the patients torso orhead.

11. The typodont models used for the restorative exercises are 860 models fromColumbia Dentoform. A variety of teeth may be used, some of which are plainIvorine, and others with simulated enamel/dentine. Some of the simulatedenamel/dentine teeth may also have simulated caries.

Plain Ivorine: These teeth are of uniform colour and consistency.

Simulated enamel: The simulated enamel is white in colour and is made ofcomposite resin that is harder than the simulated dentine and simulatedcaries. The teeth have been manufactured so that procedures may be performedusing normalpressure with a dental bur and, if desired, finishing can be doneusing normalpressure with sharphand instruments.

Simulateddentine: The simulated dentine is yellow in colour and is softer thanthe simulated enamel

Simulated caries:Currently we are using two forms of teeth that have simulatedcaries present. Some have simulated caries placed by the manufacturers andsome are pre-prepared and filled with Cavit to simulate caries. For thoseenamel/dentine teeth with simulated caries the manufacturing process ensures

that the caries depth is standardized for each tooth used. The simulated caries indentine is greyin colour and is softer than the simulated enamel but of similarhardness to the simulated dentine. In anterior teeth, there is also a cavitation(hole) in the simulated enamel on the adjacent proximal surface(s). Thiscavitation extends through the simulated enamel into the simulated dentine andmust be included as part of the preparation.

Simulated pulp chamber and canals: The simulated dental pulp chamber andcanals are hollow spaces lined with red colouring.


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The manufacturing process for teeth with simulated caries ensures that cariesdepth is standardized for each tooth used as part of the Assessment. As a resultof the manufacturing process, there may be a small cement-filled space betweenthe simulated enamel and the simulated dentin which may appear grey in colour.This is not simulated caries.

Please Note: The use of metal hand instruments in cavity preparations will leavea grey stain.

12. The FDI two digit tooth numbering system (below) is used for all Assessments.

FDI NUMBERING SYSTEM

PERMANENT DENTITION

18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

RIGHT LEFT

PRIMARY DENTITION

RIGHT LEFT

55 54 53 52 51 61 62 63 64 65

85 84 83 82 81 71 72 73 74 75


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Examination Conduct Policy

Candidates will be required to sign and return a statement indicating that they have readand understood the following Examination Conduct Policy, and agree to abide by thefollowing conditions of the examination:

1. Participants must be punctual for both days of the examination. Participants

arriving late for an examination WILL NOTbe given any extra time to completethe examination.2. The dental clinic at the Examination Centre WILL NOTbe accessible prior to

the examination.3. Space at the Examination Centre is provided ONLYfor participants. Family

and friends will not be admitted.4. Standard equipment and materials will be provided for the examination

exercises, however candidates may supply their own items of appropriateequipment if they prefer. Candidates who wish to supply their own equipmentMUST check with the allocated examination venue prior to commencement ofthe examination regarding the venues requirements.

5. Information regarding hand-piece configuration (connectors) at each centre will

be forwarded to participants prior to the examination. Candidates must ensurethat any personal hand-pieces that they intend to use in the examination arecompatible with the couplings at the Examination Centre.

6. Candidates are personally responsible for any damage to the fittings andcouplings that may occur as a result of providing and attempting to use poorlyfitting attachments and candidates will be liable to meet all associated repaircosts.

7. Please note that dental burs will not be provided. Candidates are required tobring all necessary burs to the examination.

8. At the beginning of each day, the list of tasks to be completed for the day willbe distributed. The application of the rubber dam, communication and theradiography exercises will be timetabled for each individual candidate.Participants may perform the remaining requirements for the day in any order.

9. Food and/or drink (including water) are not allowed in the examination roomunless special consideration for medical reasons has been granted by the ADCoffice. A written request to the ADC office must include a medical certificatesigned by a doctor indicating the accommodation measures required.

10. Candidates MUST NOTbring any electronic devices (including but not limitedto mobile phones, personal computers and tablet devices, cameras and otherrecording devices) into the examination room.

11. Candidates are not permitted to remove teeth from typodonts, nor are theypermitted to remove typodonts from the manikins.

12. Candidates are not permitted to have extra typodont teeth in the examinationarea.

13. Candidates must wear eye protection, masks and gloves as if they weretreating patients (not using simulation).

14. Candidates must manage excess amalgam appropriately and ensure that theirwork areas are left clean.

15. Candidates may use magnification aids and may take breaks wheneverneeded.

16. Candidates who start or complete a procedure other than an identifiedrequirement on an identified tooth or practice tooth will receive a fail grade forthat task.


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17. Candidates are financially responsible for any damage caused to any suppliedequipment.

18. The ability of participants to read, interpret and comply with instructions andother written material is part of the examination. Examination supervisors andinvigilators will not answer questions involving content.

19. Participants must stop working and leave the examination room at theindicated ending time. Participants who refuse to leave the examination room

at the indicated ending time will be given a fail grade for all requirements thatday.

20. Participants who do not abide by the above Regulations will be given a failgrade for all requirements that day.

21. A participant who considers themself disadvantaged by an adverse eventbeyond the participants control, occurring either immediately before or duringthe examination must inform the supervisor or invigilator immediately and mayask that the ADC void the results of the examination. Post examination adviceof an adverse event will not be accepted.

22. I have received and read the ADC Practical Examination Handbook

Time Extension Policy

If a candidate experiences problems with equipment, it is acceptable for them to ask amember of staff for assistance. If there is a problem with equipment that the ADC orExamination Venue has provided, and the candidate loses more than 15 minutes ofassessment time, they can ask to complete a Time Extension form to request anextension. It is important to note that the examination already has an extra 30 minutes oftime built-in to the Assessment, and generally delays of less than 30 minutes will not begranted a time extension.

Candidates may be moved to another bay in order to solve problems with non-functioningequipment.

Candidates will not be granted a time extension for problems that arise with equipmentthat they have supplied for the examination.

Adverse Incident Policy

If a candidate experiences an adverse incident during the examination, it is theirresponsibility to bring it to the attention of one of the invigilators immediately. Theinvigilator can then complete an Adverse Incident form. The ADC will not be able to takeinto consideration any adverse incidents that are reported to the ADC after theexamination.


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Assessment Tasks

Participants will be required to perform 12 tasks from the following list. The tasks will beset for each examination by the ADC.

1. Class II amalgam preparation.

2. Class III composite resin preparation.

3. Full metal crown preparation.

4. Metal-ceramic (porcelain fused to metal) crown preparation.

5. Endodontic access preparation on a molar tooth. Teeth with simulated enamel,dentine and pulp will be provided for the Endodontic Access Preparation

6. Fabricate a provisional crown restoration for a pre-prepared* metal-ceramic(porcelain fused to metal) crown preparation on Day 2 of the Assessment. Theoriginal unprepared tooth will be in the typodont used on Day 1 of the

Assessment.

7. Restore a pre-prepared* tooth with a direct Class II composite resinrestoration.

8. Restore a pre-prepared* tooth with a direct Class IV composite resinrestoration.

9. Restore a pre-prepared* tooth with a Class II amalgam restoration.

10. Taking nominated radiographs a manikin. Candidates will also be evaluated onpatient communication skills relating to a defined clinical situation.

11. Apply a rubber dam.

12. Record keeping.

13. Clinical communication

14. Infection control and material hygiene.

* A pre-prepared tooth is supplied for those tasks requiring restorations. The evaluation of the rubber dam task and infection control is attended

to on-site. The evaluation of the other tasks from all examination facilities is

attended at a central site after the examination.

Assessment Criteria

Participants will receive a score for each task as determined by using the evaluationcriteria for the requirement and the Grade Derivation Grid. The final result for eachparticipant will be determined using the Final Result Grade Derivation Grid.


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Grade Derivation Grid

Each assessment task is evaluated in one (1) or three (3) criteria categories.

The components within each category are assessed, and the category receives the lowestgrade allocated within that category.

1. Tasks with one criterion category (Infection Control, Record Keeping,Rubber Dam)

The grade assigned for these requirements will be determined as described inthe evaluation criteria.

2. Tasks with three criteria categories

The grade assigned for these requirements will be determined by the gradesassigned in the criteria categories.

Overall Grade Criteria

A 2 Aand no C or D is assigned in any criteria category.

BNo more than 1 C and no D is assigned in any criteriacategory.

C 2 CS and no D are assigned in any criteria category.

D 1 D assigned in any criteria category.

Final Result Grade Derivation Grid (12 requirements)

In order to be successful in the Practical Examination, a participant must obtain:

9 or more A / B grades and no more than 1 D grade

OR

8 or more A / B grades and no D grades


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Assessment Criteria

Class II Amalgam Cavity Preparation

Criteria describe an ideal preparation for a tooth with minimal caries. Evaluation will consider the extent of caries present.Score External Outline Form Internal Form Finish

A - Proximal and/or gingival margins clear adjacent teeth 0.5mmor less

- Gingival margin supra-gingival- Optimal buccal-lingual width based on location and extent of

caries present- No damage to adjacent teeth, Assessment tooth beyondpreparation or gingiva

- Optimal resistance and retentionform based on location and extent ofcaries present with no unnecessaryremoval of internal tooth structure

- Gingival and occlusal floors parallelto occlusal plane- All internal line angles rounded

- Smooth cavo-surfacemargins- All unsupported enamelremoved

- No debris or caries(infected dentin)

B - Adjacent tooth cleared 0.5 - 1.0mm- Minor overextension- Minor damage to adjacent tooth corrected by enameloplasty- Minor damage to assessment tooth beyond preparationmargin corrected by enameloplasty

- Minor over-preparation occlusally- Minor over-preparation axially

- Small area of roughness

C - Proximal margin not cleared- Proximal margin cleared 1.0 - 1.5mm- Proximal wall flared- Gingival margin at gingiva- Significant under-extension- Unacceptable isthmus junction- Unacceptable buccal-lingual width- Minor damage to adjacent tooth correctable by enameloplasty- Minor damage to assessment tooth beyond preparationmargin correctable by enameloplasty- Minor damage to gingiva

- Pulpal floor too deep: 2.5 - 3.0mm- Pulpal floor too shallow 1.0 -1.5mm- Axial wall too deep 1.5 - 3.0mm- Axial wall too shallow: < 0.5mm- Unnecessary removal of toothstructure- Divergent walls- Sharp line angle- Undefined line angle

- Unacceptable roughness- Unacceptableunsupported enamel- Presence of debris

D - Proximal margin cleared > 1.5mm- Gingival margin sub-gingival- Significant overextension- Major damage to adjacent tooth requiring restoration- Major damage to assessment tooth beyond preparationmargin requiring restoration- Major damage to gingiva

- Pulpal floor too deep > 3.0mm- Pulpal floor too shallow < 1.0mm- Axial wall too deep > 3.0mm- Excessive over-preparation.

Alternate design or RCT required

- Gross roughness- Grossly unsupportedenamel- Caries remaining on axialor pulpal- Caries remaining atdentinoenamel junction


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Class III Composite Cavity Preparation

Criteria describe an ideal preparation for a tooth with minimal caries. Evaluation will consider the extent of caries present.Score External Outline Form Internal Form FinishA - Optimal extension based on location and extent of caries

present- Gingival margin supra-gingival- No damage to adjacent teeth, Assessment tooth beyondpreparation or gingiva

- Optimal resistance and retention formbased on extent of caries present withno unnecessary removal of toothstructure- All internal line angles rounded

- Smooth cavosurfacemargin- No debris or caries(infected dentin)

B - Minor over-preparation

- Minor damage to adjacent tooth corrected by enameloplasty- Minor damage to assessment tooth beyond preparationmargin corrected by enameloplasty

- Minor over-preparation - Minor roughness

C - Under-extended < 0.5mm- Over-extended < 0.5mm- Gingival margin at gingiva- Minor damage to adjacent tooth correctable byenameloplasty- Minor damage to assessment tooth beyond preparationmargin correctable by enameloplasty- Minor damage to gingiva

- Inadequate resistance and retentionform- Too deep > 2.0 but < 3.0mm- Unnecessary removal of internal toothstructure- Sharp line angles

- Unacceptable roughness- Presence of debris

D - Overextended > 0.5mm- Cavitation not included- Gingival margin sub-gingival

- Major damage to adjacent tooth requiring restoration- Major damage to assessment tooth beyond preparation- Major damage to gingiva

- Unacceptable resistance and retentionform- Too deep > 3.0mm

- Excessive over-preparation.- Alternate design or RCT required

- Caries remaining on axialor pulpal- Caries remaining at

dentinoenamel junction


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Full Metal Crown Preparation

Appropriateness of occlusal clearance will be measured from the spatial relationship with the proximal teethScore Path of Draw and Axial

ConvergencePreservation of Tooth Vitality & StructuralDurability

Finish and Margin

A - Optimal path of insertion- No undercuts- Axial convergence 6 - 10

- Optimal preparation has been performed to permitfabrication of a functional restoration- Preparation is smooth and has no sharp areas- No damage to adjacent teeth- Reduction - Axial 0.5 - 1.0mm

- Occlusal 1.5mm

- Margin optimally placed, defined andidentifiable- Margin smooth, continuous and has nosteps- Margin width 0.5mm- Positioned 0.5mm supra-gingival

- No debris- No damage to gingiva

B -Minor undercuts. Manageableby lab.- Axial convergence 10 - 20

- Reduction- Axial 1.0 - 1.5mm- Occlusal 1.02.0mm

- Minor damage to adjacent tooth corrected byenameloplasty

- Located supra-gingival 0 - 1.0mm- Located sub-gingival < 0.5mm

C - Will not draw. Modificationrequired.- Will not draw. Adjacent toothrequires modification.- Axial convergence 20 - 25

- Reduction- Axial < 0.5mm- Occlusal 0.51.0mm or 2.0 to < 3.0mm

- Sharp cusps- Sharp line angles- Minor damage to adjacent tooth correctable byenameloplasty

- Indistinct, discontinuous or rough- Located supra-gingival 1.0 to < 2.0mm- Located sub-gingival 0.5 to < 1.0mm- Incorrect form- Unsupported enamel (lipping)- Presence of debris- Minor damage to gingiva

D - Will not draw. Majormodification required.- Will not draw. Adjacent toothrequires major modification.- Axial convergence >25

- Reduction- Axial - no preparation or > 1.5mm- Occlusal < 0.5 or > 3.0mm

- Pulp exposure- Major damage to adjacent tooth requiring restoration- Alternative preparation or RCT needed

- Grossly indistinct, discontinuous or rough- No discernible margin- Located supra-gingival > 2.0mm- Located sub-gingival > 1.0mm- Grossly unsupported enamel (lipping)- Major damage to gingiva


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Metal-ceramic Crown Preparation

Appropriateness of occlusal clearance will be measured from the spatial relationship with the proximal teethScore Path of Draw and Axial

ConvergencePreservation of Tooth Vitality & StructuralDurability

Finish & Margin

A - Optimal path of insertion- No undercuts- Axial convergence 6 - 10

- Optimal preparation has been performed to permitthe fabrication of an esthetic and functional restoration- Preparation is smooth and has no sharp areas- No damage to adjacent teeth- Reduction: Buccal, mesial, distal 1.2mm

Lingual 0.5mm

Incisal/occlusal 2.0mm

- Margin is optimally placed, formed andidentifiable- Margin is smooth, continuous and has nosteps- Width of margin:

Buccal 1.2mm - 1.5mm

Lingual 0.5mm- Margin positioned 0.5mm supra-gingival- No debris- No damage to gingiva

B - Minor undercuts.Manageable by lab- Axial convergence 10-20

- Reduction: Buccal, mesial, distal 1.2 - 1.5mmLingual 0.31.0mmIncisal/occlusal 2.12.5mm

- Minor damage to adjacent tooth corrected byenameloplasty

- Located supra-gingival 0 - 1.0mm- Located sub-gingival < 0.5mm

C - Will not draw. Modificationrequired- Will not draw. Adjacent toothneeds modification- Axial convergence 20 - 25

- Reduction: Buccal, mesial, distal 0.5 - 1.1mmor 1.5 - 2.5mm

Lingual < 0.3 or 1.0mm1.5mmIncisal/occlusal 1.02.0mm

or 2.53.0mm

- Sharp cusps- Sharp line angles- Minor damage to adjacent tooth correctable byenameloplasty

- Indistinct, discontinuous or rough- Incorrect form- Unsupported enamel (lipping)- Located supra-gingival 1.02.0mm- Located sub-gingival 0.5-1.0mm

- Presence of debris- Minor damage to gingiva

D - Will not draw. Majormodification of tooth required- Will not draw. Adjacent toothrequires major modification- Axial convergence > 25

- Reduction: Buccal, mesial, distal < 0.5 or > 2.5mmLingual - no preparation or >1.5mmIncisal/occlusal < 1.0 or > 3.0mm

- Major damage to adjacent teeth requiring restoration- Pulp exposure- Alternate preparation or RCT needed

- Grossly indistinct, discontinuous or rough- No discernible margin- Grossly unsupported enamel (lipping)- Located supra-gingival > 2.0mm- Located sub-gingival > 1.0mm- Major damage to gingival


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Endodontic Access Preparation

Score External Outline Form Internal Form FinishA - Optimal extension to obtain

straight line access to all canals- Optimal removal of anyunsupported structures- No over extension- Adequate extension to permitremoval of pulp horns

- Optimal internal tooth structure removed toallow straight line access to canals- Canals accessed to at least a depth of 2.0mm- Optimally tapered access preparation walls

- Optimal smoothness of walls andcavosurface- No pulp material left on walls of chamber- No debris

B - Slightly under-extended 2.0mm

- Grossly excessive removal of internal toothstructure- Reverse taper- Excessive gouging of walls

- Perforation- Separated instrument in canal

- Excessive roughness- Excessive pulp material present on walls ofchamber- Debris obscuring chamber or canals


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Provisional Crown Restoration

Score Margin Contour andAdaptation

Morphology and Occlusion Polish

A - Margin not over/under extended- Margin not over/under contoured- No excess material in/on softtissue- No excess material on hard tissue- Preparation margin intact

- Optimal contour for gingival health, esthetics anddurability- Optimal interproximal contacts- Optimal occlusal contact- Restoration can be removed

- Optimal polish- No roughness or porosities- Restoration material is hard setting,tooth coloured plastic resin

B - Over-extended < 0.5mm- Under-extended < 0.5mm- Over-contoured < 0.5mm- Under-contoured < 0.5mm

- Slightly over-contoured- Slightly under-contoured- Slight infra-occlusion

-Adequate polish

C - Over-extended 0.5 - 1.0mm- Under-extended 0.5 - 1.0mm- Over-contoured 0.5 - 1.0mm- Under-contoured 0.5 - 1.0mm- Excess material in/ on soft tissue- Excess material on hard tissue- Damage to tooth margin

- Over-contoured- Under-contoured- Proximal contact too light- Proximal contact too occlusal- Proximal contact too gingival- Proximal contact too tight- No proximal contact < 0.5mm open- Supra-occlusion 1.0mm- Over-contoured > 1.0mm- Under-contoured > 1.0mm- Gross amount of excessivematerial in/on soft tissue- Gross amount of excessivematerial on hard tissue- Needs major revision or newprovisional

- Significantly over contoured- Significantly under-contoured- No proximal contact > 0.5mm open- Broken or cracked restoration- Restoration cannot be removed- Supra-occlusion > 1.0mm- Infra-occlusion > 1.0mm

- Gross roughness- Gross porosity- Inappropriate restorative material


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Class II Composite Resin Restoration

These criteria do not include shade matching, which is NOT part of the evaluation.Score Restoration Quality and Polish Margin Contours and Function

A - Uniform smoothness- Uniform polish matching toothsurface- No contamination of resin (no stain orinclusions)

- Junction of tooth/ restoration not detectableor slightly detectable with explorer- No excess resin past preparation margin- No damage to adjacent teeth, assessmenttooth or gingiva

-Physiologic tooth contours of occlusal andproximal surfaces optimally restored

- Optimal proximal contact restored- No excess resin in/on soft tissue- No excess resin on other teeth

B - Areas needing more polish- Minor contamination of resin notaffecting durability or esthetics

- Minor amount of resin beyond preparationmargin- Minor damage to adjacent tooth corrected byenameloplasty- Minor damage to assessment tooth beyondpreparation margin corrected byenameloplasty

- Under-contoured < 0.5mm- Over-contoured < 0.5mm- Proximal contact slightly too occlusal- Proximal contact slightly too gingival- Proximal contact slightly too broad

C - Unacceptable roughness, scratchesor voids- Contamination of resin that needscorrection

- Deficiency/void at margin < 0.5mm- Excess resin beyond preparation marginrequiring correction- Minor damage to adjacent tooth correctableby enameloplasty- Minor damage to assessment tooth beyondpreparation margin correctable byenameloplasty- Minor damage to gingiva

- Under-contoured 0.5 - 1.0mm- Over-contoured 0.51.0mm- Poorly defined morphology- Proximal contact too occlusal- Proximal contact too gingival- Proximal contact too broad- Proximal contact too tight/rough- Excess resin in/on soft tissue- Excess resin on other teeth

- Excess occlusal contact

D - Excessive roughness, scratches orvoids- Excessive contamination of resinrequiring replacement of entirerestoration.

- Deficiency/void at margin > 0.5mm- Gross amount of excess resin beyondpreparation margin- Major damage to adjacent tooth requiringrestoration- Major damage to assessment tooth requiringrestoration- Major damage to gingiva

- Under-contoured > 1.0mm- Over-contoured > 1.0mm- Lack of physiologic contour- No proximal contact- Marginal ridge disharmony > 1.0mm- Gross amount of excess resin in /on softtissue- Gross amount of excess resin on otherteeth- Restoration fractured or loose


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Class IV Composite Resin Restoration

These criteria do not include shade matching, which is NOT part of the evaluation.Score Restoration Quality and Polish Margin Contours and FunctionA - Uniform smoothness

- Uniform polish matching toothsurface- No contamination of resin (no stainsor inclusions)

- Junction of tooth/ restoration not detectable orslightly detectable with explorer- No excess beyond preparation margin- No damage to adjacent teeth, assessment tooth orgingiva

- Physiologic tooth contours restored- Optimal proximal contact restored- No excess resin in/on soft tissue- No excess resin on other teeth- Appropriate occlusal contact

B - Areas needing more polish

- Minor contamination of resin notaffecting durability or esthetics ofrestoration

- Minor excess resin beyond preparation margin

- Minor damage to adjacent tooth corrected byenameloplasty- Minor damage to assessment tooth beyondpreparation margin corrected by enameloplasty

- Under-contoured < 0.5mm

- Over-contoured < 0.5mm- Proximal contact slightly too incisal- Proximal contact slightly too gingival- Proximal contact slightly too broad

C - Unacceptable roughness, scratchesor voids- Contamination of resin that requirescorrection

- Deficiency/void at margin < 0.5mm- Excess resin beyond preparation margin requiringcorrection- Minor damage to adjacent tooth correctable byenameloplasty- Minor damage to assessment tooth beyondpreparation margin correctable by enameloplasty- Minor damage to gingiva

- Under-contoured 0.5 - 1.0mm- Over-contoured 0.51.0mm- Poorly defined morphology- Light proximal contact- Proximal contact too incisal- Proximal contact too gingival- Proximal contact too broad- Proximal contact too tight/rough- Excess resin in/on soft tissue- Excess resin on other teeth- Excessive occlusal contact

D - Excessive roughness, deepscratches or excessive voids- Excessive contamination of resinrequiring replacement of entirerestoration.

- Deficiency/void at margin > 0.5mm- Gross amount of excess resin beyond preparationmargin- Major damage to adjacent tooth requiringrestoration- Major damage to assessment tooth requiringrestoration- Major damage to gingiva

- Under-contoured > 1.0mm- Over-contoured > 1.0mm- Lack of physiologic contour- No proximal contact- Gross amount of excess resin in /onsoft tissue- Gross amount of excess resin onother teeth- Restoration fractured or loose


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Class II Amalgam Restoration

Score Surface quality Margin Contours and FunctionA - Uniform smoothness - Junction of tooth/restoration not detectable with explorer

- No debris/loose amalgam in soft tissue- No damage to adjacent teeth, assessment tooth orgingiva

- Physiologic tooth contours of occlusaland proximal surfaces optimally restored- Optimal proximal contact restored- Optimal occlusal contact

B - Some areas of roughness - Margin slightly detectable- Minor damage to adjacent tooth corrected by

enameloplasty- Minor damage to assessment tooth beyond preparationmargin corrected by enameloplasty

- Slightly under-contoured- Slightly over-contoured

- Proximal contact slightly too occlusal- Proximal contact slightly too gingival- Proximal contact slightly broad

C - Roughness or scratchesrequiring correction

- Excess amalgam at margin < 0.5mm- Deficiency at margin < 0.5mm- Void at margin < 0.5mm- Debris/loose amalgam in soft tissue- Minor damage to adjacent tooth correctable byenameloplasty- Minor damage to assessment tooth beyond preparationmargin correctable by enameloplasty- Minor damage to gingiva

- Under-contoured < 0.5mm- Over contoured < 0.5mm- Light proximal contact- Proximal contact too occlusal- Proximal contact too gingival- Proximal contact too broad- Proximal contact too tight- Poorly defined morphology- Marginal ridge disharmony < 1.0mm- Supra-occlusion

D - Excessive roughness or

scratches- Deep or excessive voidsother than at margin- Restoration must bereplaced

- Excess amalgam at margin > 0.5mm

- Deficiency at margin > 0.5mm- Void at margin > 0.5mm- Grossly excessive debris/loose amalgam in soft tissue- Major damage to adjacent tooth requiring restoration- Major damage to assessment tooth requiring restoration- Major damage to gingiva

- Under-contoured > 0.5mm

- Over-contoured > 0.5mm- No proximal contact- Marginal ridge disharmony > 1.0mm- Restoration fractured or loose


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Radiographic exercise

Score Film position Beam Centring Beam orientationA Appropriate film selected and oriented

Appropriate teeth and interdental areasdemonstrated and centred

Apex and 2 mm of adjacent tissuedemonstrated

Film indicator (dot) to the occlusal / incisal inperiapical films

No cone cut No horizontal overlapping of interproximalsurfaces

No foreshortening or elongation of PA image

B Appropriate film selected and oriented Appropriate teeth and interdental areas

demonstrated

Apex and 2 mm of adjacent tissuedemonstrated

Nominated tooth not centred

Film indicator (dot) to the occlusal / incisal inperiapical films

25% cone cut involvingnominated area

Horizontal interproximal overlapping beyondthe enamel

Gross (>25%) foreshortening or elongation Vertical overlapping of bitewing image with

inadequate coverage of the tissues of one jaw


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Rubber Dam Application

Score Criteria

A - Appropriate clamp- Stable clamp- Clamp secured with an appropriate length of dental floss

- Orientation provides an unrestricted airway

- Dam inverted on all isolated teeth- All punch holes in appropriate positions- Dam and frame positioned for optimal access, safety and moisture

control and patient comfort

B - Dam is inverted on teeth in operative area only- Minor deviations in punch hole locations- Dam or frame positioning needs minor adjustment for optimal

access, safety, moisture control or patient comfort

C One or two of the following deficiencies:

- Unnecessary trauma to gingiva or teeth

- Unstable clamp- Unsecured or inadequately secured clamp- Patient airway compromised- Dam not over wings of clamp- Inappropriate number of teeth isolated- Frame incorrectly oriented- Dam not inverted in operative area- Dam not through all interproximal contact points- Punch holes improperly positioned- Tears or holes compromising function- Dam or frame positioning must be altered for access, safety,

moisture control or patient comfort

D Three or more of the above deficiencies or:- Dam not placed in allotted time- Improper position of dam and frame not allowing treatment on

indicated tooth


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Record of Procedures

Participants may be required to perform the Record of Procedures on one of theAssessment Days. Participants will record all procedures performed on that day (exceptthe Rubber Dam application), on the supplied Record of Procedures form.

The Record of Procedures should be completed assuming that:

each procedure is performed on a different patient the patient has no changes in medical history

local anesthesia has been administered for each procedure

any prepared teeth were restored during the session

any restored teeth were prepared during the session

provisional crowns were cemented during the session.

In order to preserve anonymity, do NOT sign the Record of Procedures. Participantsshould use their ADC ID number in place of a signature.

Records should comply with the Dental Board of Australias Guidelines on DentalRecords.

It is NOT necessary to include any more patient or treatment information than is illustratedin the following examples.

Examples of appropriate entries:

Record of Procedures

DATE PROCEDURES ADC IDNUMBER

(do not sign)

10/10/12 Reviewed medical history - no changeRight inferior alveolar nerve block 1.8cc 2% lidocaine,1:100,000 epinephrineTooth 4.6, MOD amalgam preparation and restorationwith Tytin amalgam 123456

10/10/12 Reviewed medical history - no changeBuccal infiltration anesthesia 1.8cc 2% lidocaine1:100,000 epinephrineTooth 3.3 MIBL composite resin preparation andrestoration with Z250, Shade B2 (etch/bond) 123456

10/10/12 Reviewed medical historyno change

Right Left inferior alveolar nerve block 3.6cc 2%lidocaine 1:100,000 epinephrinePrepared 3.4 for metal-ceramic crown, porcelainocclusion and porcelain butt margin on buccalMethylmethacrylate provisional crown fabricated,cemented with Nogenol provisional cementVita shade 3L 1.5 123456


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Examples of errors include:

Incorrect or incomplete record of procedures.

No or inappropriate date.

No or inappropriate record of updating medical history.

No or inappropriate record of type, quantity or location of local anesthesia.

No or incorrect tooth number identified. No or incorrect restored surfaces identified.

No or inappropriate type of restorative or provisional material identified.

No or inappropriate cement type identified.

No or inappropriate restorative material brand identified.

Incorrect technique or improper use of material identified.

No shade recorded.

Record not written in ink.

Record not legible.

Inappropriate correction of entry (original entry not visible through correction).

No ID number.

ID number in inappropriate location.

Scoring Grid:

Score CriteriaA

- Appropriate and accurate record of all procedures.

B- One error on Record of Procedures.

C- Two or three errors on Record of Procedures.

D- More than three errors on Record of Procedures.- No entries on Record of Procedures.

Infection Control

Participants will perform all requirements as if they were working on actual patients.Infection control and material hygiene procedures will be observed by Assessment

Invigilators. Participants will NOT be informed of any recorded violations.

It will be assumed that all instruments are sterile at the beginning of Day 1.

If an instrument or treatment material is dropped during a procedure, a participantmust notify an Invigilator who will ask the participant to describe how the situationshould be handled in actual patient treatment and give permission to pick up theinstrument or material.


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The only modifications to infection control procedures for the purposes of thisAssessment are allowing the wearing of treatment gloves while:

Loosening the clamp that allows the patients head position to be adjustedand adjusting the head.

Using the amalgamators.

Examples of unacceptable infection control and material hygiene proceduresinclude:

Gloves not worn.

Gloves worn outside of the operatory (except when using an amalgamator).

Gloves have holes or tears.

Unacceptable infection control procedures involving gloves such as wearingtreatment gloves when retrieving an article from a non-sterile area such as a

storage bin or cabinet or touching masks, glasses or hair.

Mask not worn or not worn appropriately.

Use of contaminated instruments or materials.

Hands not washed.

Contamination of operating area.

Eye protection not used.

Hair not appropriately controlled.

Inappropriate attire.

Unacceptable amalgam handling and disposal.

Unacceptable handling and disposal of sharps.

No or insufficient cooling water used with high speed handpiece

Scoring Grid:

ANo violations of infection control.

B

One infection control violation.

CTwo infection control violations.

DThree or more infection control violations.


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Results

Participants will receive a score for each requirement as determined by using theevaluation criteria for the requirement and the Grade Derivation Grid. The finalresult for each participant will be determined using the Final Result GradeDerivation Grid.

The results of the Practical Examination will be posted on a secure website that willbe accessible using the individualised candidate login details provided at the timeof initial registration. Posting of results will normally be done within 6 weeks.Candidates should check the ADC website for updates.

Results will not be released by telephone, fax or email.

Verification, Review and Appeal

Candidates are referred to the ADC Appeal Policy for information regardingverification, review and appeal processes for the Practical Examination

Repeats

If a candidate fails the Practical Examination, they are permitted to repeat it,provided that their Written Examination results are still current. There are noSupplementary Examinations for the Practical Examination and the examinationmust be taken in full and passed on the one session.


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ABN 70 072 269 900

Australian Dental Council LtdPO Box 13278Law Courts Victoria 8010

Australia

Tel +61 (0) 3 9657 1777Fax +61 (0) 3 9657 1766Email: [email protected]:www.adc.org.au

Version: 2014
http://www.adc.org.au/http://www.adc.org.au/http://www.adc.org.au/http://www.adc.org.au/

Documents

Practical Exam Handbook 2014