Module 5 Case 1 (prompt 1,2,5,6)

[Chad Carter (Course Director)]

Maria,

Going to give some thoughts here in line with the questions again.

For case 1 here:

1) Prompt 1: What is the rationale for high labial frenum be included here and how was that diagnose made? Is that part of the facial/soft tissue diagnosis? I am having hard time to separate things, as usually in this type of question I am always looking more towards the extra-oral pictures only. And for dental diagnosis I look for the intra-oral pictures. Intraoral ICP photo is where we see this frenum. From my view it is pulled taught and is high – especially when considering he has altered passive eruption – imagine doing esthetic crown lengthening and then the frenum would be right on the interdental papilla.

2) Prompt 2: why normal maxilla in AP is the answer here if after correcting for the cranial base flexure the SNA is increased and maxilla seems protrusive? And how to diagnose for absolute maxillary transverse deficiency if there is no PA cephs or CBCT coronal cuts or intraoral photos here in this prompt to include that? Would we have had to memorize previous records presented in other question? The exam samples and guidelines from the ABO is that we have the full set of records for each set of questions. We don’t have that capability on this platform. Normal Maxilla in AP from view but a corrected SNA of 82 with cranial base flexure. You are correct – referring back to the photos is where to to evaluate the transverse in absence of radiographs – An absolute transverse discrepancy communicates that when advanced into Class I that the arches would not match in the transverse.

3) Prompt 5: how to diagnose CVMS stage 5 if we cannot visualize C4. I understand shape of C3 is more towards rectangular horizontal but I did not feel confident in saying stage 5 without checking C4. Am I missing something? Would something like this situation could happen in the real exam?

Yup, I hate it when it’s cut off. No the ABO is not out to trick people with partial records. As you all can tell getting a perfect records case with clarity for boards is tough. It’s the height of the vertebra that I’m looking at here.

4) Prompt 6: how to recommend extractions of third molars prior to surgery if in that prompt we were not given the panoramic x-ray? Should we have to eyeball on the ceph because it is surgical case and usually those are on the way of a BSSO cut? Because we cannot go back and forth to see other questions

Full records will be available throughout the case. If no x-ray just be sure that 3rd molars are addressed at least 6 months pre-surgery.