EPA 4C: Dentate Direct Operative - Adult (Permanent)

Dentate Direct Operative - Adult (Permanent)	Meets Expectations of the Graduate	Progressing	Below Expectations	Critical Error

Isolation and Tissue Management	No damage and/or optimal isolation		Poor isolation and/or tissue damage requiring finishing/polishing	Poor isolation and/or tissue damage that requires a major recontour or restoration
Preparation - Initial
Axis	Parallel to crown long axis	Minor axis discrepancy		Grossly off axis
Pulpal Floor	≤ 0.5mm internal to DEJ (1.5–2.0mm total depth)	≤ 1.0mm internal to DEJ (2.5–3.0mm total depth)	Enamel present on pulpal wall (< 1.5mm total depth)	≥ 1.5mm internal to DEJ (≥ 3.5mm total depth)
Axial Wall	≤ 0.5mm internal to DEJ (1.0–1.5mm total depth)	≤ 1.0mm internal to DEJ (2.0–2.5mm total depth)	Enamel present on axial wall (< 1.0mm total depth)	≥ 1.5mm internal to DEJ (≥ 3.0mm total depth)
Peripheral Dentin (DEJ)	Removal to hard dentin		Left firm dentin	Left soft dentin
Isthmus (F/L) Extension	1.5–2.0mm wide	2.5–3.0mm wide	< 1.0mm wide	≥ 3.5mm wide
Primary Retention	Convergent	Parallel	Excessive convergence	Divergent
Proximal Clearance	Clearance > 0.5 and ≤ 0.75mm	Clearance > 0.75 and ≤ 1.0mm	Inadequate clearance (≤ 0.5mm)	Clearance >1.0mm
Gingival Clearance	Clearance > 0.5 and ≤ 0.75mm	Clearance > 0.75 and ≤ 1.0mm	Inadequate clearance (≤ 0.5mm)	Clearance > 1.0mm
Preparation - Final
Carious Tissue Removal (Peripheral dentin/DEJ)	Removal to hard dentin		Left firm dentin	Left soft dentin
Carious Tissue Removal (Shallow/Moderate lesion)	Selective removal to firm dentin		Selective removal to soft dentin	Non-selective removal to hard dentin
Carious Tissue Removal (Deep lesion)	Selective removal to soft dentin		Selective removal to soft dentin	Non-selective removal to hard dentin
Wall Surfaces	Smooth	Rough	Excessive roughness
Wall Transitions	Gentle transitions		Abrupt transitions
Cavosurface Margins	Enamel supported		Enamel unsupported 70–80° or margins > 100–110°	Enamel unsupported < 60° or margins >120°
Debridement	Clean		Debris
Adjacent Tissues	No iatrogenic damage		Damage to adjacent tooth or soft tissue – Recontour	Damage to adjacent tooth or soft tissue – Restore
Restoration
Surface Quality	Smooth	Rough	Rough/requires finishing	Rough/requires replacement
Marginal Integrity	Non-detectable	Detectable	Flawed - minor	Flawed - major
Occlusal Anatomy	Anatomy reproduced	Anatomy lacks definition	Anatomy absent	Excessive anatomy depth
Occlusal Function	Ideal occlusion restored/maintained	Restoration in occlusion		Hyperocclusion
Proximal Anatomy	Ideal embrasure form		Closed embrasure form Open embrasure form
Proximal Contact	Ideal contact area	Acceptable contact area	Incorrect contact position	No contact (open)

Silver Diamine Fluoride Pediatric (Primary)