A 53-year-old has fractured the lingual cusp of tooth #5, with dentin exposed and the defect extending subgingivally. What is the best FIRST step?

Correct answer: B. Assess restorability

• A. Preparing a crown presumes restorability and an achievable margin, neither of which has been established.
• B. CORRECT. Every subsequent decision depends on this. A subgingival fracture raises immediate questions about whether an adequate ferrule can be obtained, whether biologic width will be violated, and whether crown lengthening or orthodontic extrusion will be required — or whether the tooth is unrestorable and should be extracted. You cannot plan until you know.
• C. Vitality testing is part of the workup, but a vital tooth that cannot be restored is still extracted — restorability is the governing question.
• D. Temporization is reasonable management but comes after the restorability decision, not before it.

Note: Restorability assessment covers: remaining sound tooth structure and whether 1.5–2 mm of ferrule is achievable, the position of the margin relative to bone (biologic width needs roughly 3 mm from bone crest to margin), crown-to-root ratio, periodontal support, endodontic status, and strategic value of the tooth in the overall plan.