A 53-year-old man fractured the lingual cusp of tooth #5, with exposed dentin extending subgingivally. Which is the BEST step to manage his chief complaint?

Correct answer: A. Assess restorability, including the subgingival extent and the remaining tooth structure

• A. CORRECT. RESTORABILITY assessment must precede any restorative decision. The critical questions: how far subgingivally does the fracture extend, is there sufficient sound tooth structure for a 1.5–2 mm ferrule, can biologic width be maintained, and would crown lengthening or orthodontic extrusion be needed? Restoring a tooth that turns out to be non-restorable wastes the patient's money and delays definitive care. Pulp status is assessed in parallel, but restorability governs whether the tooth is worth treating at all.
• B. Pulp testing is necessary but not sufficient — a vital pulp in a non-restorable tooth changes nothing.
• C. Extraction is premature before restorability has been evaluated.
• D. Preparing a crown before establishing that a restorable margin exists puts the cart before the horse.

Note: Ferrule requirement: 1.5–2 mm of circumferential sound tooth structure above the margin. Without it, the crown will fail regardless of the endodontic result.