A lingual cusp fracture occurs on a mandibular premolar. What is the MOST IMPORTANT first assessment?

Correct answer: C. Restorability of the tooth

• A. ❌ Percussion sensitivity helps assess periapical status but doesn't determine the treatment direction as directly.
• B. ❌ Pulp vitality is important but should be assessed AFTER determining if the tooth is worth saving.
• C. ✅ Correct. RESTORABILITY is the first and most critical assessment — can the remaining tooth structure support a restoration? If not restorable (fracture too deep, insufficient ferrule), extraction is indicated. Restorability assessment dictates the entire treatment plan.
• D. ❌ Aesthetic impact is not the primary clinical priority for a cusp fracture.