A patient presents with a fractured lingual cusp on a premolar. What is the FIRST thing to assess?

Correct answer: B. Restorability — the amount and quality of remaining tooth structure

• A. Pulp vitality matters and must be tested, but it answers a different question. A vital, symptom-free tooth still has to be extracted if the fracture is unrestorable.
• B. CORRECT. RESTORABILITY governs everything that follows. Before any endodontic, periodontal or restorative planning, you must know whether the tooth can carry a restoration at all: how much sound structure remains, whether the fracture extends subgingivally or below the crestal bone, whether a ferrule of at least 1.5–2 mm can be obtained, and whether crown lengthening or extrusion would be needed. If the tooth is unrestorable, pulpal and periodontal findings become irrelevant.
• C. Percussion sensitivity contributes to the pulpal and periapical diagnosis, but it is a supporting test rather than the decisive first assessment.
• D. Probing depths matter for biologic width and the periodontal prognosis, and probing is essential for locating the fracture margin — but it feeds into the restorability judgement rather than preceding it.

Note: Restorability criteria: adequate ferrule (1.5–2 mm of sound circumferential dentine), the margin at or above the alveolar crest with biologic width respected, a favourable crown-to-root ratio, and a strategically worthwhile tooth.