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American Dental Licensing Examination (ADLEX)

Content

  • Five stand alone examinations
    • Critical skill sets identified by criticality in the Occupational Analysis
       
  • Computerized Examination in Applied Diagnosis and Treatment Planning
     
  • Endodontic Clinical Examination
    • Manikin-based
       
  • Fixed Prosthodontic Clinical Examination
    • Manikin-based
       
  • Restorative Clinical Examination
    • Patient-based
       
  • Periodontal Clinical Examination
    • Patient-based

Scoring

  • Criterion based scoring system
     
  • Three (3) independent raters without cross-validation

Rating Levels

  • Satisfactory
     
  • Minimally Acceptable
     
  • Marginally Substandard
     
  • Critically Deficient

ADLEX Scoring

  • Criterion-Based Analytical Scoring Rubric:
  • More detailed feedback.
     
  • More consistent scoring.
     
  • Allows for the separate evaluation of factors.
     
  • Evaluation of all gradable criteria.
     
  • Scoring methodologies were developed with consultation from the Buros Institute, University of Nebraska and the Rand Institute with input from studies completed by testing specialists from the University of Chicago.
     
  • Three (3) independent raters evaluate all measurable criteria.
     
  • Median score is utilized when there are no matching scores; all zeros must be independently corroborated to be utilized as a critical deficiency.
         
  • Performance criteria-based scoring will be provided to both the candidate and the dental school so that appropriate remediation can be completed prior to a retake when required.
     
  • Clinical sections utilize compensatory grading with critical errors within a skill set.
     
  • No grading across skills.
         
  • Critical errors are those performance deficiencies that would cause treatment to fail.  A critical error forces a failure on that skill set examination.  Not all criteria have critical errors.

Evaluation Criteria

Objective measurable criteria developed by a panel of experts consisting of examiners, practitioners, and educators.

 

 

Amalgam Prep External Outline Criteria (Example)
 
SATISFACTORY
 
  1. Contact is visibly open proximally and gingivally up to 0.5 mm.
  2. The proximal gingival point angles may be rounded or sharp.
  3. The isthmus must be 1-2 mm wide, but not more than ¼ the intercuspal width of the tooth.
  4. The external cavosurface margin meets the enamel at 90?.  There are no gingival bevels.  The gingival floor is flat, smooth and perpendicular to the long axis of the tooth.
  5. The outline form includes all carious and non-coalesced fissures, and is smooth, rounded and flowing.
  6. The cavosurface margin terminates in sound natural tooth surface.  There is no previous restorative material, including sealants, at the cavosurface margin.  There is no degree of decalcification on the gingival margin.
 
MINIMALLY ACCEPTABLE
 
  1. Contact is visibly open proximally, and proximal clearance at the height of the contour extends beyond 0.5 mm but not more than 1.5 mm on either one or both proximal walls.
  2. The gingival clearance is greater than 0.5 mm but not greater than 2 mm.
  3. The isthmus is more than ¼ and not more than 1/3 the intercuspal width.
  4. The proximal cavosurface margin deviates from 90?, but is unlikely to jeopardize the longevity of the tooth or restoration; this would include small areas of unsupported enamel.
 
MARGINALLY SUBSTANDARD
 
  1. The gingival floor and/or proximal contact is not visually open; or proximal clearance at the height of contour extends beyond 1.5 mm but not more than 2.5 mm on either one or both proximal walls.
  2. The gingival clearance is greater than 2 mm but not more than 3 mm.
  3. The outline form is inappropriately overextended so that it compromises the remaining marginal ridge and/or cusp(s).
  4. The isthmus is less than 1 mm or greater than 1/3 the intercuspal width.
  5. The proximal cavosurface margin deviates from 90? and is likely to jeopardize the longevity of the tooth or restoration.  This would include unsupported enamel and/or excessive bevel(s).
  6. The cavosurface margin does not terminate in sound natural tooth structure; or, there is explorer penetrable decalcification remaining on the cavosurface margin, or the cavosurface margin terminates in previous restorative material.  (See glossary under Previous Restorative Material).
  7. There is explorer-penetrable decalcification remaining on the gingival floor.
  8. Non-coalesced fissure(s) remain which extend to the DEJ and are contiguous with the outline form.
 
CRITICAL DEFICIENCY
 
  1. The proximal clearance at the height of contour extends beyond 3 mm on either one or both proximal walls.
  2. The gingival clearance is greater than 3 mm.
  3. The isthmus is greater than ½ the intercuspal width.
  4. The outline form is overextended so that it compromises, undermines and leaves unsupported the remaining marginal ridge to the extent that the pulpal-occlusal wall is unsupported by dentin or the width of the marginal ridge is 1 mm or less.