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Scenario-based Clinical Examination

The Scenario-based Clinical Examination is designed to objectively evaluate an orthodontist’s knowledge, abilities and critical thinking skills to certify orthodontists based on proficiency and clinical excellence. 

Scenario-based testing is utilized by several other medical and dental specialty boards.  This format allows for testing for a large amount of material in a relatively short period of time.  This allows for questions to be graded objectively based on pre-determined desired responses. 

Scenarios and questions are developed in collaboration with program directors/chairs, examiners, leaders in the industry and the ABO Board of Directors.

Requirements and Eligibility:

  1. Successful completion of ABO Written Examination
  2. Graduate of an advanced specialty education program in orthodontics and dentofacial orthopedics in the United States or Canada, accredited by the Commission on Dental Accreditation (CODA)
  3. Examinees participating in extended programs will be required to complete their program prior to being eligible to take the Clinical Examination

Components and Criteria:

The examination will be composed of four domains for assessment:

Domain Weighted % of Exam

Data Gathering and Diagnosis


Treatment Objectives and Planning


Treatment Implementation and Management


Critical Analysis and Outcomes Assessment


The scenario-based examination will be held at Pearson Vue Testing Centers worldwide and will be graded on a Pass/Fail basis.

Each examination will be comprised of scenarios from each of the four domains using ABO provided patient cases.

Examinees will be exposed to several patient cases, each scored by a different pair of examiners.

Examinees will be presented with cases and questioned on a variety of information depending on each individual scenario. The following includes some examples of things that may be included in the cases presented:

  • Patient history
  • Chief complaint
  • Treatment plan
  • Periodontal charting
  • Layout of current situation
  • Intra-oral photographs
  • Extra-oral photographs
  • Panoramic radiographs
  • Cephalometric radiographs
  • Tracings and superimposition
  • 3D Models
  • Case Management Form (CMF)   


As part of preparation for the Scenario-based Examination, the ABO highly recommends that examinees gain as much experience as possible working through patient cases completing an objective analysis of the facts to form their own judgment.  These critical thinking exercises will strengthen an examinee's skills as they prepare for the scenario-based examination.  The practice of presenting an examinee's own clinical cases to fellow residents / colleagues, educators, and/or mentors will also aid individuals to become more comfortable with the examination format.  This process also promotes the opportunity for self-evaluation and reflection on case outcomes.

The tools previously created by the ABO to assess case outcomes will be utilized within the scenario-based examination process.  These tools include the cast radiograph evaluation (CRE), case management form (CMF), and cephalometric superimposition technique and interpretation.

Utilize the ABO study materials and board prepared videos to help you prepare for the Scenario-based Clinical Exam.

Past Exam Results:

Examination # of Examinees Pass Rate

November 2020



February 2021



July 2021



November 2021



February 2022



October 2022



February 2023



February 2024



Exam Retake Policy:

Examinees retaking the Scenario-based Clinical Examination within two (2) years from the first date they attempted the Scenario-Based Clinical Examination will be offered a discounted registration fee.  Exam retakes more than two years after the first attempted Scenario-Based Clinical Examination will be required to pay the full exam registration fee.

If an examinee has 3 failed attempts at the Scenario-based Clinical Examination, they must wait 2 years before retaking the examination. If an examinee no-shows for an exam, it counts as a failed attempt at an examination. 

Examinees must present a petition to the Clinical Committee before registering for the examination for the 4th attempt. The petition must address the following items:

1. How the examinee plans to prepare going forward?
2. What domain(s) require the most attention when preparing based on past results?
3. What is the examinee’s understanding of the weak performing areas in the past examinations?
4. What adjustments will be made in the preparation process going forward?

If the candidate fails the examination after the 4th attempt, they must wait an additional 2 years and petition before registration for 5th exam. After 5 failed attempts at the Scenario-based Clinical Examination, an examinee is no longer eligible to become Board Certified.