Cu toate că anestezia locală nu este gata, examinăm coroana dentară.

It means although, even though, or despite the fact that.

It introduces a concession: something in the first clause would normally make you expect a different result, but the main clause still happens.

• Cu toate că anestezia locală nu este gata = Even though the local anesthesia is not ready
• examinăm coroana dentară = we examine the dental crown

A shorter common alternative is deși.

Because Cu toate că anestezia locală nu este gata is a subordinate clause, and it is separated from the main clause with a comma.

This is especially normal when the subordinate clause comes first:

• Cu toate că ..., examinăm ...

If you reverse the order, you still normally keep the comma:

• Examinăm coroana dentară, cu toate că anestezia locală nu este gata.

In Romanian, nu is the normal word for not, and it goes before the verb.

• este = is
• nu este = is not

So:

• anestezia locală nu este gata = the local anesthesia is not ready

In everyday speech, nu e is also very common instead of nu este.

Romanian usually puts the definite article at the end of the noun, not as a separate word like English the.

• anestezie = anesthesia

• anestezia = the anesthesia

• coroană = crown
• coroana = the crown

So anestezia locală literally means the local anesthesia, and coroana dentară means the dental crown.

Because they are feminine singular adjectives, and they agree with the nouns they describe.

• anestezia is feminine singular, so: locală
• coroana is feminine singular, so: dentară

Compare the masculine base forms:

• local
• dentar

Feminine singular:

• locală
• dentară

Examinăm is the 1st person plural present tense of a examina = to examine.

So it means:

• we examine
• or we are examining

Romanian present tense often covers both the English simple present and present progressive, depending on context.

Also, Romanian often omits the subject pronoun. You do not need noi for we, because the ending -ăm already shows that the subject is we.

Because the normal Romanian order is usually:

• noun + adjective

So:

• coroana dentară = the dental crown

Putting the adjective first is possible in some contexts, but it is less neutral and often adds emphasis or a stylistic effect. In technical or medical language, noun + adjective is the most natural order.

Grammatically, yes: gata means ready.

But in this specific medical context, anestezia locală nu este gata sounds a bit unusual to a native speaker. A more natural sentence would depend on what you mean:

• if you mean the anesthesia has not been administered yet:
  • anestezia locală nu este încă administrată
• if you mean it has not taken effect yet:
  • anestezia locală nu și-a făcut încă efectul

So the sentence is understandable, but not the most idiomatic medical Romanian.

Because gata is commonly used as an invariable adjective in this meaning.

So you can have:

• este gata
• sunt gata
• anestezia este gata

without changing gata.

That is why you do not get a separate feminine form here.

Yes. Romanian word order is fairly flexible here.

You can say:

• Cu toate că anestezia locală nu este gata, examinăm coroana dentară.
• Examinăm coroana dentară, cu toate că anestezia locală nu este gata.

Both are grammatical. The difference is mostly one of focus:

• starting with Cu toate că... highlights the contrast first
• starting with Examinăm... gives the action first

They are different words.

• că often means that, or it appears as part of fixed expressions like cu toate că
• ca usually means as or like

So in this sentence, că is part of the conjunction cu toate că = although / even though.

Also, ă is pronounced like the a in English sofa. So că and ca do not sound the same.