ADC Practice Question — Endodontic Considerations

How should this be interpreted?

Dental trauma questions test protocol-level decisions — splint type, duration, follow-up timing — where one wrong detail means a wrong answer. This high-difficulty vignette tests your ability to work through clinical details and arrive at the correct management.

At 6-month follow-up, a patient has two replanted teeth. Tooth P (closed apex, Group 2) shows: a small periapical radiolucency, mild tenderness to percussion, and a sinus tract on the labial gingiva. Tooth Q (open apex, Group 1) shows: no symptoms, normal mobility, canal obliteration progressing, but a single area where root structure appears to be replaced by bone density on the distal surface. Tooth Q shows canal obliteration (favourable) BUT also a single area of root being replaced by bone (unfavourable). How should this be interpreted?

A. The obliteration is artefact — any replacement resorption invalidates all other findings as unreliable
B. The bone replacement finding is artefact — canal obliteration proves the tooth is healing normally overall
C. Both findings are real and can coexist — the two types of resorption may occur concurrently in the same tooth
D. This combination is impossible — canal obliteration and replacement resorption are mutually exclusive processes

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: C

Integration: (1) Canal obliteration = favourable (Sec 11.2.2). (2) Root replaced by bone = ankylosis/replacement resorption = unfavourable (Sec 11.3). (3) IADT: 'the two types may occur concurrently.' (4) This tooth has BOTH favourable and unfavourable features — needs continued close monitoring. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Sections 11, 11.2.2, 11.3

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 11

Remy's study tip — Trauma questions hinge on: tooth maturity (open vs closed apex), time out of mouth, storage medium, and fracture type.

Exam preparation FAQ

How are Endodontic Considerations questions structured in the ADC written exam?

ADC Endodontic Considerations questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

Should I memorise guidelines word-for-word for Endodontic Considerations?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

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How should this be interpreted?

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