ADC Practice Question — Replantation Protocols — Closed & Open Apex

When should the decision to perform decoronation be made?

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

A 10-year-old boy's closed-apex upper central incisor was dry for 2 hours before being found and brought to the clinic. The tooth is intact. The parents ask about long-term prognosis and what to expect. When should the decision to perform decoronation be made?

A. Immediately after replantation — preemptive decoronation prevents ankylosis from developing
B. At the 6-month follow-up visit regardless of clinical findings, as a standard precautionary measure
C. When the ankylosed tooth shows infra-occlusion that is esthetically unacceptable and not restorable
D. Only after the patient reaches age 18 and growth is confirmed to be complete on cephalometric films

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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

IADT: 'The decision to perform decoronation is made when the ankylosed tooth shows evidence of infra-occlusion that is deemed esthetically unacceptable and cannot be corrected by simple restorative treatment.' SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 12

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 12

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 should I prepare for Dental Traumatology in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

How do I approach an unfamiliar Replantation Protocols — Closed & Open Apex vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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