ADC Practice Question — Endodontic Considerations

Tooth P has a sinus tract + periapical radiolucency +…

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 P has a sinus tract + periapical radiolucency + percussion tenderness. What type of resorption is this, and what is the management?

A. Replacement resorption (ankylosis) — the tooth is fusing to bone and will require decoronation within 6 months
B. Infection-related inflammatory resorption — driven by infected necrotic pulp; initiate or revise endodontic treatment
C. Surface resorption — a self-limiting process that requires no intervention beyond continued fluoride application
D. Cervical root resorption — requires surgical access and MTA repair of the resorption defect

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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: B

Integration: (1) Sinus tract = active infection. (2) Periapical radiolucency = infected pulp. (3) Percussion tenderness = inflammation. (4) All three = infection-related inflammatory resorption. (5) Treatable: endodontic treatment to remove infected necrotic pulp. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 11

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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Tooth P has a sinus tract + periapical radiolucency +…

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