Tooth Q shows canal obliteration (favourable) BUT also…
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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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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
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