ADC Practice Question — Follow-up, Outcomes & Long-term Care

When should the decision to decoronate an ankylosed replanted tooth 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's replanted incisor has become ankylosed 18 months after replantation. The tooth is now 3mm infra-positioned compared to the adjacent incisors and the discrepancy is worsening as the child grows. When should the decision to decoronate an ankylosed replanted tooth be made?

A. Immediately upon initial diagnosis of ankylosis, before any measurable infra-position develops at all
B. Only after growth is completed, when the final degree of infra-occlusion can be assessed
C. When the infra-occlusion is esthetically unacceptable and cannot be corrected by simple restorative means
D. Decoronation should never be performed — extraction and immediate implant placement is preferred

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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.' Implants are only considered after growth completion. 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 Follow-up, Outcomes & Long-term Care 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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