ADC Practice Question — Replantation Protocols — Closed & Open Apex

1.5mm infra-position can currently be masked with…

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.

A 10-year-old had a closed-apex incisor replanted 2 years ago. The tooth is now confirmed ankylosed (metallic percussion, absent PDL space, beginning infra-position at 1.5mm). The orthodontist notes active facial growth. The parents ask about the full range of options and timing. The 1.5mm infra-position can currently be masked with composite buildup. At what point should the decision about decoronation be made, and why can't an implant be placed now?

A. Decoronate now while infra-position is minimal; implant is contraindicated because titanium causes ankylosis in children
B. Decoronate when infra-position becomes esthetically unacceptable and unrestorable; implant must wait until growth is completed because it would also infra-position
C. Never decoronate — extract and place an immediate implant since modern implants are approved for children over age 8
D. Decoronate at age 18 regardless of infra-position severity; implant at age 21 when bone maturation is confirmed by CBCT

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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) Decoronation criterion: 'infra-occlusion deemed esthetically unacceptable AND cannot be corrected by simple restorative treatment' (Sec 12). (2) Implant: 'after growth is completed' because implants don't erupt with bone. (3) Currently maskable = not yet time for decoronation. 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 are Replantation Protocols — Closed & Open Apex questions structured in the ADC written exam?

ADC Replantation Protocols — Closed & Open Apex 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 Replantation Protocols — Closed & Open Apex?

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

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1.5mm infra-position can currently be masked with…

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