Both patients need root canal treatment. For Patient X…
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.
Two 14-year-olds present simultaneously. Patient X: closed apex incisor replanted by parent at scene 10 minutes post-injury (Group 1). Patient Y: closed apex incisor stored in saliva for 50 minutes after 8 minutes dry (Group 2). Both teeth are well-positioned. The dentist must plan both cases. Both patients need root canal treatment. For Patient X (replanted at scene, Group 1), when should RCT be initiated, and what should be placed first if a corticosteroid protocol is chosen?
- A. RCT at 2 weeks with calcium hydroxide only — corticosteroid paste is not used when teeth are replanted at the scene
- B. Corticosteroid paste immediately or shortly after replantation, followed by root canal filling after at least 6 weeks
- C. RCT immediately today — teeth replanted at the scene have already been in the socket long enough to start treatment
- D. No endodontic treatment needed — Group 1 teeth with viable PDL always maintain pulp vitality
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Integration: (1) Closed apex = RCT required regardless of group. (2) Corticosteroid protocol = placed immediately/shortly after replantation. (3) Duration = at least 6 weeks in situ. (4) Contrasts with Ca(OH)2 which goes in at 2-week RCT for up to 1 month. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 10
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