ADC Practice Question — Replantation Protocols — Closed & Open Apex

The narrowing of the root canal on radiograph most likely represents:

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.

An 8-year-old's open-apex upper left central incisor was replanted 3 weeks ago. At follow-up, the dentist notes the tooth is asymptomatic, has normal mobility, and radiographs show no periapical radiolucency. The root canal appears slightly narrower than at the baseline radiograph. The narrowing of the root canal on radiograph most likely represents:

A. Beginning of infection-related inflammatory resorption requiring immediate root canal treatment
B. Internal root resorption that will progress to perforation if not treated endodontically right away
C. Early pulp canal obliteration — the expected mechanism of pulp healing after replantation
D. An artefact from a slightly different radiographic angle — no clinical significance at this stage

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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 favorable open apex outcome: 'Pulp canal obliteration is expected and can be recognized radiographically sometime during the first year. It is considered to be the mechanism by which the pulp heals after replantation of avulsed immature permanent teeth.' SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 11.2.2

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 11.2.2

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

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.

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.

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The narrowing of the root canal on radiograph most likely represents:

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