ADC Practice Question — Replantation Protocols — Closed & Open Apex

For this open-apex tooth, the primary treatment goal is:

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 girl avulsed her upper right central incisor (open apex, incompletely developed root) 25 minutes ago. The tooth was stored in milk. After replantation, the dentist considers whether to start endodontic treatment. For this open-apex tooth, the primary treatment goal is:

A. Pulp revascularization — allowing continued root development and maturation in the child
B. Immediate root canal treatment to prevent infection-related resorption from developing
C. Apexification with MTA to seal the open apex before any resorption can become established
D. Extraction planning — open apex teeth have near-zero survival rates after replantation

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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: A

IADT open apex: 'Pulp revascularization, which can lead to further root development, is the goal when replanting immature teeth in children.' Endodontic treatment should be avoided unless necrosis and infection are confirmed. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 3.2.1, item 8

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 3.2.1

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 do I approach an unfamiliar Replantation Protocols — Closed & Open Apex 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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For this open-apex tooth, the primary treatment goal is:

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