ADC Practice Question — Replantation Protocols — Closed & Open Apex

Scenario D: the open-apex tooth shows continued root…

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.

Four clinical scenarios: (A) A closed-apex tooth replanted at the scene — the dentist debates anesthetic choice. (B) An avulsed tooth in a child with severe uncontrolled epilepsy. (C) A tooth stored in tap water for 25 minutes. (D) An open-apex tooth showing radiographic signs of continued root formation 4 months post-replantation. Scenario D: the open-apex tooth shows continued root formation at 4 months. Should the dentist perform RCT now?

A. No — continued root formation indicates successful revascularization; RCT would destroy this healing
B. Yes — 4 months is beyond the safe window and endodontic treatment should be initiated regardless
C. No — but begin apexification with MTA as a precautionary measure while monitoring for infection
D. Yes — revascularization is only possible in the first 2 weeks and this has now been exceeded

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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: 'In immature teeth with open apices, there is a potential for spontaneous healing to occur. This allows continued root development and maturation. Hence, endodontic treatment should not be initiated unless there are definite signs of pulp necrosis and infection.' Continued root formation = revascularization is working. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 3.2.1

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

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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Scenario D: the open-apex tooth shows continued root…

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