ADC Practice Question — Replantation Protocols — Closed & Open Apex

What endodontic treatment options are available for…

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.

A 7-year-old's replanted open-apex incisor is reviewed at 6 weeks. The tooth is tender to percussion. There is a small sinus tract on the labial gingiva. Radiographs show a periapical radiolucency and no evidence of continued root development since replantation. What endodontic treatment options are available for this open-apex tooth with confirmed necrosis?

A. Only conventional root canal treatment with gutta percha obturation is appropriate here
B. Root canal treatment, apexification, or pulp space revascularization/revitalization procedures
C. Only extraction — endodontic treatment on necrotic open-apex teeth is impossible technically
D. Only apexification with calcium hydroxide — no other technique works on immature teeth

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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

IADT: 'In cases where pulp necrosis and infection are diagnosed, root canal treatment, apexification or pulp space revascularization/revitalization should be performed.' SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 10

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 10

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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What endodontic treatment options are available for…

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