ADC Practice Question — Traumatic Dental Injuries — Permanent Teeth

approximately 2 weeks post-injury, the tooth (which…

OMS questions focus on surgical decision-making with medical comorbidities that change the surgical plan. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

A 17-year-old boy was punched during an altercation. Tooth 11 is displaced palatally. The tooth is immobile — it does not move when pressure is applied. Percussion produces a high metallic (ankylotic) sound. The tooth does not respond to cold testing. A periapical radiograph taken with a horizontal angle shift shows a widened periodontal ligament space. At approximately 2 weeks post-injury, the tooth (which has complete root formation) still does not respond to cold testing. What is the recommended endodontic approach?

A. Start root canal treatment using a corticosteroid-antibiotic or calcium hydroxide as an intra-canal medicament
B. Continue monitoring — false negative sensibility is common for several months
C. Perform a pulpotomy to preserve whatever vital tissue remains — as this timing aligns with the optimal window for treatment effectiveness
D. Extract the tooth — necrosis in lateral luxation is inevitable and treatment is futile

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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

For teeth with COMPLETE root formation and lateral luxation, the pulp will likely become necrotic. Root canal treatment should be started at about 2 weeks, using a corticosteroid-antibiotic or calcium hydroxide as an intra-canal medicament. The purpose is to prevent the development of inflammatory (infection-related) external resorption. This is where root development stage changes the decision dramatically: • Immature teeth (open apex): spontaneous revascularisation may occur — monitor and only start RCT if signs of necrosis/resorption develop • Mature teeth (closed apex): pulp will likely die — proactive RCT at ~2 weeks to prevent resorption The narrow apical foramen in mature teeth limits blood vessel regrowth, making revascularisation unlikely. SOURCE — IADT Guidelines 2020, Fractures and Luxations, Table 12

Source: IADT Guidelines 2020 — Fractures and Luxations, Table 12

Remy's study tip — Check the patient’s medical history first — anticoagulants, bisphosphonates, immunosuppression change management.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Traumatic Dental Injuries — Permanent Teeth?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are Traumatic Dental Injuries — Permanent Teeth questions structured in the ADC written exam?

ADC Traumatic Dental Injuries — Permanent Teeth questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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approximately 2 weeks post-injury, the tooth (which…

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