ADC Practice Question — Traumatic Dental Injuries — Permanent Teeth

How should infection-related (inflammatory) external root resorption be managed in this immature tooth?

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 16-year-old boy had a lateral luxation injury to tooth 11 three months ago. At his follow-up appointment, a periapical radiograph reveals radiolucent areas along the root surface consistent with external inflammatory (infection-related) root resorption. The tooth has an open apex (immature root). How should infection-related (inflammatory) external root resorption be managed in this immature tooth?

A. Place a single application of calcium hydroxide and obturate with gutta-percha after 1 week
B. Extract the tooth — resorption indicates a hopeless prognosis
C. Initiate root canal treatment with calcium hydroxide, replaced every 3 months until resorptive lesions disappear radiographically
D. Monitor without intervention — resorption may resolve spontaneously

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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

When there is evidence of infection-related (inflammatory) root resorption, root canal treatment should be initiated immediately. Calcium hydroxide should be placed for 3 weeks and replaced every 3 months until the radiolucencies of the resorptive lesions disappear. Final obturation can be performed when bone repair is visible radiographically. This resorption is driven by infected necrotic pulp tissue — the bacteria produce an inflammatory response that causes the body to resorb the root. Calcium hydroxide works by disinfecting the canal and creating an alkaline environment that arrests the resorptive process. The repeated replacement ensures sustained disinfection. In children, this resorption is very rapid — hence the IADT emphasis on regular follow-ups to catch it early. SOURCE — IADT Guidelines 2020, Fractures and Luxations, Section 13.3

Source: IADT Guidelines 2020 — Fractures and Luxations, Section 13.3

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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.

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