ABE ABE Dental Trauma Management 2 — Questions and Answers
Question 1: What is the most critical factor determining prognosis of a replanted avulsed permanent tooth?
- Patient age and tooth size
- Extra-alveolar time and storage medium (Correct answer)
- Root length and apex diameter
- Stage of root development alone
Correct answer: Extra-alveolar time and storage medium
Extra-alveolar time and storage medium are the most critical factors because PDL cell viability determines whether periodontal healing can occur.
Question 2: What is the ideal storage medium for an avulsed permanent tooth when immediate replantation is not possible?
- Plain water
- Saliva (buccal vestibule) as the only option
- Hank's Balanced Salt Solution (HBSS) or milk (Correct answer)
- Saline solution
Correct answer: Hank's Balanced Salt Solution (HBSS) or milk
Hank's Balanced Salt Solution (HBSS) is the optimal storage medium; milk is the best practical alternative available in most emergency situations.
Question 3: For an avulsed permanent tooth with an OPEN apex and less than 60 minutes of dry extra-alveolar time, what endodontic management is recommended after replantation?
- Root canal treatment within 1 week regardless
- Monitor for signs of necrosis; initiate root canal only if necrosis develops (Correct answer)
- Immediate root canal before replantation
- No endodontic treatment ever needed
Correct answer: Monitor for signs of necrosis; initiate root canal only if necrosis develops
Immature teeth with open apices have potential for pulp revascularization, so endodontic treatment is deferred unless signs of pulp necrosis develop.
Question 4: What type of splint is recommended for replanted avulsed permanent teeth according to IADT guidelines?
- Rigid splint for 6–8 weeks
- Flexible (physiologic) splint for 2 weeks (Correct answer)
- Rigid splint for 4 weeks
- No splinting is required
Correct answer: Flexible (physiologic) splint for 2 weeks
A flexible (physiologic) splint for 2 weeks is recommended to allow physiologic tooth movement that promotes PDL healing and reduces ankylosis risk.
Question 5: Which type of root resorption following tooth replantation indicates PDL cell death and direct bone-to-cementum fusion?
- Surface resorption
- Inflammatory resorption
- Replacement resorption (ankylosis) (Correct answer)
- External cervical resorption
Correct answer: Replacement resorption (ankylosis)
Replacement resorption (ankylosis) occurs when necrotic PDL cells are replaced by bone, fusing the root directly to alveolar bone without an intervening PDL.
Question 6: What systemic antibiotic is recommended by IADT guidelines for adults following tooth replantation?
- Amoxicillin 500 mg TID for 7 days (Correct answer)
- Tetracycline 500 mg QID for 7 days
- Metronidazole 400 mg TID for 5 days
- Ciprofloxacin 500 mg BID for 3 days
Correct answer: Amoxicillin 500 mg TID for 7 days
Amoxicillin 500 mg three times daily for 7 days (or doxycycline) is recommended by IADT guidelines to reduce infection risk during the critical healing period after replantation.
ABE ABE Dental Trauma Management 2
What is the most critical factor determining prognosis of a replanted avulsed permanent tooth?