ADC Practice Question — First Aid & PDL Cell Viability

What is the correct recommendation AND expected outcome?

Dental trauma questions test protocol-level decisions — splint type, duration, follow-up timing — where one wrong detail means a wrong answer. This high-difficulty vignette tests your ability to work through clinical details and arrive at the correct management.

A 12-year-old arrives after a bicycle accident. Three teeth are involved: Tooth A (11) — closed apex, replanted by bystander at scene 20 minutes ago but rotated 30 degrees. Tooth B (21) — closed apex, stored in milk for 45 minutes after 5 minutes dry, not yet replanted. Tooth C (22) — open apex, found dry on the road after 70 minutes. All sockets are intact. No alveolar fractures. The dentist must manage all three teeth in one session. After replanting Tooth B and repositioning Tooth A, the dentist turns to Tooth C (open apex, 70 minutes dry). The parents ask if it's worth replanting. What is the correct recommendation AND expected outcome?

A. Do not replant — open apex teeth with >60 minutes dry have zero chance of any healing and replantation would cause harm
B. Replant — the goal is revascularization which is still possible in open apex teeth even after prolonged dry time
C. Replant — but the expected outcome is ankylosis-related resorption; replantation maintains bone and keeps future options open despite poor prognosis
D. Replant — but only if the parents sign a consent form acknowledging the tooth will definitely be lost within 6 months

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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

Integration: (1) >60 min dry → Group 3, poor prognosis. (2) IADT: replant anyway — 'almost always the correct decision.' (3) Expected outcome: ankylosis-related resorption (not revascularization). (4) Goal: bone preservation + future options. (5) Growing patient: decoronation may be needed later. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Sections 3.1.3, 3.2.3

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Sections 3.1.3 & 3.2.3

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 First Aid & PDL Cell Viability questions structured in the ADC written exam?

ADC First Aid & PDL Cell Viability 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 First Aid & PDL Cell Viability?

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

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What is the correct recommendation AND expected outcome?

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