ADC Practice Question — First Aid & PDL Cell Viability

Which factor or combination makes replantation potentially not indicated for this patient?

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 45-year-old immunosuppressed patient on high-dose methotrexate for rheumatoid arthritis has an avulsed lower premolar with advanced periodontal disease (grade III mobility on adjacent teeth, generalized 6mm+ pockets). Which factor or combination makes replantation potentially not indicated for this patient?

A. Advanced age — patients over 40 have significantly reduced PDL regeneration capacity
B. Severe periodontal disease combined with immunosuppression — both are listed contraindications
C. The tooth is a premolar — the IADT only recommends replantation for anterior incisor teeth
D. Methotrexate use alone — this medication completely prevents any periodontal healing response

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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: 'There are also individual situations when replantation is not indicated (eg, severe caries or periodontal disease, severe medical conditions such as immunosuppression).' Both conditions are present here, making replantation potentially not indicated. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 1

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 1

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

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.

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.

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Which factor or combination makes replantation potentially not indicated for this patient?

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