ADC Practice Question — First Aid & PDL Cell Viability

Prioritizing the three teeth: which requires the most URGENT attention and why?

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. Prioritizing the three teeth: which requires the most URGENT attention and why?

A. Tooth A — it is malpositioned and requires immediate removal and re-replantation under sterile conditions
B. Tooth B — it is still not replanted and every additional minute in milk reduces PDL viability further
C. Tooth C — the 70-minute dry time means all PDL cells are dead, so it needs immediate surface treatment before replantation
D. All three have equal urgency — the dentist should manage them in alphabetical order for systematic care

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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

Integration: (1) Tooth B — Group 2 with viable but dying PDL cells — most time-sensitive. (2) Tooth A — already replanted, can be repositioned up to 48 hours, not urgent. (3) Tooth C — Group 3, PDL already non-viable, outcome determined. Clinical triage = replant B first. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Sections 3, 3.1.1, 3.1.2, 3.1.3

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 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 do I approach an unfamiliar First Aid & PDL Cell Viability vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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Prioritizing the three teeth: which requires the most URGENT attention and why?

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