ADC Practice Question — Replantation Protocols — Closed & Open Apex

If the dentist chooses the corticosteroid/antibiotic paste, what makes its timing different from calcium hydroxide?

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 15-year-old's closed-apex incisor was stored in cold milk for 50 minutes after 8 minutes dry time. The dentist replants successfully and now considers the endodontic protocol, debating between calcium hydroxide and a corticosteroid paste. If the dentist chooses the corticosteroid/antibiotic paste, what makes its timing different from calcium hydroxide?

A. Both medicaments are placed at the same time — within 2 weeks at the RCT appointment
B. Corticosteroid paste is placed immediately or shortly after replantation, while Ca(OH)2 goes in at the 2-week RCT
C. Ca(OH)2 is placed immediately, while corticosteroid paste is delayed until radiographic resorption appears
D. There is no timing difference — both are interchangeable protocols placed at the clinician's convenience

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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: Corticosteroid paste 'should be placed immediately or shortly after replantation and left in situ for at least 6 weeks.' Ca(OH)2 is 'recommended as an intracanal medicament for up to 1 month' — placed at the 2-week RCT. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 10

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 10

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 Replantation Protocols — Closed & Open Apex 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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