Dental Avulsion — ORE Part 1 MCQ

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ModerateOral SurgeryDental AvulsionORE Part 1

A 12-year-old boy attends immediately after avulsion of the upper right permanent central incisor in a bicycle accident. The tooth was stored in milk, the extra-alveolar dry time was less than 5 minutes, and it is replanted without difficulty. It has a closed apex. There is no alveolar fracture. For how long should a flexible splint be maintained?

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Correct answer: E — 2 weeks

**A. 2 weeks** is correct. An avulsed permanent tooth that is replanted promptly should be stabilised with a passive flexible splint. SDCEP advises flexible splinting for 1–4 weeks according to factors including apex maturity and time before replantation; for an uncomplicated mature tooth replanted promptly, the standard IADT-based regimen is **2 weeks**. The closed apex is relevant to subsequent endodontic management—root canal treatment is normally initiated within 2 weeks—but does not justify prolonged splinting. **1 week** is shorter than the standard period for an avulsed replanted permanent tooth. **4 weeks** may be appropriate where there is an associated alveolar fracture or a need for additional stabilisation, which is excluded in this stem. **6 and 8 weeks** are unnecessarily prolonged and are not routine management for uncomplicated avulsion.

Reference: Scottish Dental Clinical Effectiveness Programme, Management of Acute Dental Problems, section 4.13 Dento-alveolar injuries (2013): https://www.sdcep.org.uk/media/ixlpeakb/sdcep-madp-guidance-march-2013.pdf