Avulsion Immature Tooth — ORE Part 1 MCQ

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HardPaediatric DentistryAvulsion Immature ToothORE Part 1

A child aged 7 years presents with an avulsed upper central incisor with incomplete root development (wide-open apex). The tooth was replanted within 15 minutes and has been splinted. What is the expected pulp outcome?

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Correct answer: C — Revascularisation is possible and the pulp should be monitored; do not initiate RCT prophylactically

In immature avulsed teeth replanted within 15 minutes (brief extra-alveolar time), revascularisation of the pulp is possible and can lead to continued root development under ideal conditions. The tooth should be monitored clinically and radiographically for signs of pulp vitality; prophylactic RCT is not indicated at the outset. RCT is deferred and initiated only if clinical/radiographic evidence of pulp necrosis develops (typically within 2–4 weeks). Option D is incorrect because revascularisation is achievable, not inevitable necrosis. Option B is plausible (ankylosis is a real risk in avulsed teeth, ~41–56%), but ankylosis is not the primary expected pulp outcome and occurs over months. Option A is wrong because immature teeth do not inevitably fail. Option E is incorrect; pulpotomy is not the standard intervention at splint removal.

Reference: International Association of Dental Traumatology Guidelines (endorsed in PMC8233981); Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. PubMed 23402501. 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233981/