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Post-Trauma Sensibility Testing — ORE Part 1 MCQ

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HardEndodonticsPost-Trauma Sensibility TestingORE Part 1

A 7-year-old child attends on the day of injury with a permanent maxillary central incisor that is tender to percussion and mobile but not displaced. The apex is closed. Cold and electric pulp sensibility tests are negative. What is the most appropriate immediate management?

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Correct answer: E — Review clinically and radiographically, repeating sensibility tests at follow-up

**A is correct.** Following subluxation, a negative cold or electric pulp sensibility response at the initial visit may be a transient false-negative caused by trauma to the pulpal nerve supply; it does not alone diagnose pulp necrosis. The appropriate immediate approach is baseline assessment and review, including repeat sensibility testing and radiographs. A systematic review of concussion and subluxation supports monitoring because complications, including necrosis, may develop during follow-up. **B** is premature: a closed apex raises risk but does not justify treatment from one negative test. **C** is likewise unjustified without confirmed pulpal necrosis or another endodontic indication. **D** sacrifices a potentially recoverable permanent incisor. **E** is incorrect because apexification is for a non-vital immature tooth with an open apex, whereas this tooth has a closed apex.

Reference: Tewari N, et al. Complications and sequelae of concussion and subluxation in permanent teeth: A systematic review and meta-analysis. Dental Traumatology. 2020. https://pubmed.ncbi.nlm.nih.gov/32790949/