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Open Apex Revascularisation Potential — ORE Part 1 MCQ

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ModeratePaediatric DentistryOpen Apex Revascularisation PotentialORE Part 1

A 10-year-old child has an avulsed maxillary central incisor with a wide open apex. The tooth is replanted within 20 minutes of avulsion and stabilised with a flexible splint. What is the most appropriate expectation and endodontic approach?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: CAllow time for possible pulp revascularisation and review closely before endodontic treatment

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

A is correct. In a young patient with an open apex and short extra-oral time, pulp revascularisation is possible. UK Faculty of Dental Surgery guidance states that endodontic intervention may be delayed in this setting, provided the tooth is reviewed closely for clinical and radiographic evidence of loss of vitality or inflammatory resorption. B and E are inappropriate because immediate or routine early pulp extirpation would remove the opportunity for revascularisation. C is wrong because ankylosis/replacement resorption is a potential later complication, not an inevitable outcome after prompt replantation. D is wrong because apical maturation, if it occurs, takes time and does not determine splint removal at 24 hours.

Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. Treatment of avulsed permanent teeth in children, section 3.1 “Endodontic Treatment - Open apex teeth in young patients - short extra-oral time”. UK guidance. https://www.rcseng.ac.uk/-/media/files/rcs/fds/publications/ncg97.pdf