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RCT Timing After Replantation — NDEB AFK MCQ

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ModerateEndodonticsRCT Timing After ReplantationNDEB AFK

A healthy 10-year-old accidentally avulses a permanent maxillary central incisor with a closed apex. The tooth is replanted within 5 minutes and splinted. When should root canal treatment be initiated?

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

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Correct answer: B — 7-14 days after replantation

For avulsed permanent teeth with closed apices that are replanted quickly (<60 min extra-alveolar time), root canal treatment should be initiated 7-14 days after replantation (IADT 2020 guidelines). Calcium hydroxide is placed as an intracanal medicament for 1-4 weeks to eliminate bacteria and prevent inflammatory resorption, before definitive obturation. Treatment is initiated at 7-14 days (rather than immediately) to allow initial soft tissue healing of the PDL and reduce procedural trauma to the replanted tooth. For open apex teeth, RCT is deferred as revascularisation may occur.

Reference: IADT – Guidelines for Management of Traumatic Dental Injuries, 2020