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Dentistry · Caries, pulp and periodontal disease: pulp canal obliteration after trauma
Sample itemA 12-year-old had a luxation injury to an upper central incisor two years ago. The crown has slowly turned yellow, and a radiograph shows a markedly narrowed canal with no periapical radiolucency. The tooth is asymptomatic. What is the appropriate management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Monitor, with root canal treatment only if signs of pathosis appear
Calcific metamorphosis or pulp canal obliteration follows trauma and gives a yellow crown. Most such teeth remain asymptomatic with no periapical disease, so routine endodontic treatment is not advised; treatment is reserved for symptoms or a periapical lesion, and bleaching can improve colour.
Option by option
A. Pulpotomy with calcium hydroxide now
A pulpotomy is not indicated in an asymptomatic tooth with a narrowed canal.
B. Apicoectomy with retrograde filling
Apicoectomy treats persistent periapical disease, which is absent here.
C. Monitor, with root canal treatment only if signs of pathosis appear (correct)
Correct. Follow-up is enough while the tooth is symptom-free and has no periapical lesion.
D. Immediate extraction and implant placement
Extraction is excessive for a healthy-looking obliterated tooth.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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