A 10-year-old child has an avulsed maxillary central incisor that was stored in Hank's Balanced Salt Solution. The tooth was out of the socket for 30 minutes. What should the dentist suspect based on the case?

Correct answer: D. External root resorption risk

• A. Concussion affects teeth still in the socket — not the avulsed tooth.
• B. Pulp necrosis will occur in avulsed permanent teeth with fully formed roots — this is expected, not a surprise.
• C. Reimplantation cannot guarantee full success — external resorption remains a significant risk especially after >60 minutes extra-oral time.
• D. Correct. When a permanent tooth is avulsed and stored in Hank's Balanced Salt Solution (an appropriate storage medium), reimplantation is possible. However, if the tooth was out for >60 minutes or in a poor storage medium, external root resorption (replacement resorption/ankylosis) becomes a major risk. Hank's solution helps preserve PDL cells, but extended extra-oral time still increases this risk.