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Pathology · single question

A patient presents with a fractured cusp and a traumatic ulcer on the lateral tongue at the same level. What is the most appropriate initial treatment?

  1. Smooth or restore the fractured cusp
  2. Extract the tooth
  3. Perform an immediate biopsy of the ulcer
  4. Prescribe antifungal medication
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Correct answer: A. Smooth or restore the fractured cusp

Traumatic ulcer from a fractured cusp = reactive lesion from mechanical irritation. Correct management: remove the cause (smooth/restore the fractured cusp). The ulcer should resolve in 7–14 days. Biopsy only if it fails to heal after removing the cause.
  • A. CORRECT. Smooth or restore the fractured cusp to eliminate the irritant. The traumatic ulcer heals once the cause is removed.
  • B. Extraction is overly aggressive — addressing the fractured cusp is first-line.
  • C. Immediate biopsy is premature — biopsy only after the irritant is removed and the ulcer fails to heal in 2 weeks.
  • D. Antifungals treat candidiasis — the etiology here is mechanical (fractured cusp), not fungal.

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