Immediately before replanting an avulsed tooth with a short extraoral time, which action is MOST damaging?

Correct answer: D. Scraping the root surface with a curette

• A. A gentle saline rinse to remove gross debris is explicitly recommended — it does not strip viable cells the way scrubbing does.
• B. Gently irrigating the socket to remove the coagulum is acceptable; the socket walls are not curetted, but this is far less damaging than instrumenting the root.
• C. Handling by the crown alone is the correct technique, precisely because it protects the root surface.
• D. CORRECT. The entire prognosis rests on the viability of the PERIODONTAL LIGAMENT CELLS still adherent to the root surface. Curetting or scrubbing them off mechanically destroys the very tissue you are trying to preserve and guarantees ankylosis with replacement resorption. The root surface must not be instrumented under any circumstances when the ligament may still be viable.

Note: Do not curette the socket and do not scrape the root. Both errors destroy the cells on which periodontal healing depends.