Pediatric Dentistry · patient case question
Regarding traumatic injuries and pulp survival, which statement is correct?
Patient case: A young patient in the mixed dentition
demo: 5-year-old female
chief: Routine examination. Her mother is worried that her front teeth are coming through early.
history: Healthy. The family moved recently from a community with fluoridated water to one with none. Her mother reports the older sibling had a similar early pattern.
meds: None.
findings: Both mandibular permanent central incisors are fully erupted. A 3 mm midline diastema is present in the maxilla between the primary central incisors. A periapical film of a maxillary lateral incisor shows an invagination of enamel and dentin extending into the pulp chamber.
Show answer and explanation
Correct answer: A. Immature teeth with open apices have a better chance of pulpal survival and are monitored before intervening
- A. Correct. An open apex with a wide blood supply gives far better revascularisation potential than a mature tooth with a constricted foramen. Current trauma guidance is to monitor with regular clinical and radiographic review and to intervene only when definite signs of necrosis appear, so that root development can continue.
- B. Post-traumatic discolouration may be transient, reflecting pulpal haemorrhage and haemoglobin breakdown, and can regress over weeks. Necrosis is diagnosed on the accumulation of signs, not on colour alone.
- C. The reverse is true. Immature teeth are more likely to survive and to revascularise.
- D. Sensibility testing is unreliable for weeks to months after trauma because of transient neural disruption, and a false negative in that window is common.
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