Oral Surgery · patient case question
Tooth #6 is intact, non-mobile, responds normally to cold, and shows no radiographic change. What is the appropriate management?
Patient case: Face-First Fall on Concrete
Patient: 34-year-old male
Chief Complaint: “I tripped and landed on my face on the sidewalk.”
Background: Healthy. No loss of consciousness, no nausea, no visual disturbance. Tetanus status current. Injury occurred approximately 5 hours ago.
Medications: None
Vital Signs: BP 128/78 mmHg · HR 84 bpm · RR 16 · T 98.4°F
Findings: Chin shows a broad, raw, superficially scraped area with punctate bleeding and embedded grit. The inner surface of the lower lip has a full-thickness tear with irregular edges. Teeth #7 and #8 are fractured with frank pulp exposure, tender to percussion, mature apices. Tooth #6 is intact, non-mobile, responds normally to cold, with no radiographic changes.
Show answer and explanation
Correct answer: D. Monitoring with periodic clinical and radiographic reevaluation
- A. Incorrect. There is no indication to treat a vital, asymptomatic tooth. Prophylactic endodontics is never appropriate on this basis.
- B. Incorrect. Nothing about this tooth suggests it cannot be retained.
- C. Incorrect. There is no structural loss to restore. A crown would remove sound tooth structure for no benefit.
- D. Correct. A tooth adjacent to a traumatic injury may develop delayed pulpal necrosis months later even when it initially tests within normal limits. Serial follow-up at roughly 6–8 weeks, 6 months, and 1 year is the standard.