Dental OSCE (Objective Structured Clinical Examination) Practice Exam

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What are the implications of a vertical root fracture in a treated root canal tooth?

Necessary extraction of the tooth
Required retreatment of the canal
Monitoring for pulp necrosis
Immediate endodontic surgery

The correct answer is: Necessary extraction of the tooth

A vertical root fracture in a treated root canal tooth often presents significant challenges in management. When a vertical root fracture occurs, it compromises the structural integrity of the tooth, leading to potential complications such as infection, mobility, and pain. Extraction of the tooth becomes necessary because repairing a vertically fractured root is generally not feasible. The entire root structure is affected in a way that can allow bacteria to penetrate the periodontal tissues, which could lead to periapical inflammation or abscess formation. Additionally, maintaining a fractured root in the arch may lead to further complications over time, such as exacerbating periodontal disease surrounding the affected tooth. In contrast, options such as retreatment of the canal, monitoring for pulp necrosis, or immediate endodontic surgery are not appropriate responses to a vertical root fracture since these methods do not address the core issue of the fracture itself, which necessitates removal of the tooth for both the well-being of the patient and to maintain oral health.