INBDE (Integrated National Board Dental Examination) Practice Exam

When an intruded permanent tooth has a closed apex, the initial management should involve repositioning it orthodontically. This is because the tooth is still developing and there is active formation of the root apex. Repositioning can help prevent the tooth from becoming ankylosed, which would result in its eventual loss. A CaOH pulpectomy should be done in 2 weeks as part of the treatment plan to help the tooth continue to develop and prevent infection. The other options listed are not suitable as initial management because they do not address the issue of the closed apex and may lead to further complications or loss of the tooth. Splinting may cause ankylosis while closely monitoring may not effectively prevent ankylosis or infection. Primary endodontic treatment is not recommended as the first line of management for an intruded tooth with a closed apex.