Tooth replantation is the best treatment option for tooth avulsion in the permanent dentition. Although prognosis for the avulsed tooth is guarded, replantation, followed by a brief period of splinting and endodontic. Pdf intentional replantation has been practised for many years as a treatment modality for pulpless teeth. Once the extra oral procedure has been completed, the tooth is reinserted into the socket. This case report presents two cases of delayed replantation of avulsed maxillary central incisors after an extended dry extraalveolar period. That means that if it is put back in it will have to be extracted sooner or later. The avulsed permanent tooth should be gently but well rinsed with saline, with care taken not to damage the surface of the root which may have living periodontal fiber and cells. The primary goal in treating an avulsed tooth is to preserve solution from the moment of trauma until its replantation 3 and treat the supporting tooth tissues and to replant the h later in a yearold boy. While publications, including in vivo and in vitro studies, on the various aspects of replantation of avulsed permanent teeth are abundant, the replantation of primary incisors has received only scant and super. Patient developed severe pain 24 hours after root canal filling and insisted tooth be extracted. Complicated crownroot fracture management using the 180. Fractures of the socket wall should be repositioned prior to replantation. While performing intentional replantation, not only a traumatic tooth extraction is.
A tooth replantation procedure involves the teeth, gums, and mouth. If there is a preexisting abscess, the oral surgeon will remove the infected tissue before the replantation. In this report, the procedures and prognosis of the new treatment for the vertical tooth root fracture tooth reconstructed by intracanal adhesion. Replantation of avulsed primary incisors baby oral health program. The success of replantation depends on the case report patients general health, the maturity of the root, the time.
Management of avulsed permanent teeth with closed apex tooth immediately replanted at accident site verify normal position of the replanted tooth both clinically and radiographically follow the same treatment guideline for extra oral dry time methods. However, although rare, new resorptive processes could occur even after 5 or 10 years. About europe pmc funders joining europe pmc governance roadmap outreach. Dental avulsion is a real dental emergency in which prompt management within 2040 minutes of injury affects the prognosis of the tooth. Intentional replantation of endodontically treated teeth. Coagulum can be removed from the socket with a stream of sterile saline to facilitate slow, slight digital pressure replantation. Once the tooth and mouth are clean an attempt can be made to replant in its. A, appearance of tooth before intentional replantation. If replantation is not possible, the tooth teeth is to be stored in an appropriate transportation medium normal saline 0. A technique to consider in rare cases when conventional surgery is impossible. Tooth replantation is the reinsertion and splinting of a tooth that has been avulsed knocked or torn out of its socket.
Abstract pediatric dentists who treat a significant number of children under 4 years of. Pdf eightyear followup of successful intentional replantation. Intentional replantation of periodontally compromised. These factors combine to render inconclusive any findings. Eightyearold boy and 10yearold boy presented with avulsed maxillary central incisors due to trauma occurring 27 and 7 hours earlier, respectively. In the optimal scenario, the avulsed tooth should be replanted immediately or should be stored in a physiological medium such as saline for only a short period before replantation. Intentional replantation of maxillary second molar. Replantation of an avulsed incisor after prolonged dry. Intentional replantation is contraindicated in the presence of periodontal disease, in which there is marked tooth mobility, furcation involvement or gingival inflammation.
Pdf replantation of avulsed permanent anterior teeth. Prioritising replantation of avulsed and grossly mobile luxated teeth nearing avulsion is associated with best possible long term prognosis and restoration of the landscape of the mouth. Retention and healing outcomes after intentional replantation. A total of 18 cases 90% were successful over a mean followup period of 15. Replantation of a tooth with an out of socket drytime 60 minutes is futile because. Why is the tooth replantation surgical procedure performed. Few authors suggest the use of scaler, curette, pumice prophylaxis, diamond bur, sand paper disk. Ijcdc july dec 2018 vol 8 issue 2 indian journal of. Replantation in dentistry certified fixed orthodontic. Replantation of a tooth with an out of socket drytime 60 minutes is futile because the periodontal ligament pdl cells are no longer viable. Treatment guidelines for avulsed matureimmature permanent teeth with prolonged extraoral time were. The root surface pdl cells are not expected to survive.
Survive for split tooth by intracanal adhesive with. Replantation of an avulsed maxillary incisor after 12 hours. If doubt exists that the tooth can be replanted adequately, the tooth should be quickly stored in an appropriate medium until the patient can get to the dental of. The tooth rarely requires any splinting to maintain stability. Intentional replantation journal of oral health and dental. The tooth 62 was replanted in place and splinted with soft stainlesssteel wire and light cure resin figure 4. During ankylosis, the tooth root merges with the remodeled normal bone and is. Tooth replantation is a surgical procedure that involves reinserting a tooth that has been knocked or torn from its socket, back to its normal position. From a biologic perspective, removal of the apical segment of the tooth along with the attached granulation tissue, retrosealing with bioceramic putty and reinsertion of the tooth into. However, in cases where a dental implant, nonsurgical retreatment or surgical treatment is not possible, intentional replantation may be a viable treatment option. Maxillary occlusal radiograph taken immediately after replantation shows proper repositioning of avulsed tooth 11. The tooth should be gently washed and replanted as atraumatically as possible 15.
Tooth immediately replanted at accident site verify normal position of the replanted tooth both clinically and radiographically follow the same treatment guideline for ex traoral dry time replantation is extraction of a tooth to do extraoral root canal therapy, curettage of apical lesion when present, and its replacement in its socket. Terms defines intentional replantation as insertion of a tooth into its alveolus after the tooth has been extracted for the purpose of performing treatment, such as root end fillings or perforation repair. After replantation of the first upper incisor with open apex, stored in physiological solution for 5 hours and with delayed endodontic treatment forth case healing process is stable and the prognosis is. A 6yearold girl sustained an avulsion injury to her upper left central permanent incisor. Replantation of the avulsed tooth restores aesthetics and occlusal function shortly after the injury. In reality, intentional replantation is highly predictable and should be considered before condemning select teeth as having a hopeless prognosis 1, 2. Intentional replantation is defined as the extraction of the tooth and its reinsertion int o the socket after sealing the resected root end with a rootend filling material 6. Intentional replantation of an endodontically treated. Conventional and surgical endodontic therapy are established as predictable clinical procedures that save teeth with pulpal disease. Here, a case of complicated crownroot fracture of tooth. Delayed replantation after prolonged dry storage rao a. Patient was advised on advantages of immediate replantation, and that if pain persisted the tooth could easily be reextracted. Conclusion it appears that the authors of textbooks are correct to discourage replantation of primary incisors based on the low level of evidence to support the procedure and on the riskbenefit assessment of the outcomes. Intentional replantation houston tx, medical center.
Replantation of avulsed primary incisors wiley online library. Pdf avulsion of permanent front teeth is a rare accident, mostly affecting children. Tooth avulsion in the permanent dentition constitutes a dental emergency. Abu alqasim described the first replantation technique using ligatures to splint the. A replantation will have a lower success rate if the tooth is already compromised periodontally and missing the interseptal bone. Continued development of a tooth root separate from the body of the tooth was not observed. Multidisciplinary approach in the immediate replantation. In the 11th century, abulcasis described use of ligatures to splint.
It can be concluded that intentional replantation with careful case selection can have a high success rate over 2 years. Purpose teeth are replanted to prevent permanent loss of the tooth, and to restore the landscape of the mouth so that the patient can eat and speak normally. Tooth replantation is a form of restorative dentistry in which an avulsed or luxated tooth is. Infection can cause the tooth root to rapidly dissolve months to a year. Intentional replantation is an alternative to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are. Prospects for tooth survival and the incidence of pulpal necrosis, root resorption and ankylosis are unknown. Avulsion and replantation of primary teeth a feasible option. Indications and case series of intentional replantation of.