Abstract
Introduction. Tooth avulsion in the young permanent dentition is a frequent finding, and its prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient's general health. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident. Methods. A right lower central incisor of a 7-year-old girl was avulsed, and it was soaked in a glass of milk. 90 minutes after avulsion, replantation was performed, and the tooth was splinted; but after two weeks the replanted tooth's pulp was necrotic. Thus, endodontic treatment was performed and root canal was filled using a calcium hydroxide and iodoform paste (Metapex). Three months later, the intracanal medication was washed out and the canal was sealed using an apical plug of calcium enriched mixture (CEM) cement. Results. 20 months after replantation the tooth was completely asymptomatic, with physiologic mobility. Also, continued root formation including an apical segment beyond the artificial apical plug was observed. Conclusion. Creation of an appropriate apical barrier following the disinfection of root canal system promoted continued root-end growth in a replanted immature permanent tooth.
Highlights
Prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient’s general health [3, 4]
According to the guidelines which have been published by the International Association of Dental Traumatology (IADT) [6], treatment of an avulsed tooth depends upon the extra-alveolar dry time
Before removing splint, under local anesthesia, access cavity was prepared and canal was instrumented carefully using manual stainless steel files (Dentsply Maillefer, Switzerland) and irrigated with ten mL of sodium hypochlorite 2.5%; the root canal space was dried with sterile paper points (ARIADENT, Tehran, Iran) and filled using a calcium hydroxide and iodoform paste (Metapex)
Summary
Traumatic injury to the young permanent dentition is a frequent finding [1]. Avulsion of permanent teeth usually occurs in children aged 8–10 years, due in part to short and incomplete roots and resilient periodontium and bone [2]. Prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient’s general health [3, 4]. According to the guidelines which have been published by the International Association of Dental Traumatology (IADT) [6], treatment of an avulsed tooth depends upon the extra-alveolar dry time. In cases of open apices or partially developed roots with extraoral dry time less than sixty minutes, the avulsed teeth should be replanted immediately to allow revascularization [7]. Complete root development after pulp revascularization of the replanted immature permanent teeth has been reported several times [8,9,10], but continued root formation after root canal treatment of a replanted immature tooth has seldom been documented [11]. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
