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Abstract
Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy reported an uncomplicated crown fracture and avulsion of tooth 11 and complicated crown fracture of tooth 21 due to trauma. Reimplantation of element 11 was obtained within 30 min post-trauma and 3 days after both elements were diagnosed with necrotic pulp. In addition, tooth 11 showed early external root resorption. Both elements underwent endodontic treatment and root closure with apical plug using calcium-silicate-based cement. At 6-month follow-up root resorption appeared to be arrested. Twenty-four months after trauma the clinical results were stable, although signs and symptoms of ankylosis were observed. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up.
Highlights
Trauma involving the dento-alveolar region represents a major emergency in dentistry, with a frequent occurrence in children and young adults
Replantation of avulsed teeth represents nowadays the treatment of choice; some factors should be taken into account that might interfere with the prognosis and long-term survival of the dental element, such as maturity of the root, condition of periodontal ligament (PDL) and extra-oral storage [1,2]
Association of Dental Traumatology Guidelines [1] highlighted that, after 30 min of extraoral dry condition, loss or damage of PDL cells should be evaluated before reimplantation
Summary
Trauma involving the dento-alveolar region represents a major emergency in dentistry, with a frequent occurrence in children and young adults. Replantation of avulsed teeth represents nowadays the treatment of choice; some factors should be taken into account that might interfere with the prognosis and long-term survival of the dental element, such as maturity of the root (open or closed apex), condition of periodontal ligament (PDL) and extra-oral storage [1,2]. On the other hand, reimplanted dental elements with closed apex should be endodontically treated within 2–3 weeks after trauma, considering a potential contamination of the necrotic pulp after avulsion [1]. The family history of the patient if associated with the primary complaint must be provided, if relevant. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up
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