Long-Term Retention of Avulsed Maxillary Incisors with Replacement Root Resorption: A 9-Year Follow-Up.

Hyunjung Yoon,Minju Song,Jiiang H Jeng

doi:10.1155/2021/8872859

Abstract

The purpose of this case report is to present a case of long-term retention of avulsed upper maxillary incisors with external replacement root resorption in a 15-year-old boy. The avulsed teeth, #11, 21, and 22, were stored under dry conditions for 40 min and replanted. Endodontic treatment was initiated after two weeks, and the nonrigid splint was removed after 3.5 months. A year after replantation of the teeth, replacement root resorption was detected radiographically. For the following 9 years, the resorption progressed slowly, but the teeth were maintained without any adverse effects on esthetic appearance. Under dry storage conditions, replacement root resorption was expected. In this case, the patient was a growing 15-year-old boy; thus, replantation was performed despite a possible poor prognosis. Consequently, root resorption progressed. Nevertheless, maintenance of the tooth crowns led to satisfying results for the patient both esthetically and psychologically. Ankylosis or replacement root resorption is a complication occurring after replantation of avulsed teeth, which could require additional treatment. However, in young patients, replantation could be considered to maintain the teeth until growth is complete.

Highlights

The prevalence of avulsion of permanent teeth is reported to be 0.5 to 3.0%
Compared with other types of dental injuries, prompt emergency treatment for the avulsed tooth is critical to prevent complications relating to the pulp and the periodontal ligament
For the avulsed permanent teeth, pulp necrosis is inevitable because the nerves and blood vessels of the injured teeth have been severed

Summary

Introduction

The prevalence of avulsion of permanent teeth is reported to be 0.5 to 3.0%. Avulsion is most common in young permanent dentition [1, 2]. To prevent replacement root resorption or ankylosis caused by damaged periodontal ligament tissues, physiologic storage medium and functional splinting are required. Replacement root resorption cannot be controlled once initiated; prevention by minimizing damage to the periodontal ligament is the only treatment [5]. In young, growing patients, progression of replacement resorption could lead to tooth loss and ankylosis could result in infraposition of teeth, which would require further treatments such as surgical procedure, orthodontic treatment, and/or tooth extraction [8]. In cases where negative long-term prognosis is expected, leaving the socket empty without replantation may be considered appropriate This case report presents the long-term retention of avulsed maxillary incisors with replacement root resorption in a 15-year-old patient. Replacement root resorption, the patient’s teeth were maintained without any adverse effects esthetically, during a 9-year follow-up period

Case Presentation

Findings

Discussion

Conclusion