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Delayed replantation of avulsed teeth: two case reports.

Savas S, Kucukyilmaz E, Akcay M, Koseoglu S - Case Rep Dent (2015)

Bottom Line: Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed.After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed.Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Izmir Katip Celebi University, Cigli, 35640 Izmir, Turkey.

ABSTRACT
This case report presents two cases of delayed replantation of avulsed maxillary central incisors after an extended dry extra-alveolar period. Eight-year-old boy and 10-year-old boy presented with avulsed maxillary central incisors due to trauma occurring 27 and 7 hours earlier, respectively. Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed. After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed. Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position but revealed clinical initial replacement resorption and ankylosis.

No MeSH data available.


Related in: MedlinePlus

Frontal view, 18 months after trauma, slight infraposition of avulsed tooth.
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Related In: Results  -  Collection


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fig4: Frontal view, 18 months after trauma, slight infraposition of avulsed tooth.

Mentions: After informing the parents of the patient about possible risks, the socket of the tooth was gently rinsed with saline solution under local anesthesia (Maxicaine, Vem Drugs, Istanbul, Turkey). The root of the tooth was cleaned carefully to remove necrotic and dried remnants of periodontal tissue. Extra-oral endodontic treatment was carried out on the tooth, the root canals were filled with mineral trioxide aggregate (MTA) (BioAggregate, DiaDent, Burnaby, BC, Canada), and the tooth was replanted slowly, with slight digital pressure. Moist cotton pellet and glass ionomer cement (Ketac Molar, 3M/ESPE Dental Products, St. Paul, MN, USA) were used to restore the access cavity temporarily. The position of the replanted tooth was verified both clinically and radiographically. The tooth was stabilized using a flexible splint (0.195 inch round twist-flex arch wires, 3M Unitek, Monrovia, CA, USA) and the acid-etch composite resin technique (Clearfil Majesty Esthetic, Kuraray, Tokyo, Japan) (Figures 2 and 3). Moreover, oral hygiene instructions and advice about a soft diet and the need to use a chlorhexidine (Klorhex, Drogsan, Ankara, Turkey) mouth rinse during the stabilization period were provided at this time. Prophylactic antibiotic therapy with amoxicillin trihydrate/potassium clavulanate (Beecham Laboratories, Bristol, TN, USA) at a dose of 625 mg/day was prescribed for one week. The patient was also referred for an antitetanus booster. The parents were informed about the importance of regularly returning for clinical and radiographic follow-up. The patient was reviewed after two weeks, and no clinical or radiological pathological changes were detected. The patient was seen again four weeks after replantation, and the splinting wire was removed at this appointment. The permanent restoration of the fractured teeth crowns was completed with resin composite (Clearfil Majesty Esthetic, Kuraray Tokyo, Japan). In the third month follow-up, a percussion test of the avulsed tooth revealed a change in the percussion sound due to ankylosis. At a recall visit 12 months later, the right central incisor gave a negative response in a vitality test. An apexification procedure using calcium hydroxide (Sultan Chemists Inc., Englewood, NJ, USA) was started to induce apical closure. During an 18-month follow-up period, the replanted tooth remained in a stable, functional position but showed initial replacement resorption, ankylosis, and approximately 0.5 mm infraocclusion (Figures 4 and 5). The patient will be monitored till her growth is complete and appropriate treatment will be carried out if needed. CBCT images were taken to evaluate the relationship between the lateral incisor and permanent canine roots.


Delayed replantation of avulsed teeth: two case reports.

Savas S, Kucukyilmaz E, Akcay M, Koseoglu S - Case Rep Dent (2015)

Frontal view, 18 months after trauma, slight infraposition of avulsed tooth.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4355813&req=5

fig4: Frontal view, 18 months after trauma, slight infraposition of avulsed tooth.
Mentions: After informing the parents of the patient about possible risks, the socket of the tooth was gently rinsed with saline solution under local anesthesia (Maxicaine, Vem Drugs, Istanbul, Turkey). The root of the tooth was cleaned carefully to remove necrotic and dried remnants of periodontal tissue. Extra-oral endodontic treatment was carried out on the tooth, the root canals were filled with mineral trioxide aggregate (MTA) (BioAggregate, DiaDent, Burnaby, BC, Canada), and the tooth was replanted slowly, with slight digital pressure. Moist cotton pellet and glass ionomer cement (Ketac Molar, 3M/ESPE Dental Products, St. Paul, MN, USA) were used to restore the access cavity temporarily. The position of the replanted tooth was verified both clinically and radiographically. The tooth was stabilized using a flexible splint (0.195 inch round twist-flex arch wires, 3M Unitek, Monrovia, CA, USA) and the acid-etch composite resin technique (Clearfil Majesty Esthetic, Kuraray, Tokyo, Japan) (Figures 2 and 3). Moreover, oral hygiene instructions and advice about a soft diet and the need to use a chlorhexidine (Klorhex, Drogsan, Ankara, Turkey) mouth rinse during the stabilization period were provided at this time. Prophylactic antibiotic therapy with amoxicillin trihydrate/potassium clavulanate (Beecham Laboratories, Bristol, TN, USA) at a dose of 625 mg/day was prescribed for one week. The patient was also referred for an antitetanus booster. The parents were informed about the importance of regularly returning for clinical and radiographic follow-up. The patient was reviewed after two weeks, and no clinical or radiological pathological changes were detected. The patient was seen again four weeks after replantation, and the splinting wire was removed at this appointment. The permanent restoration of the fractured teeth crowns was completed with resin composite (Clearfil Majesty Esthetic, Kuraray Tokyo, Japan). In the third month follow-up, a percussion test of the avulsed tooth revealed a change in the percussion sound due to ankylosis. At a recall visit 12 months later, the right central incisor gave a negative response in a vitality test. An apexification procedure using calcium hydroxide (Sultan Chemists Inc., Englewood, NJ, USA) was started to induce apical closure. During an 18-month follow-up period, the replanted tooth remained in a stable, functional position but showed initial replacement resorption, ankylosis, and approximately 0.5 mm infraocclusion (Figures 4 and 5). The patient will be monitored till her growth is complete and appropriate treatment will be carried out if needed. CBCT images were taken to evaluate the relationship between the lateral incisor and permanent canine roots.

Bottom Line: Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed.After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed.Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Izmir Katip Celebi University, Cigli, 35640 Izmir, Turkey.

ABSTRACT
This case report presents two cases of delayed replantation of avulsed maxillary central incisors after an extended dry extra-alveolar period. Eight-year-old boy and 10-year-old boy presented with avulsed maxillary central incisors due to trauma occurring 27 and 7 hours earlier, respectively. Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed. After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed. Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position but revealed clinical initial replacement resorption and ankylosis.

No MeSH data available.


Related in: MedlinePlus