Survival of Avulsed Permanent Incisors in Children Following Delayed Replantation

Abstract

Background: Replantation of avulsed teeth is an invasive treatment approach where patient cooperation is required after the risks are explained to the patient or family. Although replantation of an avulsed permanent teeth is an accepted treatment approach, the long‑term prognosis of the replanted teeth is still controversial. This report describes the survival of delayed replanted 15 incisors that was stored in unfavorable conditions after avulsion.

Materials and Methods: Nine patients, aged 8–12 years, were referred to the Inonu University, Pediatric Dentistry Department with traumatically avulsed incisors. The parents were informed about the possible complications of a delayed replantation.

Results: Forty percent of the teeth were splinted with flexible orthodontic wire and composite. The follow‑up periods were varied from 24 to 48 months. The mean follow‑up periods were 33.3 ± 8 months. 40% of the teeth were retained in the mouth for at least 3 years and contributed to alveolar bone development. In these cases, the most common complication (9 teeth, 60%) was replacement root resorption. Two of the 15 teeth which had wide open apices, continued to the root development.

Conclusion: In this study, replanted teeth were retained in the mouth for at least 2 years and contributed to the patient’s  development. Therefore, this study has shown that delayed replantation of an avulsed tooth for a child is still worthwhile, even in cases of poor prognosis where the tooth had extended extra‑alveolar dry storage. We believe that delayed replantation should be done because of its importance for the child’s jaw and facial development.

Keywords: Dentoalveolar ankylosis, root resorption, tooth avulsion, tooth replantation