Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Oct 1;12(10):e991-e998.
doi: 10.4317/jced.57198. eCollection 2020 Oct.

What can we do with a dental avulsion? A multidisciplinary Clinical Protocol

Naia Bustamante-Hernández  1 , Jose Amengual-Lorenzo  2 , Lucía Fernández-Estevan  2 , Alvaro Zubizarreta-Macho  3 , Cátia-Gisela Martinho da Costa  4 , Rubén Agustín-Panadero  5
Affiliations
Case Reports

What can we do with a dental avulsion? A multidisciplinary Clinical Protocol

Naia Bustamante-Hernández et al. J Clin Exp Dent. .

Abstract

Purpose: The aim of this case report was to explain a multidisciplinary and conservative approach carrying out the replantation of an avulsed closed apex central incisor stored in dry conditions for a 16-hour period from the moment of trauma.

Case report: This report describes a case of a 28 year-old male who suffered contusion of the upper lip, avulsion of right upper central incisor, enamel cracks after trauma of left upper central incisor and upper left lateral incisor crown fracture due to an accident. Avulsed tooth was dry stored and it was replanted 16h after the trauma. The root was disinfected and the necrotic periodontal tissue removed, the endodontic treatment was done before replantation and a flexible splint was applied to tooth 13 to tooth 23. Two months later a contralateral tooth presented crown discoloration occurred due to pulp necrosis an endodontic treatment as well as bleaching were carried out. An esthetic restoration for lateral incisor crown fracture was also done. In the one year review the patient remains asymptomatic, with no signs of root resorption or ankylosis of the damaged teeth.

Conclusions: A conservative approach of tooth with delayed reimplantation can be a stable and functional with the appropriate treatment procedures. A clinical protocol for patients and professionals for the treatment of the avulsed tooth is proposed. Key words:Endodontics, dental avulsion, avulsed tooth protocol.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest None declared.

Figures

Figure 1
Figure 1
A,B,C) Upper lip contusion from different points of view. D,E) Avulsion of right upper central incisor. F) Socket healing after dental avulsion.
Figure 2
Figure 2
Pre-treatment radiographic study. A) Axial tomographic cut of the socket after the avulsion of the right upper incisor. B) Coronal view of the socket after the avulsion. C) Axial tomographic cut of the upper left incisor. D) Initial orthopantomography after tooth avulsion. E) 3D reconstruction of the patient’s bone jaws and teeth following dental trauma.
Figure 3
Figure 3
A) Avulsed tooth cleaned. B) Extraoral endodontic treatment. Access cavity preparation. C) Socket activated causing bleeding before intentional replantation. D,E) Tooth placed into his socket and splinted temporarily with orthodontic wire.
Figure 4
Figure 4
Radiographic study after replantation of the avulsed tooth. A) Axial tomographic cut of the upper right incisor replanted in the socket. B) Orthopantomography after tooth replantation. C) 3D axial reconstruction of the right upper incisor replanted. D) 3D reconstruction of the patient’s bone jaws and teeth after tooth replantation.
Figure 5
Figure 5
A) Contralateral tooth crown discoloration due to pulp necrosis. B) Contralateral crown bleaching due to crown discoloration after a pulp necrosis. C) Post treatment orthopantomography.
Figure 6
Figure 6
A,B,C) Post treatment clinical image. D) Axial tomographic cut of the upper right incisor in the bone socket after 1 year of treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Andreasen JO, Andreasen FM. Textbook and Color Atlas of Traumatic Injuries to the Teeth. 3rd edn. Copenhagen: Munksgaard; 1995.
    1. American Academy on Pediatric Dentistry Council on Clinical Affairs. A guideline on management of acute dental trauma. Pediatr Dent. 2008;30:175–83. - PubMed
    1. de Carvalho Rocha MJ, Cardoso M. Reimplantation of primary tooth-case report. Dent Traumatol. 2008;24:4–10. - PubMed
    1. Martins-Júnior PA, Franco FA da S, de Barcelos RV, Marques LS, Ramos-Jorge ML. Replantation of avulsed primary teeth: a systematic review. Int J Paediatr Dent. 2014;24:77–83. - PubMed
    1. Application of the international classification of diseases and stomatology. Geneva: World Health Organization; 1992.

Publication types

LinkOut - more resources