Intentional replantation and management of avulsion related ankylosis and external cervical resorption. A 10-year follow up case report |
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Authors: | Ioannis N. Kotsanos Eleftheria Tzika Nikolaos Economides Nikolaos Kotsanos |
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Affiliation: | 1. Private practice, Thessaloniki, Greece;2. Department of Pediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece;3. Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece |
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Abstract: | Replantation is the treatment of choice for avulsed permanent teeth; ankylosis and cervical root resorption are among survival complications. A 9.5-year-old boy presented with an avulsed maxillary permanent central incisor with an open root apex following a school accident. The tooth was kept in milk, after a dry time of 15–20 min. Its replantation was performed 60 min after the accident. At 8 months, apexification with apical plug was attempted upon radiographic evidence of apical periodontitis. Ankylosis sound with infraocclusion and radiographic evidence of external cervical root resorption (ECR) were evident at 3 years and 3 months. At the patient's return one year later with esthetic concerns (2 mm infraocclusion) there was a 5 mm diameter ECR cavity. After intentional atraumatic extraction the resorptive cavity was debrided and restored with Biodentine; subsequently the tooth was reimplanted and splinted at an extruded position. At the 10-year follow up since the first avulsion the tooth remains esthetically pleasing, asymptomatic, non-ankylotic and functional. The present case supports intentional replantation as an option in managing infraoccluded teeth with advanced ECR. |
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Keywords: | ankylosis avulsion Biodentine cervical root resorption intentional replantation |
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