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, 2014, 832637

Continued Root Formation After Delayed Replantation of an Avulsed Immature Permanent Tooth

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Continued Root Formation After Delayed Replantation of an Avulsed Immature Permanent Tooth

Nima Moradi Majd et al. Case Rep Dent.

Abstract

Introduction. Tooth avulsion in the young permanent dentition is a frequent finding, and its prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient's general health. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident. Methods. A right lower central incisor of a 7-year-old girl was avulsed, and it was soaked in a glass of milk. 90 minutes after avulsion, replantation was performed, and the tooth was splinted; but after two weeks the replanted tooth's pulp was necrotic. Thus, endodontic treatment was performed and root canal was filled using a calcium hydroxide and iodoform paste (Metapex). Three months later, the intracanal medication was washed out and the canal was sealed using an apical plug of calcium enriched mixture (CEM) cement. Results. 20 months after replantation the tooth was completely asymptomatic, with physiologic mobility. Also, continued root formation including an apical segment beyond the artificial apical plug was observed. Conclusion. Creation of an appropriate apical barrier following the disinfection of root canal system promoted continued root-end growth in a replanted immature permanent tooth.

Figures

Figure 1
Figure 1
Preoperative radiograph showing the intact socket of right lower central incisor.
Figure 2
Figure 2
The right lower central incisor was splinted using orthodontic wire.
Figure 3
Figure 3
Two weeks after replantation, periapical radiolucency around the replanted tooth has increased considerably.
Figure 4
Figure 4
Root canal was filled using a calcium hydroxide and iodoform paste (Metapex).
Figure 5
Figure 5
One month follow-up radiograph.
Figure 6
Figure 6
Three-month follow-up radiograph.
Figure 7
Figure 7
Twelve-month follow-up radiograph; continued root formation is detectable.
Figure 8
Figure 8
Twenty-month follow-up radiograph; continued root formation is very noticeable.

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