Intentional replantation and management of avulsion related ankylosis and external cervical resorption. A 10-year follow up case report

Dent Traumatol. 2023 Aug;39(4):392-398. doi: 10.1111/edt.12828. Epub 2023 Feb 19.


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.

Keywords: Biodentine; ankylosis; avulsion; cervical root resorption; intentional replantation.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Follow-Up Studies
  • Humans
  • Male
  • Root Resorption* / etiology
  • Root Resorption* / surgery
  • Tooth Ankylosis* / etiology
  • Tooth Ankylosis* / surgery
  • Tooth Avulsion* / complications
  • Tooth Avulsion* / surgery
  • Tooth Replantation