(TC15) Alternative Option for Management of Avulsed Teeth

Avulsion of permanent teeth is a serious dental traumatic injury. Studies have shown that the prognosis of this type of injury is dependent on prompt access to dental care. Immediate reimplantation is recommended but not always feasible. Emergency management and treatment often involve collaborative care. Frequent follow-ups are essential to ensure good prognosis. Since avulsions commonly occur in children it is important to recognize and address complications that may occur as retention of the tooth is imperative for continued alveolar growth. The objective of this table clinic is to present management of avulsed #8 and #9 in a 12-year-old Caucasian male. #8 was repositioned three hours post injury and splinted with a flexible splint. Root canal therapy (RCT) was initiated and calcium hydroxide medicament placed. Sealer-based obturation with bioceramics was completed four weeks later. Since #9 had an extended extra-oral dry time of two days, the periodontal ligament (PDL) was removed, and the tooth soaked in sodium fluoride (NaF). Prior to reimplantation and flexible splint placement, 3 mm root resection and a 3 mm bioceramic root-end filling was completed. At the three-month follow-up the splint was removed and no complications were noted with #8. However, mesial periodontal bone loss was detected adjacent to #9, which was treated with periodontal surgery, Emdogain application and bone grafting. At the 12-month follow-up both teeth were in good standing. This table clinic offers clinicians alternative options to manage avulsed teeth with extended extra-oral dry times.