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Replantation of avulsed tooth


Replantation, as the name implies, is the process in which a tooth, normally the front tooth, is reinserted into the bone after its loss, or displacement by accidental means. There are few reports in literature of this technique proving successful for indefinite periods of time. {{more}}The failure occurs mainly because of root resorption, which occurs with even the most precise and careful technique. This technique is strongly recommended because prolonged retention is achieved, especially if replantation is done soon after the accident.

The most commonly avulsed teeth are front upper teeth. The cause is mostly trauma, which can be because of an accident, or it can be during playing. This type of injury is three times more likely to happen to boys than girls.

What Should Be Done If the Tooth Is Avulsed

If the person gets in an accident and the tooth is avulsed – that is it has come out – the first thing that the person should do is to preserve the tooth. The tooth should be immersed in a suitable storage medium. Milk has been shown to be a suitable, storage medium and it is readily available also. The avulsed tooth can also be stored in the isotonic saline. A commercial product designed specifically for storing avulsed teeth is also available by the name of Emergency Tooth Preserving System (Save –A –Tooth). This system has an appropriate container for the tooth. If nothing is available, the tooth can be stored in patient’s own saliva. The main purpose is to keep the tooth hydrated.

The patient should report to the dental office within 30 minutes of avulsion; only then the best results can be achieved.

As soon as the patient reaches the dental office we

immediately try to insert the tooth in the socket without wasting any time, after quickly assessing the patient’s condition. In case of replantation, the time elapsed between the avulsion and replantation is very important. After the tooth is placed in the socket, the splinting is done to stabilize the tooth.

In general stabilization for replanted teeth without any complications is required for seven to 14 days.

Home Care Instructions during Splinting Period

1. The patient is instructed not to bite directly on the replanted teeth for three to four weeks after the injury and then, slowly, he should start biting normally. During this time the food should either be cut into bite sizes or should be chewed with the unaffected teeth.

2. Patient should be on soft diet.

3. Most important is the patient should maintain good

oral hygiene


4. Adjunctive Drug Therapy

a) Oral/systemic antibiotics can be given

b) Patient should be given tetanus prophylaxis within 48 hrs.

d) Analgesics are given for pain.

Endodontic Treatment

All the replanted teeth should undergo root canal treatment, irrespective of the length of time the tooth remained out of the socket. This treatment should be done before the splints are removed.

Dr Keith John

Clinic: SVG Dental Corporation

Telephone: 784-456-2220

Cell: 784-526-0752