Tooth avulsion and its consequences: Case series

Abstract

On an average about 30% of all school children suffer traumatic dental injury in primary dentition, whereas 22% suffer in permanent dentition. Avulsion is a serious injury which causes damage to dental and supportive tissues, ranging from 0.5-16 % among dental injuries and it mostly occurs in maxillary incisors. Tooth avulsion can be described as the complete displacement of the entire tooth out of its alveolar socket as a result of force generated due to external injury. The accepted management of choice is immediate replantation of the tooth into its socket provided dental facilities are nearby available and if it is delayed, placement of the tooth in an appropriate storage media until dental treatment can be initiated. Replantation of avulsed incisors in children has shown successful prognosis. The replanted teeth with time may lead to ankylosis followed by inflammatory or replacement resorption, as immediate replantation is practically rare. This case series showcases management of an avulsed maxillary left central incisor which was kept in patient oral cavity from the moment of trauma until its replantation in a eight year old boy. The avulsed tooth was replanted back into the alveolar socket after completion of endodontic treatment extra orally in same visit and splinted with composite resin. The other 2 case reports are 01 & 1.5 years follow up of replantated avulsed central incisors. During the follow up of these cases it was found that the teeth reported in these cases have remained in a stable, functional position but revealed external root resorption & replacement resorption even after completion of endodontic treatment. The amount of damage to tooth and supporting structures like bone, gingiva, emergency management and follow up period play a vital role in the prognosis of the avulsed tooth. It can be recommended to keep the avulsed tooth in saline solution as it is easily available when more appropriate storage media like HBSS are not available immediately.