Page 99 - FINAL COMPENDIUM 2020-2021 27.2.2022

DELAYED REPLANTATION OF AVULSED TEETH : A CASE WITH UNEXPECTED OUTCOME

Gunasegaran P, Sukeri S

Introduction: Tooth avulsion or complete displacement of a tooth from the socket, is one
of the most severe dental injury. In most cases involving permanent tooth, immediate
replantation is the ideal treatment, which may result in a favourable outcome.
Documented here is a case with delayed replantation and specific management that
should instigate negative consequences but none was yet seen. Case report: A 15-year
old male patient who presented with 4 avulsed teeth, secondary to a fall. Teeth were kept
dry for a total dry time of 17 hours. Replantation was performed albeit the poor prognosis.
All parties involved understood the circumstances and informed consent was established.
Generally, management was done according to guidelines including intervention,
splinting, radiographs, medication and post treatment home care. Root canal treatment
was completed extra-orally and periodontal ligament (PDL) was scraped off the root
surfaces. Interestingly, subsequent follow up reviews showed normal clinical and
radiographical presentations. Discussion: Avulsion injury has always been associated with
poor prognosis. Common unfavourable outcomes include resorption, ankylosis and loss
of tooth especially if replantation does not take place immediately. This is due to the injury
to PDL and the non-viability of the cells. Some storage mediums were able to extend the
survival of the cells. However, this case had a very prolonged dry condition and the PDL
was removed prior to the replantation. Conclusion: Possibly, older children present with
slower or less clinical impact due to their growth rate and bone metabolism.

Virtual presentation at the MAPD 2021 Virtual Scientific Conference & AGM on 8 March 2021
Dr Prabhashini Gunasegaran
Dr Suriani Sukeri
Department of Paediatric Dentistry
Hospital Tunku Azizah
Kuala Lumpur

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