Immediate reimplantation of avulsed immature teeth. Case report

Abstract

Dental avulsion is one of the most alarming traumas with a reserved prognosis, with a prevalence of 1 to 16% in permanent teeth. The ideal treatment is immediate reimplantation. The pulp  is one of the most affected tissues, especially in cases that exceed 20 minutes in extraoral dry periods. When immediate reimplantation is performed and the apex is open, revascularization can be expected. Objective: To present the case of two permanent teeth avulsed and reimplanted before arriving at the consultation. Case presentation: A 7-year-old female patient, with a dental avulsion of 11 and 12  due to a fall on a bicycle and referred to the CMDLT Pediatric Dentistry and Orthodontics service. Clinical examination revealed  the reimplantation of both teeth, mobility, edema and laceration of the upper lip. The relocation of the teeth is rectified and the splint is placed with the wire-resin technique. During follow-up, dentoalveolar abscesses appeared, which evidenced pulpal necrosis. Cleaning of the canals and obturation with iodoform calcium hydroxide (11) and calcium hydroxide (21), respectively, were carried out. She is referred to an endodontic specialist for treatment with stromal mesenchymal cell transplantation, an innovative procedure in regenerative endodontics. Currently the teeth have shown continuity of their root development. Conclusions: Preserving avulsed teeth is always a challenge, especially to favor survival for more than 5 years. Innovative advances with the best available scientific evidence guide us to make the best decisions.