Different Resorptive Patterns of Two Avulsed and Replanted Upper Central Incisors Based on Scanning Electron Microscopy and Stereomicroscopic Analysis: A Case Report

Abstract

Dental trauma resulting in permanent tooth avulsion commonly affects the young population. The prognosis of replantation after avulsion depends on the natural history of inflammatory and replacement resorption. Several risk factors for type and onset of external resorption have been defined. This case study describes different resorptive patterns observed in two upper central incisors belonging to a single individual, avulsed in the same moment, and replanted after thirty-six hours of dry storage. The roots were analyzed by scanning electron microscopy and stereomicroscope imaging, to obtain an in-depth analysis of the resorptive pattern. The aim of this report is to: (i) underline the high variability in the incidence of root resorption after replantation across and within types of teeth and resorption; and (ii) underline the possible concurrence of different factors affecting the onset and type of resorptive pattern. In conclusion, an unpredictable pattern of resorption may account for the poor prognosis when teeth are replanted outside the current recommendations.

Knowledge of Emergency Management of Avulsed Teeth among Italian Dentists-Questionnaire Study and Next Future Perspectives

“…By contrast, the majority of respondents were aware of the possible complications of avulsed and replanted teeth, with 84.9% and 71.7% indicating, respectively, root resorption and tooth ankylosis. It is widely documented that the timing and nature of the endodontic treatment of a replanted tooth are crucial to avoid further tough complications [ 6 , 7 , 8 , 9 , 10 ].…”

External Root Resorption Management of an Avulsed and Reimplanted Central Incisor: A Case Report

“…However, root resorption is a well-established consequence of tooth reimplantation [ 5 ] and should be correctly treated to guarantee a better prognosis over time [ 1 ]. Mazur et al [ 13 ] reported a high heterogeneity in root resorption pattern of reimplanted central incisors due to several factors, probably related to extra-oral dry time and storage, and concluded that the poor prognosis often occurred when teeth are replanted not in accordance with current guidelines for the management of dental avulsion [ 1 ]. In the present case report, to contrast the progression of external root resorption, reimplanted tooth underwent root canal treatment just 1 week after the occurrence of trauma.…”

Management of 3 Avulsed Permanent Teeth: Case Report of a 3-Year Follow-up

“…Besides, the consequences of dental avulsion are countless; they differ from patient to patient and may be related to the individuals' quality of life, psychological, and social problems, as well as the costs of treatment. [ 6 ]. In case of tooth avulsion, most periodontal ligament cells left on the root surface are due to the tearing of the alveolar-dental ligament; these cells must be hydrated to maintain the durability of the tooth while reducing the phenomenon of resorption and allowing healing.…”

“…However, several criteria can lead to slow progression and a better prognosis over time if they are well respected. [ 6 ] After all, the natural history of inflammatory and replacement resorption is important in order to detect the right prognosis of the replanted tooth. [ 6 ]…”