EMERGENCY : Reimplantation of avulsed dry permanent teeth after three days

Avulsion is a traumatic injury which results in loss of the tooth from the alveolus, while reimplantation is the technique of reinserting an avulsed tooth into the alveolus or tooth socket after its loss. 

The success of reimplantation depends on many factors among which are the time lapse before the tooth is reimplanted in the socket and the storage medium of the avulsed tooth. 

Other factors which may affect the success of reimplantation include the condition of the tooth, particularly the periodontal ligament tissue remaining on the root surface, sex, age, type of tooth reimplanted, stage of root formation, type of cleansing procedure following contamination of the root surface, duration of splinting, and the use of antibiotics. 


With favorable conditions such as the periodontal ligament remaining on the root surface, the tooth stored in adequate storage medium for not more than 60 minutes, and immediate reimplantation after the accident, the tooth may be retained for as long as 5 to 10 years and few for a lifetime, but some fail soon after reimplantation. 

Unfavorable conditions include teeth out of the mouth for more than 6 hours in no storage media and without periodontal ligament on the root surface. In such cases, the reimplanted tooth fails with subsequent loss of the tooth. 

This is because dry storage affects pulp revascularization and survival of the periodontal ligament cells along the root surface resulting in either replacement resorption or loss of the tooth.

Surface resorption is generally diagnosed after 12 months and inflammatory resorption and replacement resorption are usually observed after 1 and 1-2 months, respectively. 

However, irrespective of the state of the tooth or time spent out of the mouth, the avulsed tooth that is reimplanted remains the best implant. 

However, when endodontic treatment is carried out on avulsed teeth, it improves the chances of retention and prevention of replacement resorption. 

These cases are being reported because the literature search on the subject did not reveal data on avulsed teeth reimplanted after three days. 

Nigerian Journal of Clinical Practice 
IN Ize-Iyamu, BDO Saheeb



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