- Authors: AAE.
- Title: Treatment of the avulsed permanent tooth.
- Journal: AAE guidelines
- Date: Oct 1995
- Citation: updated 1995
- Category: Trauma
- Evidence-based Ranking: 5
- Discussion: Management at site of injury: immediately or transport medium. Transport medium: HBSS, milk, saline, saliva, water. Management in the dental office: if extraoral time < 1 hr- reimplant, if > 1 hr, Fl solution for 20 minutes. Keep root moist; dont handle root surface, rinse with HBSS if root is contaminated. Light saline irrigation of socket, do not curette. Compress plates after replantation. Suture any soft tissue lacerations. Acid-etch or soft wire arch for splint. 7-10 days, or until mobility is acceptable. Bony fractures should be splinted longer, 2-8 weeks. Adjunctive Drug Therapy Considerations: Abs, CHX, ANA, referral for tetanus consultation. Endodontic Treatment A. Open apex/less than 1 hr extraoral- replant to revitalize, recall every 3-4 weeks. B. Open apex/greater than 1 hr extraoral- clean and fill canal with Ca OH. (MTA?). C. Closed apex/ less than 1 hr extraoral,- biomechanical clean RC in 7-14 days., medicate with CaOH for 6-12 months, obturate as usual. D. Closed apex/ greater than 1 hr extraoral- RCT intraoral/extraoral, soak root in FL treatment. Restoration of Avulsed Tooth- temporary and permanent restorations. Additional considerations- primary teeth should not be replanted, permanent teeth need 5 year follow up. Complications include inflammatory, replacement resorption, ankylosis, and tooth submergence
Reviewers Comments: Quick guideline for treatment of avulsed teeth.