(TC45) Can You Replant a Tooth One Month Later? Management of a Failed Avulsion Case Using a Novel Concept

Avulsion injuries with extended extra-oral time are managed by replantation of the tooth in its original socket and splinting for 2-4 weeks, with the ultimate goal of achieving ankylosis. Lack of stabilization following splinting can result from secondary periodontal involvement and bone loss; subsequently, the tooth may require extraction. After tooth extraction and allowing time for the socket to heal, can we replant the same tooth later into its socket?
In this table clinic, we are presenting a case with two failed stabilization attempts following an avulsion injury. The tooth was subsequently extracted to allow for the socket to heal. The external root surface of the extracted tooth was decontaminated, and the tooth was stored for 1 month in a storage medium. One month post-extraction, the socket was curetted again to remove any soft tissue ingrowth, and the tooth was reinserted together with bone graft material into the socket space and stabilized for 8 weeks using a rigid splint, followed by an additional 4 weeks using a flexible splint. Short-term follow-up showed a change in mobility from grade 3 to grade 1, with an absence of symptoms. The approach presents proof of concept for the possibility of reinserting extracted teeth, affected by periodontal disease, back into their own socket after initial socket healing and extra-oral decontamination of the root surface.