Intentional replantation and management of avulsion related ankylosis and external cervical resorption. A 10‐year follow up case report

Abstract Replantation is the treatment of choice for avulsed permanent teeth; ankylosis and cervical root resorption are among survival complications. A 9.5‐year‐old boy presented with an avulsed maxillary permanent central incisor with an open root apex following a school accident. The tooth was kept in milk, after a dry time of 15–20 min. Its replantation was performed 60 min after the accident. At 8 months, apexification with apical plug was attempted upon radiographic evidence of apical periodontitis. Ankylosis sound with infraocclusion and radiographic evidence of external cervical root resorption (ECR) were evident at 3 years and 3 months. At the patient's return one year later with esthetic concerns (2 mm infraocclusion) there was a 5 mm diameter ECR cavity. After intentional atraumatic extraction the resorptive cavity was debrided and restored with Biodentine; subsequently the tooth was reimplanted and splinted at an extruded position. At the 10‐year follow up since the first avulsion the tooth remains esthetically pleasing, asymptomatic, non‐ankylotic and functional. The present case supports intentional replantation as an option in managing infraoccluded teeth with advanced ECR.