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Accidental extraction and replantation of an immature permanent tooth
JOURNAL OF ENDODONTICS [ VOL 3, NO 6, JUNE 1977
ACCIDENTAL EXTRACTION AND REPLANTATION OF AN IMMATURE PERMANENT TOOTH
Willitmt B. Kemp, DDS, a n d Arthur P. Mourino, DDS, MS, MSD, Richmond, V a
Accidental avulsion occurs most commonly in the maxillary anterior teeth. 1 The following is a report of the replantation of an immature mandibular second premolar that was accidentally avulsed during the extraction of a second primary molar.
tooth. In this situation, sectioning of the primary tooth in a buccolingual plane and removal of the segments is the recommended procedure3 This
precaution may prevent luxation or accidental avulsion of the succedaneous tooth. Andreasen 1 has reported that the
Report of C a s e
A 9-year-old girl was seen in the pediatric dental clinic for extraction of her mandibular right second primary molar. During extraction, the incompletely formed and unerupted mandibular right second premolar was accidentally removed from its developmental crypt by a dental student. The faculty member in charge rinsed the tooth (solution unknown) and replanted the tooth within an elapsed time estimated at less than two minutes. Records available on the patient are incomplete, with no significant clinical information other than radiographs taken at one week (Fig 1), five years (Fig 2), and six years (Fig 3) after replantation. These radiographs show that root formation continued and that calcific metamorphosis occurred. Discussion
Extraction of primary molars by forceps is the usual method. On occasion, the roots of a primary molar will not resorb and may partially encircle the crown of the succedaneous 240
Fig 1--Bitewing radiograph taken one week after replantation ol mandibular right second premolar.
Fig 2--Bitewing radiograph taken live years aJter replantation o[ mandibular right second premolar.
JOURNAL OF ENDODONTICS [ VOL 3, NO 6. JUNE 1977
sion. It also illustrates the potential for repair that exists if elapsed time is minimal, even though the mechanisms are poorly understood.
Fig 3---Bitewing radiograph taken six years after replantation of mandibular right second premolar.
Dr. Kemp is assistant professor, department of endodontics, and Dr. Mourino is assistant professor and acting chairman, department of pedodontics, School of Dentistry, Medical College of Virginia, Richmond. Requests for reprints should be directed to Dr. William B. Kemp, Department of Endodontics, School of Dentistry, Medical College of Virginia, Richmond, 23298. References
prognosis for the survival of the replanted tooth is improved if there is incomplete root development and the extraoral period is short, that is, with-
in 30 minutes. This case emphasizes the importance of immediate replantation of immature teeth in the pediatric patient after accidental avul-
1. Andreasen, J.O. Traumatic injuries of the teeth. Copenhagen, Munksgaard, 1972, pp 194, 214, 221. 2. Kruger, G.O., ed. Textbook of oral surgery, ed 4. St. Louis, C. V. Mosby Co. 1974, p 101.
241
ACCIDENTAL EXTRACTION AND REPLANTATION OF AN IMMATURE PERMANENT TOOTH
Willitmt B. Kemp, DDS, a n d Arthur P. Mourino, DDS, MS, MSD, Richmond, V a
Accidental avulsion occurs most commonly in the maxillary anterior teeth. 1 The following is a report of the replantation of an immature mandibular second premolar that was accidentally avulsed during the extraction of a second primary molar.
tooth. In this situation, sectioning of the primary tooth in a buccolingual plane and removal of the segments is the recommended procedure3 This
precaution may prevent luxation or accidental avulsion of the succedaneous tooth. Andreasen 1 has reported that the
Report of C a s e
A 9-year-old girl was seen in the pediatric dental clinic for extraction of her mandibular right second primary molar. During extraction, the incompletely formed and unerupted mandibular right second premolar was accidentally removed from its developmental crypt by a dental student. The faculty member in charge rinsed the tooth (solution unknown) and replanted the tooth within an elapsed time estimated at less than two minutes. Records available on the patient are incomplete, with no significant clinical information other than radiographs taken at one week (Fig 1), five years (Fig 2), and six years (Fig 3) after replantation. These radiographs show that root formation continued and that calcific metamorphosis occurred. Discussion
Extraction of primary molars by forceps is the usual method. On occasion, the roots of a primary molar will not resorb and may partially encircle the crown of the succedaneous 240
Fig 1--Bitewing radiograph taken one week after replantation ol mandibular right second premolar.
Fig 2--Bitewing radiograph taken live years aJter replantation o[ mandibular right second premolar.
JOURNAL OF ENDODONTICS [ VOL 3, NO 6. JUNE 1977
sion. It also illustrates the potential for repair that exists if elapsed time is minimal, even though the mechanisms are poorly understood.
Fig 3---Bitewing radiograph taken six years after replantation of mandibular right second premolar.
Dr. Kemp is assistant professor, department of endodontics, and Dr. Mourino is assistant professor and acting chairman, department of pedodontics, School of Dentistry, Medical College of Virginia, Richmond. Requests for reprints should be directed to Dr. William B. Kemp, Department of Endodontics, School of Dentistry, Medical College of Virginia, Richmond, 23298. References
prognosis for the survival of the replanted tooth is improved if there is incomplete root development and the extraoral period is short, that is, with-
in 30 minutes. This case emphasizes the importance of immediate replantation of immature teeth in the pediatric patient after accidental avul-
1. Andreasen, J.O. Traumatic injuries of the teeth. Copenhagen, Munksgaard, 1972, pp 194, 214, 221. 2. Kruger, G.O., ed. Textbook of oral surgery, ed 4. St. Louis, C. V. Mosby Co. 1974, p 101.
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