Treatment of Avulsed Teeth

November 1, 2012 | By | Reply More

Treatment of Avulsed Teeth

Avulsion: complete dislodgement of the tooth from the socket.

Management :

if patient comes < 2 hours

(open apex)
1. Replant immediately if possible
2. Transport in Hank’s solution or milk
3. Present to nearest qualified facility (decrease time call first)
4. Check ABCs; evaluate for associated injuries (history and physical examination)
5. Store in Hank’s Solution for about 30 min
6. Transfer to a 1 mg/20 mL doxycyline bath for about 5 min
7. Perform radiography (posteroanterior, occlusal, panoramic, chest)
8. Initiate local anesthesia
9. Irrigate socket with saline solution
10. Perform tetanus prophylaxis as needed
11. Initiate antibiotic coverage
12. Replant tooth
13. Splint for 7–10 d
14. Perform apexification with CaOH in cases of pathosis

(Closed apex)
1. Store in Hank’s solution for about 30 min
2. Replant
3. Splint for 7–10 d
4. Perform endodontic cleansing and shaping of canal at time of splint removal
5. Fill canal with CaOH (6–12 mo)
6. Perform final gutta-percha obturation (~6–12 mo)

if patient comes > 2 Hours

( open and close apex)
1. Replant immediately, if possible
2. Transport in Hank’s solution or milk
3. Present to nearest qualified facility (decrease time call first)
4. Check ABCs; evaluate for associated injuries (history and physical examination)
5. Bathe tooth in sodium hypochlorite for ~30 min vs manual débridement of the periodontal ligament
6. Perform extraoral RCT
7. Bathe tooth in citric acid (~3 min)
8. Bathe tooth in 1% stannous fluoride (~5 min)
9. Transfer to a 1 mg/20 mL doxycyline bath for ~5 min
10. Perform radiography (posteroanterior, occlusal, panoramic, chest)
11. Initiate local anesthesia
12. Perform tetanus prophylaxis as needed
13. Initiate antibiotic coverage
14. Replant tooth
15. Splint for 7–10 d

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Category: Dental, Oral Surgery, Pedodontics

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