Delayed tooth replantation after dry storage: Preservation of function and aesthetics for a decade

Abstract

Introduction: Currently, determining therapeutic strategies for improving prognosis of delayed replantation of teeth that have been inadvertently stored in a dry environment is a challenge. A 22-year-old patient sought dental care three days after avulsion of tooth #8. Mechanically, the root surface was carefully scraped with periodontal curettes and chemically treated with 5.25% sodium hypochlorite followed by 17% EDTA. Following extraoral treatment and chemomechanical preparation, the root canal was filled with calcium hydroxide paste. The patient did not attend all follow-ups. After 102 months, maxillary right central incisor was clinically functional, but ankylosed. There was palatal periodontal pocket measuring 5 mm in depth and purulent exudate. Radiography revealed advanced external root resorption. After periodontal treatment, the root canal was dressed with calcium hydroxide paste and subsequently filled with MTA. At follow-up after 18 months, root resorption had stabilized. Experimentally, an extracted tooth stored under identical conditions received similar root surface treatment. With scanning electron microscopy, the root surface showed a high degree of cleanliness with patent dentinal tubules, suggesting favorable root permeability. Root surface treatment and intracanal dressing enabled preservation of the avulsed tooth after delayed replantation, with satisfactory function and aesthetics for approximately a decade.