Luxation and avulsion injuries represent dental emergencies. The time elapsed between the injury and the repositioning or reimplantation significantly affects the prognosis. Prolonged drying of the tooth leads to the loss of vitality in the periodontal tissue and pulp, as well as additional complications like root resorption.
Therefore, it’s crucial to reposition or reimplant the tooth as soon as possible, preferably within 30 to 60 minutes after the injury. In the meantime, if the tooth is avulsed, it should be kept in a moist environment using appropriate storage methods. Immediate initiation of antibiotic treatment is recommended, along with a preoperative radiographic examination.
During the management of the socket and root surface, aggressive debridement should be avoided, and any blood clots or debris should be gently removed through irrigation. The tooth should be manually repositioned or reimplanted, and if there is bony obstruction, an instrument should be used to realign the fragments.
After confirming the correct position with radiographs, the injured tooth must be stabilized. The immobilization period should be brief to improve outcomes and reduce complications.
In the postoperative period, systemic antibiotics and analgesics are prescribed, a soft diet is recommended, and at-home oral care is indicated. Since these injuries often result in pulp necrosis, root canal therapy is necessary. Potential long-term complications include inflammatory root resorption, dentoalveolar ankylosis, and replacement root resorption.
Long-term radiographic follow-up is required for repositioned or reimplanted teeth.
It’s not recommended to reposition or reimplant deciduous teeth due to the risk of damaging developing permanent teeth.
