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An alternative approach to replacement of an avulsed central incisor

From Volume 45, Issue 3, March 2018 | Pages 215-225

Authors

Amar A Lakhani

BChD(Leeds), MFDS RCS(Ed)

Dental Core Trainee, Chesterfield Royal Hospital, UK

Articles by Amar A Lakhani

Andrew M C Flett

Consultant Orthodontist, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK

Articles by Andrew M C Flett

Abstract

Abstract: This report describes the case of a young girl who underwent orthodontic and restorative treatment following the ankylosis of an UR1. The case sets out an alternative treatment to prosthetic replacement following the loss of an incisor tooth.

CPD/Clinical Relevance: This case report gives an insight into an alternative treatment using orthodontics to provide a cost-effective and aesthetic result following avulsion of a central incisor.

Article

When an avulsion injury occurs in a permanent maxillary incisor, ankylosis often occurs. In order to restore aesthetics and function, dental treatment is required.

Avulsion is classed as complete displacement of a tooth from its socket.1 Ankylosis is frequently a sequela following avulsion injury. The determining factor in whether a tooth becomes ankylosed after avulsion is the health and status of the periodontal ligament (PDL) after injury. Minimal damage and disruption to the PDL reduce the chances of ankylosis. There are three main factors that have the strongest impact on PDL:

Optimal conditions are considered to occur when the tooth is re-implanted immediately following injury and has an open root apex. The risk of ankyloses injury in this case is approximately 12% after 5 years.3 Suboptimal conditions are considered to occur when the tooth has been out of the socket for over 5 minutes, not stored in a physiologic medium, such as saliva, and has complete root development.

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