Long-term Follow-up of Apexogenesis, Root Canal Obliteration and External Replacement Resorption Following Tooth Replantation.

Abstract

Dental replantation is the treatment of choice for tooth avulsion; however, complications such as root canal obliteration, pulp necrosis and tooth resorption can arise, influenced by factors like extra-alveolar time and the storage medium in which the tooth was maintained. This case report discusses a seven-year-old child who experienced a traumatic avulsion of a permanent maxillary right central incisor with incomplete root formation. While the tooth was successfully replanted and both pulp vitality and complete root formation (apexogenesis) were initially maintained, the tooth later developed root canal obliteration and ankylosis, followed by external replacement root resorption. The tooth was extracted after six years due to advanced root resorption, leading to the placement of a space maintainer during childhood. Subsequently, an osseointegrated dental implant with a ceramic crown was placed. A 10-year follow-up post-implant installation demonstrated successful oral rehabilitation 20 years after the trauma. This case highlights the importance of long-term follow-up and a multidisciplinary approach in treating severely traumatized permanent teeth.