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Case Reports in Dentistry
Volume 2014, Article ID 832637, 5 pages
Case Report

Continued Root Formation after Delayed Replantation of an Avulsed Immature Permanent Tooth

1Department of Endodontics, Dental School, Qazvin University of Medical Sciences, Qazvin 34157-59811, Iran
2Dental Research Center, Shahid Beheshti University of Medical Sciences, Evin, Tehran 1983963113, Iran

Received 21 February 2014; Revised 12 April 2014; Accepted 28 April 2014; Published 8 May 2014

Academic Editor: Malka Ashkenazi

Copyright © 2014 Nima Moradi Majd et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Tooth avulsion in the young permanent dentition is a frequent finding, and its prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient’s general health. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident. Methods. A right lower central incisor of a 7-year-old girl was avulsed, and it was soaked in a glass of milk. 90 minutes after avulsion, replantation was performed, and the tooth was splinted; but after two weeks the replanted tooth’s pulp was necrotic. Thus, endodontic treatment was performed and root canal was filled using a calcium hydroxide and iodoform paste (Metapex). Three months later, the intracanal medication was washed out and the canal was sealed using an apical plug of calcium enriched mixture (CEM) cement. Results. 20 months after replantation the tooth was completely asymptomatic, with physiologic mobility. Also, continued root formation including an apical segment beyond the artificial apical plug was observed. Conclusion. Creation of an appropriate apical barrier following the disinfection of root canal system promoted continued root-end growth in a replanted immature permanent tooth.