Delayed replantation of an avulsed immature permanent incisor and apexification using a novel fast-setting calcium silicate cement containing fluoride: a 3-year follow-up case report

Abstract

Background Traumatic tooth avulsion requires an urgent intervention to replant the tooth. Prolonged post-injury dry extra-oral conditions worsen the prognosis and increase the risk of root resorption. Fluoride has the potential to delay replacement resorption. Calcium silicate cements (CSC) are used to seal the root canal system and to stimulate periapical regeneration in immature open apex teeth (apexification). This report suggests the application of a novel fast-setting CSC with fluoride for apexification in an attempt to hinder root resorption. Case report A delayed replantation of an avulsed open apex permanent central incisor after 75 h of storage in a dry condition in a 6-year-old girl. Standard treatment guidelines for avulsed immature permanent teeth were followed. After tooth replantation a novel fast-setting, CSC containing fluoride was used for apexification. Follow-up The radiographic and clinical evaluations over a period of 3 years demonstrated periodontal bone healing without root resorption, mobility, and ankylosis and an acceptable periapical tissue tolerance to the novel CSC. However, a longer follow-up period is needed. Conclusions Delayed replantation of the avulsed open apex permanent incisor after 75 h of storage under dry conditions and apexification with a novel fast-setting CSC showed a successful outcome after 3 years. Novel CSC with fluoride demonstrated an acceptable biocompatibility and tissue tolerance.