As soon as the patient reaches the dental office, dentist immediately try to insert the tooth in the socket without wasting any time, after quickly assessing the patient’s condition. In case of replantation the time elapsed between the avulsion and replantation is very important. After the tooth is placed in the socket, the splinting is done to stabilize the tooth. Dentist can use the direct bond splint or wire splint depending upon the case.
In general stabilization for replanted teeth without any complications is required for 7 to 14 days
HOME CARE INSTRUCTIONS DURING SPLINTING PERIOD
The patient is instructed not to bite directly on the replanted teeth for 3 to 4 weeks after the injury and then slowly he should start biting normally. During this time the food should either be cut into bite sizes or should be chewed from the unaffected teeth.
Patient should be on the soft diet.
Most important is the patient should maintain good oral hygiene.
ADJUNCTIVE DRUG THERAPY
Oral/systemic antibiotics can be given
Patient should be referred to physician for tetanus prophylaxis within 48 hrs.
Chlorhexidine rinses are recommended.
Analgesics are given for pain.
ENDODONTIC TREATMENT
All the replanted teeth with complete apical root formation should undergo root canal treatment irrespective of the length of time the tooth remained out of the socket. This treatment should be done before the splints are removed because adverse reactions are virtually certain if the degenerating pulp tissue is allowed to remain in the canal more than few days. if the avulsed tooth is immature and root formation is not completed then the decision whether to do the root canal treatment or not depends upon the dentist. If the root formation is not completed and on follow ups dentist feels that the pulp tissue is getting necrosed and it has to be removed then another procedure called as Apexification has to be done.
Avulsed permanent teeth require follow up evaluation for a minimum of 2-3 years to determine the outcome therapy.