Dental avulsion

Dental avulsion
Specialty	Dentistry

Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma, such as can be caused by a fall, road traffic accident, assault, sports, or occupational injury.^[1][2] Typically, a tooth is held in place by the periodontal ligament, which becomes torn when the tooth is knocked out.^[3]

Avulsions of primary teeth are more common in young children as they learn to move independently (walk and run) and also from child abuse. Avulsed deciduous (primary) teeth should not be replanted. Deciduous teeth are not replanted because of the risk of damaging the developing permanent tooth germ. Pulp necrosis with draining fistula, crown discoloration and external root resorption are reported consequences of primary tooth replantation. Tooth dilaceration, impaction and deviation from proper eruption path have been reported to have occurred in permanent teeth as a result of reimplantation of primary teeth.^[4]

Avulsed permanent teeth however may be replanted, i.e., returned to the socket. Immediate replantation is considered ideal, but this may not be possible if the patient suffered other serious injuries. If properly preserved, teeth may be replanted up to one hour after avulsion. The success of delayed replantation depends on the survival of the cells remaining on the root surface. Storage in an environment similar to the tooth socket can protect these cells until replantation can be attempted.^[5]