Letter to the editor: An alternative to dental trauma guidelines: replantation of avulsed primary incisors with 3.5-year follow-up

To the editor:

The recent case report “An alternative to dental trauma guidelines: replantation of avulsed primary incisors with 3.5-year follow-up” by Alshehri FS et al. [1] was incredibly insightful and stimulated interesting discussions. This long term follow up case of replantation of primary teeth with successful results highlighted the potential of replantation as a viable treatment alternative for primary teeth under specific, well defined conditions. Padhy et al.’s [2] systematic review suggests that replantation of primary teeth can be considered under favourable biological circumstances, diverging from existing guidelines by International Association of Dental Traumatology (IADT), 2020 [3]. Replantation of primary teeth is a debated treatment approach due to potential complications like ankylosis, root resorption, pulpal necrosis and adverse effect on developing permanent successors alongside hazard of aspiration-related medical emergencies. This case emphasizes the importance of careful case selection, brief extra oral dry time and suitable storage media (such as milk) for successful reimplantation outcomes. A gentle reimplantation technique using slow, controlled motion to avoid damaging the haversion system of alveolar bony socket followed by Semi-rigid splinting for 2 weeks is recommended. Successful outcomes depends on various factors, including the size of apical foramen, root length, patient age, presence of contaminants, preciseness of repositioning, dry time and tooth’s developmental stage. Timely and precise endodontic treatment, regular follow-ups, Child’ cooperation, and patient compliance also impacts the treatment outcome. Traumatic dental injuries (TDIs) in primary teeth have a worldwide prevalence rate of 22.7% as reported by Petti S et al. [4]. Dental trauma resulting from Unintentional injuries, collisions, sports and leisure activities [5] can significantly impact a young patient’s self esteem, confidence and overall psychological well being. Loss of primary teeth can compromise critical functions like speech, mastication and aesthetics. This highlights the need of adaptable clinical guidelines for effectively managing traumatic injuries in pediatric patients. Due to scarcity of research available on replanting primary teeth clinicians are encouraged to document and report both successful and unsuccessful outcomes with detailed follow up, thus enhancing our understanding. However before drawing definitive conclusions, studies with larger sample sizes and extended follow up periods are necessary to gain deeper understanding of the long-term effectiveness and impact of this treatment approach on the development and eruption of permanent teeth.

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Author contributions

NJ—designed; performed the research; analyzed the data and wrote the manuscript.

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Not applicable.

Acknowledgment

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Funding

This research received no external funding.

Conflict of interest

The author declares no conflict of interest.