Reimplantation of an avulsed tooth: in which case is it possible?

Reimplantation of an avulsed tooth: in which case is it possible?

After the loss of a tooth caused by an impact, it is sometimes possible to consider its reimplantation in the oral cavity. In what cases is this intervention possible? Explanations from Dr Christophe Lequart, dental surgeon and spokesperson for the French Oral Health Union (UFSBD).

Tooth expelled in case of impact or fall

During a sudden shock (fall, traffic accident or while playing sports, etc.), a tooth (or even several teeth), generally anterior (canine or incisor), can be suddenly expelled from the oral cavity. . In certain cases, it is possible to consider reimplantation of the tooth, provided that strict instructions are followed. “After the expulsion of a tooth, the first thing to do is to recover it without rubbing it or rinsing it because this could destroy pulp cells essential to the good health of the tooth. underlines Dr Christophe Lequart, dental surgeon and spokesperson for the French Oral Health Union (UFSBD).

Another recommendation: the lost tooth should be preserved in saliva (by placing it under the tongue) or in milk, but never in water. “The difference in osmotic pressure existing between the water and the pulp cells risks causing these cells to burst. explains the dental surgeon. Another possibility: store the tooth in food-safe film.

Dental reimplantation of an avulsed tooth: an urgent intervention

After the shock, it is strongly recommended to contact your dentist as soon as possible, ideally within the hour following the accident which caused the loss of the tooth. In fact, dental reimplantation can only be considered within a very short period of time, one to two hours maximum.

Beyond this period, the pulp and the cells of the alveolar-dental ligament dehydrate, then become necrotic. “The intervention consists of re-implanting the tooth inside the socket. It is then a matter of creating a flexible retainer, using a grid held by points of resin glued to the expelled tooth, on both sides, in order to hold it in place. explains Dr. Chrisophe Lequart.

When dental reimplantation is not possible

If the intervention time is exceeded, reimplantation of the avulsed tooth will not be possible. There are also other contraindications to this intervention: severe or unstabilized periodontal disease, significant alveolar fracture, congenital heart malformation, etc.

In these situations, the installation of a dental implant or a bridge remains the most suitable solution for adults. “In children, the placement of an implant is not possible because their growth is not complete. We will prefer the installation of a removable device which will be readjusted according to the growth of the child, as an alternative to the implant.adds Dr. Christophe Lequart.

Monitoring and possible complications

Even if performed on time, the surgical procedure is not successful in all cases. It is very important to consult your dentist for regular check-ups. “This makes it possible to check that the tooth is not necrotic. If this is the case, it will therefore be necessary to consider endodontic treatment, namely inside the root. continues the dental surgeon.

Another possible complication on a replanted tooth: the appearance of rhizalysis, that is to say the destruction of the root of the tooth internally or externally. “Cells will consider the replanted tooth as a foreign body and will gradually destroy it. explains the specialist.

Although it is desirable to consider dental reimplantation when possible, there is nevertheless a risk of losing the replanted tooth in the medium or long term. “It happens that the re-implanted tooth falls out again, even 20 or 30 years after the initial shock. In this case, it will be necessary to consider the installation of a dental implant”specifies the dental surgeon.

Furthermore, as is the case with any dental surgery, there is a risk of possible abscess. This is why prophylactic antibiotic treatment can be administered to prevent infection. After reimplantation of the avulsed tooth, painkillers and mouthwashes are usually prescribed.

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