Immediate Reimplantation of a Permanent Tooth After Iatrogenic Extraction:

A Case Report

Abstract

Dental avulsion refers to the complete displacement of a tooth from its socket, representing one of the most severe traumatic injuries to the permanent dentition. Its prognosis depends on multiple factors, including the extraoral time, the method of tooth preservation, the viability of periodontal ligament cells, the stage of root development, the type of splinting used, and the proper conduct of endodontic treatment. Immediate dental reimplantation represents the main conservative approach in cases where the procedure is feasible, potentially contributing to maintaining the tooth's function, preserving the alveolar bone, and delaying more invasive prosthetic rehabilitations. This study aims to report a clinical case of immediate reimplantation of a permanent tooth after iatrogenic extraction, emphasizing the clinical sequence adopted, the complementary examinations used, and the factors associated with a favorable prognosis. A 22-year-old male patient was referred to the Endodontics department after an erroneous extraction of tooth 45, when the requested extraction corresponded to tooth 44. The tooth was immediately reimplanted after avulsion and stabilized with a semi-rigid splint for seven days. Subsequently, given the negative pulp vitality test, endodontic treatment was instituted with intracanal medication based on calcium hydroxide, serial replacements, clinical, radiographic, and tomographic follow-up. After seven months, the tooth presented no pain on palpation or percussion, no pathological mobility, fistula or exudate, and no signs of root resorption or ankylosis, although cone-beam computed tomography showed loss of the vestibular bone plate. It is concluded that immediate reimplantation, careful handling of the tooth, use of semi-rigid splinting, and the established endodontic protocol were decisive for the favorable outcome observed during the follow-up period. (FOUAD et al., 2020).