What Is a Tooth Replantation? In What Cases Is It Necessary?


Tooth replantation is a progressive surgical method in dentistry that permitting the patient to restore an incisor that has been squeezed out of the alveolar bone after injury. The operation is complex and is usually performed on adult patients. It is most often applied to single-rooted teeth since they most often fall out due to injury. Sometimes it is possible to replant a lost tooth even in small patients but this requires special diagnostic criteria.

What Is Tooth Replantation?

Modern technologies make it possible to restore lost teeth by installing them in the natural alveolar area. Dental replantation is a particular method in which a tooth is extracted from the socket, treated outside the mouth, and then returned to its original location. The main goal of this manipulation is to eliminate a chronic source of infection that cannot be effectively treated with other methods and to sustain the patient's dentition.

In most cases, the reinsertion procedure is performed on adult patients. If a doctor decides to perform surgery on a child, there must be a serious reason for this, for example, deformation of the dentition or impaired jaw formation due to a missing tooth. If a tooth is traumatically lost, it should be immediately placed in a saline solution at room temperature or plain water and contact the NYC dentist as soon as possible.

Dental practice distinguishes between two types of avulsion tooth replantation: devital and vital. In a devital case, the following manipulations are performed: the dental nerve is removed and the canals are filled, clearing of damaged tissue, then the tooth is returned to its place. In a vital root canal filling is not required, the root is preserved.

Such operations can be urgent, performed immediately after tooth loss, or delayed, performed later to eliminate inflammation and other pathologies. The main thing to remember is that teeth replantation is a complex procedure that requires a lot of experience. Mistakes can lead to serious complications, including tooth loss.

When Is Dental Replantation Necessary?

Tooth replantation may be necessary in various situations when its integrity is compromised, which can occur not only due to severe trauma but also due to jaw dislocation, fracture, accident, blow, or fall.

However, a lost tooth does not always require this procedure. The decision to perform it is made by the dentist, taking into account factors such as the condition of the tooth – if it is too fragmented or damaged, it may not be possible to restore it, as well as the condition of the socket into which it must be returned. If the tooth is too damaged or the socket is deeply damaged, replantation may not be effective.

In addition to jaw injury and resulting tooth loss, there are many other situations in which avulsed tooth reimplantation may be required:

  • chronic periodontitis;
  • hole in tooth root;
  • complications resulting from errors in dental treatment;
  • the impossibility of removing a tooth root using the classical method;
  • the purulent or inflammatory process associated with infection;
  • acute form of periostitis in the jaw.

In case of accidental damage to teeth and the presence of mobility of one or more teeth, it is extremely important to immediately consult a dentist. Carrying out the procedure as quickly as possible increases the likelihood of successful tooth implantation and maintains the beauty of your smile.

There are several contraindications to the tooth replantation procedure, including enamel cracks, as well as diseases such as diabetes, oncology and disorders of the cardiovascular system. In addition, it is worth postponing treatment in case of elevated temperature and inflammatory processes in the mucous membranes and gingival tissues, acute viral or infectious diseases, as well as blood diseases. Mental disorders of any severity are also an absolute contraindication, since a person may not control his behavior, which can lead to undesirable consequences during the procedure.

Features of the Teeth Replantation Procedure

Before replanting a knocked-out tooth, several preparatory steps must be completed. The patient undergoes a mandatory examination, which may include a computed tomography scan or x-ray. If necessary, blood tests are also prescribed to identify hidden infections and inflammatory processes. In addition, other procedures will be carried out:

  • treatment of various dental diseases;
  • removal of tartar and plaque from enamel;
  • cutting off the upper part of the root;
  • if necessary, cleaning and filling carious cavities.

After preparation is completed and defects are eliminated, the patient is sent for an x-ray to assess the quality of the filling, after which replantation begins. An important point is that immediately before the procedure you should refrain from eating, smoking, drinking alcohol and physical activity, and also ensure that your mouth is clean.

Then, the treated tooth is carefully inserted into the prepared hole, while the doctor controls its position. Next, a splinting device is applied to fix the tooth for 4–6 weeks.

The intentional tooth replantation takes from 20 to 60 minutes, depending on the complexity. The engraftment period of the replantant is 2–3 weeks but sometimes it can be longer. After surgery, pain is possible, so the doctor may prescribe painkillers and anti-inflammatory drugs or antibiotics.

It is quite difficult to predict how the tooth after replantation will heal. It is important to strictly follow your doctor's recommendations, including taking antibiotics and maintaining oral hygiene. Mechanical impacts on the jaw should be avoided and soft foods should be chosen for six months. Regular dental visits and X-rays will help monitor healing and prevent complications.

Article Approved by:

Antonio Clares General Dentist, DDS