Re-plantation of avulsed permanent incisor after 4 days of trauma

Tooth avulsion is a complete displacement of a tooth from its socket and is seen in about 0.5-3% of dental injuries [1-3]. Avulsion cases in children increases between the ages of 7 and 9 years due to the immaturity of roots in addition to the low resistance of the alveolar bone/Periodontal Ligament (PDL) against extrusive forces during the eruption period of the teeth [1,3]. The cause of avulsion depends on the type of dentition. Avulsion in primary teeth is usually due to the hitting of hard objects with the teeth, while avulsion in permanent teeth is generally caused from falls, sports, fights, or child abuse [4-5]. In both types of dentition, avulsion usually happens in maxilla, and the most avulsed teeth are the maxillary central incisors. Increased overjet and incompetent lips are potential etiological factors in such avulsion cases [2,4,6]. In spite of the fact that avulsion usually involves one tooth, there have been cases reported tooth-supporting tissue injuries, lip injuries, and multiple avulsions [7,8]. The main goal in treating an avulsed tooth is to conserve and treat the supporting tooth tissues and to replant the avulsed teeth in its socket. The success rate of this operation relys on the patient's general health, maturity of the root, the time the tooth is out of its socket, and storage medium [9-11]. The period of extra-oral time and the storage medium have the most definitive effect on the PDL cells' status [10,11]. The goal of this case report was to exhibit a case of a delayed replantation of avulsed maxillary central incisor after an extended dry extra-alveolar period