PMC9868993_01
Sequence of the treatment performed: A) Initial clinical condition of teeth #21 and #22, extruded relation to their neighboring teeth; B) Detaching the periodontal ligament with scalpel blade #15 to perform exodontia; C) After extraction of tooth #21, tooth #22 was extracted using forceps, with care taken not to traumatize the root surface; D) The extracted teeth were preserved in saline solution; E) Blood clots in the alveolus were removed by careful curettage followed by cautious irrigation with sterile saline solution; F) Blood clots were removed from the root surfaces with gauze soaked in sterile saline solution; G) The teeth were replanted and repositioned into the alveolus with slight finger pressure; H) Splinting was performed using orthodontic wire fixed to the brackets with elastic ligature; I) Five-year clinical control, showing normal periodontium and acceptable aesthetics of the treated teeth
IEJ-17-205-g001.jpg
PMC9868993_01_IEJ-17-205-g001.jpg
F1
Clinic of the Aracatuba Dental School-UNESP" for the treatment of a dental traumatic injury to the anterior region of her mouth; which resulted from a bicycle fall that had happened 5 days before the appointment. Clinical examination revealed that the crowns of teeth #21 and #22 were extruded for 5 mm from their neighboring teeth (Figure 1A). After careful sindesmotomy (detaching the periodontal ligament) with scalpel blade #15 (Figure 1B), tooth #21 was extracted while taking care not to damage the root surface and alveolus wall (Figure 1C). The extracted tooth was kept in sterile saline solution (Figure 1D) whilst curettage and cautious irrigation of the alveolus with saline were performed in order to only remove the already-formed clot (Figure 1E). The clot adhering to the apical third of the root was removed using gauze soaked in saline solution (Figure 1F). After 10 min, the teeth were replanted in their original alveoli by finger pressure (Figure 1G); observing the alignment of their incisal edges with those of the adjacent teeth. Morelli, Sorocaba, SP, Brazil), fixed with an elastic ligature (Dental Morelli, Sorocaba, SP, Brazil) on the existing brackets (Figure 1H), and kept for 14 days. Moreover, occlusal adjustment prevented premature contact. The clinical and radiographic follow-ups showed no root resorption, a sulcus depth of 2 mm, no marginal bone loss, normal mobility and no symptoms (Figures 1I and 2D).
Radiographic images; A) Preoperative periapical radiography of the tooth #21 and tooth #22 showing the integrity of root surface and increased periodontal ligament space; B) Periapical radiography of odontometry during root canal treatment; C) Periapical radiography with root canals instrumented and filled with calcium hydroxide paste; D) Periapical radiograph of the 5-year control showing the integrity of root surface and periodontium
IEJ-17-205-g002.jpg
PMC9868993_01_IEJ-17-205-g002.jpg
F2
The roots were radiographically unharmed and the periodontal ligament space was showed to be thickened along its length (Figure 2A). After 10 days, the root canals were instrumented (Figure 2B) and filled with calcium hydroxide and filled with calcium hidroxide paste (Figure 2C). The clinical and radiographic follow-ups showed no root resorption, a sulcus depth of 2 mm, no marginal bone loss, normal mobility and no symptoms (Figures 1I and 2D).