The best outcome in the case of tooth avulsion can be expected when the tooth is replanted within a few minutes of the traumatic event. According to Endodontics: Colleagues for Excellence, if teeth can be replanted within 15 minutes of being avulsed, the periodontal ligament (PDL) will be restored within a few weeks in a very high percentage of teeth. However, the pulp cannot be expected to survive; therefore root canal therapy is an important part of successful treatment. The sole exception to performing routine root canal treatment of teeth that have been replanted is in the case of a very immature tooth, where revascularization of the pulp is possible and desired. Ideally, root canal treatment should be performed on a tooth during the second week after replantation. Calcium hydroxide placed for up to 1 month prior to filling the root canal will aid in disinfection of the root canal system, and stabilization of the tooth with a functional, nonrigid splint for 2 to 3 weeks will help re-establish PDL support of the tooth. If an avulsed tooth has been left dry for more than 1 hour, chances for restoration of the PDL are very poor. However, replantation of such a tooth may be worthwhile because the patient may benefit from several years of use, even though ankylosis and resorption are likely.
(Source: Endodontics: Colleagues for Excellence, Spring 2006; American Association of Endodontists)
