Comparative Evaluation of Replantation Outcomes of Avulsed Teeth-Influence of Extraoral Time and Storage Medium: A...

Tooth avulsion is a severe dental trauma predominantly affecting children and adolescents. Prognosis depends largely on extraoral time and storage medium before replantation. Cone-beam computed tomography (CBCT) provides superior evaluation of healing outcomes compared to traditional radiography.

To evaluate the influence of extraoral time and storage medium on clinical and radiographic outcomes of replanted permanent maxillary central incisors in children aged 9-14 years.

This randomized, controlled, parallel-arm trial was conducted at a private dental college in India over 12 months, from July 2024 to July 2025. A total of 48 avulsed permanent maxillary central incisors from children aged 9 to 14 years were included based on standardized inclusion criteria and grouped according to extraoral dry time and storage medium. Clinical parameters (pain, pocket depth) and radiographic outcomes [lesion diameter (LD), apical diameter (AD), root wall thickness, and tooth-bone resorption] were evaluated at baseline, 6, and 12 months using CBCT and clinical examination. Data were analyzed with repeated measures ANOVA, correlation, and multiple linear regression, with p < 0.05 considered statistically significant.

Significant improvements were observed in pain (p < 0.001), pocket depth (p < 0.001), lesion diameter (p < 0.001), and tooth-bone resorption (p < 0.001) over time. Tooth-bone resorption was the most protocol-sensitive parameter, with better protocols showing lower resorption scores. Larger lesion diameter and thinner root walls were significantly associated with increased resorption.

Rapid replantation with biologically compatible storage media and adjunctive root-surface treatments optimizes healing outcomes for avulsed teeth. CBCT is an indispensable tool for monitoring healing and guiding prognosis.