Interdisciplinary management of dental avulsion: from emergency care to long-term prognosis

INTRODUCTION. Dental avulsion is a traumatic dental injury defined by the total displacement of a tooth from its alveolar socket. The most effective intervention in these cases is the reimplantation of the avulsed tooth. Additionally, a long-term follow-up plays a crucial role in managing potential complications. AIM. To present and analyze two clinical cases of dental avulsion in children, emphasizing the importance of immediate reimplantation, appropriate storage media, and strict follow-up protocols in determining long-term prognosis. MATERIAL AND METHODS. Two pediatric patients with dental avulsion were examined and treated: Case 1: A 12-year-old patient with avulsion of two mature upper central teeth stored in milk, presented 15 minutes post-trauma. Initial reimplantation and rigid contention were performed by a general practitioner. Root canal treatment was initiated 2 weeks later at the Pediatric Dentistry and Prevention Department, Monastir Dental Clinic, followed by interceptive treatment and a 24-month follow-up. Case 2: A 10-year-old patient with avulsion of two immature upper central teeth stored in milk for 24 hours. Reimplantation and rigid contention were carried out after the appearance of inflammatory signs, followed by further management. RESULTS. In Case 1, the rapid intervention, appropriate storage medium, and timely endodontic treatment contributed to favorable healing and tooth retention over a 24-month follow-up. In Case 2, the delayed reimplantation and prolonged extraoral time negatively affected prognosis, with clinical signs of inflammation influencing the long-term stability of the teeth. CONCLUSION. These cases highlight that immediate reimplantation, correct choice of storage medium, and strict adherence to follow-up protocols are critical for successful management of avulsed teeth. Prompt intervention and compliant follow-up care significantly influence the long-term prognosis and survival of reimplanted teeth.