Treatment outcomes of replantation of primary teeth with/without splinting and endodontic treatment modality following avulsion injury: A systematic review

Abstract

Aim: The objective of this review is to conduct a thorough systematic literature search and evaluate the risks and benefits of replanting avulsed primary teeth, which will aid clinicians in proper decision-making. Materials and Methods: In this review, a systematic search of five electronic databases (Web of Science, PubMed-MEDLINE, Scopus, Ovid SP, and Embase) was independently conducted by two reviewers. After following the eligibility criteria, the collated data was uploaded to Zotero and Excel Workbooks. Any disagreement was resolved through adjudication by the third reviewer. For case reports and case series, the Joanna Briggs Institute checklist was used to assess quality. Results: Following the application of the eligibility criteria, 15 papers were deemed eligible for final analysis, and full texts were acquired. Among 26 replanted teeth, adverse effects were seen in 19 primary teeth and 7 permanent successors. The primary teeth that were replanted had the following unfavorable effects: mobility, resorption of the bone, fistula formation, radicular cyst formation, crown discoloration, and pulp necrosis. Similarly, the adverse effects on the permanent successors were impaction, enamel hypoplasia, dilacerations, and infra-occlusion. Conclusions: Following the biological principles, such as the condition of the tooth, the time elapsed since avulsion and age of the child, and replantation of avulsed primary teeth, can be a feasible treatment option. However, the feasibility is case-dependent and cannot be generalized because of the paucity of high-quality research with sufficient sample sizes and long follow-up periods.