Replantation of three avulsed permanent incisors with complicated crown fractures


Dr Clemens Walter/Dr Gabriel Krastl, Department of Periodontology, Endodontology and Cariology, University of Basel, Hebelstrasse 3, 4056 Basel, Switzerland (Tel.: +41 61 2672623; fax: +41 61 2672659; e-mails:


Aim  To report a rare case of multiple avulsions of permanent teeth associated with complicated crown fractures.

Summary  The case describes a 3-year follow-up of the treatment of three avulsed maxillary incisors with complicated crown fractures. The teeth were replanted after an extra-oral time of 90 min (extra-oral dry time 6 min). After root canal treatment, the fractured maxillary incisors were restored with a layered hybrid composite material to re-establish aesthetics and function. Follow-up visits showed signs of replacement resorption affecting the maxillary central incisors but only minor signs of root resorption on the maxillary right lateral incisor. These findings were supported by digital volume tomography, which was performed 18 and 36 months post-trauma in order to assess extent, severity and progression of root resorption more accurately.

Key learning points 

  • Healing of avulsed teeth depends on the degree of periodontal ligament (PDL) damage.
  • Digital volume tomography might improve diagnostics of root resorption.