Manajemen Replantasi Avulsi Gigi Insisivus Sentral Permanen Muda pada Anak Usia 5,5 Tahun Melebihi Golden Period: Laporan Kasus
DOI:
https://doi.org/10.35790/eg.v15i1.67359Keywords:
replantasi gigi permanen muda; trauma dentoalveolar; mineral trioxide aggregate; fiber reinforced compositeAbstract
Abstract: Tooth avulsion is common in children involving young permanent teeth with open apices. The success of replantation is greatly influenced by extraoral time with a golden period of 15–60 minutes according to the International Association of Dental Traumatology (IADT). Delayed treatment increases the risk of complications, such as ankylosis and replacement resorption. This case report discussed about the management of permanent central incisor replantation in a 5.5-year-old child with an extraoral time exceeding 2 x 24 hours. A 5.5-year-old girl came with her parents carrying a tooth that had been dislodged from its socket without adequate storage media. Clinical and radiographic examinations showed an intact alveolar socket without fractures and an immature tooth with an open apex. Considering the long extraoral time, extraoral root canal treatment was performed to eliminate necrotic pulp tissue, followed by apical sealing using mineral trioxide aggregate (MTA). The tooth was then replanted into the alveolar socket in its anatomical position and stabilized using a fiber reinforced composite (FRC). Post-procedure evaluation showed good tooth stability with no signs of acute infection. In conclusion, although the long-term biological prognosis is limited due to decreased viability of periodontal ligament cells, replantation remains clinically valuable as a temporary, conservative approach in pediatric patients to maintain function, esthetics, and alveolar bone contour during growth. Regular monitoring at six months and 12 months post-treatment is necessary to detect post-replantation complications early.
Keywords: Replantation young permanent teeth; dentoalveolar trauma; mineral trioxide aggregate; fiber reinforced composite
Abstrak: Avulsi gigi sering terjadi pada anak yang melibatkan gigi permanen muda dengan apeks terbuka. Keberhasilan replantasi sangat dipengaruhi oleh waktu ekstraoral dengan golden period 15–60 menit menurut International Association of Dental Traumatology (IADT). Keterlambatan tindakan meningkatkan risiko komplikasi, seperti ankylosis dan replacement resorption. Laporan kasus ini mendeskripsikan manajemen replantasi gigi insisivus sentral permanen pada anak usia 5,5 tahun dengan waktu ekstraoral yang melebihi 2 × 24 jam. Seorang anak perempuan berusia 5,5 tahun datang bersama orangtuanya membawa gigi yang sudah terlepas dari soket tanpa media penyimpanan adekuat. Pemeriksaan klinis dan radiografis menunjukkan soket alveolar utuh tanpa fraktur serta gigi imatur dengan apeks terbuka. Mengingat lamanya waktu ekstraoral, dilakukan perawatan saluran akar secara ekstraoral untuk mengeliminasi jaringan pulpa nekrotik, diikuti penutupan apikal menggunakan mineral trioxide aggregate (MTA). Gigi kemudian direplantasi ke dalam soket alveolar sesuai posisi anatomis dan distabilisasi menggunakan fiber reinforced composite (FRC). Evaluasi pascatindakan menunjukkan stabilitas gigi yang baik tanpa tanda infeksi akut. Simpulan kasus ini ialah meskipun prognosis biologis jangka panjang terbatas akibat menurunnya viabilitas sel ligamentum periodontal, replantasi tetap memiliki nilai klinis sebagai pendekatan konservatif sementara pada pasien anak guna mempertahankan fungsi, estetika, dan kontur tulang alveolar selama masa pertumbuhan. Pemantauan berkala pada 6 bulan dan 12 bulan pasca perawatan diperlukan untuk mendeteksi komplikasi pasca replatansi secara dini.
Kata kunci: replantasi gigi permanen muda; trauma dentoalveolar; mineral trioxide aggregate; fiber reinforced composite
References
1. Mazur M, Jedlinski M, Janiszewska-Olszowska J, Ndokaj A, Ardan R, Nardi GM, et al. Knowledge of emergency management of avulsed teeth among Italian Dentists-Questionnaire Study and next future perspectives. Int J Environ Res Public Health. 2021;18(2):706. Doi: https://doi.org/10.3390/ijerph 18020706
2. Ulfat H, Javed Q, Haq S. Case report delayed replantation of avulsed tooth with 22 hours dry time: four years follow-up of a viable treatment modality. JAMC. 2021;33(2):341–3. Available from: http://www.jamc.ayubmed.edu.pk
3. Fouad AF, Abbott P V, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2020;36(4):331–42. Doi: https://doi.org/10.1111/edt.12573
4. Levin L, Day PF, Hicks L, Connell AO, Fouad AF, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. 2020;36(4):309–13. Doi: https://doi.org/10.1111/edt.12574
5. Bourguignon C, Cohenca N, Lauridsen E, Therese M, Anne F, Peter COC, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dental Traumatology. 2020;36(4):314–30. Doi: https://doi.org/10.1111/edt.12578
6. Rivera-pimentel NL, Campos-lara NP, Arturo O, Comas-garc A, Vitales-noyola M. Treatment of Young permanent avulsed teeth with multidisciplinary approach—a case report. Dentistry Journal. 2024;12(12):380. Doi: https://doi.org/10.3390/dj12120380
7. Sheikhnezami M, Azarpazhooh A, Mokhber A, Shamsian K, Bagheri M, Jafarzadeh M. The outcome of endodontic regeneration in a delayed replanted immature permanent incisor: a turboreg analysis of a case. Clin Pediatr Dent. 2022;46(3):183-7. Doi: https://doi.org/10.17796/1053-4625-46.3.2
8. Wikström A, Brundin M, Vestman NR, Rakhimova O, Romani N, Tsilingaridis G. Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long term outcomes —a longitudinal cohort study. International Endondotic Journal. 2022;55(6):630–45. Doi: https://doi.org/10.1111/iej.13735
9. Mittmann CW, Kostka E, Ballout H, Preus M, Preissner R, Karaman M, et al. Outcome of revascularization therapy in traumatized immature incisors. BMC Oral health. 2020;20(270):1–10. Doi: https://doi.org/10.1186/s12903-020-01193-5
10. Wang L, Jiang H, Bai Y, Luo Q, Wu H, Liu H. Clinical outcomes after intentional replantation of permanent teeth: a systematic review. Bosn J Basic Med Sci. 2020;20(1):13-20. Doi: http://dx.doi.org/10.17305/bjbms.2019.3937
11. Zerman N, Paglia L, Silva R, Bonfadelli E, de Manzoni R, Pardo A, et al. Replantation after avulsion of permanent teeth: clinical procedures and adherence of cases report to IADT Guidelines: a scoping review. European Journal of Paediatric Dentistry. 2025;():1-. Doi: https://doi.org/10.23804/ejpd.2025.234412
12. Koum N, Musa M, Awad R, Izeldin S, Guo Q. Regenerative endodontic treatment in avulsed immature permanent teeth: a scoping review. Pediatr Dent J. 2025;35(3):100363. Doi: https://doi.org/10.1016/j.pdj.2025.100363
13. Adel M, Asgari Z. Regenerative endodontic treatment in an immature permanent tooth with necrotic pulp and periradicular lesion. Clin Case Rep. 2025;13(10):e70941. Doi: https://doi.org/10.1002/ccr3.70941
14. Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2020;36(4):331-42. Doi: https://doi.org/10.1111/edt.12573
15. Krastl G, Weiger R, Filippi A, Van Waes H, Ebeleseder K, Ree M, et al. Endodontic management of traumatized permanent teeth: a comprehensive review. Internantional Endodontic Journal. 2021;54(8):1221–45. Doi: https://doi.org/10.1111/iej.13508
16. Parirokh M. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview – part I : vital pulp therapy. International Endodontic Journal. 2018;51(2):177–205. Doi: https://doi.org/10.1111/iej.12841
17. Saghiri MA, Asatourian A, Garcia-godoy F, Gutmann JL, Sheibani N. The effect of thermocycling on the sealing ability of White Mineral Trioxide Aggregate : an in vitro study. Acta Odontologica Turcica. 2016;33(1):1–5. Doi: https://doi.org/10.17214/aot.71459
18. Saoud TM, Martin G, Chen Y-H, Chen K-L, Chen C-A, Songtrakul K, et al. Treatment of mature permanent teeth with necrotic pulps and apical periodontitis using regenerative endodontic procedures : a case series. J Endod . 2015;42(1):57-65. Doi: http://dx.doi.org/10.1016/j.joen.2015.09.015
19. Kahler B, Hu J-Y, Marriot-Smith CS, Heithersay GS. Splinting of teeth following trauma : a review and a new splinting recommendation. Aust Dent J. 2016;61(S1):59–73. Doi: https://doi.org/10.1111/adj.12398
20. Krug R, Kremeier K, Krastl G. Long-term retention of avulsed maxillary permanent incisors replanted after prolonged non-physiological storage. Dental Traumatology. 2019;35(2):147-52. Doi: https://doi.org/10.1111/edt.12445
21. Zaim SB. Evaluation of dental trauma splints in early permanent dentition through finite element analysis. Applied Science. 2025;15(19):1–17. Doi: https://doi.org/10.3390/app151910307
22. Kharroubi S El, Drouri S, Doumari B, Dhoum S, Merini H El. Management of 3 avulsed permanent teeth : case report of a 3- year follow-up. Case Reports in Dentistry. 2022;2022. Doi: https://doi.org/10.1155/2022/2081684
23. Lopes LB, Botelho J, Machado V. Severe case of delayed replantation of avulsed permanent central incisor: a case report with four-year follow-up. Medicina (Kaunas). 2020;56(10):503. Doi: https://doi.org/10.3390/medicina56100503
24. Pereira LIC, Bosso-martelo R, Neves FS, dos Santos LCA, dos Santos Carvalho E . Frequency and risk factors of root resorption in endodontic practice. RSBO. 2021;18(1):60–4. Doi: https://doi.org/10.21726/rsbo.v18i1.1454
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Nina Runting, Brilliana C. P. Wibowo
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
