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Diagnosis ,Clinical
situation
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The tooth has already been replanted
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The tooth has been kept in special
storage media, milk, saline or saliva.
The extra-oral dry time is
less than
60 min
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Extra-oral dry time
>60 min
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Treatment
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Clean affected area with water spray, saline or chlorhexidine
Do not extract the tooth (x)
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If contaminated, clean the root surface and apical foramen with a
stream of saline.
Remove the coagulum from the socket with a stream of saline. Examine
the alveolar socket. If there is a fracture in the socket wall,
reposition it with a suitable instrument.
Replant slowly with slight digital pressure (x)
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Remove debris and necrotic periodontal ligament (xx) Remove the
coagulum from the socket with a stream of saline. Examine the alveolar
socket. If there is a fracture of the socket wall, reposition it
with a suitable
instrument.
Immerse the tooth in a 2.4% sodium fluoride solution acidulated to a
pH 5.5 for a minimum of 5 min or, if available, fill the socket with
Emdogain~.
Replant slowly with slight digital pressure (xx)
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Suture gingival laceration, especially in the cervical area
Verify normal position of the replanted tooth radiographically
Apply a flexible splint for 1 week (x)
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Administer systemic antibiotics: Doxycycline 2x per day for 7 days
at appropriate dose for patient age and weight (xx).
Refer to physician to evaluate need for a tetanus booster if avulsed
tooth has come into contact with soil or tetanus
coverage is uncertain
Initiate endodontic treatment after 7—10 days. Place calcium
hydroxide as an intra-canal medicament (x)
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