Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Case Report Volume 5 Issue 8

Bone-Like Tissue Growth in the Root Canal of an Immature Permanent Avulsed and Replanted Central Incisor

Gali Zisman, Sigalit Blumer, Gisela Berenstein Ajzman*

Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel

*Corresponding Author: Gisela Berenstein Ajzman, Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.

Received: June 24, 2021; Published: July 19, 2021


Background: Avulsion is considered one of the most serious dental injuries known. Among the parameters studied with respect to the pulpal healing were development of pulp necrosis, pulp canal obliteration (PCO) and the ingrowth of bone into the root canal.

Case Report: This study discusses an immature avulsed permanent maxillary left central incisor which was replanted within 2 hours after stored in a physiologic medium of an eight-years-old boy. Thirteen months after avulsion, a radiopaque material was observed inside the root canal. Six months later, 19 months after avulsion, the root canal was filled completely with bone-like tissue with an internal PDL-like structure surrounding.

Follow-up: The tooth was followed up 3 years after the replantation with bony metaplasia inside the root canal and no other clinical and radiographic findings.

Conclusion: The bony metaplasia is reviewed less than other types of healing. Important to know, it is related to regaining vitality and could comprise partial root's development, in which endodontic treatment should not be consider and therefor follow ups are acceptable, of course when no other pathological signs exist.

Keywords: Pulp Necrosis; Pulp Canal Obliteration (PCO); Root Canal


  1. Andreasen A. “Textbook and Color Atlas of Traumatic Injuries to the Teeth”. 4th edition (2007).
  2. Fouad AF., et al. “International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth”. Dental Traumatology 36 (2020): 331-342.
  3. Andreasen JO. “Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys”. International Journal of Oral and Maxillofacial Surgery 10 (1981): 43-53.
  4. Barbizam JVB., et al. “Histopathological evaluation of the effects of variable extraoral dry times and enamel matrix proteins (enamel matrix derivatives) application on replanted dogs’ teeth”. Dental Traumatology 31 (2015): 29-34.
  5. Kling M., et al. “Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors”. Dental Traumatology 2 (1986): 83-89.
  6. Fouad AF and Verma P. “Healing after regenerative procedures with and without pulpal infection”. Journal of Endodontics 40 (2014): S58-64.
  7. M Cvek., et al. “Pulp revascularization in reimplanted immature monkey incisors - predictability and the effect of antibiotic systemic prophylaxis”. Endodontics and Dental Traumatology (1990): 157-169.
  8. M Cvek., et al. “Effect of topical application of doxycycline in pulp revascularization and periodontal healing in re-implanted monkeys incisors”. Endodontics and Dental Traumatology 6 (1990): 170.
  9. Andreasen JO., et al. “Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing”. Dental Traumatology 11 (1995): 59-68.
  10. Andreasen JO., et al. “Replantation of 400 avulsed permanent incisors. 1. diagnosis of healing complications”. Dental Traumatology 11 (1995): 51-58.
  11. Bastos JV and Côrtes MI de S. “Pulp canal obliteration after traumatic injuries in permanent teeth - scientific fact or fiction?” Brazilian Oral Research 32 (2018): 159-168.
  12. A Robertson. “A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries”. Endodontics and Dental Traumatology 14 (1998): 245-256.
  13. Heling I., et al. “Bone-like tissue growth in the root canal of immature permanent teeth after traumatic injuries”. Dental Traumatology 16 (2000): 298-303.
  14. Nishioka M., et al. “Tooth replantation in germ-free and conventional rats”. Endodontics and Dental Traumatology (1998): 163-173.
  15. Andreasen JO., et al. “Damage of the Hertwig’s epithelial root sheath: effect upon root growth after autotransplantation of teeth in monkeys”. Dental Traumatology 4 (1988): 145-151.
  16. Andreasen JO., et al. “Replantation of 400 avulsed permanent incisors. 3. Factors related to root growth”. Dental Traumatology 11 (1995): 69-75.
  17. Ratson T and Peretz B. “Bone-like material growth in a replanted immature central incisor following avulsion”. European Archives of Paediatric Dentistry 14 (2013): 271-275.


Citation: Gisela Berenstein Ajzman., et al. “Bone-Like Tissue Growth in the Root Canal of an Immature Permanent Avulsed and Replanted Central Incisor”. Acta Scientific Dental Sciences 5.8 (2021): 73-77.


Copyright: © 2021 Gisela Berenstein Ajzman., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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