Tooth Avulsion with Open Root Apex: A Case Report
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Abstract
Objective: To study the treatment of tooth avulsion in children with the root apex still open.
Method: Boy, 11 years old right upper central incisor (tooth #21) dislodged from the socket due to an
accident. His parents kept it dry for 90 minutes. Tooth #21 and the socket were cleaned with a sterile
isotonic saline solution. Grasp its root put it into the original position, and check the occlusion. Fix tooth
#21 to the upper front teeth with a 0.16 niti. wire on the fixed orthodontic appliance. This tool allows the
teeth to move slightly, called semi-rigid. Holding them for 7-10 days takes time. Apexification treatment to
encourage root tip closure with calcium hydroxide mixed with distilled water filling into the root canal.
Follow-up with X-rays for one year. The root apex is closed, and resorption has stopped. Root canal filling
with gutta-percha and tooth crown filling with composite resin.
Result: 6 months after root canal filling, periodontal organs around right upper central incisor (tooth #21)
is typical. Root X-ray shows no resorption. The surrounding bone does not have a translucent area.
Conclusion: Right upper central incisor (tooth #21), with an open root end, is dislodged from the socket.
Storing in a dry state for 90 minutes is a negative factor for treatment results. At the early stage, due to
the resorption of the root, tooth #21 is short compared with tooth #11. Calcium hydroxide is mixed with
distilled water, continually changing for one year. The tooth's root begins to stop resorption, causing root apex closure. Follow-up 6 months after root canal filling, x-ray results, and surrounding periodontal organs
normal. But short roots and treatment with calcium hydroxide for a long time often make the tooth not
strong.
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