MANAGEMENT AND 4 YEARS FOLLOW-UP OF AN AVULSED MAXILLARY CENTRAL INCISOR FOLLOWING A TRAFFIC ACCIDENT: A CASE REPORT

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Dental avulsion is one of the most severe traumatic dental injuries and is defined as the complete displacement of a tooth from its alveolar socket. This condition most frequently affects the maxillary central incisors, particularly in children and young adults, due to their anterior position and increased exposure during high-impact trauma. Traffic accidents are among the leading causes and can result in complex dental and periodontal damage. Successful outcomes depend on rapid and appropriate emergency management. Critical factors include the extra-alveolar period, storage medium, replantation technique, splinting method, and the timing of endodontic treatment. Even with correct protocols, complications such as external root resorption, ankylosis, or tooth loss may occur. This case report describes the clinical management and 4-year follow-up of a 16-year-old male who experienced avulsion of tooth #21 and luxation injury of tooth #11 following a traffic accident. The avulsed tooth was replanted within approximately one hour at a general hospital and initially splinted with stainless steel wire. Upon referral to Ankara University, inadequate splinting was corrected using a semi-rigid fiber splint to minimize additional trauma and provide physiological mobility. Root canal treatment of both teeth was initiated on day 5, and calcium hydroxide was used as an intracanal medicament before final obturation with gutta-percha and AH Plus sealer. At 3 months, tooth #21 demonstrated class I mobility and apical resorption but remained asymptomatic. Four-year follow-up revealed an increase in resorption areas but maintained function and no signs of infection. This case highlights the importance of early replantation, proper splinting, and timely endodontic treatment in achieving favorable long-term outcomes after avulsion. Continuous clinical and radiographic follow-up remains essential to detect and manage potential resorptive changes over time

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