Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2023; 11(3): 635-644
Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.635
Rescuing “hopeless” avulsed teeth using autologous platelet-rich fibrin following delayed reimplantation: Two case reports
Yang Yang, Yan-Li Liu, Lie-Ni Jia, Jun-Jun Wang, Min Zhang
Yang Yang, Yan-Li Liu, Lie-Ni Jia, Jun-Jun Wang, Min Zhang, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
Author contributions: Yang Y, Jia LN and Wang JJ performed the dental treatment; Yang Y and Liu YL reviewed the literature and contributed to the drafting of the manuscript; Zhang M checked all aspects of this paper, including data collection, data analysis and paper writing; All authors have read and approved the final manuscript.
Supported by Natural Science Foundation of China, No. 31971248; and National Clinical Research Center for Oral Diseases Project of Military Stomatology, No. LCA202007.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Zhang, MD, PhD, Professor, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, No. 145 Changle West Road, Xincheng District, Xi'an 710032, Shaanxi Province, China. zhangmin@fmmu.edu.cn
Received: August 25, 2022
Peer-review started: August 25, 2022
First decision: November 22, 2022
Revised: December 10, 2022
Accepted: January 9, 2023
Article in press: January 9, 2023
Published online: January 26, 2023
Processing time: 144 Days and 1.2 Hours
Abstract
BACKGROUND

Tooth avulsion is one of the most severe types of dental trauma. Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis. The aim of this work was to improve the success rate of avulsed teeth after delayed reimplantation using autologous platelet-rich fibrin (PRF).

CASE SUMMARY

Case 1 was a 14-year-old boy who fell and knocked out his left upper central incisor 18 h prior to his arrival at the department. The diagnoses were avulsion of tooth 21, lateral luxation of tooth 11 and alveolar fracture of teeth 11 and 21. In case 2, a 17-year-old boy fell 2 h prior to his presentation to the hospital, and his left upper lateral incisor was completely knocked out of the alveolar socket. The diagnoses included avulsion of tooth 22, complicated crown fracture of tooth 11 and complicated crown-root fracture of tooth 21. The avulsed teeth were reimplanted along with autologous PRF granules and splinted using a semiflexible titanium preshaped labial arch. The root canals of the avulsed teeth were filled with calcium hydroxide paste, and root canal filling was performed 4 wk after reimplantation. The reimplanted teeth showed no symptoms of inflammatory root resorption or ankylosis at the 3-, 6-, and 12-mo follow-up examinations after reimplantation with autologous PRF. In addition to the avulsed teeth, the other injured teeth were treated using corresponding conventional treatment methods.

CONCLUSION

These cases provide examples of the successful use of PRF to reduce pathological root resorption of the avulsed teeth, and the application of PRF may provide new healing opportunities for traditionally “hopeless” avulsed teeth.

Keywords: Avulsion; Periodontal healing; Platelet-rich fibrin; Ankylosis; Delayed reimplantation; Case report

Core Tip: Tooth avulsion is one of the most severe types of dental trauma. Most avulsed teeth will undergo ankylosis and replacement resorption after delayed reimplantation and generally experience a poor prognosis. We previously demonstrated that autologous platelet-rich fibrin (PRF) could effectively help to control the occurrence and development of initial root resorption. In this report, we presented two clinical cases of avulsed teeth with delayed reimplantation that were treated with autologous PRF. Ideal periodontal healing over 12 mo of follow-up suggested that PRF, as an adjuvant therapy, may provide new insights and perspectives on the management of traditionally hopeless avulsed teeth.