Pediatric Dentistry · patient case question
After the tooth is replanted, how long should it be stabilized, and with what type of splint?
Patient case: Avulsed Central Incisor on the Soccer Field
Patient: 8-year-old male
Chief Complaint: “His tooth got knocked out at soccer practice.”
Background: Healthy, immunizations current, no allergies. Tooth #8 was avulsed 35 minutes ago. The coach placed it directly into a container of Hank’s Balanced Salt Solution from the sideline kit. No loss of consciousness, no other injuries.
Medications: None
Vital Signs: BP 100/64 mmHg · HR 98 bpm · RR 20 · T 98.6°F
Findings: Empty socket at #8 with no alveolar fracture. The avulsed tooth is intact with a wide open apex and short root (approximately two-thirds formed). Adjacent teeth #7 and #9 are firm and respond within normal limits.
Show answer and explanation
Correct answer: B. Two weeks with a passive, flexible splint
- A. Incorrect. Four weeks with a more rigid splint is indicated only when there is an associated alveolar or jawbone fracture, which this patient does not have.
- B. Correct. The 2020 IADT guidelines direct that the replanted tooth be stabilized for 2 weeks with a passive, flexible wire up to 0.016 inch or 0.4 mm in diameter. Flexibility permits physiologic movement, which encourages periodontal ligament healing rather than ankylosis.
- C. Incorrect. Rigid splinting restricts physiologic mobility and increases the risk of replacement resorption and ankylosis. It is reserved for bony injuries.
- D. Incorrect. Eight weeks far exceeds any recommended interval and would substantially increase the risk of ankylosis and plaque-related complications.
Note: Correction to source. The recall recorded “one week.” The 2020 IADT guideline is 2 weeks flexible for avulsion, extended to 4 weeks only with an associated alveolar fracture. The older 7–10 day figure comes from the previous guideline generation and still circulates in study material.
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