Name of the Procedure:

Tooth Reimplantation and/or Stabilization of Accidentally Evulsed or Displaced Tooth (D7270)

Summary

Tooth reimplantation and stabilization involves putting a knocked-out or dislocated tooth back into its socket and securing it so it can heal properly. The procedure can often save a tooth that has been dislodged by trauma.

Purpose

This procedure addresses dental trauma, specifically when a tooth has been knocked out (avulsed) or dislocated. The goal is to reinsert and stabilize the tooth, promoting reattachment to the bone and surrounding tissues, which helps maintain dental function and aesthetics.

Indications

• Teeth that have been knocked out due to injury or accident.
• Teeth that have been displaced but not completely knocked out.
• Patients who have sufficient bone structure and tissue health to support reimplantation.

Preparation

• Patients should seek immediate care as success rates are higher if the procedure is performed quickly after the injury.
• Avoid touching the root of the tooth; handle it by the crown if possible.
• Rinse the tooth gently if it's dirty, but do not scrub it.
• Ideally, transport the tooth in milk or a tooth preservation solution.
• Diagnostic X-rays may be taken to assess the injury's extent.

Procedure Description

1. Assessment and Preparation: The patient is assessed, and local anesthesia is administered if necessary.
2. Cleaning the Socket and Tooth: The tooth is cleaned and irrigated if dirty, taking care not to scrub the root.
3. Reimplantation: The tooth is gently reinserted into its socket.
4. Stabilization: The tooth is stabilized using a splint, which may be made of wire or a composite material that attaches to adjacent teeth.
5. Follow-Up: Antibiotics and a tetanus shot may be given if the injury was substantial. Further dental check-ups will be required to monitor healing.

Duration

The entire procedure typically takes about 30 to 60 minutes.

Setting

The procedure is performed in a dental office, an outpatient clinic, or an emergency room equipped for dental care.

Personnel

• Dentist or Oral Surgeon
• Dental Assistant
• Sometimes, a nurse or anesthesiologist if sedation is necessary

Risks and Complications

• Infection at the reimplantation site
• Tooth root resorption or ankylosis (fusion to bone)
• Discoloration of the tooth
• Possible need for root canal therapy later
• Partial or complete loss of the tooth despite reimplantation

Benefits

• Preservation of natural teeth and maintenance of dental function and appearance.
• Helps in maintaining bone structure and alignment of surrounding teeth.
• Immediate benefits seen in reduced pain and trauma stabilization, with full integration taking several weeks to months.

Recovery

• Follow a soft diet and avoid biting with the affected tooth for several weeks.
• Maintain good oral hygiene but avoid brushing the reimplanted tooth initially.
• Use any prescribed mouth rinses to prevent infection.
• Attend all follow-up appointments for monitoring and removal of the splint.
• Full recovery can take several weeks to months.

Alternatives

• Dental implants if the tooth cannot be reimplanted.
• Partial dentures.
• Bridges to replace missing teeth.
• Each alternative has pros and cons (e.g., longer healing times, higher costs, multiple procedures).

Patient Experience

• During the procedure, the patient may feel some discomfort despite local anesthesia.
• Post-procedure, mild pain and swelling are common but can be managed with over-the-counter pain medications.
• The splint may feel awkward but usually becomes more comfortable over time.
• Patients must follow specific instructions on diet and oral care to ensure the best outcome.