Systematic Review on Relation Between Surface Treatment and Outcome of Delayed Replantation of Permanent Anterior Avulsed Teeth

Introduction: One of the most severe dental injury is Tooth Avulsion or exarticulation. Tooth avulsion is the complete displacement of tooth out of the socket. The common treatment employed for avulsed teeth is replantation, the prognosis of which depends on the handling of the tooth specimen and time lag between avulsion and replantation of the teeth. Surface treatment of root surface of avulsed teeth prior to delayed replantation is a common practice and a variety of agents and methods have been used for the same. The literature lacks evidence that establishes a definitive relation between surface treatment and prognosis of delayed replantation of avulsed teeth. Aim: To understand the effect of surface treatment and outcome after replantation of avulsed anterior permanent teeth with an extraoral dry time of more than 60 minutes. Materials and Methods: The protocol for systematic review was registered on PROSPERO, registration number was CRD42020222919. A search was performed on case reports and case series available on delayed replantation of avulsed anterior permanent teeth on databases like Medline/PubMed, Google Scholar, and Cochrane from the year 2000 to 2018. The MESH terms and keywords like tooth avulsion*, tooth fractures*, tooth injuries*, traumatology*, delayed replantation methods and delayed replantation standards with Boolean operators were used for data identification and screening. After applying inclusion and exclusion criteria, total five articles were included. Results: The duration of storage of the teeth were variable with cases reported from 24 hours to 72 hours of extraoral dry time. All five reports used different methods for surface treatments. No complications were reported after 12 months in three cases. No complication was reported after 24 months in one case. After 12 weeks, one article reported ankylosis and infraocclusion after replantation. Conclusion: As a result of data heterogenicity and a short follow-up period of the articles, a clear relation between surface treatment and delayed replantation of an avulsed teeth could not be established. However, it can be safely concluded that surface treatment of avulsed teeth prior to delayed replantation results in a better prognosis and predictable outcomes.