Management of Avulsed Permanent Maxillary Incisor Tooth with 11 Hours of Extraoral Time: A Case Report.

AIM: This study describes the management of a replanted and endodontically treated avulsed permanent maxillary incisor tooth with 11 hours of extraoral time.

BACKGROUND

Avulsion is one of the most common and severe dental injuries occurring in young children and has an unreliable prognosis. Immediate avulsion treatment is essential to maintain the tooth's vitality and minimize complications. A successful outcome is determined by adequate preservation and early replantation.

CASE DESCRIPTION: A nine-year-old boy reported to the advanced dental care clinic with an avulsed tooth #21 due to a bicycle fall. The boy's mother attempted to preserve the tooth by storing it in the refrigerator for 11 hours immediately after the trauma. The tooth was replanted and splinted; however, the tooth showed pulpal necrosis after 2 weeks, suggesting replantation failure that necessitated further intervention. Accordingly, an apexification procedure employing mineral trioxide aggregate and gutta-percha was performed to treat the tooth's open apex and promote continued root development. The patient remained asymptomatic during the follow-up periods of 6 and 12 months.

CONCLUSION

This case report demonstrates the effective treatment of an open apex avulsed tooth through an apexification procedure despite the unusual tooth preservation attempt by the patient's mother.

CLINICAL SIGNIFICANCE: Although delayed replantation of an avulsed tooth is accompanied by few complications, it might inadvertently preserve the alveolar bone and provide psychological advantages to the patient, making it a viable alternative to dental prosthesis. How to cite this article: Alrashedi AH, Alanazi HM, Alenezi AM, et al. Management of Avulsed Permanent Maxillary Incisor Tooth with 11 Hours of Extraoral Time: A Case Report. J Contemp Dent Pract 2026;27(2):185-189.