Shorts

Common sequelae of replanted avulsed tooth are ankylosis and resorption of roots. These complications occur due to: 1) Periodontal ligament damage during avulsion and handling, 2) Extended extraoral time leading to PDL cell death, 3) Inflammatory response triggering resorptive processes, 4) Direct bone-root contact causing ankylosis, 5) Root surface damage predisposing to replacement resorption. These complications are more common when extraoral time exceeds 30 minutes or when the tooth is stored in inappropriate media. Proper immediate management can reduce but not eliminate these risks.

Tooth discoloration most commonly results from pulp necrosis. When pulp tissue dies: 1) Hemoglobin breaks down into iron sulfide and other dark pigments, 2) Protein degradation products penetrate dentin tubules, 3) These pigments become embedded in the tooth structure, 4) The discoloration progresses from pink to dark brown/gray over time. This is more common than hyperemia (which is reversible), pulpal abscess (which may not always cause visible discoloration), making pulp necrosis the primary cause of intrinsic tooth discoloration.

All listed factors (skillful extraction, short extraoral time, intact periodontal ligament) are essential for successful intentional reimplantation. Therefore, none of these can be excluded from success factors.

The most desirable healing response is cementum deposition at the apical foramen, which seals the apex and maintains the periodontal ligament space. This represents optimal biological healing.

The most common cause of pulp pathology, or pulpitis, is microbial invasion, typically stemming from dental caries (tooth decay). 

Gutta-percha cones are generally not recommended for root canal filling in primary teeth because the root canals of primary teeth are more likely to contain vital tissue, and the material can potentially cause harm to these tissues. However, they are suitable for permanent teeth with wide root canals and even those with curved roots, provided that the root canals are properly cleaned and shaped to allow for optimal filling.

Vertical root fractures have the poorest prognosis among all tooth fractures. This is because: 1) The fracture line extends from crown to apex, compromising the entire root structure, 2) Bacterial contamination occurs along the entire fracture line, 3) Periodontal ligament attachment is severely compromised, 4) Healing is virtually impossible due to constant separation of fragments during function, 5) Almost always requires extraction. Horizontal fractures at the apical third have the best prognosis, while gingival level and middle third fractures have intermediate prognosis depending on management.

Pulpectomy involves the complete removal of the pulp from the root canals, followed by cleaning, shaping, and filling the canals with a suitable material.

An apicectomy (or root-end resection) is a minor surgical procedure performed to remove the apex, or very end, of a tooth's root. This procedure is typically necessary when inflammation or infection persists in the bony area around the end of a tooth after a standard root canal procedure has failed. The procedure is often followed by a retrograde filling (retrograde restoration) to seal the end of the root canal.