After 60 mins
1. Rinse/soak in 2.4% acidulated fluoride solution at pH 5.5 (citric acid + sodium fluoride) (helps prevent root resorption )
2. Extra-oral RCT is performed by holding the tooth in fluoride soaked gauze.
3. The socket clot is suctioned and irrigated with saline to remove the clot.
4. Replant with digital pressure, the Splint with flexible splint for 4 weeks
5. Possible complications –
a. Here we expect either ankyloses or replacemental root resorption – which will happen within 2 years
b. inflammatory external root resorption (IERR) – which is the main reason for failure of reimplantation Therefore can displace the tooth i.e. possibility of avulsion again
c. Ankyloses will give better prognosis than ERR, which will lead to failure.
Once ankylosed, chances for IERR decreases over time.

CLASS VI – ROOT FRACTURE

Vertical Root Fracture
Causes
- Post & core cases
- Warm GP / vertical condensation cases
- Bite / chewing
- Accidental trauma
Diagnosis
- J-shaped radiographic appearance
- Tear-drop shape
- Isolated PDL pocket
[Other causes for isolated pockets
o Endoperio lesion – pathological
o Developmental groove (max LI) – normal variant ]

Horizontal Root Fracture
Apical 1/3rd
- Treatment is wait & watch
- Small fragment may get resorbed by cementoblasts & odontoblasts
- Later do RCT
- Best prognosis
Middle 2/3rd
- Wait & watch
- May get resorbed
- Then go for RCT for rest of the coronal root
- Lesser prognosis
Cervical 3rd
- Prognosis is very poor
- Splint to adjacent teeth with rigid splint such as metallic band / wire
- Wait & watch
- Extraction if no re-attachment seen