Replantation after avulsion of permanent teeth: clinical procedures and adherence of cases reports to IADT Guidelines: a scoping review

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ABSTRACT

Aim

Avulsive trauma to permanent teeth is a critical dental emergency, particularly in children and adolescents, where timely intervention is essential for preserving aesthetics, function, and psychological well-being. This scoping review evaluates clinical adherence to the International Association of Dental Traumatology (IADT) guidelines for the replantation of avulsed permanent teeth, with a specific focus on the 2012 and 2020 versions. A comprehensive search of PubMed, Scopus, and Web of Science yielded 812 records, from which 92 studies were included after rigorous screening. Findings indicate that while adherence to IADT guidelines is generally observed, a greater alignment with the 2012 guidelines persists even in cases reported after the 2020 update. Adaptations of the guidelines were common, often reflecting case-specific considerations. Despite the IADT’s standardized framework, long-term outcomes for replanted teeth remain unpredictable, with failure rates ranging from 55% to 96%. Key challenges include complications like ankylosis and root resorption, particularly in delayed replantation. These issues underscore the need for enhanced focus on long-term management and prognosis in future guideline updates. The review highlights the critical role of replantation in preserving aesthetics, functionality, and psychological stability, especially for adolescents in developmental stages. However, limitations in current guidelines regarding long-term care and medico-legal clarity necessitate revisions to address complications, future prosthetic needs, and comprehensive follow-up protocols. Structured guidelines have significantly advanced the management of dental avulsions, yet further research and refinement are essential to improve outcomes and provide clearer medico-legal guidance, ensuring optimal care for affected patients.

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