Pulps should be removed from replanted avulsed teeth within 14 days

shutterstock_70287046 - avulsed tooth

This 2009 review by Hinckfuss & Messer regarding the timing of pulp extirpation following the replantation of avulsed teeth has just been critically appraised under the auspicies of the American Dental Associations Centre for Evidence-based Dentistry.

The commentator highlights some methodological issues with the conduct of the review and the heterogeneity of the available evidence that was included.  Only 6 studies (236 teeth) were included 3 retrospective and 3 prospective.   The review found  an association between reduced incidence of root resorption and performing  pulp extirpation before 14 days. This finding would support existing guidelines from a number of groups.

A useful online guide to the management of dental trauma can be found at The Dental Trauma Guide

Go to the ADA summary

Evidence-based Dental Journal commentary

 Hinckfuss SE, Messer LB. An evidence-based assessment of the clinical  guidelines for replanted avulsed teeth. Part I: Timing of pulp extirpation. Dent Traumatol. 2009 Feb;25(1):32-42. Review. PubMed PMID: 19208008



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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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