After examining the alveolus and the tooth, begin replantation, tiently insert the tooth into the socket; anesthesia will probably not be necessary. The insertion should be slow and gentle so that pressure is minimized. When the tooth is nearly in place, have the patient complete the process by biting on a piece of gauze. Even small children will be able to follow the instruction to bite gently, and it allows them a measure of participation in the treatment.The following steps in the replantation treatment also apply to situations in which the tooth may have been replanted before the patient’s arrival. Check it for alignment with respect to adjacent and opposing teeth. It is most important that it not be in hyperocclusion. Such premature contact would delay or prevent recovery. Next, evaluate the need for stabilization. Splinting may not be necessary if the tooth fits firmly in its socket. If there is mobility, however, it should be stabilized with a futictional splint.
Use either a thin orthodontic wire attached with acidetched resin to the labial surfaces of the replanted and adjacent teeth or use only an unfilled resin bonded to small etched labial spots. In mixed dentition and cases of missing, nonreplaceable adjacent teeth, other types of splints may be necessary in case of affordable denture. The splint should be left in place only long enough for the initial reattachment of periodontai ligament fibers; in most cases, that can be expected to take place in 1 to 2 weeks, after which the splint should be removed. Further support of the replantation procedure consists of initial antibiotic coverage, tetanus prevention, and root canal therapy. The latter is ideally performed 10 to 14 days after replantation.