Continued Root Development after Avulsion of Immature Teeth

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig’s epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig’s epithelial root sheath to initiate root development despite a traumatic injury.