Therapeutic proposal for avulsed teeth using calcium hydroxide associated to 2% chlorhexidine gel and zinc oxide

Tooth avulsion deserves great attention in dentistry due to its esthetic and functional implications. The prognosis of tooth replantation is usually related to the need of endodontic treatment, and several substances have been used as intracanal dressing. The objective of this study was to present a case of a dental replantation that was endodontically treated with a new therapeutic proposal for avulsed permanent teeth that associates calcium hydroxide P.A., 2% chlorhexidine gel and zinc oxide. A 10-year-old patient suffered tooth avulsion of both right and left central incisors due to a bicycle accident. Both teeth were replanted and endodontically treated, with different protocols. The right incisor was conventionally treated with periodic changes of calcium hydroxide intracanal medication and the left incisor was maintained with the filling paste composed of calcium hydroxide, 2% chlorexidine gel and zinc oxide during all the period of apexification, without changes. During 3 years of follow-up, both teeth showed absence of symptomatology and apical repair. This intracanal dressing played an important role as a filling paste with effective elimination of microorganisms present in the root canal system, stimulated the formation of a mineralized apical barrier, and stabilized root inflammatory resorption.