If exposed, the root surface of the displaced tooth should be cleansed with
saline solution. The tooth is repositioned with axial digital pressure until
its normal position has been reestablished.
In some cases, as shown in this illustration, the apex of the tooth is
locked in its displaced position. In such cases, repositioning will involve a
movement of the tooth in direction out of its socket (1) before the axial
digital pressure (2) makes it click into its proper position.
Fixation is preferably accomplished with acid etch of the incisal enamel and
application of a resin splint involving intact neighboring teeth. The teeth
involved are gently dried with compressed air (as illustrated) or absolute
alcohol and kept dry during the fixation procedure.
A finger on the lingual aspect of the tooth can maintain tooth position
during the fixation procedure.
Points of fixation in the repositioned tooth as well as neighboring teeth
are etched with phosphoric acid for 20 seconds.
Remember to place a suction tube to maintain dryness during etching
The etch gel is removed by saline irrigation. Make sure to direct the saline
jet in a direction away from soft-tissue wounds and to place a suction tube to
remove the spray of the saline and etch gel.
The fixation spots are then dried.
It is imperative that the enamel be kept dry until the resin has completely
Application of resin material
Resin material (eg, used for temporary crowns and bridges) is applied to
provide a splint. This material allows a certain flexibility of the splint and
is easy to remove.
In cases of lateral luxation, fixation should generally be maintained for 4
weeks (due to the associate bone fracture).
Note: the patient should be put on soft diet for 2 weeks. Exposure to
temperature extremes should be avoided.
Note: care has to be taken that there is no occlusal loading to the affected
After the fixation period (four weeks) the resin can be peeled off with a
dental scaler or removed with a burr. The tooth must be supported by axial
digital pressure during this procedure.