Case Report: Favorable long-term outcomes of autologous PRF-augmented delayed replantation for traumatic avulsion of three mandibular anterior teeth with 10-year follow-up

The first-line treatment for permanent tooth avulsion is immediate replantation. Delayed replantation is associated with a high risk of survival-related complications, such as root resorption. Autologous platelet-rich fibrin (PRF) may promote the periodontal healing of delayed-replanted avulsed teeth and may potentially reduce the occurrence and progression of early root resorption. This case report explores the dental treatment process of autologous PRF-assisted delayed replantation in an adult patient with the avulsion of three mandibular anterior teeth. After an accident, the patient wiped the roots of the avulsed teeth and stored them in dry tissue. Two hours later, the patient visited the emergency department for treatment. On the same day, PRF granules were prepared, and the teeth were replanted with the granules and fixed with semi-elastic splints. The treatment was based on the 2012 guidelines of the International Association of Dental Traumatology. Two weeks later, the patient returned, and root canal treatment was performed, the fixation device was removed at the same visit. Two weeks after intracanal medication with calcium hydroxide, root canal filling was completed. Follow-up visits at 3, 6, and 12 months and up to 10 years after the trauma revealed no clinical symptoms in the affected teeth, and radiography showed no sign of root resorption. The patient expressed satisfaction with both the esthetic and functional outcomes. This case report describes a favorable outcome following PRF-assisted replantation of delayed-replanted avulsed teeth. The findings suggest a potential adjunctive role of PRF in promoting periodontal healing, which warrants further investigation.