Cbct based comparative evaluation of avulsed teeth replantation outcomes : influence of extra-oral time and storage medium

This study evaluates the outcomes of replantation in cases of avulsed permanent teeth treated with extraoral root canal treatment (RCT), using cone-beam computed tomography (CBCT) for precise assessment. A cluster randomized trial design is employed, with dental trauma care centers as clusters. Centers are randomized to different standardized management protocols, such as variations in extraoral dry time, storage medium, and replantation techniques. The study includes patients aged 9-14 years with a history of traumatic avulsion and extraoral dry time. Only cases with proper replantation protocols and consent for post-operative CBCT imaging are included. Outcomes focus on periapical healing, root resorption, and periodontal health, with a minimum follow-up of 6-12 months. Clusters implement assigned protocols, ensuring uniformity within centers while allowing comparison across groups. Statistical analysis accounts for clustering effects, using hierarchical models to evaluate the impact of management strategies on clinical and radiographic outcomes. By integrating CBCT imaging with a cluster randomized approach, the study aims to enhance evidence-based protocols for avulsed tooth management, improving long-term treatment success and patient care