https://doi.org/10.65770/HXEA6725
ABSTRACT
Replacement resorption, a pathologic consequence of severe dental trauma, represents a formidable clinical challenge, particularly in the young adult demographic. This sequela, characterized by the progressive substitution of tooth structure with bone, leads to ankylosis and infra-position, compromising long-term periodontal health, alveolar ridge contour, and esthetic outcomes. In young adults, the transition from active skeletal growth to functional maturity creates a complex temporal window where intervention timing is critical. This narrative review synthesizes the contemporary understanding of replacement resorption, beginning with an in-depth exploration of its biological underpinnings, from the critical loss of periodontal ligament (PDL) viability to the subsequent osseous replacement. We critically evaluate the most current guidelines from the International Association of Dental Traumatology (IADT), delineating management paradigms based on a patient’s growth potential. Furthermore, we dissect contemporary management strategies, ranging from the biologically-driven “decoronation” procedure for alveolar preservation to advanced restorative “rescue” protocols. The review culminates in a discussion of the profound esthetic and functional dilemmas posed, advocating for a multidisciplinary, patient-centered approach that prioritizes the management of the alveolar foundation over the futile preservation of the tooth itself.
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