Introduction: Management of dental trauma in pediatric patients requires not only immediate intervention but also long-term follow-up regimen. Especially, avulsion of permanent teeth is the most serious injuries of the tooth, and replantation of teeth must be carried out immediately for good prognosis.

Case Report: This article describes the treatment of four anterior maxillary permanent incisors of an 11-year-old boy with history of traumatic avulsion and delayed replantation. The avulsed teeth were kept in unclean and dry conditions for 5 h. The root canal treatment was carried out with mineral trioxide aggregate (MTA). After treatment, the patient was referred to the orthodontic department and two of replanted teeth were extracted orthodontically. The remained replanted teeth were stable and functional position during the four-year follow-up. However, one of teeth showed an excessive root resorption on the last radiographic examination.

Conclusion: Although the risk of progressive root resorption and ankloysis is high, delayed replantation of avulsed teeth can be a best choice to avoid early tooth loss. To prevent the complications of delayed replantation, MTA might be used for root canal treatment. Thus, the level of alveolar bone can be preserved till the growth is completed.

Keywords: Avulsion, Delayed replantation, Dental trauma, Mineral trioxide aggregate