D7270 Dental Code: Tooth Replantation and Transplantation

Tooth loss can significantly impact oral function, aesthetics, and self-confidence. While dental implants and bridges are common solutions, tooth replantation (D7270) offers a unique alternative by preserving a natural tooth. This procedure involves reinserting an avulsed (knocked-out) or surgically removed tooth back into its socket, providing a biologically favorable outcome when performed correctly.

This in-depth guide explores the D7270 dental code, detailing its clinical applications, procedural steps, success factors, and alternatives. Whether you’re a dental professional or a patient considering this treatment, this article provides valuable insights into tooth replantation and transplantation.

2. Understanding the D7270 Dental Code

Definition and Purpose

The D7270 dental code refers to tooth replantation and/or transplantation, a procedure where a dislodged or donor tooth is repositioned into its original or a new socket. The American Dental Association (ADA) categorizes this under surgical services and typically applies to:

• Avulsed teeth due to trauma

• Intentional replantation for endodontic reasons

• Transplantation of a donor tooth (e.g., wisdom tooth to replace a missing molar)

When Is D7270 Used?

This code is utilized in scenarios such as:

• Traumatic tooth avulsion (e.g., sports injuries, accidents)

• Hopeless teeth with periapical lesions (intentional replantation as a last resort before extraction)

• Autotransplantation (moving a tooth from one socket to another within the same patient)

3. Tooth Replantation vs. Tooth Transplantation

4. Clinical Procedure for Tooth Replantation (D7270)

Step-by-Step Process

1. Emergency Handling of Avulsed Tooth

   • Rinse gently with saline (avoid scrubbing the root).

   • Store in milk or Hank’s Balanced Salt Solution (HBSS).

2. Socket Preparation

   • Clean the socket, remove clots, and preserve bone integrity.

3. Tooth Reinsertion

   • Reposition the tooth and stabilize it with a splint (e.g., wire-composite splint).

4. Follow-Up Care

   • Monitor for infection, ankylosis, or root resorption.

5. Success Rates and Prognostic Factors

Success depends on:
✔ Extraoral dry time (<60 minutes ideal)
✔ Proper storage medium (milk or HBSS)
✔ Patient age (better outcomes in younger patients)
✔ Root development status (open apex has higher survival)

6. Potential Complications

• Ankylosis (fusion to bone)

• Root resorption

• Infection or necrosis

7. Cost and Insurance Coverage

• Average Cost: $600–$1,500 per tooth

• Insurance: Some plans cover D7270 under surgical benefits.

8. Alternatives to D7270

• Dental Implants (more predictable but costly)

• Fixed Bridges (require adjacent tooth preparation)

9. FAQs About D7270

Q1: Can any knocked-out tooth be replanted?

A: Ideally, yes, if handled properly and reinserted quickly.

Q2: How long does a replanted tooth last?

A: Varies—some last decades, while others may need replacement due to resorption.

Q3: Is D7270 covered by Medicaid?

A: Partial coverage may apply; check with your provider.

10. Conclusion

The D7270 dental code offers a viable solution for preserving natural teeth through replantation or transplantation. While success depends on timely intervention and proper technique, it remains a valuable alternative to implants and prosthetics. Consulting an experienced dentist or oral surgeon is crucial for optimal outcomes.

11. Additional Resources

• American Association of Endodontists – Trauma Guidelines

• ADA Dental Code Manual