What is the most likely diagnosis after replantation of an avulsed tooth 2 ½ hours post-incident?

The most likely diagnosis following replantation of an avulsed tooth after being out of the socket for 2 ½ hours is external resorption. When a tooth is avulsed, it is subjected to a loss of vitality due to the interruption of the blood supply. Replanting the tooth in a timely manner (though 2 ½ hours is still considered prolonged) does allow for some recovery, but the risk of external root resorption increases significantly with time out of the socket.

External resorption occurs at the root surface where inflammatory processes from the periodontal tissue can lead to the loss of dentin and cementum, potentially resulting in a reduced survival of the tooth. This phenomenon is particularly notable in cases of avulsion, especially when teeth are replanted after a delayed timeframe.

The other conditions mentioned are less likely based on the timing of replantation. Internal resorption usually occurs as a result of chronic irritation within the pulp chamber and is not directly related to the replantation timing. Pulp stones are calcifications that can develop within the pulp chamber over time but wouldn’t be a direct outcome of the replantation procedure after an avulsion. Necrotic pulp is also a potential consequence of the avulsion,