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PubMedDate not supplied

Replantation of avulsed primary anterior teeth: treatment and limitations.

In addition to the successful replantation of avulsed permanent teeth, the replantation of primary anterior teeth may also be indicated. The decision is based on age and stage of tooth development, development of dentition, storage of the avulsed tooth and the way it is transported to the treatment site, the appropriate in vitro treatment of the tooth before reinsertion, and the willingness of the child to cooperate. A method involving retrograde filling of the primary tooth root with calcium hydroxide after resecting the root apex has proved successful. Other commercially available root filling materials and pins are not indicated. Calcium hydroxide allows the tooth to heal in place without reaction and prevents the development of apical periodontitis. As regards any surgical intervention, the attending dentist in this case has to weigh the benefits against the risks.

Age Factors↗
PubMed1989

[Avulsed teeth. A case study].

A clinical case of exarticulation and replantation served to discuss recent insights regarding the treatment of total avulsions of permanent teeth. A flow chart representing all treatment options is given. The tooth has been replanted in near ideal conditions; within one hour after the avulsion, the young patient attended the dental school with his avulsed tooth stored in milk. After replantation, a very simple splint was applied for only a fortnight and a provisory endodontic therapy with calcium hydroxide was performed. Adequate oral hygiene measures supported with chlorhexidine gel were instructed. These promote the healing process and ultimately also contribute to a long-term survival of the replanted tooth. After healing, a permanent root canal filling was applied and the crown was restored by means of composite material. The one-year- follow up check did not show any sign of resorption and/or ankylosis.

Child↗
PubMed2004

Endodontic treatment of reimplanted avulsed teeth.

By using an appropriate storage system such as a Save-A-Tooth and having knowledge of appropriate treatment options, an avulsed tooth can be reimplanted with the greatest chance of success. Using the different categories of avulsed teeth discussed in this article as a guide, the clinician can determine the most applicable course of treatment. If endodontic treatment is based on the clinical condition of the pulp and PDL cells, the chance of success following reimplantation is improved.

Follow-Up Studies↗
PubMed1997

Epidemiology of dental trauma treated in an urban pediatric emergency department.

STUDY OBJECTIVE: To describe the epidemiology of traumatic dental injuries to children treated in an urban pediatric emergency department (ED). DESIGN: A descriptive study of a consecutive series of patients. SETTING: The ED of a large, academic children's hospital. PARTICIPANTS: Children presenting to the ED with dental trauma from December 1992 to November 1993. RESULTS: Of 1459 children treated for dental emergencies, 541 had dental trauma (37%) and were enrolled in this study. Patients ranged in age from five months to 18 years. Fifty-nine percent of patients were less than seven years of age, and 59% of patients were male. Falls caused 63% of injuries, followed by being struck (17%), and motor vehicle crashes (2%). Injuries to the soft tissues included lacerations (32%), swelling (8%), abrasions (7%), and contusions (6%). Injuries to hard dental structures included tooth fractures (33%), luxations (18%), concussions (12%), avulsions (8%), and jaw fractures (1%). Tooth luxation and concussion were more common among children less than seven years of age, and fractures to the tooth crown with dentin exposure (Ellis class II) were seen most often among children with permanent dentition (chi 2 = 41.4, P < 0.005). The central incisors were the teeth most frequently traumatized. CONCLUSION: Findings of this large consecutive series provide a useful description of the epidemiology of this common type of pediatric trauma for pediatric emergency care providers.

Accidental Falls↗
PubMed2003

[Dental implants following trauma in young adults].

Various statistics have shown that avulsion (total displacement of tooth out of its socket) following traumatic injuries is relatively infrequent, ranging from 0.5 to 16% of traumatic injuries in the permanent dentition. The maxillary central incisors are the most frequently avulsed teeth. Avulsion of teeth occurs most often in children from 7 to 9 years of age, when the permanent incisors are erupting. Most frequently, avulsion involves a single tooth; but multiple avulsion are occasionally encountered. Fractures of the alveolar socket wall are often associate with avulsion. After the tooth is lost, an almost certain sequelae is the rapid resorption of alveolar bone. In many cases, only a very thin crestal bony lamella remains after healing of the alveolus, with clinically obvious horizontal and vertical depressions. In a young patient missing an anterior tooth, the operator may find implant insertion, in the proper anatomical position, difficult or impossible, because of inadequate bone volume. This situation aggravates with time because of continuous resorption and relative growth of the adjacent alveolar bone around the teeth. New and predictable bone augmentation techniques allow compensation for bone reduction while waiting for completion of growth. In cases of localized ridge augmentation, the amount of initial bone volume and its shape dictate whether implant insertion and bone augmentation will be performed simultaneously. The indications for this approach are: sufficient bone volume to achieve initial implant stability and a predictably high success rate for the augmentation. When bone volume and shape do not allow for initial stability, there is indication for a staged approach, in which the bone is initially augmented, the results are evaluated and the implant is then inserted. The first stage, the bone regeneration phase, may last between 8-10 months. The second, the implant integration period, may take an additional 6-8 months. The effect of growth on the augmented bone is not quite clear and there is only a paucity of information concerning the use of bone regeneration procedures in growing patients. Clinical decision when to start implant treatment after avulsion is dependent not only on the timing of implant insertion, but also on bone regeneration procedures. When most of horizontal and vertical bony walls of the extraction site is lost, augmentation procedure as a measure to reduce the deficiency, may be considered even in preadolescents. Three cases describing different clinical situations following avulsion, tooth replacement, resorption, regeneration treatment and implant insertion are discussed.

Adolescent↗
PubMed1992

An investigation of replantation of traumatically avulsed permanent incisor teeth.

The success of treatment of 46 replanted, avulsed permanent incisors in 36 children was investigated in relation to some of the factors which have been reported to affect prognosis. Treatment was considered to have been successful if the tooth was still present in the mouth and required no further treatment. If more treatment was necessary, the outcome was considered to be uncertain, while if the tooth had been lost a failure was recorded. Treatment was considered to be successful for 21 teeth, uncertain for 20 teeth and a failure for 5 teeth. A significant relationship was found between success and the method of storing the avulsed tooth, with milk, saliva or saline being the best media. No relationship was demonstrated between the time the avulsed tooth was out of the mouth and success. Root resorption was the most frequent complication of replantation and occurred in 24 teeth. However, no significant relationship between resorption and the time that the avulsed tooth was out of the mouth was demonstrated.

Adolescent↗