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PubMedDate not supplied

The treatment of avulsed teeth.

More than 2 million teeth are accidentally avulsed each year in the United States. Most of the victims are children. Almost all of these teeth can be saved if the proper treatment is instituted. Regardless of the frequency with which it occurs, every pediatric health care provider must be prepared for patients who have avulsed teeth. By instituting the proper treatment, the provider may help to save a victim's tooth, thus saving the family and child the expense of dental treatment and the possible psychologic problems associated with false teeth. Each health care provider should take the following steps: 1. Inform all health care personnel that avulsed teeth can and should be saved. 2. Teach all health care personnel what action should be taken if a tooth is avulsed. 3. Fabricate or purchase tooth-preserving devices such as the Emergency Tooth Preserving System, which can safely store, preserve, and transport avulsed teeth. 4. Place these tooth-preserving devices at strategic locations such as in emergency kits or at nurses' stations.

Animals↗

PubMed1998

[Injuries to the permanent teeth. Periodontal lesions].

Tooth luxations are relatively common. In case of concussion or subluxation the tooth is not displaced. The treatment will consist of relief of the tooth. Most frequent complications are pulp necrosis and obliteration of pulpal tissues. In case of extrusive luxation pulpal tissues and the periodontal ligament are injured. When tooth mobility is increased flexible splinting should be considered. Endodontic treatment is necessary after extrusive luxation of a tooth with completed root formation. Teeth with open apex often show pulpal obliteration after extensive luxation. Lateral luxation is more complex than extrusive luxation since the alveolar bone is also damaged. Repositioning and splinting of the tooth are necessary. When the apical foramen in closed, endodontic treatment will be necessary. Teeth with incomplete root formation will develop pulp obliteration. Following lateral luxation, external root resorption and loss of marginal bone are not infrequent. Intrusive luxation is the type of trauma with most unfavorable prognosis. All intruded teeth will become necrotic and external root resorption and marginal bone loss are frequent. There is no consensus regarding the therapeutic approach. Orthodontic extrusion or surgical mobilisation are possible options. In case of avulsion, both the pulpal tissues and the periodontal ligament are disrupted. Preservation of the vitality of the periodontal ligament covering the root will determine the prognosis of the reimplanted tooth. Therefore the tooth will be repositioned as soon as possible. When this is not possible, milk or a specific solution are most appropriate for tooth conservation. When the reimplanted tooth has complete root formation, devitalization will be performed one week after after repositioning. In case of a tooth with open apex revascularisation can be awaited. Healing of the periodontal ligament will determine prognosis. When a normal ligament is obtained during healing or when surface resorption is obtained, the tooth can be preserved for a long period. When progressive replacement resorption (ankylosis) develops, most teeth can remain in position for about 10 years. When inflammatory resorption develops, the tooth will be lost within a short time.

Dental Pulp Calcification↗

PubMedDate not supplied

[Complete luxation with loss of the tooth: an implant case].

The purpose of this article is to report a possible use of dental implants in children. The immediate implantation of an aluminium artificial frialite root, is described in an 8 years old child following the complete avulsion with loss of her center incisor. Osteo integration and the surgical placement technique of the Frialite implant are reviewed. The selection of an implant and of the immediate implantation concept are also discussed in this article. This implant will either become functional as a prosthetic abutment or esthetic by filling the alveolus, as it avoids the formation of a concavity in the edentulous ridge.

Aluminum Oxide↗

PubMed2005

Tooth loss and subluxation in the primary dentition: a twelve-year follow-up case report.

The case of a five-year-old child is reported, who suffered dento-alveolar injury including subluxation of the right upper lateral incisor and avulsion of the upper central incisors and left upper lateral incisor and laceration in the mucosa. The case was followed for 12 years until complete root formation and alignment of the anterior permanent teeth.

Child, Preschool↗

PubMed2005

Orthodontic treatment of a traumatically intruded tooth with ankylosis by traction after surgical luxation.

This report presents the treatment of a patient with anterior crossbite and displacement of ankylosed maxillary and mandibular right lateral incisors. The maxillary lateral incisor, which was traumatically intruded, was successfully treated with 2 surgical luxations followed by orthodontic traction. The mandibular lateral incisor, which was avulsed and replanted, experienced replacement root resorption during orthodontic treatment and was ultimately extracted. Two years after active orthodontic treatment, the occlusal results were considered satisfactory.

Cephalometry↗

PubMed1997

Suture splint: an alternative for luxation injuries of teeth in pediatric patients--a case report.

Stabilization of replanted tooth "splinting" is done to prevent further damage to the pulp and periodontal structure during the healing period. Suture and bonded resin splint is passive, semirigid and functional splint. It is easy to fabricate directly in mouth without lengthy laboratory procedures. A case is presented in which suture and bonded resin splint was performed on laterally luxated maxillary central incisor and avulsed lateral incisor. The splint was removed after one week and sufficient periodontal and gingival healing was observed.

Adolescent↗

PubMed1995

Crown dilaceration of permanent incisors following trauma to their primary predecessors.

Crown dilaceration of a permanent tooth constitutes 3% of traumatic injuries to developing teeth. It usually involves the maxillary incisors and less frequently their mandibular counterparts. This report concerns a patient, whose primary mandibular central incisors, following a fall at the age of 14 months, sustained partial avulsion with displacement. The teeth were repositioned by the father, with the aid of a pediatrician, and without the assistance of a dentist. The patient presented at the age of 8 years, and, following clinical and radiographic examination, a diagnosis was made of crown dilaceration with lingual displacement of the incisal third of the permanent mandibular central incisors, and hypoplastic enamel on all but the gingival third of their crowns. In addition to this, a supernumerary tooth was discovered labial to and between the mandibular right permanent central incisor and the mandibular right primary lateral incisor. After a brief review of the literature, the treatment of this patient is described and the restoration of the dilacerated teeth, followed by a discussion on crown dilaceration and issues concerning the restoration of such teeth.

Child↗

PubMed1995

Clinical investigation of traumatic injuries of permanent incisors in Izmir, Turkey.

470 injured teeth of 370 patients who consulted the Dental Clinic of Ege University, Izmir, Turkey for examination or treatment between 1981-1993 were evaluated. Information concerning sex, age of patients at the time of injury, cause of trauma, number of injured teeth, type of tooth and type of trauma were recorded. More boys suffered traumatic injuries (64.8%) than girls (35.2%). Patients aged 11-15 years old exhibited the highest number of injuries (34.4%) followed by the 6-10 years old group (24.5%). Most injuries involved one tooth (60%) and maxillary central incisors were the most often affected teeth (66.2%). The leading cause of injury was undefined falls (45.1%). At the initial examination, cases seen after a long posttraumatic period showed more complications than those presented within a short time period. Educational programs about the importance of dental trauma, the benefits of immediate attendance and conservation of avulsed and fractured teeth would be very helpful for patients. Additionally improving the knowledge of the dental practitioner about trauma would be another important point in solving the problem.

Accidental Falls↗

PubMed1991

[Tooth injuries during general anesthesia, oral endoscopy and vibro-massage].

It is generally recognized that dental injury during and after tracheal intubation is a significant problem. Damage may occur during oro-tracheal intubation, oral endoscopy or seismotherapy. The incidence was reported in a study conducted in the contentious department of Lyon hospitals, in France, from 1978 to 1988. Results confirm that damage is relatively common and that the majority of damaged teeth (67%) were known to have been previously restored, or weakened through periodontal disease prior to the damage occurring. Maxillary incisors were the most frequently injured teeth. Fracture of crowns and roots of natural teeth (44,8%), followed by partial luxation (20,8%) and avulsion (20,8%) were the most common injury. Several cases are presented which reveal the clinical value of dental damages that occur during orotracheal intubation, oral endoscopy or seismotherapy. Besides dental or gingival complications can appear immediately but also after a few days or weeks. Some of the most recent development in dental therapy such as the butterfly bridge, titanium implants and porcelain laminate veneers are described. Tooth protective guards must be put into widespread use. Legal implications of dental lesions occurring during oro-tracheal intubation, oral endoscopy or seismotherapy are presented.

Anesthesia, Dental↗

PubMed1986

Splinting and replantation after traumatic avulsion.

A rational approach can be taken in the dental office to avulsion and replantation. Consideration must be given to: Extraoral time. During this critical time, the prognosis for successful replantation noticeably decreases as the out-of-mouth time increases. Transport. Preferably the tooth will be transported in the socket, but milk or water may be used to keep the tooth moist. The buccal vestibule may be recommended for adults and teenagers but not for young children. Root surface. The root surface must not be handled, scraped, brushed, or have any part removed; it can be rinsed with sterile water, saline, or tap water but not with caustic solutions, disinfectants, or medicaments to clean the surface. Endodontic treatment. A tooth with an open apex should be evaluated bimonthly for revitalization. A tooth with a fully formed apex should have the pulp removed in 7 to 14 days after avulsion. Status of the alveolar process. Alveolar fractures may require a modified splint design to provide additional strength for a longer splinting duration. Obturation materials. Calcium hydroxide paste is used for a minimum of 6 to 24 months before filling permanently with gutta-percha. Selection of a splint. Each case is different and should be treated as such. Special consideration must be given to splint design, which will directly influence the desired result. Although any number of splints may be effective, inherent advantages and disadvantages of each should be understood fully by the clinician. This is where the art, the clinical experience, and the common sense of endodontic therapy dictate the proper splint and appropriate duration of splinting for the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

Replantation in general dental practice.

This paper presents a comparison of the outcome of two cases where teeth, avulsed in sporting accidents, were replanted in general dental practice and have been reviewed for 5 years. Avulsed teeth which were stored dry, had a long extra-alveolar period and were splinted for a longer period of time, ultimately underwent replacement root resorption (case 1). There was no evidence of resorption, after 5 years, in the tooth that was stored in the patient's own saliva and was replanted within 45 minutes of being avulsed (case 2). The replantation procedure for these two cases was based on recent literature, which is also reviewed in this paper, and a protocol for the management of avulsed teeth is suggested.

Adolescent↗

PubMed2006

Aspiration of an impacted lower third molar during its surgical removal under local anaesthesia.

In this case of an aspirated impacted lower third molar during its removal under local anaesthesia, the problem was recognized immediately during the surgical procedure. The patient, a 23-year-old male, was subjected to urgent radiological examination. The aspirated tooth was detected in the right bronchus and eventually removed by rigid bronchoscopy. Oral surgeons should suspect any tooth that has been avulsed or extracted and not found as having been aspirated. Early diagnosis and management of such incidents is essential.

Adult↗

PubMedDate not supplied

Idiopathic odontoma formation following avulsion of immature permanent incisors: two case reports.

From the findings of Case 1 and those cases reviewed in the literature it would appear that overfilling a canal with gutta percha prevents continued root formation after reimplantation of the tooth. The canal should be underfilled, therefore, if gutta percha is used as the obturating medium. Consequently, the authors recommend that calcium hydroxide be used as the root canal filling material of choice after reimplanting immature permanent teeth subsequent to traumatic avulsion. Since, however, calcium hydroxide paste tends to be resorbed, periodic refilling of the canal with the paste is required. Case 2 emphasizes the importance of periodic postoperative radiographic evaluation for several years after traumatic avulsion of immature permanent teeth.

Calcium Hydroxide↗

PubMed2003

[Tooth replantation after traumatic exarticulation. Present therapeutic orientations and future perspectives].

Replantation is a method in which an avulsed dental element is replaced into its alveolar socket. The dental traumatic exarticulation occurs in any age, but most frequently in the juvenile population. The aim of this paper is to rewiew the risks and benefits of tooth replantation and to discuss the present therapeutic orientations and future perspectives for avulsion management.

Adolescent↗

PubMed2005

Physical education undergraduates and dental trauma knowledge.

The aim of the present study was to assess the level of knowledge of undergraduates from the College of Physical Education (Toledo, Araçatuba) concerning dental avulsion injuries. Data showed that 95% of the respondents did not know what dental avulsion is, 73.5% said they know how to define dental replantation, however, only 26% were able to do it correctly. When asked about first emergency measures after an avulsion, 50% of the respondents said they know what they should do, and the most cited measure was to seek a dentist. When asked about optimal storage media, 45.5% would keep it in a favorable one, and 28% did not know where to keep the tooth until treatment. Only 25.6% indicated a suitable extra-oral time for replantation; 90.3% of the respondents had received no advice about the emergency management of dental avulsion; 90% said they consider this an important and necessary subject. The results indicated that educational campaigns are necessary to improve the emergency management of dental injuries by those future P.E. professors for a better prognosis of dental replantation.

Chi-Square Distribution↗

PubMed1990

Replantation: an analysis of 29 teeth.

The results of replantation of 29 teeth are described. Maxillary incisors constituted 85% of 27 permanent teeth. The period between avulsion and replantation ranged from within an hour to 86 days, but the actual extraoral period was within 5 hours in all but one case. Nineteen of the 27 permanent teeth were functioning for 7 months to 6 years and 7 months postoperatively. Root resorption was the cause of tooth loss in five cases. The incidence of root resorption seemed to increase with the increase of the extraoral period, but it was not affected by the period between avulsion and replantation, the condition of supporting tissues, the degree of root formation, and the type and period of splinting, indicating multiple factors involved in determining the prognosis of replanted teeth. In conclusion, every effort should be made to preserve avulsed teeth even in unfavorable conditions.

Adolescent↗

PubMed2005

[Analysis of the causes and emergency management of 154 traumatized permanent incisors in primary school children].

PURPOSE: This study was designed to investigate the related factors of permanent incisors trauma among primary school children, and evaluate the results of replantation of 56 avulsed teeth. METHODS: Data were collected by 122 questionnaire from teachers or parents of the primary school children with dental trauma, with regard to the related trauma causes, altitudes and emergency management of dental avulsion. 56 avulsed teeth were replanted immediately after appropriate manipulation. The results of replantation were evaluated 1 year later. RESULTS: Tumble (fall off) was the main cause for dental trauma. The maxillary central incisor was most vulnerable to injury, without differences between the right and the left side. Single tooth injury was predominant in all age groups. Children with an incisal overjet tended to have a greater chance of dental trauma. Crown fractures represented 89 (57.79%)of 154 traumatized teeth; root fractures represented 9 (5.84%); avulsed represented 56 (36.3%). Most teachers and parents had little knowledge of the correct procedures for replanting or transporting avulsed teeth. 53 of 56 replanted teeth (94.64%) were integrated successfully. CONCLUSION: The parents and school educators should be advised about prevention of injuries and actions to be taken in case of an accident. The functional and esthetical outcome of replantation in avulsed teeth is excellent.

Child↗

PubMed2002

[A new splint technique in dental traumatology].

The treatment of displacement injuries and fractures of permanent teeth is an important emergency therapy in the dental office. Due to new sport trends and various outdoor activities, the frequency of dental trauma of children and adolescents alike is steadily rising. The standard treatment of displacement or avulsion injuires of permanent teeth is repositioning or replantation with subsequent splinting. The dental trauma splint must be flexible to allow for the physiologic movement of the repositioned or replanted teeth in order to reduce the risk for ankylosis or external root resorption. Stabilization of a repositioned tooth with a flexible splint over a short time period optimises the rehabilitation of the periodontal tissues. In the literature various splinting techniques have been described. This paper presents a new splinting technique; the Titanium Trauma Splint (TTS), which is made of pure titanium and was specifically developed for the treatment of traumatically displaced or avulsed permanent teeth. The TTS-splint has certain advantages when compared to traditional splinting techniques. These advantages are beneficial both for the dentist and patient alike.

Adolescent↗