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Lee WW, Seo JW, Jang IS, Kwon YJ, Joung WJ, Jun JH, Kim J, Son D, Lim SW, Yun SH, Tallarico M, Park CJ. Comparison of Prophylactic Effects between Localized Biomimetic Minocycline and Systematic Amoxicillin on Implants Placed Immediately in Infected Sockets. Biomimetics (Basel) 2023; 8:461. [PMID: 37887592 PMCID: PMC10604678 DOI: 10.3390/biomimetics8060461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/28/2023] Open
Abstract
This study evaluated the prophylactic effect of localized biomimetic minocycline and systemic amoxicillin on immediate implant placement at infected extraction sites. Twelve mongrels with six implants each were randomly assigned to five groups: uninfected negative control (Group N); infected with oral complex bacteria (Group P); infected and treated with amoxicillin one hour before implant placement (Group A); infected and treated with minocycline during implant placement (Group B); and infected and treated with amoxicillin one hour before implant placement and with minocycline during implant placement (Group C). Radiographic bone level, gingival index (GI), probing depth (PD), papillary bleeding index (PBI), and removal torque (RT) were recorded. There was no significant difference between Groups A, B, and C for bone loss. Group A showed the highest RT, the lowest PBI, and significantly lower GI and PD values than Group P. Group B exhibited significantly higher RT value than Group N and significantly smaller PD value than Group P at 6 w postoperatively. Localized minocycline could improve implant success by reducing bone loss and increasing RT and systemic amoxicillin could maintain the stability of the peri-implant soft tissue. However, combined use of these two antibiotics did not augment the prophylactic effect.
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Affiliation(s)
- Won-Woo Lee
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jin-Won Seo
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Il-Seok Jang
- Osstem R&D Center, Seoul 07789, Republic of Korea
| | | | - Won-Jun Joung
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jong-Hun Jun
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Jiyeong Kim
- Department of Pre-Medicine, College of Medicine and Biostatistics Lab, Medical Research Collaborating Center (MRCC), Hanyang University, Seoul 04763, Republic of Korea
| | - Donghee Son
- Laboratory of Biostatistical Consulting and Research, Medical Research Collaborating Center, Industry-University Cooperation Foundation, Hanyang University, Seoul 04763, Republic of Korea
| | - Seung-Weon Lim
- Division of Orthodontics, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Seo-Hyoung Yun
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | - Chang-Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea
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Li K, Ishida Y, Hatano-Sato K, Ongprakobkul N, Hosomichi J, Usumi-Fujita R, Kaneko S, Yamaguchi H, Ono T. Nuclear factor-kappa B (NF-κB) decoy oligodeoxynucleotide-loaded poly lactic-co-glycolic acid (PLGA) nanospheres promote periodontal tissue healing after tooth replantation in rats. J Periodontol 2021; 93:458-470. [PMID: 34319612 DOI: 10.1002/jper.21-0134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/11/2021] [Accepted: 06/10/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Excessive inflammation in the periodontal tissue after tooth replantation can lead to inflammatory root resorption and interrupt periodontal tissue regeneration. We tested the hypothesis that NF-κB decoy oligodeoxynucleotide-loaded poly lactic-co-glycolic acid nanospheres (NF-PLGA) inhibit excessive inflammation and promote healing of periodontal tissue after replantation in rats. METHODS The upper right incisors of rats were extracted, immersed in different specific solutions, and replanted. The rats were euthanized at 7, 14, and 28 days after replantation. Morphological evaluation with micro-CT and histological assessment with hematoxylin and eosin and tartrate-resistant acid phosphatase (TRAP) staining was performed. Additionally, we examined the expression of interleukin (IL)-1β, IL-6, transforming growth factor-β1 (TGF-β1), and fibroblast growth factor-2 (FGF-2) in the periodontal ligament (PDL) by performing immunohistological assessment. RESULTS The NF-PLGA group showed significantly greater dental root thickness than the other experimental groups. Root resorption was not observed after the application of NF-PLGA on day 7. The application of NF-PLGA also resulted in a significantly lower number of TRAP-positive osteoclasts on days 7 and 14 after replantation. Significantly lower expression of IL-1β and IL-6 and higher expression of TGF-β1 and FGF-2 were observed under the application of NF-PLGA in the PDL. CONCLUSIONS NF-PLGA promoted the healing process by inhibiting the initial excessive inflammatory response in the PDL, preventing root resorption, and promoting periodontal tissue regeneration. The findings also suggested that the PLGA nanospheres-mediated transfection of the decoy oligodeoxynucleotides can be useful for the clinical application of replanted tooth root surfaces. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kai Li
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuji Ishida
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kasumi Hatano-Sato
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Narubhorn Ongprakobkul
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Orthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Jun Hosomichi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risa Usumi-Fujita
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sawa Kaneko
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroyuki Yamaguchi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Department of Pediatrics, The University of Texas Medical School at Houston, Houston, TX, United States
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Meng M, Chen Y, Ren H, Zhang Q, Chen S, Zhou X, Zou J. Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies. BMC Oral Health 2021; 21:289. [PMID: 34090399 PMCID: PMC8180113 DOI: 10.1186/s12903-021-01615-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/09/2021] [Indexed: 02/08/2023] Open
Abstract
Background Pulpal and periodontal healing are two main concerns of delayed replantation of avulsed teeth. The objective of this review was to evaluate the effectiveness of topical and systemic application of tetracyclines on pulpal and periodontal healing after tooth replantation. Methods A comprehensive electronic search was conducted in six databases. This systematic review was carried out according to Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results After exclusion of 246 irrelevant papers, 14 animal studies and one human study were included in this review. The human study showed that avulsed permanent teeth treated with doxycycline did not show a better clinical outcome for pulp and periodontal healing compared with treatment with normal saline. As for animal studies, significant more pulpal healing was observed in immature teeth treated with topical doxycycline in two researches, while another one study showed that there is no difference between teeth treated with normal saline and teeth treated with doxycycline. Systemic doxycycline exerted no significant effect on pulpal revascularization illustrated by one research. Only one out of four articles illustrated the positive effect of systemic tetracyclines on periodontal healing. One paper reported that intracanal application of demeclocycline promoted favorable periodontal healing. Two articles showed topical doxycycline contributed to favorable periodontal healing, while five studies showed no significant effect of topical tetracyclines on periodontal healing. Conclusions As a result of data heterogeneity and limitations of the studies, the effect of topical or systemic application of tetracyclines on pulpal and periodontal healing is inconclusive. More studies are required to get more clinically significant conclusions.
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Affiliation(s)
- Mingmei Meng
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yandi Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Huidi Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Qiong Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China. .,Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
| | - Jing Zou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China. .,Departments of Pediatric Dentistry and Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China.
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Abstract
Dental trauma and injuries to the dentition are difficult to treat because the treatment goals serve to restore esthetics and function. The oral and maxillofacial surgeon is often called on to coordinate the efforts of rehabilitation after a dentoalveolar injury. A comprehensive understanding of the ideal treatments and use of endodontic, orthodontic, periodontal, and pediatric dental colleagues leads to the best possible results with regards to a restoration of form and function. This article provides a succinct review of the oral and maxillofacial surgeon's treatment in dentoalveolar trauma. Epidemiology, treatment, and preventative measures are discussed in this article.
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Affiliation(s)
- Lewis C Jones
- Private Practice, Oral and Maxillofacial Surgery, Elizabethtown OMFS, Louisville, KY, USA; Oral and Maxillofacial Surgery, University of Louisville, Louisville, KY, USA.
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5
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Coste SC, Silva EFE, Santos LCM, Barbato Ferreira DA, Côrtes MIDS, Colosimo EA, Bastos JV. Survival of Replanted Permanent Teeth after Traumatic Avulsion. J Endod 2020; 46:370-375. [DOI: 10.1016/j.joen.2019.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/18/2019] [Accepted: 11/23/2019] [Indexed: 10/25/2022]
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6
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Ng L, Malandris M, Cheung W, Rossi-Fedele G. Traumatic dental injuries presenting to a paediatric emergency department in a tertiary children's hospital, Adelaide, Australia. Dent Traumatol 2020; 36:360-370. [PMID: 32012455 DOI: 10.1111/edt.12548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIM There is a scarcity of data regarding paediatric traumatic dental injuries (TDI) in tertiary teaching hospitals. Therefore, the aim of this study was to review the TDI presenting to the Women's and Children's Hospital in Adelaide (Australia) on an emergency basis and to identify the characteristics of the presenting patient cohort, their accident, injuries and management. METHODS Medical health records of 337 paediatric patients attending the Paediatric Emergency Department (PED) for the management of TDI over 18 months were prospectively reviewed. RESULTS TDI were more frequent in children under 5 years of age (56.1%) with a predominance of injuries sustained by males (63.8%). The accident characteristics included weekend occurrence (35.6%), the most common aetiology was falls (64.4%) and many incidents occurred at home (48.5%). Overall, 654 teeth were injured with the majority affecting deciduous teeth (58.4%) and the maxillary central incisors (69.9%). The most frequent injury was lateral luxation (27.5%). The majority of patients were referred to the Paediatric Dentistry Department (60.8%). However, almost half of presenting patients did not require further management locally and were subsequently discharged to their dental practitioners (39.2%). Most patients receiving treatment were managed under general anaesthetic (36.9%), and there was often a delay of 3-12 hours before treatment commenced (49.1%). Similarly, more severe injuries in the permanent dentition (avulsion, extrusion, root fracture, intrusion, alveolar fracture) were more frequently managed between 3 and 12 hours following the accident. CONCLUSION The patient, accident, injury and management characteristics are comparable to what has previously been reported in other studies in paediatric populations. Injuries affecting the permanent dentition are more likely to be managed within 3 and 12 hours in an outpatient setting, whereas injuries affecting the deciduous dentition had a delay in management between 12 and 24 hours under general anaesthetic.
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Affiliation(s)
- Lydia Ng
- Dental Department, Hutt Valley District Health Board, Hut Hospital, Wellington, New Zealand.,Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | | | - Wendy Cheung
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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How standard deviation contributes to the validity of a LDF signal: a cohort study of 8 years of dental trauma. Lasers Med Sci 2019; 34:1905-1916. [PMID: 31093798 DOI: 10.1007/s10103-019-02791-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
The aim of this cohort study was to document the potential of laser Doppler flowmetry (LDF) for diagnosing tooth vitality in traumatized teeth in a population of 88 referred patients with dental trauma over a period of 8 years (2011-2018). The main reason to refer was tooth discoloration (26%), and the main trauma cause was a traffic injury (35%). Taking into account that referral for LDF is best given within the week after trauma, 66% of referrals were overdue. In 73% of cases, root canal treatment could be avoided, and in 65%, the presence of a fixed orthodontic retainer showed beneficial for pulp recovery. Data of 394 teeth were collected and submitted to multilevel modelling statistics. As a general conclusion, both LDF perfusion and concentration values proved to be highly reliable in the appreciation of tooth vitality. The difference of variability of standard deviation and range of LDF measurements involving intra-subject control teeth showed statistically significant in discriminating between vital and non-vital pulps. In non-vital teeth, the diagnostic combination of LDF, sensibility tests and peri-apical X-ray is advised.
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8
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McTigue DJ. Managing Traumatic Injuries in the Young Permanent Dentition. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Abbott PV. Prevention and management of external inflammatory resorption following trauma to teeth. Aust Dent J 2016; 61 Suppl 1:82-94. [DOI: 10.1111/adj.12400] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- PV Abbott
- School of Dentistry; The University of Western Australia; Western Australia Australia
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10
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Gomes WDDS, Silva CA, Melo ME, Silva VFD, Almeida MMD, Pedrini D, Poi WR, Sonoda CK, Panzarini SR. Delayed tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline. Dent Traumatol 2015; 31:448-56. [PMID: 26332890 DOI: 10.1111/edt.12207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2015] [Indexed: 11/30/2022]
Abstract
Systemic antibiotic therapy (SAT) has usually been recommended after tooth replantation, but its actual value has been questioned. As there are no reports in the literature about its influence on tooth replantation, the aim of this study was to evaluate the influence of systemic administration of antibiotics (amoxicillin and tetracycline) at the different phases of the repair process (7, 15, 30 days) in delayed rat tooth replantation. Ninety Wistar rats (Rattus norvegicus albinus) had their maxillary right incisors extracted and bench-dried for 60 min. The dental papilla, enamel organ, pulp tissue, and root surface-adhered periodontal ligament were removed, and the teeth were replanted. The animals received no antibiotics (n = 30) or were medicated systemically with amoxicillin (n = 30) and tetracycline (n = 30), and were euthanized after 7, 15, and 30 days. Regardless of the evaluation period, the acute inflammatory infiltrate was less intense and root resorption presented smaller extent and depth in the group treated with amoxicillin. The results suggest that SAT has a positive influence on the repair process in delayed tooth replantation and that amoxicillin is an excellent treatment option.
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Affiliation(s)
- Weglis Dyanne de Souza Gomes
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Cristina Antoniali Silva
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Moriel Evangelista Melo
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Vanessa Ferreira da Silva
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Melyna Marques de Almeida
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Denise Pedrini
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Wilson Roberto Poi
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Celso Koogi Sonoda
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
| | - Sônia Regina Panzarini
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP - Univ Estadual Paulista, Araçatuba, SP, Brazil
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Melo ME, Silva CA, de Souza Gomes WD, da Silva VF, Brandini DA, Poi WR, Castilho LR, Sonoda CK, Panzarini SR. Immediate tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline. Clin Oral Investig 2015. [PMID: 26205067 DOI: 10.1007/s00784-015-1534-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the influence of systemic administration of antibiotics (amoxicillin and tetracycline) at the different phases of the repair process (7, 15, 30 days) in immediate rat tooth replantation. MATERIALS AND METHODS Ninety rats had their incisors extracted and stored in saline for 5 min. Next, the teeth were replanted, and the animals were assigned to three groups according to the antibiotic administered by oral gavage: control group, amoxycillin group, and tetracycline group. Euthanasia was performed at 7, 15, and 30 days after replantation. RESULTS Regardless of the evaluation period, the connective tissue underlying the epithelial attachment and the periodontal ligament showed statistically significant difference relative to the acute inflammatory infiltrate, which was more intense in the control group followed by the tetracycline group. CONCLUSION These results point to the fact that systemic antibiotic therapy (SAT) in immediate tooth replantation is beneficial to pulpal and periodontal ligament repair and that amoxycillin is an excellent option. CLINICAL RELEVANCE There is a lack of randomized studies assessing how the use of systemic antibiotics could influence tooth healing after immediate replantation.
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Affiliation(s)
- Moriel Evangelista Melo
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Cristina Antoniali Silva
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Weglis Dyanne de Souza Gomes
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Vanessa Ferreira da Silva
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Daniela Atili Brandini
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Wilson Roberto Poi
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Lithiene Ribeiro Castilho
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Celso Koogi Sonoda
- Department of Surgery and Integrated Clinics, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - Sônia Regina Panzarini
- Department of Surgery and Integrated Clinic, Discipline of Integrated Clinic, School of Dentistry of Araçatuba, UNESP -Univ Estadual Paulista, Rua José Bonifácio 1193, CEP, 1601-050, Araçatuba, São Paulo, Brazil.
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Sardana D, Goyal A, Gauba K. Delayed replantation of avulsed tooth with 15-hours extra-oral time: 3-year follow-up. ACTA ACUST UNITED AC 2014; 35:71-6. [PMID: 25496589 DOI: 10.1016/j.sdj.2014.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 03/19/2014] [Accepted: 04/16/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Avulsion is one of the most serious injuries of the tooth which is most commonly seen in young children and occurs in the upper front teeth. Immediate transplantation of the avulsed tooth is recommended treatment and results in good prognosis although this may not be always possible. CASE REPORT The present case highlights the 3-year follow-up of delayed replantation (after 15h) of maxillary central incisor which was avulsed due to trauma. The complications seen in the present case were ankylosis and inflammatory resorption, but clinically the tooth was asymptomatic and maintains the esthetics of the individual signifying the importance of delayed replantation even after prolonged extra-oral time. CLINICAL IMPLICATIONS AND CONCLUSION Although complications like ankylosis or root resorption may be unavoidable, delayed replantation of avulsed tooth may be a good alternative to prosthesis (implant or fixed partial denture) till the growth is completed due to preservation of the alveolar bone and psychological benefit to the patient. Also efforts should be made to educate and update children, teachers and parents regarding management of avulsed tooth at accident site and also the dentists regarding its management in dental office.
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Affiliation(s)
- D Sardana
- Unit of Pedodontics and Preventive Dentistry Oral Health Sciences Center Post-graduate Institute of Medical Education and Research, Chandigarh, India.
| | - A Goyal
- Unit of Pedodontics and Preventive Dentistry Oral Health Sciences Center Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - K Gauba
- Unit of Pedodontics and Preventive Dentistry Oral Health Sciences Center Post-graduate Institute of Medical Education and Research, Chandigarh, India
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Age and Timing of Pulp Extirpation as Major Factors Associated with Inflammatory Root Resorption in Replanted Permanent Teeth. J Endod 2014; 40:366-71. [DOI: 10.1016/j.joen.2013.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/02/2013] [Accepted: 10/02/2013] [Indexed: 11/18/2022]
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14
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Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, Diangelis AJ, Kenny DJ, Sigurdsson A, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Tsukiboshi M. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2012; 39:412-419. [PMID: 22409417 DOI: 10.1111/j.1600-9657.2012.01125.x] [Citation(s) in RCA: 341] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth.
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Affiliation(s)
- Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
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Kim DS, Shin DR, Choi GW, Park SH, Lee JW, Kim SY. Management of complicated crown-root fractures using intentional replantation: two case reports. Dent Traumatol 2011; 29:334-7. [PMID: 22066915 DOI: 10.1111/j.1600-9657.2011.01075.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The management of complicated crown-root fractures is a challenge. Intentional replantation with 180° rotation may be a useful procedure to overcome this problem. In Case 1, a 23-year-old woman with complicated crown-root fractured teeth #11, #21, and #22 was referred for treatment. All fractured teeth were extracted, rotated 180°, and replanted in a slightly extruded position. After 3 months, root canal treatment was completed and the final restorations fabricated. At the 18-month follow up, the patient was asymptomatic, the tooth was functional, and no root resorption was observed radiographically. At the 90-month follow up, slight cervical root resorption of tooth #11 was noted. In Case 2, a 27-year-old woman with a crown-root fractured tooth #21 was referred for treatment. Despite immediate repositioning of the coronal fragment and a 2-week stabilization with a wire splint, the coronal fragment remained separated from the apical tooth segment. The apical segment was extracted, rotated 180°, and replanted in a slightly extruded position. After 1 and 4 weeks, the root canal treatment was completed and the final restoration fabricated, respectively. At the 24-month follow up, the patient was asymptomatic and apical healing was completed.
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Affiliation(s)
- Duck-Su Kim
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea.
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Treatment of avulsed teeth by oral and maxillofacial surgeons. J Oral Maxillofac Surg 2010; 68:2888-92. [PMID: 20727639 DOI: 10.1016/j.joms.2010.05.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2009] [Revised: 05/06/2010] [Accepted: 05/21/2010] [Indexed: 11/23/2022]
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Thong YL, Messer HH, Zain RB, Saw LH, Yoong LT. Intracanal bisphosphonate does not inhibit replacement resorption associated with delayed replantation of monkey incisors. Dent Traumatol 2009; 25:386-93. [DOI: 10.1111/j.1600-9657.2008.00631.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hinckfuss SE, Messer LB. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics. Dent Traumatol 2009; 25:158-64. [DOI: 10.1111/j.1600-9657.2008.00736.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Guzmán-Martínez N, Silva-Herzog FD, Méndez GV, Martín-Pérez S, Cerda-Cristerna BI, Cohenca N. The effect of Emdogain®and 24% EDTA root conditioning on periodontal healing of replanted dog’s teeth. Dent Traumatol 2009; 25:43-50. [DOI: 10.1111/j.1600-9657.2008.00741.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ferrazzini Pozzi EC, von Arx T. Pulp and periodontal healing of laterally luxated permanent teeth: results after 4 years. Dent Traumatol 2008; 24:658-62. [DOI: 10.1111/j.1600-9657.2008.00687.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Er K, Polat ZA, Özan F, Taşdemir T, Sezer U, Siso ŞH. Cytotoxicity Analysis of Strontium Ranelate on Cultured Human Periodontal Ligament Fibroblasts: A Preliminary Report. J Formos Med Assoc 2008; 107:609-15. [DOI: 10.1016/s0929-6646(08)60178-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Panzarini SR, Gulinelli JL, Poi WR, Sonoda CK, Pedrini D, Brandini DA. Treatment of root surface in delayed tooth replantation: a review of literature. Dent Traumatol 2008; 24:277-82. [PMID: 18410388 DOI: 10.1111/j.1600-9657.2008.00555.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The time elapsed between a trauma and tooth replantation usually ranges from 1 to 4 h. The chances of root surface damage are higher when tooth replantation is not performed immediately or if the avulsed tooth is not stored in an adequate medium. This invariably leads to necrosis of pulp tissue, periodontal ligament cells and cementum, thus increasing the possibility of root resorption, which is the main cause of loss of replanted teeth. This paper presents a comprehensive review of literature on root surface treatments performed in cases of delayed tooth replantation with necrotic cemental periodontal ligament. Journal articles retrieved from PubMed/MedLine, Bireme and Scielo databases were reviewed. It was observed that, when there are no periodontal ligament remnants and contamination is under control, replacement resorption and ankylosis are the best results and that, although these events will end up leading to tooth loss, this will happen slowly with no loss of the alveolar ridge height, which is important for future prosthesis planning.
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Affiliation(s)
- Sônia Regina Panzarini
- Department of Surgery and Integrated Clinic, Faculty of Dentistry of Araçatuba, São Paulo State University, Araçatuba, SP, Brazil.
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Manfrin TM, Boaventura RS, Poi WR, Panzarini SR, Sonoda CK, Massa Sundefeld MLM. Analysis of procedures used in tooth avulsion by 100 dental surgeons. Dent Traumatol 2007; 23:203-10. [PMID: 17635352 DOI: 10.1111/j.1600-9657.2005.00432.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Accurate diagnosis and adequate treatment plan may constitute very complex tasks, particularly in tooth avulsion, because several variables are involved. In addition to the technical knowledge and clinical experience directed toward the quality of treatment, patient education may favorably influence the survival of replanted teeth. The aim of this study was to analyze the procedures used in the management of tooth avulsion by 100 dental surgeons (DSs). Thus, by means of a descriptive questionnaire, information was obtained about the profile of the professionals interviewed, procedures used in cases of tooth avulsion, and patient orientation and education. One hundred properly filled questionnaires were obtained. Descriptive statistics was used for the data, and the chi-squared statistics was employed (epi-info 3.2 software). According to the results, this type of trauma is part of the routine of 15 DSs, although 71 have reported some experience with avulsed teeth. Great deficiencies were found regarding root surface treatment and occlusal adjustment. Positive findings were related to socket treatment, adjunctive therapy, and patient education and orientation (extra-alveolar period, storage medium, manipulation of the avulsed tooth, replantation by the own patient). It was possible to conclude that 47.5% of the procedures reported by 100 professionals interviewed are adequate, and patient education is favorable in 87.7% of cases, a fact that can positively interfere with the prognosis of tooth replantation.
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Affiliation(s)
- Thais Mara Manfrin
- Araçatuba Dental School, Sao Paulo State University - UNESP, Araçatuba, São Paulo, Brazil
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Güngör HC, Cengiz SB, Altay N. Immediate surgical repositioning following intrusive luxation: a case report and review of the literature. Dent Traumatol 2007; 22:340-4. [PMID: 17073929 DOI: 10.1111/j.1600-9657.2005.00356.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing.
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Affiliation(s)
- H Cem Güngör
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
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ANDREASEN JENSOVE, STORGÅRD JENSEN SIMON, SAE-LIM VARAWAN. The role of antibiotics in preventing healing complications after traumatic dental injuries: a literature review. ACTA ACUST UNITED AC 2006. [DOI: 10.1111/j.1601-1546.2008.00231.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Thirty-four patients with 45 avulsed and replanted permanent teeth were followed for 1 year. All teeth were soaked in tetracycline before replantation. In addition, enamel matrix derivative was used in teeth with dry storage times exceeding 30 min. Splinting was carried out with a non-rigid titanium splint and was limited to 7-10 days. Within that period, root canal treatment was begun in all teeth with a closed apex, whereas teeth with an open apex and ideal post-traumatic storage were not instrumented. All patients were given tetracycline systematically for 10 days. The survival rate of replanted avulsed permanent teeth was 95.6% at the 1-year follow-up. In 82.2%, root canal treatment was performed. Pulp survival was never observed, but three teeth had pulp canal obliteration. Normal periodontal healing was observed in 57.7% of teeth; 42.3% of teeth showed external root resorption (28.9% replacement resorption, 6.7% infection-related resorption, 6.7% surface resorption). The occurrence of replacement resorption correlated with the period of extraoral dry storage. Compared with other clinical studies on avulsed and replanted teeth, the present study reports a higher percentage of periodontal healing. The favorable treatment outcome may be associated with a strict protocol to enforce endodontic treatment, the use of topical and systemic tetracycline, and the relatively high number of ideally stored teeth following avulsion. In contrast, the present study has a follow-up period limited to 1 year.
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Affiliation(s)
- Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Switzerland.
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Castro JCM, Poi WR, Manfrin TM, Zina LG. Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002. Dent Traumatol 2005; 21:121-6. [PMID: 15876320 DOI: 10.1111/j.1600-9657.2005.00276.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to analyze crown fractures and crown-root fractures due to dentoalveolar trauma, treated in the Integrated Clinic comprehensive dental care at Aracatuba School of Dentistry (UNESP), from January 1992 to July 2002. The data were obtained from files of trauma cases. On the analysis period, 293 patients had crown fractures or crown-root fractures, in 605 teeth. Sixty-nine percent were males and 31% were females. Adolescents between 11 and 18 years old were the most prevalent group (41.6%) and the maxillary arch was the most commonly traumatized (83%). The most commonly affected tooth was the maxillary central incisor (58.3%). The most frequent causes were falls from bicycles (30.8%). It was concluded that the reality of the local service is similar to the published data.
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Affiliation(s)
- José Carlos Monteiro Castro
- Integrated Clinic Discipline, Department of Surgery and Integrated Clinic, Faculty of Dentistry, Universidade Estadual Paulista, UNESP, Aracatuba, Sao Paulo, Brazil
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Pohl Y, Filippi A, Kirschner H. Results after replantation of avulsed permanent teeth. II. Periodontal healing and the role of physiologic storage and antiresorptive-regenerative therapy. Dent Traumatol 2005; 21:93-101. [PMID: 15773888 DOI: 10.1111/j.1600-9657.2004.00298.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The status of the periodontal ligament (PDL) and of the pulp are decisive for the healing of avulsed and replanted teeth. A tooth rescue box was developed and distributed to offer optimal storage conditions for avulsed teeth. The therapy comprised extraoral endodontic treatment and applications of medicaments to enhance periodontal healing. In this long-term clinical study the healing results following avulsion and replantation were investigated. Twenty-eight permanent teeth in 24 patients were evaluated. The extraoral storage media and periods varied considerably. Soon after avulsion six teeth were stored in a cell culture medium (tooth rescue box Dentosafe) for 1-53 h; the PDL was defined as not compromised. Sixteen teeth were stored in a non-physiologic situation temporarily, the PDL was considered as compromised. Six teeth were stored in non-physiologic conditions for longer periods; the condition of the PDL was defined as hopeless. On 14 teeth antiresorptive-regenerative therapy (ART) with the local application of glucocorticoids and enamel matrix derivative and the systemic administration of doxycyclin was used. In all teeth extraoral endodontic treatment by retrograde insertion of posts was performed. The mean observation period was 31.2 months (+/-24.1; 5.1-100.2; median: 23.8). All six teeth rescued physiologically healed with a functional PDL (functional healing, FH) irrespective of the storage period. Of eight teeth with a compromised PDL on which ART was used, three teeth healed with a functional PDL. All other teeth showed replacement resorption, in three teeth additionally infection-related resorption was recorded. The predominant influence on the healing results was the immediate physiologic rescue of avulsed teeth (chi-square, P = 0.0001). The use of ART seemed to support FH (chi-square, P = 0.0547) in teeth with a compromised PDL. No other factors (maturity of roots, crown fractures, gender, age, antibiotics) were related to healing. In a linear regression analysis physiologic storage (P = 0.0013) and ART (P = 0.0421) were related to FH. For a good prognosis avulsed teeth should be stored immediately in a cell-compatible medium. Therefore the tooth rescue box should be distributed at places with higher risks of accidents, in families with children and in emergency facilities. The use of ART might have potential for enhancing the prognosis of teeth with a PDL that is compromised but not in a hopeless condition. Extraoral endodontic treatment reduces infection-related complications; this item was discussed in the first part of the publication.
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Affiliation(s)
- Yango Pohl
- Department of Oral Surgery, University of Bonn, Bonn, Germany.
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Panzarini SR, Perri de Carvalho AC, Poi WR, Sonoda CK. Use of vitamin C in delayed tooth replantation. Braz Dent J 2005; 16:17-22. [PMID: 16113928 DOI: 10.1590/s0103-64402005000100003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study evaluated microscopically the effects of root surface treatment with three different solutions in delayed rat teeth replantation. Central incisors from 30 rats (Rattus norvegicus, albinus Wistar) were extracted and left on a bench for 6 h. The pulps were extirpated and root canals were irrigated with 1% sodium hypochlorite. After endodontic treatment, the root surfaces of all teeth were submitted to a 10-min treatment with 1% sodium hypochlorite, changed every 5 min. The teeth were then rinsed with saline for 10 min and assigned to 3 groups with ten specimens each. Groups I, II and III were treated, respectively, with 2% acidulated-phosphate sodium fluoride, vitamin C solution and effervescent vitamin C (2 g, Redoxon®). After root surface treatment, the teeth were filled with calcium hydroxide and replanted. The animals were sacrificed after 10 and 60 days. Group I (fluoride) presented the largest areas of replacement resorption and ankylosis. Comparing both vitamin C groups, Group III (effervescent vitamin C) yielded better results, showing more areas of ankylosis and replacement resorption than areas of inflammatory resorption.
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Affiliation(s)
- Sônia Regina Panzarini
- Department of Surgery and Integrated Clinics, Faculty of Dentistry of Araçatuba, UNESPAraçatuba, SP, Brazil.
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Shinohara J, Shibata T, Shimada A, Komatsu K. The biomechanical properties of the healing periodontium of replanted rat mandibular incisors. Dent Traumatol 2004; 20:212-21. [PMID: 15245520 DOI: 10.1111/j.1600-9657.2004.00244.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
One of the most important aspects in tooth replantation seems to be restoration of the tooth support function of the healing periodontal ligament (PDL). We examined the support function, as measured by the mechanical properties, of the healing PDL at 7, 14, and 21 days after replantation of the left mandibular incisor in rats. From each dissected left mandible, a transverse section(650 microm in thickness) of the incisor was cut through an axis near the labial alveolar crest. Each section was intrusively loaded at a rate of 5 mm min(-1), and the shear stress-strain curve for the PDL was analyzed. Mechanical measures of the healing PDL showed gradual improvement after replantation. By 21 days, the mechanical strength returned to 53% of the control value; the extensibility, to 85%; the stiffness, to 61%; and the toughness, to 52%. The healing PDL exhibited reattachment of fibers in the middle region of the PDL, and the birefringent collagen fibers appeared to have regained the functional orientation by 14 days. The ratios occupied by the birefringent collagen fibers in the tooth-related, middle, and bone-related areas of the healing PDL gradually improved and returned to 78, 51, and 48% of the respective control values by 21 days. These results suggest that the support function of the healing PDL is gradually restored and that the biomechanical restoration is closely related to the reorganization and reorientation of collagen fiber bundles in replanted rat incisors.
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Affiliation(s)
- Josuke Shinohara
- Department of Periodontics & Endodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi-ku, Yokohama 230-8501, Japan
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Sheroan MM, Roberts MW. Management of a complex dentoalveolar trauma with multiple avulsions: a case report. Dent Traumatol 2004; 20:222-5. [PMID: 15245521 DOI: 10.1111/j.1600-9657.2004.00226.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Treatment of permanent tooth avulsions in an adolescent poses significant difficulties for the dental clinician. This case report gives details about the treatment of a complex dentoalveolar trauma involving multiple avulsions of primary molars, permanent incisors, permanent molars, and premolar toothbuds. Immediate treatment of the injury and short-term esthetic replacement of the dentition is described. A brief review of current research relative to the treatment of permanent tooth avulsions is provided.
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Affiliation(s)
- Marianne Mills Sheroan
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, 27599-7450, USA
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Demiralp B, Nohutçu RM, Tepe DI, Eratalay K. Intentional replantation for periodontally involved hopeless teeth. Dent Traumatol 2003; 19:45-51. [PMID: 12656855 DOI: 10.1034/j.1600-9657.2003.00084.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate the clinical and radiographic results of intentional replantation of periodontally involved teeth after conditioning of root surfaces with tetracycline-HCl. Thirteen patients (seven female, six male; age range: 35-52 years) with 15 periodontally involved hopeless teeth were included in this study. During the replantation procedure, the affected teeth were gently extracted, then the granulation tissues, calculus, remaining periodontal ligament and necrotic cementum on the root surfaces were removed. Tetracycline-HCl, at a concentration of 100 mg ml(-1), was applied for 5 min to the root surfaces. The teeth were then replaced into the socket and splinted. Patients were clinically and radiographically evaluated at baseline (time of surgery) and 6 months after the surgery. The following measurements were recorded: probing depth (PD), gingival recession (R), the amount of bone loss (BL) and bone gain (BG). Results indicated a reduction in PD and in the amount of bone loss and healthy gingiva. Mean PD was decreased from 5.25 to 2.36 mm, gingival recession was increased from 3.73 to 4.0 mm, and BL was reduced from 73.20 to 56.86%. At the end of 6 months, no root resorption or ankylosis was observed radiographically. Even during the short period of evaluation, it may be suggested that intentional replantation can be an alternative approach to extraction in cases where advanced periodontal destruction is present and no other treatments could be considered.
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Affiliation(s)
- Burak Demiralp
- Department of Periodontology and Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
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Hokett SD, Peacock ME, Burns WT, Swiec GD, Cuenin MF. External root resorption following partial-thickness connective tissue graft placement: a case report. J Periodontol 2002; 73:334-9. [PMID: 11922264 DOI: 10.1902/jop.2002.73.3.334] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report an unusual case of external root resorption (ERR) that developed in a 37-year-old black male approximately 1 year following routine partial thickness connective tissue graft surgery. The lesion was accessed via flap surgery, thoroughly root planed, and the mucoperiosteal flap replaced. The site healed uneventfully and the patient has been closely observed for over 1 year without symptoms or recurrence of the resorptive lesion and the affected tooth remained vital. Clinicians performing partial-thickness connective tissue grafts should be alert to the possible occurrence of root resorption over extended periods of time. The authors speculate that retention of the donor periosteum with placement on the recipient dentin and root biomodification may limit the resorptive response following connective tissue graft procedures to treat tooth root recession.
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Affiliation(s)
- Steven D Hokett
- US Army Periodontic Residency Program, Dental Activity, Tingay Dental Clinic, Fort Gordon, GA 30905, USA.
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Abstract
The aim of this review article is to supplement the recently published International Association of Dental Traumatology (IADT) guidelines on treatment of the avulsed tooth. A thorough discussion on the reasoning behind each guideline is presented. In addition, the author's views on alternate treatment strategies and future directions, along with recent research on the subject of the avulsed tooth, are also presented.
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Affiliation(s)
- Martin Trope
- Department of Endodontics, School of Dentistry, University of North Carolina, North Carolina, NC 27599, USA
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Kinirons MJ, Gregg TA, Welbury RR, Cole BO. Variations in the presenting and treatment features in reimplanted permanent incisors in children and their effect on the prevalence of root resorption. Br Dent J 2000; 189:263-6. [PMID: 11048394 DOI: 10.1038/sj.bdj.4800740] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine variations in the presentation and treatment of reimplanted incisors in children and to determine the effect of these on the prevalence of external root resorption. SETTING Departments of Paediatric Dentistry, Belfast and Newcastle upon Tyne. DESIGN Recording of the timing of the injury and the storage mediums (including air) and of reimplantation, the stage of root development, the degree of contamination and the time of commencement of root treatment. Cases were reviewed clinically and radiographically at intervals of 3 months. Root resorption was classified as present or absent. Logistic regression and cross-tabulations were produced with the presence of resorption set as the outcome. RESULTS 128 reimplanted permanent incisor teeth, their median dry time prior to reimplantation being 15 minutes (range 4-52 mins), the median time in a liquid medium being 45 minutes (range 0-650 mins), with a median splinting time of 15 days (range 4-52 days) and a median pulp extirpation time of 15 days (range 0-612 days). There was a lower prevalence of resorption when the period of dryness was less than or equal to 5 minutes (p = 0.025). The prevalence of resorption in teeth with no visible contamination was 57.1%, for those with contamination which were washed clean it was 75%, in those rubbed clean it was 87.5%, and it was 100% for those reimplanted with visible contamination still present (p = 0.014). The corrected odds ratio for contamination was 2.99 and for an extension of 10 minutes of dryness it was 1.29. CONCLUSION The degree of contamination and the period of dryness were the major risk factors for resorption in this study of reimplanted teeth in children.
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Abstract
Antibiotics have been used extensively for the management of odontogenic infections since their discovery early this century. Although they have been invaluable in the management of acute and severe infections, many members of the dental and medical professions have unfortunately used these drugs inappropriately for the management of dental pain when "local" dental treatment would have sufficed. This, and the general over-use of antibiotics in other situations such as for growth enhancement in animals for human consumption, is leading to the widespread development of strains of bacteria that are resistant to antibiotics--hence, their effectiveness is being reduced at a rapid rate. The dental profession has a responsibility to patients and to the community as a whole to restrict the use of antibiotics to those situations that actually require them. This philosophy should also be extended to other professions who may be called upon to manage dental pain at times.
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Affiliation(s)
- P V Abbott
- School of Dental Science, University of Melbourne
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Affiliation(s)
- M Trope
- Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA
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