1
|
Eggmann F, Filippi A, Mukaddam K. Endodontic and restorative management of an adult with avulsion of multiple teeth: A case report with 5 years and 9 months of follow-up. Dent Traumatol 2024; 40:345-352. [PMID: 38031999 DOI: 10.1111/edt.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
Simultaneous avulsion of four or more teeth is a rare event. This case report examines the dental care given to an adult who, during a bicycle accident, experienced the avulsion of a mandibular incisor as well as all of his maxillary incisors. In the immediate aftermath of the accident, four out of the five incisors were located, promptly collected, and stored in a tooth rescue box, all within a 20-min window. Replantation and splinting were performed on the day of the accident. Endodontic treatment involved sequential intracanal dressing with an antibiotic-corticosteroid paste followed by calcium hydroxide prior to root canal obturation. 3 months post-accident, signs of external replacement resorption (ERR) began to appear in all the replanted teeth. The gap created by the missing maxillary central incisor was managed with a three-unit fixed dental prosthesis, despite the onset of ERR in the incisors used as abutment teeth. Regular follow-ups showed a relatively slow ERR progression rate over a span of nearly 6 years. The patient expressed satisfaction with both the esthetic and functional outcomes. This case, marked by multiple avulsions, underscores the importance of immediate and appropriate intervention alongside the imperative for carefully considered long-term management strategies. Given the decelerated bone remodeling rate in adults, ERR generally progresses at a slower pace than in children. Accordingly, this case demonstrates the viability of retaining replanted teeth over the long term, even when these teeth have been subjected to nonphysiological storage for extended durations, a factor known to impede periodontal healing.
Collapse
Affiliation(s)
- Florin Eggmann
- Department of Periodontology, Endodontology, and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Center of Dental Traumatology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Andreas Filippi
- Center of Dental Traumatology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Khaled Mukaddam
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| |
Collapse
|
2
|
Lee HJ, Jeon M, Kim YH, Kim SO, Lee KE. Comparative gene expression analysis of stemness between periodontal ligament and umbilical cord tissues in humans. J Dent Sci 2023; 18:211-219. [PMID: 36643271 PMCID: PMC9831792 DOI: 10.1016/j.jds.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/09/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose Due to their regenerative potential, periodontal ligament (PDL) and umbilical cord (UBC) tissues are an attractive potential mesenchymal stem cells (MSCs) source. This study compared the expression patterns of genes related to stemness between fresh PDL and UBC tissues. Materials and methods PDL tissues were collected from 38 permanent premolars extracted for orthodontic purposes, and UBC tissues were obtained from three newborns. Each sample was immediately frozen to prevent RNA degradation. cDNA microarray analysis, quantitative real-time polymerase chain reaction (PCR), and immunohistochemical staining were performed. Gene expression patterns associated with dental stemness (DS) and induced pluripotent stemness (iPS) were compared between PDL and UBC tissues. Results In the cDNA microarray analyses, the expressions of most iPS genes were greater in the PDL than in the UBC. Meanwhile, the expressions of most DS genes were greater in the UBC than in the PDL. Quantitative real-time PCR analyses showed that the expression levels of matrix metallopeptidase 13 (MMP13), ADAM metallopeptidase domain 22 (ADAM22), vascular cell adhesion protein 1 (VCAM1), and kruppel-like factor 4 (KLF4) genes were greater in the PDL than in the UBC, while the expressions of melanoma cell adhesion molecule (MCAM) and activated leukocyte cell adhesion molecule (ALCAM) were greater in the UBC than in the PDL. Conclusion These results suggest that UBC and PDL tissues showed slightly different expression patterns of genes related to stemness, which warrants further investigation to use these tissues for future regeneration and implantation therapies.
Collapse
Affiliation(s)
- Hyung-Joo Lee
- Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Mijeong Jeon
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Young-Han Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seong-Oh Kim
- Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea,Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea,Department of Pediatric Dentistry, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea,Corresponding author. Department of Pediatric Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ko Eun Lee
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea,Corresponding author. Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| |
Collapse
|
3
|
Patel S, Saberi N, Pimental T, Teng P. Present status and future directions: Root resorption. Int Endod J 2022; 55 Suppl 4:892-921. [PMID: 35229320 PMCID: PMC9790676 DOI: 10.1111/iej.13715] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/30/2022]
Abstract
Root resorption is the loss of dental hard tissue because of odontoclastic action. In permanent teeth, it is undesirable and pathological in nature. Root resorption may occur on the inner aspect of the root canal (internal root resorption) or on the outer aspect of the root (external root resorption). Regardless of its location, root resorption is irreversible, and may result in discomfort for the patient, requires management and/or, in some cases, results in the premature loss of the affected tooth. Root resorption is often challenging to accurately diagnose and manage. The aim of this narrative review is to present the relevant literature on the aetiology, pathogenesis, diagnosis and management, as well as discuss the future directions of diagnosis and management of root resorption.
Collapse
Affiliation(s)
- Shanon Patel
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK,Specialist PracticeLondonUK
| | - Navid Saberi
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| | - Tiago Pimental
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| | - Peng‐Hui Teng
- Faculty of Dentistry, Oral & Craniofacial SciencesKing’s College LondonLondonUK
| |
Collapse
|
4
|
Krastl G, Weiger R, Ebeleseder K, Galler K. Present status and future directions: Endodontic management of traumatic injuries to permanent teeth. Int Endod J 2021; 55 Suppl 4:1003-1019. [PMID: 34862800 DOI: 10.1111/iej.13672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/02/2021] [Indexed: 12/26/2022]
Abstract
The prognosis of traumatized teeth depends largely on the fate of the pulp and its treatment. This review aims to update the present status on the endodontic management of traumatic injuries to permanent teeth and to identify relevant research areas that could contribute to an improvement in diagnosis and treatment of traumatized permanent teeth. Future research should pay greater attention to (1) diagnostic methods to assess the perfusion of the pulp and enhance detection of tooth cracks and initial signs of root resorption; (2) improved materials for vital pulp treatment; (3) studies focusing on type and duration of splinting after root fractures; (4) antiresorptive intracanal medication in case of posttraumatic pulp necrosis and infection-related resorption and (5) long-term data on the apical barrier technique compared to revitalization.
Collapse
Affiliation(s)
- Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Kurt Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - Kerstin Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
5
|
Guo H, Li B, Wu M, Zhao W, He X, Sui B, Dong Z, Wang L, Shi S, Huang X, Liu X, Li Z, Guo X, Xuan K, Jin Y. Odontogenesis-related developmental microenvironment facilitates deciduous dental pulp stem cell aggregates to revitalize an avulsed tooth. Biomaterials 2021; 279:121223. [PMID: 34736149 DOI: 10.1016/j.biomaterials.2021.121223] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 12/11/2022]
Abstract
Harnessing developmental processes for tissue engineering represents a promising yet challenging approach to regenerative medicine. Tooth avulsion is among the most serious traumatic dental injuries, whereas functional tooth regeneration remains uncertain. Here, we established a strategy using decellularized tooth matrix (DTM) combined with human dental pulp stem cell (hDPSC) aggregates to simulate an odontogenesis-related developmental microenvironment. The bioengineered teeth reconstructed by this strategy regenerated three-dimensional pulp and periodontal tissues equipped with vasculature and innervation in a preclinical pig model after implantation into the alveolar bone. These results prompted us to enroll 15 patients with avulsed teeth after traumatic dental injuries in a pilot clinical trial. At 12 months after implantation, bioengineered teeth led to the regeneration of functional teeth, which supported continued root development, in humans. Mechanistically, exosomes derived from hDPSC aggregates mediated the tooth regeneration process by upregulating the odontogenic and angiogenic ability of hDPSCs. Our findings suggest that odontogenic microenvironment engineering by DTM and stem cell aggregates initiates functional tooth regeneration and serves as an effective treatment for tooth avulsion.
Collapse
Affiliation(s)
- Hao Guo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China; Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Bei Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
| | - Meiling Wu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China; Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Wanmin Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Xiaoning He
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Bingdong Sui
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Zhiwei Dong
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ling Wang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China
| | - Songtao Shi
- South China Center of Craniofacial Stem Cell Research, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong, China
| | - Xiaoyao Huang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China; Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Xuemei Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China; Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Zihan Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China; Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Xiaohe Guo
- Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Kun Xuan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China; Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
| | - Yan Jin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China.
| |
Collapse
|
6
|
Deferoxamine Reduces Inflammation and Osteoclastogenesis in Avulsed Teeth. Int J Mol Sci 2021; 22:ijms22158225. [PMID: 34360988 PMCID: PMC8348439 DOI: 10.3390/ijms22158225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/28/2022] Open
Abstract
Replacement and inflammatory resorption are serious complications associated with the delayed replantation of avulsed teeth. In this study, we aimed to assess whether deferoxamine (DFO) can suppress inflammation and osteoclastogenesis in vitro and attenuate inflammation and bone resorption in a replanted rat tooth model. Cell viability and inflammation were evaluated in RAW264.7 cells. Osteoclastogenesis was confirmed by tartrate-resistant acid phosphatase staining, reactive oxygen species (ROS) measurement, and quantitative reverse transcriptase–polymerase chain reaction in teeth exposed to different concentrations of DFO. In vivo, molars of 31 six-week-old male Sprague–Dawley rats were extracted and stored in saline (n = 10) or DFO solution (n = 21) before replantation. Micro-computed tomography (micro-CT) imaging and histological analysis were performed to evaluate inflammation and root and alveolar bone resorption. DFO downregulated the genes related to inflammation and osteoclastogenesis. DFO also reduced ROS production and regulated specific pathways. Furthermore, the results of the micro-CT and histological analyses provided evidence of the decrease in inflammation and hard tissue resorption in the DFO group. Overall, these results suggest that DFO reduces inflammation and osteoclastogenesis in a tooth replantation model, and thus, it has to be further investigated as a root surface treatment option for an avulsed tooth.
Collapse
|
7
|
Krastl G, Weiger R, Filippi A, Van Waes H, Ebeleseder K, Ree M, Connert T, Widbiller M, Tjäderhane L, Dummer PMH, Galler K. European Society of Endodontology position statement: endodontic management of traumatized permanent teeth. Int Endod J 2021; 54:1473-1481. [PMID: 33934366 DOI: 10.1111/iej.13543] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023]
Abstract
This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the endodontic management of traumatized permanent teeth. A recent comprehensive review with detailed background information provides the basis for this position statement (Krastl et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13508). The statement is based on current scientific evidence as well as the expertise of the committee. Complementing the recently revised guidelines of the International Association of Dental Traumatology, this position statement aims to provide clinical guidance for the choice of the appropriate endodontic approach for traumatized permanent teeth. Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.
Collapse
Affiliation(s)
| | - G Krastl
- Department of Conservative Dentistry and Periodontology & Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - R Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.,Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - A Filippi
- Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.,Department of Oral Surgery, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - H Van Waes
- Department of Paediatric Dentistry, Clinic for Orthodontics and Paediatric Dentistry, University of Zürich, Zürich, Switzerland
| | - K Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - M Ree
- Private Practice, Purmerend, Netherlands
| | - T Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland.,Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - P M H Dummer
- School of Dentistry, College of Biomedical & Life Sciences, Cardiff University, Cardiff, UK
| | - K Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
8
|
Krastl G, Weiger R, Filippi A, Van Waes H, Ebeleseder K, Ree M, Connert T, Widbiller M, Tjäderhane L, Dummer PMH, Galler K. Endodontic management of traumatized permanent teeth: a comprehensive review. Int Endod J 2021; 54:1221-1245. [PMID: 33683731 DOI: 10.1111/iej.13508] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine-pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.
Collapse
Affiliation(s)
- G Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - R Weiger
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - A Filippi
- Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland.,Department of Oral Surgery, University School of Dental Medicine, Basel, Switzerland
| | - H Van Waes
- Department of Paediatric Dentistry, Clinic for Orthodontics and Paediatric Dentistry, University of Zürich, Zürich, Switzerland
| | - K Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - M Ree
- Private Practice, Purmerend, Netherlands
| | - T Connert
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, University of Oulu, Oulu, Finland
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - K Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
9
|
Albertsson J, Lauridsen E, Andreasen JO, Gerds TA, Andersson L. The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation-A re-evaluation of a long-term clinical study. Dent Traumatol 2021; 37:537-545. [PMID: 33527633 DOI: 10.1111/edt.12659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/02/2021] [Accepted: 01/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIM The survival of an avulsed tooth highly depends on the emergency management. The aim of this study was to evaluate the risk of ankylosis for avulsed human teeth stored in saliva preceded by various dry storage conditions prior to replantation. MATERIAL AND METHODS Data include 74 patients (54 male and 20 female) with 89 avulsed and replanted teeth (16 immature teeth, 73 mature teeth). Patient ages ranged from 6 to 36 years (median: 13.0 years). All teeth were stored in saliva before replantation. Treatment and follow-up were performed according to a standardized procedure. Follow-up periods ranged from 7 months to 20 years (mean 5.3 years). The risk of ankylosis over time was estimated by the Aalen-Johansen method in relation to the length of dry storage and the stage of root development. The effect of risk factors (root development and length of dry time) on the risk of ankylosis was analysed by Cox regression analysis. RESULTS For mature teeth, dry storage for 5 min or less before saliva storage resulted in a 47.4% (95% confidence interval (CI): 32.8-60.7) ankylosis rate. When dry storage was >5 min and <20 min, the risk of ankylosis was 76.8% (95% CI: 45.7-91.5). When dry storage exceeded 20 min prior to saliva storage, ankylosis increased to 89.3% (95% CI: 68.0-96.7). Ankylosis also increased with increasing saliva storage time. Specifically, one additional minute of wet time increased the ankylosis hazard rate (HR) by approximately 1% (CI = [0%, 2%], p = .052). Teeth with mature root development were significantly more frequently affected by ankylosis than teeth with immature root development (HR: 2.4 (95% CI: 1.0-5.5), p = .04). CONCLUSION Temporary storage in saliva should be encouraged if an avulsed permanent tooth cannot be immediately replanted or a suitable storage medium such as milk or saline is not immediately available at the place of the accident.
Collapse
Affiliation(s)
- Josefin Albertsson
- Department of Oral and Maxillofacial Surgery and Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Eva Lauridsen
- Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark
| | - Jens O Andreasen
- Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark
| | - Thomas A Gerds
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Lars Andersson
- Department of Oral and Maxillofacial Surgery and Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| |
Collapse
|
10
|
Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O'Connell AC, Day PF, Tsilingaridis G, Abbott PV, Fouad AF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol 2020; 36:314-330. [DOI: 10.1111/edt.12578] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Nestor Cohenca
- Department of Pediatric Dentistry University of Washington and Seattle Children's Hospital Seattle WA USA
| | - Eva Lauridsen
- Resource Center for Rare Oral Diseases Copenhagen University Hospital Copenhagen Denmark
| | - Marie Therese Flores
- Department of Pediatric Dentistry Faculty of Dentistry Universidad de Valparaíso Valparaíso Chile
| | - Anne C. O'Connell
- Paediatric Dentitsry Dublin Dental University HospitalTrinity College DublinThe University of Dublin Dublin Ireland
| | - Peter F. Day
- School of Dentistry University of Leeds and Community Dental Service Bradford District Care NHS Trust Leeds UK
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Paul V. Abbott
- UWA Dental School University of Western Australia Nedlands WA Australia
| | - Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery Resource Centre for Rare Oral Diseases University Hospital in Copenhagen (Rigshospitalet) Copenhagen Denmark
| | - Zafer C. Cehreli
- Department of Pediatric Dentistry Faculty of Dentistry Hacettepe University Ankara Turkey
| | - Stephen Harlamb
- Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
| | - Bill Kahler
- School of Dentistry The University of Queensland St Lucia Qld Australia
| | - Adeleke Oginni
- Faculty of Dentistry College of Health Sciences Obafemi Awolowo University Ile‐Ife Nigeria
| | | | - Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| |
Collapse
|
11
|
Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, O'Connell A, Flores MT, Day PF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2020; 36:331-342. [DOI: 10.1111/edt.12573] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | - Paul V. Abbott
- UWA Dental School University of Western Australia Crawley WA Australia
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Nestor Cohenca
- Department of Pediatric Dentistry University of Washington and Seattle Children’s Hospital Seattle WA Australia
| | - Eva Lauridsen
- Resource Center for Rare Oral Diseases Copenhagen University Hospital Copenhagen Denmark
| | | | - Anne O'Connell
- Paediatric Dentistry Dublin Dental University Hospital Trinity College Dublin The University of Dublin Dublin Ireland
| | - Marie Therese Flores
- Department of Pediatric Dentistry Faculty of Dentistry Universidad de Valparaíso Valparaíso Chile
| | - Peter F. Day
- School of Dentistry Community Dental Service Bradford District Care NHS Trust University of Leeds Leeds UK
| | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery Resource Centre for Rare Oral Diseases University Hospital in Copenhagen (Rigshospitalet) Copenhagen Denmark
| | - Zafer C. Cehreli
- Department of Pediatric Dentistry Faculty of Dentistry Hacettepe University Ankara Turkey
| | - Stephen Harlamb
- Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
| | - Bill Kahler
- School of Dentistry The University of Queensland St Lucia QLD Australia
| | - Adeleke Oginni
- Faculty of Dentistry College of Health Sciences Obafemi Awolowo University Ile‐Ife Nigeria
| | | | - Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| |
Collapse
|
12
|
Lauridsen E, Andreasen JO, Bouaziz O, Andersson L. Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage: A re‐evaluation of a long‐term clinical study. Dent Traumatol 2019; 36:108-116. [DOI: 10.1111/edt.12520] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Eva Lauridsen
- Department of Oral and Maxillofacial Surgery University Hospital Copenhagen Denmark
| | - Jens O. Andreasen
- Department of Oral and Maxillofacial Surgery University Hospital Copenhagen Denmark
| | - Oliver Bouaziz
- Laboratoire MAP5 Université Paris Descartes and CNRS Sorbonne Paris Cité France
| | - Lars Andersson
- Department of Oral and Maxillofacial Surgery University Hospital Copenhagen Denmark
- Department of Oral and Maxillofacial Surgery and Medicine Faculty of Odontology Malmö University Malmö Sweden
| |
Collapse
|
13
|
Matos FDS, do Prado RF, Khoury RD, de Oliveira LD, Valera MC, Tomson PL, Carvalho CAT. Anti-inflammatory and anti-resorptive efficacy of adrenergic blockers on late replanted rat incisors. Dent Traumatol 2019; 36:253-263. [PMID: 31647601 DOI: 10.1111/edt.12523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIM In addition to their anti-inflammatory and anti-osteoclastogenesis properties, adrenergic blockers may also have promising anti-resorptive effects that can prevent root resorption when teeth are replanted because of avulsion. The aim of this study was to investigate the effects of phentolamine (Ph) and propranolol (Pr) in gels on the repair process of late replanted rat incisors. A further aim was to evaluate the biocompatibility of both drugs to human periodontal ligament fibroblasts (HPDLFs). MATERIALS AND METHODS Forty-eight maxillary right incisors were extracted from male Wistar rats, stored in paper napkins for 60 minutes, and randomly allocated to one of eight groups (n = 6). The root canal, root surface, and alveolus were treated with 0.75 µg/mL Ph gel (Ph0.75), 10 µg/mL Ph gel (Ph10), 100 µg/mL Ph gel (Ph100), 2.5 µg/mL Pr gel (Pr2.5), 10 µg/mL Pr gel (Pr10), 100 µg/mL Pr gel (Pr100), or sodium carboxymethylcellulose gel (CMC) before replantation. In the control group (CH), only the root canal was treated with calcium hydroxide paste. Thirty days following surgery, the animals were euthanized, and the right hemimaxilla was removed to perform micro-CT and histomorphometric analysis to determine osteoclastic activity. Ethanolic solutions of Ph10 and Pr10 were selected based on the in vivo study, and the viability of HPDLFs stimulated with lipopolysaccharide was determined by MTT assays. RESULTS The micro-CT and histomorphometric analysis revealed no significant differences among the treatments (P > .05). The presence of active osteoclasts was significantly decreased in the Ph10 and Pr10 groups (P < .05). Ph10 and Pr10 produced statistically similar cell survival rates compared to the control group (P > .05). CONCLUSIONS Ph10 and Pr10 significantly decreased osteoclastogenesis in delayed replanted rat teeth and were not cytotoxic toward HPDLFs.
Collapse
Affiliation(s)
- Felipe de Souza Matos
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Renata Falchete do Prado
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Rayana Duarte Khoury
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Marcia Carneiro Valera
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Phillip Leo Tomson
- Department of Oral Biology, Institute of Clinical Sciences, The University of Birmingham School of Dentistry, Birmingham, UK
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| |
Collapse
|
14
|
Kenny K, Vinall-Collier K, Douglas G, Day PF. 'He was distraught, I was distraught.' Parents' experiences of accessing emergency care following an avulsion injury to their child. Br Dent J 2019; 227:705-710. [PMID: 31654007 DOI: 10.1038/s41415-019-0738-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective To explore how parents access emergency care for their children following avulsion of a permanent tooth.Method Semi-structured qualitative interviews were undertaken with parents of children who had suffered a tooth avulsion injury in the previous two years. The interviews were recorded and transcribed verbatim. Framework analysis was used to analyse the data and interpret the core concepts from the interviews. Results Nine parents participated in the study. None of the children received the appropriate emergency dental care within the timeframe identified by national and international guidelines. The core themes that emerged following the analysis were knowledge, access and emotion.Discussion & Conclusions The parents who were interviewed for this study had poor knowledge of what to do in the event of a tooth avulsion injury. This lack of knowledge directly impaired their ability to navigate emergency dental care for their child. They described their upset and distress following their child's injury, but also feelings of frustration and disappointment in relation to the emergency care their child received. There is a need to develop appropriate support and clinical pathways to enable parents to rapidly access appropriate and timely care for their child following a complex dental trauma.
Collapse
Affiliation(s)
- Kate Kenny
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, UK.
| | - Karen Vinall-Collier
- Department of Dental Public, Leeds, School of Dentistry, University of Leeds, UK
| | - Gail Douglas
- Department of Dental Public, Leeds, School of Dentistry, University of Leeds, UK
| | - Peter F Day
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, United Kingdom; Community Dental Service, Bradford District Care NHS Trust, Bradford, UK
| |
Collapse
|
15
|
Zare Jahromi M, Kalantar Motamedi MR. Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review. Restor Dent Endod 2019; 44:e32. [PMID: 31485428 PMCID: PMC6713075 DOI: 10.5395/rde.2019.44.e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/25/2019] [Accepted: 06/13/2019] [Indexed: 11/11/2022] Open
Abstract
Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.
Collapse
Affiliation(s)
- Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | | |
Collapse
|
16
|
Day PF, Duggal M, Nazzal H. Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted. Cochrane Database Syst Rev 2019; 2:CD006542. [PMID: 30720860 PMCID: PMC6363052 DOI: 10.1002/14651858.cd006542.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Traumatic dental injuries are common. One of the most severe injuries is when a permanent tooth is knocked completely out of the mouth (avulsed). In most circumstances the tooth should be replanted as quickly as possible. There is uncertainty on which interventions will maximise the survival and repair of the replanted tooth. This is an update of a Cochrane Review first published in 2010. OBJECTIVES To compare the effects of a range of interventions for managing traumatised permanent front teeth with avulsion injuries. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 March 2018), Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 2) in the Cochrane Library (searched 8 March 2018), MEDLINE Ovid (1946 to 8 March 2018), and Embase Ovid (1980 to 8 March 2018). The US National Institutes of Health Ongoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We considered randomised and quasi-randomised controlled trials that included a minimum follow-up period of 12 months, for interventions for avulsed and replanted permanent front teeth. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data and assessed the risk of bias. Authors were contacted where further information about their study was required. MAIN RESULTS Four studies, involving a total of 183 participants and 257 teeth were identified. Each of the interventions aimed to reduce infection or alter the inflammatory response or both at the time of or shortly after the tooth or teeth were replanted. Each study assessed a different intervention and therefore it was not appropriate or possible to numerically synthesise the data. All evidence was rated as being of very low quality due to problems with risk of bias and imprecision of results. This means that we are very uncertain about all of the results presented in this review.One study at high risk of bias with 69 participants (138 teeth) compared a 20-minute soak with gentamycin sulphate for both groups prior to replantation with the experimental group receiving daily hyperbaric oxygen for 80 minutes for the first 10 days. There was some evidence of a benefit for the hyperbaric oxygen group in respect of periodontal healing, tooth survival, and pulpal healing.One study at unclear risk of bias with 22 participants (27 teeth) compared the use of two root canal medicaments, Ledermix and Ultracal. There was insufficient evidence of a difference for periodontal healing or tooth survival. This was the only study to formally report adverse events with none identified. Study authors reported that Ledermix caused a greater level of patient dissatisfaction with the colour of avulsed and replanted teeth.A third study at high risk of bias with 19 participants compared extra- or intra-oral endodontics for avulsed teeth which were stored dry for longer than 60 minutes before replantation. There was insufficient evidence of a difference in periodontal healing.The fourth study at high risk of bias with 73 participants compared a 10-minute soak in either thymosin alpha 1 or saline before replantation followed by daily gingival injections with these same medicaments for the first 7 days. There was some evidence of a benefit for thymosin alpha 1 with respect to periodontal healing and tooth survival. AUTHORS' CONCLUSIONS Based on the results of the included studies, there is insufficient evidence to support or refute the effectiveness of different interventions for avulsed and replanted permanent front teeth. The overall quality of existing evidence was very low, and therefore great caution should be exercised when generalising the results of the included trials. There is urgent need for further well-designed randomised controlled trials.
Collapse
Affiliation(s)
- Peter F Day
- Leeds Dental InstituteDepartment of Paediatric DentistryClarendon WayLeedsUKLS2 9LU
| | - Monty Duggal
- Faculty of Dentistry, National University of SingaporeDepartment of Paediatric Dentistry9 Lower Kent Ridge Road Level 10National University Centre for Oral HealthSingaporeSingapore119085
| | - Hani Nazzal
- Leeds Dental InstituteDepartment of Paediatric DentistryClarendon WayLeedsUKLS2 9LU
| | | |
Collapse
|
17
|
Fagundes NCF, Bittencourt LO, Magno MB, Marques MM, Maia LC, Lima RR. Efficacy of Hank's balanced salt solution compared to other solutions in the preservation of the periodontal ligament. A systematic review and meta-analysis. PLoS One 2018; 13:e0200467. [PMID: 30005079 PMCID: PMC6044542 DOI: 10.1371/journal.pone.0200467] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/27/2018] [Indexed: 02/02/2023] Open
Abstract
This systematic review and meta-analysis (MA) aimed to verify the capacity of different storage media to preserve viability of periodontal ligament cells in comparison to Hank’s Balanced Salt Solution. The searches, selection process, data extraction and Risk of Bias control were conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five MA were conducted to compare the cell viability between milk versus Hank's balanced salt solution (HBSS) in a dichotomous (1) or continuous (2) data model; tap water versus HBSS (3); medicinal herbals versus HBSS (4); and saline solution versus HBSS (5). 693 potentially studies were identified, with 18 studies included in the qualitative and 8 studies included in the quantitative analysis. Most of the articles presented a low risk of bias. HBSS medium showed a superior ratio of cell viability compared to tap water (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%) and saline solution (RR 0.76; 95% CI [0.69, 0.84]; p < 0.0001; I2 = 99%). Herbal medicines showed a similar ratio of cell viability when compared to HBSS (RR 0.97; 95% CI [0.94, 1.00]; p = 0.08; I2 = 50%). Mixed results were observed between milk and HBSS: a superior ratio of HBSS was observed in an overall evaluation (RR 0.26; 95% CI [0.21, 0.32]; p < 0.00001; I2 = 96%), and a similar ratio was achieved when periodontal ligament (PDL) cells were removed prior to immersion in the solution (RR 0.94; 95% CI [0.87, 1.01]; p = 0.10; I2 = 0%) or rinsed in tap water or maintained in open air prior to immersion (RR 0.63; 95% CI [0.35, 1.12]; p = 0.11; I2 = not applicable). This systematic review and MA suggests that milk and herbal medicines could represent an alternative to HBSS. However, more studies are necessary to obtain a reliable conclusion.
Collapse
Affiliation(s)
- Nathalia Carolina Fernandes Fagundes
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém-Pará, Brazil.,School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém-Pará, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Márcia Martins Marques
- Department of Restorative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Lucianne Cople Maia
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém-Pará, Brazil
| |
Collapse
|
18
|
Souza BDM, Dutra KL, Kuntze MM, Bortoluzzi EA, Flores-Mir C, Reyes-Carmona J, Felippe WT, Porporatti AL, De Luca Canto G. Incidence of Root Resorption after the Replantation of Avulsed Teeth: A Meta-analysis. J Endod 2018; 44:1216-1227. [PMID: 29866405 DOI: 10.1016/j.joen.2018.03.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION An avulsion injury is a serious trauma to pulp and periodontal tissues. After avulsion and replantation, teeth are at risk of infection and root resorption, which may affect treatment outcome and survival rate. Thus, the purpose of this systematic review was to evaluate the incidence of root resorption after the replantation of avulsed teeth. METHODS Two reviewers searched 7 electronic databases for observational studies involving human subjects that evaluated the incidence of root resorption after tooth avulsion. Risk of bias (RoB) was evaluated using the Meta-Analysis of Statistics Assessment and Review Instrument, and the quality of available evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS Of the 1507 articles, 23 met the inclusion criteria. A meta-analysis was conducted and showed that the incidence of internal root resorption was 1.2% (95% confidence interval [CI], 0.02-5.50). Regarding external root resorption, the incidence of surface root resorption was 13.3% (95% CI, 6.21-22.62), that of inflammatory root resorption was 23.2% (95% CI, 13.94-34.19), and that of replacement root resorption was 51.0% (95% CI, 40.10-62.00). Two studies presented a high RoB, 16 had a moderate RoB, and 11 had a low RoB. The overall level of evidence identified was very low. CONCLUSIONS The incidence of root resorption after avulsion and replantation in descending order was replacement root resorption > inflammatory root resorption > surface root resorption > internal root resorption.
Collapse
Affiliation(s)
| | - Kamile Leonardi Dutra
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Morgane Marion Kuntze
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta Edmonton, Alberta, Canada
| | | | - Wilson Tadeu Felippe
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - André Luís Porporatti
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Graziela De Luca Canto
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta Edmonton, Alberta, Canada; Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
19
|
Ivancic Jokic N, Bakarcic D, Grzic R, Majstorovic M, Sostarek M. What general medicine students of University of Rijeka know about dental avulsion? EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:e131-e134. [PMID: 27578273 DOI: 10.1111/eje.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Injuries of decidouos and premanent teeth can be rather hard, esspecially in combinatin if they involve adjacent supportive tissue. Among all injuries, the loss of the teeth is considered the most stressful for both a child and its parents. Tooth injury usually involves soft tissue damage, which means severe bleeding. As parents often look for help from their family general practitioners, it is very important that general practitioner is acquainted with the first aid in order to preserve the tooth and enable further skeletal development. MATERIALS AND METHODS This study was carried out in the form of a questionnaire, which was distributed among general medical students at the Medical studies of the Faculty of Medicine of the University of Rijeka, Croatia. The study included 86 pre-doctoral students of the 3rd, 4th and 5th years of studies. The questionnaire consisted of 23 questions, which were related to demographics, personal experience in treating dental injuries, theoretical knowledge about dental injuries and their interest in additional training on the subject. RESULTS The results showed that only 32.6% of the students heard of 'tooth avulsion'. Replacement of the avulsed tooth in its original position in the jaw was considered by 77.6% of the students. In their entire education, 84.9% students didn't acquire any knowledge about dental injuries. CONCLUSION The study showed that medical students have very poor knowledge about dental injuries. Also, the vast majority of the students were neither informed nor educated about it during their studies.
Collapse
Affiliation(s)
- N Ivancic Jokic
- Department of Paediatric Dentistry, Faculty of Medicine of the University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - D Bakarcic
- Department of Paediatric Dentistry, Faculty of Medicine of the University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - R Grzic
- Department of Prosthodontics, Faculty of Medicine of the University of Rijeka, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - M Majstorovic
- Department of Paediatric Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- New York University College of Dentistry, New York, NY, USA
| | | |
Collapse
|
20
|
Lucena C, Souza EM, Voinea GC, Pulgar R, Valderrama MJ, De-Deus G. A quality assessment of randomized controlled trial reports in endodontics. Int Endod J 2016; 50:237-250. [DOI: 10.1111/iej.12626] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- C. Lucena
- Department of Conservative Dentistry; School of Dentistry; University of Granada; Granada Spain
| | - E. M. Souza
- Department of Dentistry II; Federal University of Maranhão UFMA; São Luis Brazil
| | | | - R. Pulgar
- Department of Conservative Dentistry; School of Dentistry; University of Granada; Granada Spain
| | - M. J. Valderrama
- Department of Statistics and Operations Research; Faculty of Pharmacy; University of Granada; Granada Spain
| | - G. De-Deus
- Department of Endodontics; Grande Rio University (UNIGRANRIO); School of Dentistry; Rio de Janeiro Brazil
| |
Collapse
|
21
|
Sharif MO, Tejani-Sharif A, Kenny K, Day PF. A systematic review of outcome measures used in clinical trials of treatment interventions following traumatic dental injuries. Dent Traumatol 2015; 31:422-8. [DOI: 10.1111/edt.12227] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Kate Kenny
- Department of Paediatric Dentistry; School of Dentistry, University of Leeds; UK
| | - Peter F. Day
- Department of Paediatric Dentistry; School of Dentistry, University of Leeds; UK
- Salaried Dental Service; Bradford District Care Trust; Bradford UK
| |
Collapse
|
22
|
Kenny KP, Day PF, Douglas GVA, Chadwick BL. Primary care dentists' experience of treating avulsed permanent teeth. Br Dent J 2015; 219:E4. [DOI: 10.1038/sj.bdj.2015.673] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/09/2022]
|
23
|
Kostka E, Meissner S, Finke CH, Mandirola M, Preissner S. Multidisciplinary treatment options of tooth avulsion considering different therapy concepts. Open Dent J 2014; 8:180-3. [PMID: 25352922 PMCID: PMC4209498 DOI: 10.2174/1874210601408010180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 07/24/2014] [Accepted: 08/27/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Avulsion of permanent front teeth is a rare accident, mostly affecting children between seven and nine years of age. Replanted and splinted, these teeth often develop inflammation, severe resorption or ankylosis affecting alveolar bone development and have to be extracted sooner or later. OBJECTIVES The purpose of this study was to evaluate different therapy concepts to create a structured concept for the treatment of avulsions. RESULTS Based on existing therapy concepts, a concept for different initial conditions (dry time, age, growth, tooth, hard and soft tissues) was developed and is presented here. CONCLUSION A great deal of research has been performed during recent years and guidelines for the management of avulsions have been published. With the help of this literature it is possible to identify the best treatment procedure for each tooth. CLINICAL RELEVANCE The prognosis of avulsed teeth can be improved by considering evidence-based therapy concepts. Resorption, ankylosis and tooth loss could be minimized.
Collapse
Affiliation(s)
- Eckehard Kostka
- Department of Operative and Preventive Dentistry, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Simon Meissner
- Department of Oral Medicine, Dental Radiology and Oral Surgery, Assmannshauser Straße 4-6, 14197 Berlin,
Germany
| | - Christian H Finke
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Manlio Mandirola
- Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| | - Saskia Preissner
- Department of Operative and Preventive Dentistry, Assmannshauser Straße 4-6, 14197 Berlin, Germany
| |
Collapse
|
24
|
Kaufman AY, Solomonov M, Galieva D, Abbott PV. Allergic reaction to the tetracycline component of Ledermix paste: a case report. Int Endod J 2014; 47:1090-7. [DOI: 10.1111/iej.12252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A. Y. Kaufman
- Endodontics and Dental Traumatology Department; Graduate School of Dentistry; Rambam Health Care Campus; Haifa Israel
| | - M. Solomonov
- Department of Endodontics; Sheba Hospital; Tel Hashomer Israel
| | - D. Galieva
- Department of Therapeutic Stomatology; Moscow State University of Medicine and Dentistry; Moscow Russia
| | - P. V. Abbott
- School of Dentistry; The University of Western Australia; Perth WA Australia
| |
Collapse
|
25
|
A study of factors that influence the number of visits following traumatic dental injuries. Br Dent J 2013; 214:E28. [DOI: 10.1038/sj.bdj.2013.532] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2013] [Indexed: 11/09/2022]
|
26
|
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.
Collapse
Affiliation(s)
- Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|