No abstract

-Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. 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 specialities were included in the task group. 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 for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome.174

No abstract

In growing individuals, infraposition of a reimplanted, ankylosed tooth may disrupt normal alveolar development and compromise prosthetic treatment. The aims of this study were to analyze the rate of infraposition of ankylosed incisors in growing subjects and to provide guidelines for the timing of extraction. The subjects comprised 30 boys and 12 girls, selected consecutively from patients on annual post-trauma follow-up, and observed for periods ranging from 1 to 10 years. Only patients with one replanted ankylosed maxillary central incisor were included, the homologous teeth with healthy periodontal ligaments serving as controls. Growth intensity was evaluated from analyses of annual body height measurements. The following four periods were established: before the growth spurt, from initial to maximal growth spurt, from maximal growth spurt to the end and after the growth spurt. In 11 patients, cephalograms were taken at diagnosis and at extraction. Progression of infraposition varied individually. Diagnosis before the age of 10 or before the growth spurt was associated with very high risk of severe infraposition. In these cases the ankylosed tooth should be removed within 2-3 years. If ankylosis develops during the growth spurt, the tooth should be monitored regularly, but no intervention is indicated provided the adjacent teeth do not tilt and infraposition is minor or stable. Annual body height measurements, indicating the intensity of skeletal growth, are an aid to assessment. Cephalometric radiographs are important for evaluating the direction of growth of the jaws since there is a difference between horizontal and vertical growers.

No firm conclusion could be drawn for the difference in outcome between orthodontic extrusion and surgical reposition. To conclude, evaluation of the prognosis for intruded teeth should be based on the stage of root development and degree of intrusion. In teeth with immature root development, no active treatment appears to result in fewer healing complications.