A retrospective clinical and radiologic study of teeth re‐implanted following traumatic avulsion

Abstract

Re-implantation is the recommended therapeutic procedure following traumatic exarticulation of teeth though its long-term prognosis remains controversial. The purpose of the following study was to evaluate the periodontal healing of 33 reimplanted incisors lost after trauma. The sample, which included 24 upper and 9 lower incisors, was divided in two groups: 15 teeth were reimplanted within 1 hour (=Group A) and 21 teeth after 3 hours or more (=Group B). The reimplanted teeth were followed for different radiographic evaluation periods up to 5 years (mean=2-9 years). The results showed a high rate of periodontal healing in Group A (66.7%), while Group B demonstrated a high percentage (83.3%) of both inflammatory and replacement resorption. Thus, even if the whole sample was prevented from drying before reimplantation, the teeth were affected by different rates of root resorption. Among the various prognostic factors suggested by the literature, bacterial contamination during extra-alveolar storage seemed the most critical.

Delayed Replantation of Multiple, Avulsed Maxillary Young Permanent Teeth with Open Apex

“…However, periodontal curettage may remove cemental layer from root and this in turn allow resorption process. [16][17][18] So we gently scraped the root surface with wet gauge, taking care not to do any damage to cementum layer and then tooth is immersed in sodium hypochlorite for removal of remaining cells. Several substances have been used for the treatment of the root surface of replanted teeth in an attempt to increase their retention rate, like formol acid solutions (such as citric acid, hydrochloric acid, acidulated fluoride and neutral fluoride), alkaline substances (such as calcium hydroxide and sodium hypochlorite), antibiotics (such as tetracycline and rifacin), antibiotic/corticosteroid combination, corticosteroid, alendronate, vitamin C, carbonic anhydrase inhibitor (acetazolamide) and tooth enamel protein (Emdogain, Biora AB, Malmo, Sweden).…”

Dental Pulp Revascularization in a Replanted Avulsed Immature Maxillary Permanent Central Incisor

“…Additionally, the overall rate of periodontal healing was related to the stage of root development and was better for teeth with incomplete apical closure (23). sonable prognosis for the retention (25)(26)(27)(28). In an assessment of 154 replanted avulsed permanent incisors that correlated pulp revascularization with respect to the width of the apical foramen, the rate of revascularization in the entire sample studied was 8% with a difference between immature teeth (which was 18%) and mature teeth (which was 0%).…”

“…A clinical and radiographic retrospective study of 33 teeth with fully formed root lengths but with open apices at Moorrees (24) stages 5 and 6, replanted within 1 to 3 hours or more after avulsion and followed for up to 5 years, found that only 24% were diagnosed with pulp necrosis and endodontically treated. For those teeth replanted within 1 hour after avulsion, the periodontal healing rate was 67%, whereas for teeth replanted three or more hours after avulsion, 83% had root resorption (26). In an investigation of 103 replanted permanent incisors in different age groups that were examined after being followed for an average of 2.5 years, it was found that pulp revascularization occurred in 41% of the teeth of children, 9% of the teeth of adolescents and 0% of the teeth of adults (27).…”

“…In light of these clinical studies (25)(26)(27)(28), it is clear that pulp revascularization and periodontal reattachment can be considered viable outcomes with favourable prognoses for replanted avulsed immature permanent teeth among children, within the parameters of current guidelines for the management of tooth avulsions (16,17).…”

Trauma dentário na infância: avaliação da conduta dos educadores de creches públicas de Patos-PB

“…Há uma maior prevalência de traumatismo na dentição decídua, quando comparada à permanente, em especial na idade pré-escolar, podendo atingir, em média, 36,8% das crianças 2,3 . Nesta fase, as características comportamentais, como a curiosidade e a inquietação, levam a criança a explorar o ambiente escolar, não possuindo esta coordenação motora sufi ciente para evitar quedas e promover autoproteção, o que justifi ca a ocorrência desses tipos de lesões [4][5][6] .…”