Combination injuries 1. The risk of pulp necrosis in permanent teeth with concussion injuries and concomitant crown fractures

Abstract

No response to EPT at the initial examination or a concomitant crown fracture significantly increased the risk of PN in teeth with concussion injury and mature root development. If both risk factors were present there was a synergetic effect.

Pulpal Response after Acute Dental Injury in the Permanent Dentition: Clinical Implications—A Review

“…By using multivariate regression statistics, Lauridsen et al (32)(33)(34)(35) found in combined luxation-crown fracture injuries that beside the already known variables for predicting PN after luxation injuries (ie, luxation diagnosis and stage of root development), reaction to electrical pulp testing (EPT) at the time of injury played an important role. Thus, teeth that did not respond to EPT had a significantly greater risk of developing PN in the first year after injury.…”

An update on clinical regenerative endodontics

“…The prevalence of trauma in the permanent dentition has been reported to range from 2.6% to 35% with a greater incidence occurring between the ages of 7 and 15 , when most permanent teeth are in an incomplete root development stage. Unfortunately, approximately 50% of the traumatized teeth may be diagnosed with pulpal necrosis , with a greater incidence occurring following severe injuries such as intrusions and avulsions and combination injuries . Thus, children with a developing dentition are at an increased risk for sustaining injury that could lead to pulpal necrosis.…”

Frequência de reabsorção radicular inflamatória decorrente de trauma em dentes anteriores atendidos em um Centro Clínico de Traumatismo Dentário

“…Quando a subluxação está associada à fratura dental sem exposição pulpar, a frequência de reabsorção inflamatória não é elevada; contudo, não houve diferença quando a fratura dentária não estava presente. Lauridsen et al 13 conjecturam que a fratura coronária absorveria grande parte da energia de impacto e, dessa forma, reduziria as lesões do ligamento periodontal e, consequentemente, as reabsorções dentárias.…”

“…Observa-se, neste estudo, que a reabsorção não se torna prevalente quando se promove o controle sistemático e regular dos casos de traumatismos dentários. É importante que as lesões traumáticas nos tecidos dentários sejam submetidas a um procedimento de diagnóstico mais detalhado para verificar o nível de comprometimento dos tecidos de sustentação 13 .…”