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At least 253 records · Page 14Linked to original sources
PubMed2004

Evaluation of pulpal blood flow after tooth splinting of luxated permanent maxillary incisors.

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess whether LDF could be used to detect short- and long-term changes of PBF values of luxated permanent maxillary central incisors after repositioning and splinting. In 18 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in four sessions: on the day of splint removal, and 12, 24, and 36 weeks after splint removal. Analysis of the luxation type-related PBF measurements revealed intrusion type-related PBF values to be associated with a significant decrease in PBF values (P < 0.05), while lateral luxation and extrusion type-related PBF values showed no significant difference between the session-related values (P > 0.05). PBF measurements did not change over time for the contralateral incisors (P > 0.05). Teeth affected by an intrusion-type luxation injury remained unresponsive to sensitivity testing at follow up, while 3 (60%) developed grey discoloration of the crown. LDF may become useful in the detection of ischemic episodes of luxated maxillary central incisors after repositioning and splinting. Further studies are warranted to assess the validity of post-traumatic 'ischemic episodes' by comparing it to histological tooth pulp changes.

Adolescent↗
PubMed2000

Autotransplantation of premolars to replace maxillary incisors: a comparison with natural incisors.

The published literature contains no comprehensive studies that compare the outcome of premolar autotransplantation to the maxillary anterior region with natural incisors in the same patients. This article describes the gingival and periodontal conditions around premolars transplanted to the maxillary incisor region, subsequent to restoration. Forty-five premolars autotransplanted to the maxillary incisor region in 40 adolescent patients were evaluated after a mean observation period of 4.0 years. Mean age at surgery was 11.0 years. Established clinical criteria were used to assess tooth mobility, plaque and gingival indexes, probing pocket depth, and percussion. Recession and hyperplasia of interproximal gingival papillae were assessed according to a recently proposed index. Standardized radiography was used to evaluate presence of pathosis, pulp obliteration, root length, and crown-root ratios. Clinical variables for transplants did not differ from those of the natural incisors, except for increased mobility and more plaque in a few transplanted premolars. The interproximal gingival papillae adjacent to all transplanted teeth were normal or slightly hyperplastic. Radiographically, all transplants showed varying degrees of pulp obliteration, but no signs of pathosis. Crown-root ratios were similar for natural and transplanted teeth as were distances from cementoenamel junction to marginal bone. The overall status of the transplanted premolars and surrounding tissues indicated that this treatment modality may be recommended when maxillary incisors are missing in adolescents. In addition, tooth transplantation represents an inherent potential for bone induction and reestablishment of a normal alveolar process.

Adolescent↗
PubMed2003

Extraoral endodontic treatment by retrograde insertion of posts: a long-term study on replanted and transplanted teeth.

OBJECTIVE: The aim of the study was to investigate the healing results of teeth replanted or transplanted in different indications and treated by extraoral root canal therapy. STUDY DESIGN: Extraoral root canal treatment was performed from a retrograde direction with posts made of ceramics or titanium. Preoperatively, the pulp status was classified as definitely infected (n = 47) or not infected/symptomless (n = 78), and the condition of the periodontal ligament (PDL) was classified as damaged (n = 50) or not damaged (n = 75) according to trauma type and extraoral storage. The healing after replantation or transplantation was diagnosed as functional, ankylosis, or infection depending on clinical and radiographic findings. RESULTS: In total, 125 teeth in 99 patients were replanted or transplanted. Mean observation period was 44.4 months. Teeth with a less damaged PDL in no case exhibited ankylosis/replacement resorption after a mean observation period of 53 months. Teeth without preoperative infection of the pulp in no case showed infection-related complications after a mean observation period of 30 months. Teeth classified as definitely infected before treatment had a high frequency of continuous periradicular bone and root resorption. CONCLUSIONS: The extraoral insertion of posts appeared to inflict no additional damage to the PDL that was clinically relevant. Infection-related complications were prevented. Teeth that were classified as definitely infected at the time of treatment had a low rate of healing and should undergo conventional root canal disinfection before this surgical procedure is applied.

Adolescent↗
PubMed2002

Treatment time of traumatic dental injuries in a cohort of 16-year-olds in northern Sweden.

The aim of the present study was to account for treatment time and number of visits required for treatment of traumatic dental injuries in a cohort of 16-year-olds, born in 1975, and residing in the county of Västerbotten, Sweden, and to analyze the correlation between total treatment time and background factors. The study material comprised 1012 dental records from the Public Dental Health Service containing information on dental injuries to primary and/or permanent incisors or canines. The mean total treatment time per individual was 1.3 h, with a range of 0.1 to 27.5 h. For injuries to the primary dentition, the mean number of visits per individual was 2.2. One visit was sufficient in 21% of the trauma episodes. In the permanent dentition, each trauma episode required a mean of 3.4 visits, and 90% of the patients had to return for follow-up visits. The correlation between explanatory variables and total treatment time was described and analyzed by linear multiple regression analyses. Degree of severity and number of injured teeth were two parameters of major significance to treatment time. Treatment by a specialist had an impact on time in the permanent but not in the primary dentition. In the permanent dentition, the treatment time increased if the dental injury occurred before the age of 11 years. Treatment time was not dependent on where the clinic was located or on gender of the injured child. Different diagnoses could explain 33% of the variation in treatment time in the permanent dentition.

Adolescent↗
PubMed1977

Dealing with dental injuries.

Any physician who sees patients on an emergency basis will be confronted with dental or oral injuries. Certain patients, eg, those with pulp exposure or with any apparent tooth displacement, should be referred immediately to a dentist. Patients with lesser dental injury, eg, with chipped teeth, can wait until the next day to see a dentist. Patients with dental or oral injury should be examined for jaw fractures and for lacerations inside and outside the mouth. Following emergency management, they should be instructed in proper mouth care to be used until they can see a dentist or return to that physician for follow-up examination.

Adolescent↗
PubMed1989

Oral trauma. Emergency care of lacerations, fractures, and burns.

Emergency physicians are usually the first to see patients with injuries to oral and facial tissues. Because many of these patients may have life-threatening neurologic injuries, secondary oral and perioral problems may be overlooked initially. These injuries, however, have a profound potential for causing lifelong disability and disfigurement and should be addressed as soon as the patient's condition stabilizes. It is essential to diagnose and manage these problems effectively in the emergency setting and then to make prompt direct referral to an appropriate specialist when the patient's condition permits.

Burns, Electric↗
PubMed1977

Management of dental trauma in children and adolescents.

The emergency treatment of dental trauma has traditionally been handled in the emergency rooms of medical centers, or in the dental office. With increasing emphasis on comprehensive medical care, and the tendency of more recent graduates to locate in rural areas, there is a growing trend for physicians to be involved in providing emergency care for traumatic injuries to the dental and oral tissues. The authors discuss the etiology of dental trauma and the highly psychologic impact of such injuries upon the patient and parents. Techniques for prevention and a comprehensive plan are outlined for systematic history taking and examination. A classification of eight levels of dental injuries (5), techniques for the emergency, and subsequent restorative care are given. Emphasis is placed upon immediate care which can, if necessary, be provided by the physician pending referral to a dentist.

Child↗
PubMed2005

Dental injuries in sports.

The expanding arena of sports and vigorous recreational activities is associated with an increased risk for sports-related injuries, including trauma to the teeth. Because dental professionals may not be present on site, in the best interest of athletes, it is suggested that sports medicine professionals who are present be provided with current evaluative, emergent, and referral protocols for proper management of sports-related dental injuries to address the immediate needs of the athlete and to enhance the long-term prognosis of the traumatized tooth. This article provides information related to some of the more common dental injuries encountered in sports, including crown fractures, root fractures, and traumatic tooth displacements. Use of properly fitted, custom-fabricated athletic mouth guards for the prevention of dental injuries is recommended strongly, as is the inclusion of a dentist on the sports medicine team roster.

Adolescent↗
PubMed2005

Immediately loaded anterior single-tooth implants: two cases.

Immediate loading of implants into fresh extraction sockets has the advantage of decreasing the period of healing, reducing the resorption of the alveolar bone, and achieving optimal esthetic results. These cases reveal the clinical success of immediate loaded single-tooth implants placed in fresh extraction sites.

Adult↗
PubMed1991

Analysis of an emergency dental service provided at a children's hospital.

An analysis was undertaken of the evening, weekend and public-holiday emergency dental service provided at the Royal Belfast Hospital for Sick Children during one calender year (1987). Dental emergencies accounted for 4% of all attendances during these periods at the Accident & Emergency Department. Toothache, with or without abscess, was the most frequent dental complaint (49%) and abscesses were most frequently associated with primary first molars. Acute trauma was the second most frequent dental complaint (39%) and traumatic injuries were most commonly caused by falls and bicycle accidents. Tooth displacement was was the most common dental injury of primary and permanent teeth. Complaints other than toothache, abscess or traumatic injury accounted for only 12% of dental emergencies.

Abscess↗
PubMed1996

An unusual dental cause of nasal discharge: a case report.

A case is reported of an unusual cause of localized nasal discharge. A 6-year-old girl presented complaining of pain and discharge from the left nostril. Clinical and radiological evaluation revealed the cause of the symptoms to be a previously asymptomatic intruded primary incisor on the floor of the nasal cavity. The tooth was removed under general anaesthesia and healing occurred without complication.

Child↗