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At least 343 records · Page 19Linked to original sources
PubMed2005

Treatment of a severe dental lateral luxation associated with extrusion in an 8-month-old baby: a conservative approach.

This case report documents the trauma and follow-up care of lateral luxation associated with extrusion of the lower central incisors in an 8-month-old patient. The teeth were repositioned by digital pressure and stabilized using proximal sutures. Clinical and radiographic follow-up 40 months after the injury showed alterations in both incisors, but both remained functional and free of pathology.

Female↗
PubMed2005

Conservative treatment for root fracture located very close to gingiva.

When a root fracture is located very close to the gingiva, the chance of healing with calcified tissue is poorest. Therefore, a preferable treatment is usually thought to be the removal of the coronal fragment and subsequent orthodontic or surgical extrusion of remaining apical fragment. This case report describes conservative treatment for root fracture located very close to the gingiva. The treatment of root fracture was by repositioning and fixation. A 7-years follow-up showed healing with calcified tissue and pulp canal obliteration.

Accidental Falls↗
PubMed2004

Healing of 400 intra-alveolar root fractures. 1. Effect of pre-injury and injury factors such as sex, age, stage of root development, fracture type, location of fracture and severity of dislocation.

This retrospective study consisted of 400 root-fractured, splinted or non-splinted incisors in young individuals aged 7-17 years (mean = 11.5 +/- 2.7 SD) who were treated in the period 1959-1995 at the Department of Pediatric Dentistry, Eastman Dental Institute, Stockholm. Four hundred of these root fractures were diagnosed at the time of injury; and 344 teeth were splinted with either cap-splints, orthodontic appliances, bonded metal wires, proximal bonding with composite resin or bonding with a Kevlar or glass fiber splint. In 56 teeth, no splinting was carried out for various reasons. In the present study, only pre-injury and injury factors were analyzed. In a second study, treatment variables will be analyzed. The average observation period was 3.1 years +/- 2.6 SD. The clinical and radiographic findings showed that 120 teeth out of 400 teeth (30%) had healed by hard tissue fusion of the fragments. Interposition of periodontal ligament (PDL) and bone between fragments was found in 22 teeth (5%), whereas interposition of PDL alone was found in 170 teeth (43%). Finally, non-healing, with pulp necrosis and inflammatory changes between fragments, was seen in 88 teeth (22%). In a univariate and multivariate stratified analysis, a series of clinical factors were analyzed for their relation to the healing outcome with respect to pulp healing vs. pulp necrosis and type of healing (hard tissue vs. interposition of bone and/or PDL or pulp necrosis). Young age, immature root formation and positive pulp sensibility at the time of injury were found to be significantly and positively related to both pulpal healing and hard tissue repair of the fracture. The same applied to concussion or subluxation (i.e. no displacement) of the coronal fragment compared to extrusion or lateral luxation (i.e. displacement). Furthermore, no mobility vs. mobility of the coronal fragment. Healing was progressively worsened with increased millimeter diastasis between fragments. Sex was a significant factor, as girls showed more frequent hard tissue healing than boys. This relationship could possibly be explained by the fact that girls experienced trauma at an earlier age (i.e. with more immature root formation) and their traumas were of a less severe nature. Thus, the pre-injury or injury factors which had the greatest influence upon healing (i.e. whether hard tissue fusion or pulp necrosis) were: age, stage of root development (i.e. the size of the pulpal lumen at the fracture site) and mobility of the coronal fragment, dislocation of the coronal fragment and diastasis between fragments (i.e. rupture or stretching of the pulp at the fracture site).

Adolescent↗
PubMed2004

Diagnostic characteristics of pulpal blood flow levels associated with adverse outcomes 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 significant PBF reduction. The purpose of this study was (i) to describe PBF characteristics of teeth with specific clinical outcomes, and (ii) to demonstrate diagnostic characteristics for different threshold PBF values for detection of specific multiple adverse outcomes. In 80 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous control tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in two sessions, on the day of splint removal (session I), and 12 weeks after splint removal (session II). The ability of session II-related PBF measurements at 2.9, 6.4 and 9.9 PU levels to identify adverse outcomes occurring 36 weeks after splint removal was investigated. Adverse outcomes were classified as type I (loss of sensitivity), type II (periapical radiolucency), type III (grey discolouration), type IV (loss of sensitivity and periapical radiolucency), and type V (loss of sensitivity, periapical radiolucency and grey discolouration of crown). Receiver-operator characteristic (ROC) curves were used to evaluate the sensitivity and specificity of PBF assessments. There was a significant increase in PBF values from session I to session II (P=0.0001) for teeth without an adverse outcome, while teeth affected by a type II-V outcome showed a significant decrease in PBF values (P <0.05). PBF measurements did not change over time for the contralateral incisors (P >0.05). A type IV and V outcome occurred in 21 and 24% of the instances, respectively. The PBF of 2.9 PU demonstrated a sensitivity of 70% and a specificity of 93% for type V outcomes. The best likelihood ratio was found for the PBF 2.9 PU level and incisors associated with a type V outcome. The data suggest that the LDF test to be a valuable diagnostic adjunct for luxated teeth showing signs of adverse outcomes including grey discolouration or a combination of other signs. However, it may also become necessary to apply clinical decision-making methods in order to correctly evaluate the value of information gathered. The clinical implication is that LDF may become useful in the prediction of adverse outcomes at a much earlier time period than may be accomplished by standard sensitivity tests.

Adolescent↗
PubMed2005

Evaluation of intruded primary incisors.

Tooth intrusion consists of the displacement of the tooth into its alveolus and is the most common trauma during early infancy. This work aims to evaluate the aspects related to tooth intrusion in primary teeth by monitoring 16 patients (22 teeth) for a period between 3 and 36 months. Of the patients who suffered from tooth intrusion, 56.25% were male and 91% of the intruding teeth were upper central incisors. In all cases the treatment indicated was to await spontaneous re-eruption: total re-eruption occurred in 42.5% of cases, partial re-eruption in 47% of cases and in 10.5% there was no re-eruption. Twenty-three percentage of the teeth suffered necrosis, 33% suffered internal or external root resorption and none suffered root canal obliteration. Fifty-seven percentage indicated healthy pulps independent of degree of re-eruption.

Accidental Falls↗
PubMed2005

Root fracture in immature anterior teeth followed for 15 years.

We report a case of injury to an immature tooth, observed over a period of 15 years. In 1987, a 9-year-old boy fell down in a schoolyard. The right central incisor demonstrated palato-version and radiographic observations revealed that the roots of both central incisors were incomplete. Further, a root fracture in the apical region of the central incisors was observed. During the first treatment visit, the right central incisor was repositioned and both teeth splinted. After confirming that the line of fracture was aligned, the fixation was continued for 2 months. The teeth were examined periodically for the next 15 years. Both teeth had favorable outcomes with continued root development of both the apical and coronal segments with good apposition of the fracture lines.

Child↗
PubMed2005

Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 years.

The aim of this study was to evaluate etiology, types of traumatic dental injuries, treatment and to determine the incidence of complications according to dental injuries in patients who referred to Yeditepe University, Faculty of Dentistry, Istanbul, Turkey. The study was based on the clinical data of the 161 traumatized teeth in 92 patients. WHO classification slightly modified by Andreasen & Andreasen for dental trauma was used. The causes and localization of trauma, traumatized teeth classification, treatment and complications were evaluated both primary and permanent teeth. The distribution of complications according to diagnosis and treatment of the injured teeth were evaluated. Of 35 (38%) girls and 56 (72%) boys with a mean age 7.6 +/- 3.5 (ranging 1-14.2) participated to study and the mean followed up was 1.72 +/- 1.28 years (ranging 0.10-3.8 years). From the 161 affected teeth, 69 (42.9%) were in primary teeth and 92 (57.1%) in permanent teeth. The highest frequency of trauma occurred in the 6-12 year age group. Overall boys significantly outnumbered girls by approximately 1:1.6. The most common type of injury in the primary and permanent teeth was seen as luxation (38%) and enamel fracture (20%) of the maxillary central incisors, respectively. Falls were the major sources of trauma both the primary (90%) and the permanent teeth (84%). In the primary dentition, the most common type of soft tissue injury is contusion (62.5%) and in the permanent dentition, it is laceration (49%). The most of the treatment choice was determined as examination only and extraction in primary teeth (58 and 24.6%, respectively) while it was applied as restoration and pulpectomy in permanent teeth (31.5 and 18.5%, respectively). Complications were recorded on 37 teeth (23%) with a most common type of necrosis (10.5%) and dental abscess (7.4%). Necrosis was more frequent in luxation whereas dental abscess were in crown fracture with pulpal involvement in both dentitions. The study showed that boys were more prone to dental traumas than girls. Falls were more frequent trauma type with a high complication risk. It reveals that the time of the immediate treatment showed the important predisposing factors that increase the success of treatment and decrease the risk of complication. The correct diagnosis of dental injuries is more important for eliminating the occurrence of complications.

Abscess↗
PubMed2005

Level of information concerning dental injuries and their prevention in Swiss basketball--a survey among players and coaches.

Basketball carries a medium risk of dental injuries. Swiss data are not available in this respect. Using a standardized questionnaire 302 basketball players from 29 Swiss teams and their 29 coaches were interviewed. The questions focused on the frequency of dental accidents, their prevention and subsequent procedure. The participating 302 players came from three divisions: semi-professional players of National League A and B (102), amateurs of Regional League 2 and 3 (100) and young people of up to the age of 18 (100). The data were evaluated in relation to division, sex and team function. Of the 331 interviewed persons 102 had already seen a dental trauma in basketball and 55 had already had a dental trauma. Only four of the interviewed persons wore mouthguards. The awareness of the procedure following a dental trauma was unsatisfactory. The results of the survey show that significantly more information and education is required in Swiss basketball not only through sports associations but also through coaches and dentists.

Adolescent↗
PubMed2005

Evaluation of dental injury following endotracheal intubation using the Periotest technique.

The hazards of damage to teeth and their periodontal attachment during tracheal intubation are well known. Dental trauma represents the commonest single reason for complaints against anesthesiologists. In order to predict the possible risk of perianesthetic iatrogenic tooth luxation we evaluated the use of a measuring method (Periotest technique), being well established for the diagnosis of periodontal disease. In 120 patients undergoing elective surgery, we compared the amount of tooth mobility before and after general anesthesia to different scores assessing the difficulty of tracheal intubation. Furthermore, the level of work experience of the intubating anesthetist was compared with the degree of postoperative tooth mobility. Changes of periodontal attachment could not be detected by the Periotest technique. The Periotest technique does not seem to have the ability to detect early periodontal changes associated with endotracheal intubation.

Adolescent↗
PubMed2006

Immediate surgical repositioning following intrusive luxation: a case report and review of the literature.

This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing.

Child↗
PubMed2006

Traumatic injuries to the primary dentition and effects on the permanent successors - a clinical follow-up study.

This study investigated problems in the permanent dentition that, according to history and records, were attributable to dental alveolar injuries of the primary dentition. 106 children have been involved in the study, who had experienced primary anterior tooth trauma affecting a total of 200 teeth. Thirty-nine patients (81 teeth) were available for follow-up examinations. In 25% of the cases followed up, damage was found on the successors in the secondary dentition (16 children/20 teeth). In half of the cases, a comparatively mild form of lesion like enamel discoloration was observed. This was the result of an injury during the tooth maturation process causing enamel hypoplasia. Clinically more relevant were the dental deformities: cessation of root formation or retention caused by ankylosis, which made up the remaining 50% of cases. This was confirmed by clinical long-term observation. The different effects on the permanent teeth can only be detected by radiography after an interval of several months or may even be clinically assessed only after the eruption of the clinical crown.

Child↗
PubMed2006

The role for 'reminders' in dental traumatology: 3. The minimum data set that should be recorded for each type of dento-alveolar trauma - a review of existing evidence.

The aim of this study was to establish the prognostic factors recorded at the time of diagnosis or initial treatment that affect pulp and periodontal healing and tooth survival. A search strategy and quality assessment method was established to review the literature. The significant factors identified are listed for each type of dento-alveolar injury. These factors identified are the gold standard against which quality assessments of dento-alveolar trauma records can be compared and all new computer or paper-based methods for recording any type of dento-alveolar trauma should aim to record this minimum information.

Humans↗
PubMed2006

Severe sequelae of acute dental trauma in the primary dentition--a case report.

The incidence of traumatic injuries to primary teeth is high. Previous studies report frequencies ranging from 4% to 33% of all children. The damage limitation and the prevention of sequelae are goals that shall direct the treatment for dental trauma. Inappropriate approaches to dental trauma can cause more damage than the trauma itself. This article describes the diagnosis, management and follow-up of a 5-year-old boy who presented with uncommon sequelae of an inappropriate approach following a severe luxation of the primary maxillary right central incisors 2 years ago.

Child, Preschool↗
PubMed1999

Integrated orthodontic and restorative procedures for replacement of lost central incisors.

UNLABELLED: The use of adhesive material in association with many clinical procedures has contributed a great deal to solving functional and esthetic problems. Before adhesive techniques were known, dental procedures were more invasive and aggressive, especially in young patients. This article describes some integrated clinical procedures used to esthetically and functionally restore a mouth with traumatic loss of both central incisors. The treatment involved the orthodontic mesialization of the upper teeth toward the midline followed by anatomic and functional recovery through restorative dentistry. CLINICAL SIGNIFICANCE: This article describes some integrated clinical procedures that may effectively and conservatively improve the esthetic and functional results when a young patient loses the central incisors.

Child↗
PubMed2003

Transient root resorption after dental trauma: the clinician's dilemma.

UNLABELLED: The diagnostic shortcomings encountered in the clinical evaluation of pulpal and periodontal healing subsequent to trauma comprise a major problem in dental traumatology. An acute dental trauma may imply impact to the hard dental tissues and damage to the pulp and periodontium (including surrounding alveolar bone). In the case of luxation injuries, the trauma often results in rupture of the neurovascular supply at the level of the apical foramen, whereas in a root fracture, the same occurs at the level of the fracture. Conventional diagnostic criteria for pulpal status (coronal discoloration, loss of pulpal sensibility, tenderness to percussion, and radiographic change [i.e., resorption]) reflect, only indirectly, certain parameters of healing. These parameters are based empirically on clinical findings after dental caries and dental restorative techniques, where the pulp has an intact neurovascular supply apically. In these situations, long-standing bacterial or chemical attack can lead to irreversible change. In contrast, following traumatic impact, a presumably intact pulp is deprived of its neurovascular supply instantaneously. In the absence of infection, events following acute dental trauma aim at either tissue repair or regeneration. Thus, based on a series of long-term clinical studies, it was found that all conventional signs, with the exception of tenderness to percussion, could be signs of pulpal healing, as well as signs of pulpal death. Based on the results of these studies, this report discusses the significance of radiographic change (resorption) in relation to pulpal and periodontal healing following acute trauma. Moreover, implications of tooth luxation with respect to the long-term prognosis following crown, crown-root, and root fractures are discussed. CLINICAL SIGNIFICANCE: Whenever possible, it is to the patient's advantage that pulp vitality be preserved. Correct diagnostic techniques and patient selection enable the clinician to decide when endodontic therapy is appropriate and when intelligent observation is the "treatment" of choice.

Dental Pulp↗
PubMed1998

Trauma quiz. Terribly troublesome, trauma teeth.

Unfortunately, we come across many traumatised teeth during our practising career. Some of these traumatic injuries are rather simple to treat whereas others provide us with a real challenge. It is absolutely essential that the diagnosis of the injury be known before any treatment is attempted. When it comes to trauma, however, defining the exact form of treatment can often be very difficult. In this paper I will discuss some of the cases that I have managed and leave it up to YOU to decide whether my treatment has been correct, incorrect or whether there is some other form of treatment that we have at our disposal that could have been attempted.

Adolescent↗