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Evaluation of the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil.

Tooth avulsion is common in children, and emergency management in these cases is critical. This management can be made, not only by a dentist but by people who are present where the accident occurs. Consequently, knowledge of tooth avulsion is fundamental for school professionals working with children. The purpose of the present study was to evaluate the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil. For that purpose a questionnaire, including questions regarding emergency procedures for tooth avulsion, was answered by 117 teachers. The results demonstrated that 75.2% of school professionals knew the importance of emergency management and 60.6% would look for a dentist for treatment of the cases; 18.8% would reimplant the tooth and 7.6% would keep it in milk. This study showed the lack of knowledge of teachers on tooth avulsion; educational campaigns are necessary to improve the emergency management of tooth avulsion.

Adult↗

[Autografts and tooth transplants. Operative indications].

In order to evaluate the prognosis in tooth transplant procedure the literature on this subject was reviewed. The survival of the periodontal ligament is necessary to prevent ankylosis and root resorption. In order to obtain optimal clinical results, the following guidelines are proposed: preparation of the recipient site 2 weeks prior to graft placement, preservation of intact Pdl at time of extraction, rapid reimplantation of tooth in new socket, short term contention (2-3 weeks); endodontic therapy 8-10 weeks after tooth transplantation.

Adolescent↗

Rate of infraposition of reimplanted ankylosed incisors related to age and growth in children and adolescents.

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.

Adolescent↗

[The reimplantation of teeth avulsed by trauma].

The paper underlines the importance of the reimplantation of teeth following injury in young subjects. The positive results achieved within the short term encourage the extension of this method even to those cases with a poor prognosis (unsuitable means of conservation, long interval between injury and reimplantation). The tooth with in any case serve to retain the space until a prosthetic replacement is inserted when growth has ended.

Adolescent↗

Treatment of root perforation by intentional reimplantation: a case report.

Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. In this paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8-year follow-up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforation/instrument retrieval.

Adult↗

Endodontic treatment of reimplanted avulsed teeth.

By using an appropriate storage system such as a Save-A-Tooth and having knowledge of appropriate treatment options, an avulsed tooth can be reimplanted with the greatest chance of success. Using the different categories of avulsed teeth discussed in this article as a guide, the clinician can determine the most applicable course of treatment. If endodontic treatment is based on the clinical condition of the pulp and PDL cells, the chance of success following reimplantation is improved.

Follow-Up Studies↗

Connective tissue reattachment as related to presence or absence of alveolar bone.

The present study was designed to examine if alveolar bone, located adjacent to a root surface deprived of its periodontal ligament and cementum layer, can stimulate the reformation of a connective tissue attachment. The maxillary and mandibular incisors in 3 monkeys were extracted. Immediately after tooth extraction, the buccal root surfaces of the incisors from the left side of the jaws were planed by means of curettes to a level corresponding to half the root length. All teeth were then reimplanted into their original sockets. However, before tooth reimplantation, the buccal alveolar bone plate was removed in 2 of the monkeys to a level corresponding to half the depth of the sockets. The animals were sacrificed 6 months after the reimplantation procedure. The jaws were removed and histological sections of the experimental teeth and adjacent periodontal tissues were produced. The sections were analyzed in the microscope and subjected to histometric measurements. The results demonstrated that, irrespective of the presence or absence of alveolar bone, a fibrous reattachment failed to form on that part of the reimplanted teeth which had been deprived of their periodontal ligament. This indicates that alveolar bone located adjacent to a root surface may have limited influence on the biological conditions which determine whether periodontal healing results in connective tissue reattachment or new attachment.

Alveolar Process↗

Emergency dental care.

Health care workers in any setting who deal with children should have a basic understanding of the management of dental emergencies. Immediate action is required to reimplant the avulsed permanent tooth while primary teeth are not reimplanted. Dental infections are usually due to pulpal pathosis secondary to caries or trauma. They are managed like any other infection using drainage, antibiotics and removal of the source.

Adolescent↗

Six-year histology of an avulsed molar reimplanted in a hydroxyapatite augmented socket: a case report.

This case report deals with the histologic examination of an avulsed tooth that was reimplanted in a socket where a distal root defect was augmented with hydroxyapatite. The 6-year results showed a "repair" type of connective tissue attachment. There were areas of ankylosis present on the distal root above an area of prior cystic debridement. The hydroxyapatite particles present demonstrated biocompatibility and encapsulation by new bone growth. There was a longer junctional epithelium present on the distal root than on its mesial counterpart. Histology of the distal root demonstrated fibrous repair, ankylosis, and osseous formation around the hydroxyapatite particles. This type of result was not apparent on the mesial root, devoid of hydroxyapatite, where a "splicing" type of healing occurred in the periodontal ligament.

Adult↗

Idiopathic odontoma formation following avulsion of immature permanent incisors: two case reports.

From the findings of Case 1 and those cases reviewed in the literature it would appear that overfilling a canal with gutta percha prevents continued root formation after reimplantation of the tooth. The canal should be underfilled, therefore, if gutta percha is used as the obturating medium. Consequently, the authors recommend that calcium hydroxide be used as the root canal filling material of choice after reimplanting immature permanent teeth subsequent to traumatic avulsion. Since, however, calcium hydroxide paste tends to be resorbed, periodic refilling of the canal with the paste is required. Case 2 emphasizes the importance of periodic postoperative radiographic evaluation for several years after traumatic avulsion of immature permanent teeth.

Calcium Hydroxide↗

Common dental emergencies.

Dental caries, a bacterial disease of teeth characterized by destruction of enamel and dentine, is often the underlying cause of dental pain. When a carious lesion impinges on the dental pulp, pulpitis follows and, ultimately, necrosis of the pulp occurs. Untreated necrosis may lead to a localized abscess or a spreading infection into the surrounding soft tissue that results in cellulitis. Immediate treatment involves antibiotic therapy for cellulitis, perhaps with drainage of abscesses, while definitive treatment requires root canal therapy or extraction of the involved tooth. Pericoronitis is an inflammation of the soft tissue overlying a partially erupted tooth. Localized cases respond to irrigation. Secondary cellulitis can develop. Definitive treatment may require surgical extraction of the underlying tooth or excision of the gum flap. Avulsion of a permanent tooth secondary to trauma is a true dental emergency. The tooth should be reimplanted on the spot, and the patient should be seen immediately by a dentist for splinting and antibiotic prophylaxis. Most dental problems can be prevented with regular dental care and steps to minimize risks of oral trauma.

Abscess↗