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Shalish M, Abed J, Keinan D, Slutzky-Goldberg I. The consequences of orthodontic extrusion on previously intruded permanent incisors-A retrospective study. Dent Traumatol 2024; 40:54-60. [PMID: 37638617 DOI: 10.1111/edt.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023]
Abstract
AIM The aim of this study is to compare the adverse effects that occur after orthodontic extrusion of teeth that have been traumatically intruded with those of similar teeth that have not experienced any trauma. BACKGROUND The outcome of incisors intrusion can be affected by the patient's age, extent of injury, root development, and malocclusion. Orthodontic extrusion is a potential solution, but it may also cause complications. MATERIALS AND METHODS A retrospective study of the effects of extrusion of traumatically intruded teeth was carried out. The study group included 21 teeth in 14 patients. The control group included 32 teeth in 10 patients that underwent orthodontic extrusion with no history of trauma. Patients' age, gender, and stage of root development were recorded. The severity of the intrusion was classified as mild (<3 mm), moderate (3-6 mm), and severe (≥7 mm). A comparison of signs of pulp necrosis and root resorptions between the groups was made. RESULTS The central incisor is the tooth that is most injured in 80.9% of cases. A majority of these incidents involve severe intrusion, which was found in 42.9% of cases. 90% of the traumatized teeth had already lost their vitality prior to orthodontic treatment. Various forms of root resorption were observed in the study group. In the control group, 31.2% of teeth showed signs of external root resorption, but no endodontic intervention was carried out during the follow-up period, as these teeth remained vital. CONCLUSIONS Following intrusion, there is a high risk for root resorption and pulp necrosis. Orthodontic repositioning should be carried out with caution and mild force to prevent complications. Long-term follow-ups are required to ensure the best possible outcome.
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Affiliation(s)
- Miriam Shalish
- Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jawad Abed
- Department of Oral and Maxillofacial Surgery, Orthodontic Division, Baruch Padeh Medical Center Poriya, The Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
| | - David Keinan
- Department of Endodontology, The Maurice and Gabriella Golschlegger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iris Slutzky-Goldberg
- Department of Endodontics, Galilee College of Dental Sciences, The Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
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Trauma Surgery. J Oral Maxillofac Surg 2023; 81:E147-E194. [PMID: 37833022 DOI: 10.1016/j.joms.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Philip N, Nazzal H, Duggal MS. Critical appraisal of the 2020 IADT Guidelines: A personal commentary. Dent Traumatol 2023; 39:509-516. [PMID: 37408436 DOI: 10.1111/edt.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 07/07/2023]
Abstract
The 2020 International Association of Dental Traumatology (IADT) Guidelines feature several important changes in the treatment recommendations for traumatic dental injuries (TDIs) from the previous 2012 iteration of these Guidelines. This evidence-based narrative review aims to provide a detailed appraisal of five specific changes incorporated in the 2020 IADT Guidelines, based on the available literature evidence that may have prompted these changes. The paper discusses three excellent additions/changes to the new Guidelines: (i) inclusion of a core outcome set for reporting TDIs; (ii) more conservative management of primary dentition TDIs including the changed recommendations for radiation exposure and managing primary dentition luxation injuries; and (iii) the changes in the treatment recommendations for permanent dentition avulsion injuries. The paper further debates whether two other changes made in the current IADT Guidelines for-(i) intrusion injuries in immature teeth; and (ii) complicated crown-root fractures in mature teeth-have sufficient evidence to support the changed recommendations.
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Affiliation(s)
- Nebu Philip
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hani Nazzal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
- Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
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Wang N, Chen J, Zhao Y. Clinical outcomes of 79 traumatically intruded permanent teeth in Chinese children and adolescents: A retrospective study. Dent Traumatol 2019; 36:174-184. [PMID: 31638331 DOI: 10.1111/edt.12521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Nan Wang
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Peking University Beijing China
| | - Jie Chen
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Peking University Beijing China
| | - Yuming Zhao
- Department of Pediatric Dentistry Peking University School and Hospital of Stomatology Peking University Beijing China
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Diangelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A, Andersson L, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Pohl Y, Tsukiboshi M. Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations of Permanent Teeth. Dent Traumatol 2018; 39:401-411. [PMID: 22230724 DOI: 10.1111/j.1600-9657.2011.01103.x] [Citation(s) in RCA: 271] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented.
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Affiliation(s)
- Anthony J Diangelis
- Department of Dentistry, Hennepin County Medical Center and University of Minnesota School of Dentistry, Minneapolis, MN, USA;, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415, USA.
| | - Jens O Andreasen
- Center of Rare Oral Diseases, Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshopitalet, Denmark
| | - Kurt A Ebeleseder
- Department of Conservative Dentistry, Medical University Graz, Graz, Austria
| | - David J Kenny
- Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Martin Trope
- Department of Endodontics, School of Dentistry, University of Pennsylvania, Philadelphia, PA, USA
| | - Asgeir Sigurdsson
- Department of Endodontics, UNC School of Dentistry, Chapel Hill, NC, USA
| | - Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center Kuwait University, Kuwait City, Kuwait
| | | | - Marie Therese Flores
- Pediatric Dentistry, Faculty of Dentistry, Universidad de Valparaiso, Valparaiso, Chile
| | - Morris Lamar Hicks
- Department of Endodontics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | | | - Barbro Malmgren
- Department of Clinical Sciences Intervention and Technology, Division of Pediatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Alex J Moule
- Private Practice, University of Queensland, Brisbane, Australia
| | - Yango Pohl
- Department of Oral Surgery, University of Bonn, Bonn, Germany
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Soares Ditzel A, Tulio Manfron AP, Westphalen FH, da Silva Neto UX, Kowalczuck A, Carneiro E, Ditzel Westphalen VP. Management of Multiple Dental Trauma: Case Report with Eight-Year Follow-up. IRANIAN ENDODONTIC JOURNAL 2018; 13:410-412. [PMID: 30083217 PMCID: PMC6064017 DOI: 10.22037/iej.v13i3.21090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This case report documents the clinical approach adopted for two maxillary incisors with intrusion and horizontal root fracture in the middle third after trauma. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 8 years of follow-up.
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Affiliation(s)
- Alessandra Soares Ditzel
- Department of Oral Radiology, School of Life Sciences, Pontifícia Universidade Católica do Paraná. Curitiba, Paraná, Brazil
| | | | | | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Alexandre Kowalczuck
- Department of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Everdan Carneiro
- Department of Endodontics, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Spinas E, Mameli A, Giannetti L. Traumatic Dental Injuries Resulting from Sports Activities; Immediate Treatment and Five Years Follow-Up: An Observational Study. Open Dent J 2018; 12:1-10. [PMID: 29430263 PMCID: PMC5791204 DOI: 10.2174/1874210601812010001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/29/2017] [Accepted: 12/15/2017] [Indexed: 11/22/2022] Open
Abstract
Background: Traumatic dental injuries (TDIs) represent 18-30% of all oral pathologies and a considerable number of these are sports related. It is very important to treat sports-related injuries and prevent complications. However, very few studies investigate the most expedient therapeutic strategies for the treatment of dental trauma correlated to sports. Objective: The aim of this work was to focus on the average recovery time for different lesions, to assess adequate times for each athlete, to identify any association with complications and to investigate whether or not the use of mouth-guards interfered with a full recovery to normal health. Methods: This study involved a group of 30 athletes (15 male and 15 female) who had dental injuries of varying severity. For the purposes of data collection, two classifications were taken into account: a classification for hard tissue trauma and another for periodontal lesions. The athletes were subdivided in “type of lesion’ groups”.They were then treated depending on their individual lesions and followed up for 5 years. A statistical analysis was carried out to study the association between recovery time, lesion types and occurrence of complications. Results: The time for recovery was different for each type of lesion and ranged from 3-5 days (only uncomplicated fractures) to 14 days (all hard-periodontal tissue traumas). The total number of recorded pulp complications amounted to 6 cases. Among 30 athletes, 20 had begun and maintained, during the five-year follow-up period, the habit of using mouth-guards when practicing their sport activities. Conclusions: Recovery time and the severity of lesions are statistically associated: the more serious the injury, the more time an athlete needs to recover and return to competitive sports events. Furthermore, recovery time and precautionary measures (mouth-guards) did not influence the onset of complications. The subjects’ habit of wearing a mouth guard continued even after the end of the therapy and follow-up periods.
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Affiliation(s)
- Enrico Spinas
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - Antonello Mameli
- Department of Surgical Sciences, Sports Dental Research Center, University of Cagliari, Cagliari, Italy
| | - Luca Giannetti
- Department of Surgical Sciences, Pedodontics Division, University of Modena-Reggio, Modena, Italy
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Costa L, Ribeiro C, Cantanhede L, Santiago Júnior J, de Mendonça M, Pereira A. Treatments for intrusive luxation in permanent teeth: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2017; 46:214-229. [DOI: 10.1016/j.ijom.2016.08.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 08/24/2016] [Accepted: 08/31/2016] [Indexed: 11/27/2022]
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Rocha Lima TF, Nagata JY, de Souza-Filho FJ, de Jesus Soares A. Post-traumatic complications of severe luxations and replanted teeth. J Contemp Dent Pract 2015; 16:13-19. [PMID: 25876944 DOI: 10.5005/jp-journals-10024-1628] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The aim of this study was to evaluate the main post-traumatic complications of severe luxation and replanted teeth using clinical and radiographic analyses. MATERIALS AND METHODS Eighty-three patients aged between 7 and 55 years old presenting 180 traumatized teeth that suffered extrusive luxation (n=67), lateral luxation (n=69), intrusive luxation (n=10) and tooth avulsion (n=34) followed by replantation were evaluated. The follow-up period was 24 months. The complications examined were: pulp canal obliteration, pulp necrosis and root resorption (infammatory and replacement). Furthermore, the relationship between time elapsed before receiving dental attendance and development of infammatory resorption was observed. RESULTS Pulp necrosis was the main complication, occurring in 147 teeth (82.7%). All of the teeth that suffered intrusive luxation and tooth avulsion were diagnosed with pulp necrosis, with significant difference in comparison with another traumas (p<0.001/Fisher's exact test). Infammatory root resorption was observed in 20.5% of the cases and replacement resorption was more related to tooth replantation (94.1%), showing significant prevalence among tooth luxations (p<0.001/Fisher's exact test). In addition, it was noted that patients who seek treatment 9 weeks after the trauma episode presented 10 times more chance of developing infammatory resorption when compared with patients who seek treatment soon after dental trauma (Odds ratio test). CONCLUSION It may be concluded that pulp necrosis was the main post-traumatic complication observed in traumatized teeth and that delay in seeking treatment may damage the prognosis of severe luxation and replanted teeth. CLINICAL SIGNIFICANCE Clinical studies describing the main complications that may affect traumatized teeth present great relevance to make the population aware of the importance of seeking immediate treatment and to alert the professional to the need for follow-up. When traumatic injuries are diagnosed and treated early, post-traumatic complications may be controlled, allowing conservation of the tooth in oral cavity.
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Affiliation(s)
- Thiago Farias Rocha Lima
- Professor Department of Restorative Dentistry, Endodontics Area Federal University of Paraíba, João Pessoa, Paraiba, Brazil Phone: 982226564, e-mail:
| | | | - Francisco José de Souza-Filho
- Department of Restorative Dentistry, Endodontics Area Piracicaba Dental School, State University of Campinas Piracicaba, Brazil
| | - Adriana de Jesus Soares
- Department of Restorative Dentistry, Endodontics Area Piracicaba Dental School, State University of Campinas Piracicaba, Brazil
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AlKhalifa JD, AlAzemi AA. Intrusive luxation of permanent teeth: a systematic review of factors important for treatment decision-making. Dent Traumatol 2014; 30:169-75. [DOI: 10.1111/edt.12104] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Jasem Dawood AlKhalifa
- Ministry of Health - Internship in General Dentistry; Planning and Training Oral Health Services Dental Administration, Rumaithiya Kuwait
| | - Abdulaziz A. AlAzemi
- Ministry of Health - Internship in General Dentistry; Planning and Training Oral Health Services Dental Administration, Rumaithiya Kuwait
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Tsilingaridis G, Malmgren B, Andreasen JO, Malmgren O. Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. Dent Traumatol 2011; 28:416-22. [DOI: 10.1111/j.1600-9657.2011.01088.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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