Prognosis of replanted primary incisors after injuries

Assessment of Parents’ Knowledge and Attitudes on Emergency Management of Permanent Avulsed Teeth in Western Saudi Arabia

Objective:

One of the most common dental injuries is dental avulsion. This study, conducted in the western region of Saudi Arabia, aimed to evaluate parent’s knowledge and attitudes regarding the emergency management of avulsed permanent and deciduous teeth in children.

Methods:

A cross-sectional study was conducted among 393 parents recruited from six dental clinics and hospitals in Makkah and Jeddah, Saudi Arabia. The data were collected with a self-administered questionnaire that assesses the level of knowledge for managing deciduous and permanent avulsed teeth.

Results:

The total score for correct answers about managing permanent avulsed teeth had a mean of 4.77 and a standard deviation of 2.14 (out of 10 questions). With a permanent avulsed tooth, 35.37% were aware of dental reimplanting, 27.7% identified milk as an appropriate medium, and 57.5% would seek professional help immediately after dental trauma. Females and participants with a bachelor’s or higher degree had significantly higher levels of knowledge than males and participants with a high school or lower education. There were 28.5% of respondents who had a previous history of dental trauma for a child. A total of 62.1% knew that there is a difference in managing deciduous versus permanent teeth, but only 40.7% knew the proper management for deciduous avulsed teeth. Previous history of child dental avulsion was not found to be associated with more knowledge on managing avulsed deciduous or permanent teeth.

Conclusion:

Parents in the western region of Saudi Arabia have inadequate levels of knowledge to manage deciduous and permanent tooth avulsion. More efforts should be applied for conducting promotional health campaigns aimed at improving parents’ knowledge.

Replantation of avulsed primary teeth: a systematic review

BACKGROUND

There is little evidence regarding the risks and benefits of replantation of avulsed primary teeth.

AIM

The aim of this study was to perform a systematic review of the literature on the replantation of avulsed primary teeth, analysing the risks and benefits to help guide dentists regarding the best clinical decision-making in such cases.

DESIGN

The Medline/Pubmed, LILACS, and SciELO databases were searched for articles published in English, Portuguese, German or Spanish on the replantation of avulsed primary teeth in dental journals dating from the inception of the databases through to May 2013.

RESULTS

Among the 891 papers identified in the search, nineteen fulfilled the inclusion criteria. All 19 studies were case reports involving a total of 41 replanted primary teeth. No negative consequences to either the primary tooth or permanent successor were observed in 15 cases. Among the other 26 cases, there were negative consequences to only the replanted primary tooth in 16 cases, only the permanent successor in three cases and both the replanted primary tooth and permanent successor in seven cases.

CONCLUSION

There is a lack of high-quality studies that can help guide clinicians regarding the best approach in cases of primary tooth avulsion.

Replantation of an avulsed maxillary primary central incisor and management of dilaceration as a sequel on the permanent successor

This case report outlines the sequel and possible management of a permanent tooth traumatized through the predecessor, a maxillary right primary central incisor that was avulsed and replanted by a dentist 1 h after the trauma in a 3-year-old girl. Three years later, discoloration and fistula were present, so the primary tooth was extracted. The patient did not come to the scheduled follow-ups to perform a clinical and radiographic control of the succeeding permanent incisor, and only returned when she was 10 years old. At that moment, the impaction and dilaceration of the maxillary right permanent central incisor were observed through radiographic examination. The dilacerated permanent tooth was then surgically removed, and an esthetic fixed appliance was constructed with the crown of the extracted tooth. Positive psychological influence of the treatment on this patient was also observed.

Complications following replantation of a primary incisor: A cautionary tale

The replantation of avulsed primary incisors is contra-indicated. This case describes an 8-year-old child who six years previously had avulsed and had replanted a primary central incisor. At presentation, this tooth was retained, the permanent successor had failed to erupt and appearance of the adjacent lateral incisor was notably delayed. Investigation revealed a radicular cyst in relation to the replanted deciduous incisor together with severe displacement of the permanent tooth, which could not be saved.

Tooth replantation after traumatic avulsion: a 27-year follow up

This report presents a case of replantation of a traumatically avulsed central incisor in a 32-year-old woman. The tooth was replanted after a 30-min extra-alveolar period. Emergency unconventional immobilization was performed, using 2-0 chromic gut, and a restorative composite made Gunning-type splint. The tooth is still in place 27 years after replantation (1976 to date) without marked resorption.

Traumatic injuries in the primary dentition

As a support for the guidelines published in 2001, a review of the literature was carried out using the evidence-based approach in order to update the state of the art regarding epidemiology and treatment of traumatic dental injuries in the primary dentition. An online search in Medline, and a review of expert literature, lead to the conclusion that most luxation injuries heal spontaneously, and unless more conclusive evidence is available, conservative treatment of acute dental trauma for preschool children is suggested. Pain control, the dentist's ability to cope with the child's anxiety, and follow-up instructions in oral hygiene techniques will allow many primary teeth that are currently lost at the time of injury to be saved.

Tooth replantation after traumatic avulsion: a report of ten cases

This report compares the manner in which the avulsed tooth was handled at home versus at school, and presents the different outcomes of the replanted teeth in both groups. Eighteen of 32 avulsed teeth were not replanted, and four replanted teeth could not be followed. Thus, the material comprised 10 avulsed permanent incisors of 10 traumatized children, aged between 8 and 13 years, who were treated at the Pediatric Dental Clinic of Niigata University Dental Hospital. Half of the patients avulsed the tooth at school and the other half at or near home. Of the five teeth avulsed at school, three were kept under wet conditions. The time until their replantation ranged between 0.5 and 3.5h. Their outcomes were fairly good, except for one incisor that was extracted about 3 years later owing to the undesirable replantation procedures by the dentist. Of the avulsed teeth at or near home, three were left under dry conditions. Their time until replantation ranged scattered between 0.5 and 12h. Of these, two incisors preserved under wet conditions survived without significant root resorption. These results suggested that information about the way to keep the avulsed tooth was relatively well known to school nurse-teachers compared with parents. Depending on the kind of lay people, it appears that it is necessary to select the best way to convey information about the management of avulsed permanent teeth.