Pulp aspects of traumatic dental injuries in primary incisors: Dark coronal discoloration

Effectiveness evaluation of autotransplanted teeth after performing extraoral endodontic surgery instead of conventional root canal therapy

PURPOSE

The aim of this study was to examine the viability and efficacy of utilizing extraoral apicoectomy and retrograde filling in combination to seal the root canal system of mature molars without the need for root canal therapy (RCT) during the autotransplantation of teeth (ATT).

MATERIALS AND METHODS

This study screened 27 patients who received ATT at the Department of Oral Surgery in the Hospital of Stomatology from 2019 to 2021. Extraoral apicoectomy and retrograde filling were performed, while RCT was temporarily not performed. The study analysed the periodontal status and masticatory function of transplanted teeth one to three years postoperation and used cone-beam computed tomography (CBCT) and periapical radiograph (PA) to evaluate the integrity of the periodontal space and intra/periapical inflammation. The potential predictors of survival/success were analysed statistically. We also conducted questionnaires and chewing efficiency tests.

RESULTS

In this study, 27 TTs from 27 patients were found to be fully functional in terms of chewing ability. The overall survival rate was 100% (27/27), and the success rate was 70.4% (19/27). A total of 90.9% (20/22) of patients reported being satisfied or very satisfied with their TTs. Additionally, the chewing efficiency of the transplantation side was on average 82.0% of that of the healthy side, with a significant difference between the two sides (P < 0.05). None of the potential predictors were found to significantly affect the success or survival of the transplanted tooth (TT).

CONCLUSION

The combination of extraoral apicoectomy and retrograde filling in TT showed promising outcomes, but further clinical cases and longer follow-up times are still required to validate the treatment plan.

Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, part 2: dental injury types, treatment strategies, and complications

OBJECTIVES

This article focuses on treatments and complications in patients presenting dental trauma in primary teeth. Treatment alternatives begin with the decision of performing a procedure under clinical settings or pharmacological techniques (PC) in young children. Correct diagnosis and treatment are crucial to maximize the chances of a favorable outcome.

MATERIALS AND METHODS

The files of 320 patients aged 0-9 years who presented to the Erciyes University Faculty of Dentistry Department for dental trauma management in primary teeth were evaluated in between 2018 and 2021 for 3-year period. The following information were extracted from patients' records: injury type, affected teeth, caries condition of the teeth, treatment preferences of the dentists. Additionally postoperative complications and their management were evaluated.

RESULTS

While 63.1% of the traumatized teeth were caries-free, 35.8% of the teeth had caries. The most frequent dental injuries was simple crown fractures (42.9%), followed by complicated crown fractures (38.5%). Treatments were mostly done in clinical conditions (67.9%) and mostly patients attend regularly to follow-up visits (85.6%). Clinicians prefer more radical treatments under sedation or GA (92.4% extraction of injured tooth). Coronal discoloration was the most common complication, and 35.3% had pulp necrosis for longer term results.

CONCLUSION

Follow-up decisions made after concussion in the primary teeth might be appropriate for the patient. Examination of the complication status of primary teeth with simple crown fracture injury revealed that 59.5% of patients did not have any complications. Follow-up decisions were found to be appropriate for crowns with coloration alone.

CLINICAL RELEVANCE

All options should be considered to provide the best care for children after primary tooth trauma; this can be achieved by being informed about the treatment and its consequences, and if necessary, a positive prognosis can be achieved with an interdisciplinary approach.