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Raza MA, Khan JA, Akhtar H, Farooqui WA, Faraz H, Hasan A. Comparison of two composite resin materials for splinting of dental luxation injuries: A double blind randomized controlled trial. Dent Traumatol 2024; 40:44-53. [PMID: 37615239 DOI: 10.1111/edt.12883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/11/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND/AIM Luxation is a common traumatic dental injury treated with a wire composite (WC) splint. However, bulk-fill flowable composite and conventional packable composite have not been compared for retaining these splints. Therefore, the objectives of this randomized controlled trial were (1) to compare retention of WC splints, and (2) to compare adhesive point dimension, application and removal time, and effect on tooth mobility between the two WC splints. MATERIALS AND METHODS In this parallel group, non-inferiority double blind randomized controlled trial, a total of 90 patients, aged 16-50 years participated. They were randomly allocated into two groups, the packable composite group (PC) n = 45 and the bulk-fill flowable composite group (BF-FC) n = 45 by lottery method. Following measurements were taken at the splint application appointment. Horizontal tooth mobility measured via Periotest, splint application time, and frontal images of splinted teeth to measure the percentage composite adhesive point area. After 2 weeks, splints were visually inspected for retention, whereas mobility and removal times were also recorded. Statistically, comparisons were made using independent samples sample T-test, Fisher's exact test, and Mann-Whitney U at p ≤ .05. RESULTS A total of 88 patients with 156 luxated teeth completed the trial, as two patients were lost to follow-up. Two patients in the PC group reported with completely de-bonded splints while none de-bonded in the BF-FC group. Both groups were similar in terms of splint retention (p = .352), reduction of mobility (p = .426), and splint removal times (p = .372). The BF-FC group performed significantly better in adhesive point dimension percentages (p < .001) and splint application time (p < .001). CONCLUSION Both groups were comparable in most parameters of the study. However, for BF-FC group application time and adhesive point dimension were significantly less.
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Affiliation(s)
- Misbah Ali Raza
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | - Javeria Ali Khan
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | - Hira Akhtar
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | | | - Hira Faraz
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
| | - Arshad Hasan
- Department of Operative Dentistry, Dow Dental College, Dow University of Health Sciences Baba-e-Urdu Road Karachi, Karachi, Pakistan
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Huang J, Gan Y, Li D, Xu H, Han S, Zhu H, Jia L, Li N, Chen H, Li K, Liu Y, Cai Z. Clinical applications and outcomes of the surgical tooth extrusion technique: A bibliometric analysis from 1982 to 2023. J Prosthet Dent 2023:S0022-3913(23)00630-3. [PMID: 37852858 DOI: 10.1016/j.prosdent.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023]
Abstract
STATEMENT OF PROBLEM The surgical extrusion technique has been advocated for severely damaged teeth as well as for intruded and unerupted teeth. However, a quantitative literature analysis is lacking. PURPOSE The purpose of this bibliometric analysis was to provide a comprehensive overview of surgical extrusion, assess the applications and outcomes, and evaluate topics for future research. MATERIAL AND METHODS An electronic search was conducted in leading databases in April 2023. Human studies with surgical tooth extrusion or synonyms in titles or abstracts were included. A bibliographic analysis, co-occurrence analysis, and coupling of publications were performed. The analysis of variance was used to assess the characteristics of the subgroups based on indications. The survival rate was evaluated by using the Kaplan-Meier method in the R software program (α=.05). RESULTS Fifty-one studies from 1982 to 2023 were included. The Journal of Dental Traumatology and the Journal of Prosthetic Dentistry combined published approximately one-third of the papers and acquired the most citations. The burst detection of keywords revealed 4 popular research topics: the Benex extraction system, chlorhexidine for infection control, rigid or semi-rigid splints to decrease the risk of complications, and novel restorative materials to improve esthetics. An overall survival rate of 96.36% was reported among 316 participants with 330 extruded teeth. No significant differences were found in study types, geographic distribution, year of publication, or citation counts among the 4 subgroups (surgical extrusion for subgingival fractures, extensive caries, intruded teeth, and unerupted teeth). A significant difference was observed among the Kaplan-Meier curves of the 4 subgroups (P=.030). CONCLUSIONS Surgical extrusion may be used to save otherwise nonrestorable teeth, and the procedure has shown promising survival rates when teeth are properly selected and the procedure is well executed. Subgingival fractures and extensive caries near bone level are the predominant indications, as well as intruded and unerupted teeth. Surgical extrusion is a reliable treatment option to facilitate tooth restoration for severely damaged teeth, especially for maxillary anterior teeth.
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Affiliation(s)
- Jinwei Huang
- Attending Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yena Gan
- Graduate student, Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - Duoduo Li
- Professor, Department of Tuina and Pain, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, PR China
| | - He Xu
- Associate Chief Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Sheng Han
- Director, Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, PR China
| | - He Zhu
- Assistant Research Fellow, Department of Academic Research, International Research Center for Medicinal Administration, Peking University, Beijing, PR China
| | - Lu Jia
- Lab Technician, Dental Laboratory Center, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Nan Li
- Associate Researcher, Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, PR China
| | - Huimin Chen
- Associate Chief Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Kai Li
- Attending Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ying Liu
- Attending Dentist, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Zhigang Cai
- Professor, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China..
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3
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Graf T, Stimmelmayr M, Gutmann P, Güth JF, Krennmair G, Edelhoff D, Schubert O. Forced surgical extrusion using an axial tooth extraction system as a practicable technique for preserving severely destroyed teeth? - Clinical outcomes up to 4.8 years. J ESTHET RESTOR DENT 2023; 35:1152-1161. [PMID: 37096865 DOI: 10.1111/jerd.13059] [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: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE Several extrusion techniques have been described to restore teeth with insufficient coronal tooth structure and to avoid their extraction. Still, there is little evidence for a treatment concept combining surgical extrusion using an atraumatic axial extraction system. MATERIALS AND METHODS A total of nine patients, each with an iso- or subgingival fractured tooth, were retrospectively examined. Treatment of the damaged tooth comprised an atraumatic forced surgical extrusion performed with an axial tooth extraction system and a more coronal positioning within the socket. The teeth were initially splinted and subsequently restored. The follow-up period was up to 57.1 months and averaged 36.5 (SD: ±13.5) months. RESULTS All nine teeth were still in situ, without signs of inflammation. During the period of the provisional restoration, six prosthetic complications occurred, which were resolved with little effort, whereas, success rate for the definitive restoration was 100%. No biological complications were observed concerning the root apex or soft tissue. The radiographically measured mean extrusion distance was 3.4 (SD: ±1.0) mm, so that a sufficient prosthetic ferrule could be reestablished. CONCLUSIONS Surgical extrusions using an axial tooth extraction system demonstrate low biological and prosthetic complications rates over observation time. CLINICAL SIGNIFICANCE The presented extrusion approach preserves soft and hard tissue and is an efficient treatment option for severely destroyed teeth. Saving hopeless teeth by this relatively predictable and feasible procedure has hardly any disadvantages for patients, and in case of failure, an implant or fixed partial denture are still an option.
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Affiliation(s)
- Tobias Graf
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Pauline Gutmann
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan-Frederik Güth
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Gerald Krennmair
- Dental School, Siegmund Freud University of Vienna, Vienna, Austria
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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Plotino G, Abella Sans F, Duggal MS, Grande NM, Krastl G, Nagendrababu V, Gambarini G. Present status and future directions ‐ Surgical extrusion, intentional replantation, and tooth autotransplantation. Int Endod J 2022; 55 Suppl 3:827-842. [DOI: 10.1111/iej.13723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Gianluca Plotino
- Department of Endodontics "Sapienza" ‐ University of Rome Rome Italy
| | - Francesc Abella Sans
- Department of Endodontics Universitat Internacional de Catalunya Barcelona Spain
| | - Monty S Duggal
- Faculty of Dentistry National University Health System Singapore
| | - Nicola M Grande
- Department of Endodontics Catholic University of Sacred Heart Rome Italy
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
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