Management and Sequelae of Intruded Anterior Primary Teeth: A Systematic Review

Oral Rehabilitation of a Child Superimposed with Tooth Impaction and Ranula

Introduction

Dental impaction may be due to several etiological factors, including genetic conditions, lack of space, failure of primary tooth resorption and prolonged retention of these teeth, presence of intraosseous cysts, and trauma in the region. The ranula is a mucus-filled cyst-like mass that usually originates from extravasation of mucus from the sublingual gland.

Case description

A 7-year-old Saudi female presented to the pediatric dental clinic at Prince Mohammed Bin Abdulaziz Hospital (PMBAH), Al-Madinah al-Munawwarah, Saudi Arabia, with complicated orodental problems that were identified after clinical and radiological assessment, including the following: an intruded primary central incisor in close relation to the nasal cavity, hypodontia, hypomineralization, multiple carious teeth, abscess, and sublingual ranula. The pediatric dentistry, oral and maxillofacial surgery (OMFS), and anesthesiology teams discussed the diagnosis and treatment plan for comprehensive oral rehabilitation under general anesthesia (GA).

Conclusion

This case report highlights the crucial need for early dental screening and intervention in pediatric patients to educate the parents, prevent orodental problems, and treat the current complaints. It also shows the importance of a multidisciplinary approach in such cases to reach an ideal treatment plan and results.

Clinical significance

The potential for pain, difficulty chewing, malalignment of surrounding teeth, and the risk of infection or cyst formation if left untreated.

How to cite this article

Ghulman R, Kabadaya M, Al-Blowi RH, et al. Oral Rehabilitation of a Child Superimposed with Tooth Impaction and Ranula. Int J Clin Pediatr Dent 2024;17(9):1057-1062.

Factors associated with the survival of primary maxillary anterior teeth after intrusive luxation: a retrospective longitudinal study

PURPOSE

To evaluate the survival rate of primary maxillary anterior teeth following intrusive luxation and identify associated factors.

METHODS

A retrospective longitudinal study was conducted at a primary dental trauma centre using 88 dental records of children with intrusive luxation between 2007 and 2018. The variables of interest were time the tooth remained in the alveolus, degree of intrusion, accentuated overjet, lip protection, visible plaque, compromised germ of the permanent successor, clinical signs of infectious and inflammatory processes, endodontic treatment, pulp canal obliteration, sex, age at the time of trauma, family income, mother's schooling, and immediate care. Descriptive, bivariate, and Cox regression analyses were performed (p < 0.05; 95% CI).

RESULTS

The 88 dental records of children with intrusive luxation included 128 teeth. Survival rate throughout the follow-up period was 65.6% (n = 84). Age older than three years and eight months (HR 2.28; 95% CI 1.04-4.99; p = 0.039), the development of an infectious process (HR 3.51; 95% CI 1.39-8.86; p = 0.008), development of an inflammatory process (HR 2.35; 95% CI 1.17-4.71; p = 0.016) and compromised germ of the permanent successor (HR 4.38; 95% CI 1.99-9.61; p < 0.001) were associated with a lower survival rate of intruded primary maxillary anterior teeth.

CONCLUSION

The survival rate during the follow-up period of intruded primary maxillary anterior teeth was considered high. A significantly lower survival rate was associated with age, the occurrence of an infectious process and inflammatory process, and the compromised germ of the permanent successor.

Long-Term Sequalae of Undiagnosed Intrusion of a Primary Tooth

Aims: This case demonstrates the adverse sequelae that can follow a traumatic dental injury at a young age. It also highlights the importance of taking a full history and undertaking a thorough exam, independent of the information in the referral. Case presentation: A 9-year-old boy was referred for treatment of “an extra tooth” and “hypoplastic and non-vital” maxillary left permanent incisors. Examination revealed a sinus tract labial to these incisors (21,22) with increased probing depth. However, the teeth were otherwise normal. The child sustained a fall as a baby and lost one of his primary teeth that was never recovered. Information collected suggested the most likely diagnosis was an undiagnosed complete intrusion of a primary incisor, with subsequent hypoplasia and malalignment in the developing teeth. Management included the removal of the intruded primary tooth and monitoring of the hypoplastic permanent incisors until complete eruption and root maturation. Aesthetic restorations were then provided. The patient was referred for orthodontic correction of the malalignment. Conclusion: Misdiagnosis and inappropriate management of dental trauma can cause additional damage. In this case, endodontic therapy in the permanent incisors was avoided by correct diagnosis. Clinicians have to correctly assess and justify their decisions on each individual case.

Evidence mapping and quality assessment of systematic reviews in dental traumatology

BACKGROUND/AIMS

Evidence mapping of systematic reviews (SRs) systematically and comprehensively identifies, organizes, and summarizes the distribution of scientific evidence in a field. The aims of this study were to delineate domains in dental traumatology (DT), evaluate the existing SRs within the domains, and identify the paucity of evidence for future research.

METHODS

Domains and sub-domains of DT were established according to the methods of qualitative research. The protocol for evidence mapping was prepared as per the guidelines of GEM and PRISMA. The search strategy was formulated using words and MeSH terms in eight databases without restriction of languages and year of publication. Gray literature, protocol registries, and references of selected articles were also searched. Duplicates were removed, and the final selection of SRs was completed. Data extraction and quality analysis using the ROBIS tool and the PRISMA checklist were performed.

RESULTS

The overall search resulted in 64 SRs from 1999 to 2020 with 44 published in last six years. The highest number of SRs had been performed in the Prognostic domain (n = 19) followed by the domains of Epidemiology (n = 15), Therapeutics (n = 10), Oral Biology (n = 7), Diagnostics (n = 6), Preventive (n = 5), and Research Methods (n = 2). Within each domain, there were variabilities in the number of reviewers, a priori protocols, search limitations, risk of bias methods, and meta-analysis. Of the SRs, including 4 Cochrane reviews, 28.4% were inconclusive. A low risk of bias was found in 48.4% of the SRs. Among the registered and ongoing SRs, six were from the domain of epidemiology, two in the domain of therapeutics, five from prognostics, and one each in the domains of prevention and research methods.

CONCLUSION

The SRs in DT could be mapped in seven domains with variabilities in the methods. The majority had an a priori registered protocol and a low risk of reporting errors. Within the Epidemiology and Preventive domains, SRs were present in all the sub-domains with the majority demonstrating low-risk of bias (ROB). The domain of prognosis had SRs in most sub-domains but with a high ROB. Insufficient numbers of SRs were present in most sub-domains of the Diagnostics, Therapeutics, Research Methods and Oral Biology domains.

Sequelae in permanent teeth after traumatic injuries to primary dentition

Traumatic injuries to the primary dentition are critical events in dentistry not only due to the need for urgent care, but also since they have potential sequelae in the permanent dentition, with a prevalence ranging from 12% to 74%. The aim of this article was to provide an overview of the prevalence, etiology, and clinical and radiographic characteristics as well as the management of permanent teeth sequelae resulting from traumatic injuries to their deciduous predecessors. An extensive literature review was performed to reveal the current evidence on enamel discoloration with or without hypomineralization/hypoplasia, crown dilaceration, odontoma-like malformation, root anomalies, partial or complete arrest of root formation, sequestration of the permanent tooth germ, and eruption disturbances.