Challenges in clinical dental traumatology.

Abstract

Abstract Traumatic dental injuries are very frequent in both the primary and permanent dentition. As these often imply combined injury to both the pulp and periodontium, a variety of healing complications may arise, such as pulp necrosis, pulp canal obliteration, root resorption and loss of marginal attachment. Furthermore, trauma in the primary dentition can be transmitted to the permanent successors, leading to a variety of developmental disturbances. The analysis of the etiology of these complications has hitherto been seriously hampered by a lack of agreement on the registration of the extent of injury to the tooth and its supporting structures (i.e. trauma classification), lack of agreement on the definition of healing complications and shortcomings in the statistical analysis of follow‐up studies of traumatized primary and permanent teeth. The consequences of these shortcomings are described with respect to the evaluation of prognosis of various types of trauma. Suggestions are made for data collection and analysis of future trauma studies which should enable the identification of factors determining the outcome of traumatic dental injuries. Through a perusal of recent dental literature, various trauma entities and treatment procedures are evaluated. Furthermore, areas are outlined where present knowledge does not allow rational treatment selection or prognosis evaluation.