Abstract
(1) Background: The purpose of this study was to analyze the influence of the chosen diagnostic and therapeutic approach (repositioning and splinting methods) on the risk, frequency and timing of the onset of pulp canal obliteration and pulp necrosis following extrusive luxation in young patients with permanent dentition. (2) Methods: From an initial sample of 50 subjects affected by extrusive luxation, were selected the clinical data of 13 patients presenting extrusive luxation but no other type of injury to the dental hard tissue. All teeth were examined according to a standardized protocol. Follow-up examinations were performed at regular intervals for 5 years. Statistical associations between pulp consequences and several covariates were assessed using the Mann–Whitney test and Fisher’s exact test. (3) Results: Among the 13 studied teeth, only 1 healed completely, whereas 9 showed pulp obliteration and 3 developed pulp necrosis. No tooth with obliteration developed pulp necrosis. The average time to treatment was 11.9 h. The treatment approaches used were manual repositioning, orthodontic repositioning and stabilization splinting. “Time to treatment” was the only covariate that showed a weak statistical association with the onset of pulp consequences. (4) Conclusions: There is still uncertainty over the most appropriate therapeutic approach to adopt in young patients with extrusive luxation injuries, particularly for repositioning of the injured tooth. Extruded teeth should be treated as soon as possible after the traumatic event. This study highlighted the value of orthodontic repositioning of the extruded tooth, which does not seem to aggravate the conditions of the dental pulp. In addition, the study confirmed that prophylactic endodontic treatment is not appropriate for immature teeth affected by extrusive luxation injuries, given the extreme rarity of pulp necrosis in teeth already affected by pulp obliteration.
Highlights
IntroductionIn 18–33% [3,4] of cases there is damage to pulp and/or supporting tissue
Traumatic injuries to permanent teeth are common, affecting 10.5–17.3% [1,2] of the population.In 18–33% [3,4] of cases there is damage to pulp and/or supporting tissue
This study highlighted the value of orthodontic repositioning of the extruded tooth, which does not seem to aggravate the conditions of the dental pulp
Summary
In 18–33% [3,4] of cases there is damage to pulp and/or supporting tissue. Lateral luxation and intrusion are among the most serious types of dental trauma. Few studies have focused on extrusion, which has been reported to account for around 3% of all cases of traumatic dental injury [5]. Extrusive luxation injuries are caused by the action of an oblique force, and they are characterized by high mobility and partial dislocation of the tooth outside its socket [6]. The apical and lateral parts of the socket appear empty [11] and, overall, the periodontal ligament space is enlarged [5,6]
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