Periodontal healing complications following concussion and subluxation injuries in the permanent dentition: a longitudinal cohort study

Abstract

The purpose of the study was to analyze the risk of periodontal ligament (PDL) healing complications following concussion and subluxation injuries in the permanent dentition. A total 469 permanent teeth (358 patients) with concussion and 404 permanent teeth with subluxation were included in the study. All teeth were examined according to a standardized protocol including clinical, photographic, and radiographic registration. The risk of repair-related resorption (surface resorption), infection-related resorption (inflammatory resorption), replacement-related resorption (ankylosis), marginal bone loss, and tooth loss were analyzed with the Kaplan-Meier method. Concussion: In teeth with immature root development, no healing complications were observed. For teeth with mature root development, the risk of repair related resorption after 3 years was 3.2% (95% CI: 0.3-6.0%) and occurred only in cases where several teeth were injured simultaneously (multiple-trauma cases). The risk of marginal bone loss in teeth with mature root development was 0.7% (95% CI: 0-1.6%). Infection-related resorption, replacement resorption, and tooth loss were not observed among teeth with concussion. Subluxation: In teeth with immature root development, the risk of infection-related resorption after 3 years was 1.7% [95% confidence interval (CI): 0-3.8%]. Infection-related resorption occurred significantly more often in teeth with concomitant crown fracture (P = 0.004). For teeth with mature root development, the risk of periodontal healing complications after 3 years was: repair-related resorption, 3.6% (95% CI: 0-7.6%); infection-related resorption, 0.6% (95% CI: 0-1.7%); replacement-related resorption, 0.6% (95% CI: 0-1.7%); and marginal bone loss, 0.6% (95% CI: 0-1.7%). No teeth were lost in the observation period. The risk of periodontal healing complications after concussion as well as subluxation injuries in permanent teeth is very low.