Relationship between Initial Attendance after Dental Trauma and Development of External Inflammatory Root Resorption.

Thiago Farias Rocha Lima,Alexandre Augusto Zaia,Adriana De Jesus Soares,José Flávio Affonso De Almeida,Emmanuel João Nogueira Leal Da Silva,Brenda Paula Figueiredo De Almeida Gomes

doi:10.1590/0103-6440201701299

Abstract

This clinical study aimed to evaluate the relationship of the delay between dental trauma and the initial attendance to the development of external inflammatory root resorption in permanent teeth affected by severe luxation. Sixty-seven patients, aged between 11 and 56 years, presenting 133 injured teeth with closed apex (56 extrusive luxation, 69 lateral luxation and 8 intrusive luxation) were followed up for a minimum of 24 months. The time elapsed between dental trauma and the initial attendance was recorded. The presence of necrotic pulp and external inflammatory resorption for each type of trauma was verified. Fisher's exact test was used to verify the influence of the initial attendance date at the Dental Trauma Center and the development of inflammatory resorption (p<0.05). The odds ratio was used to check the risk of developing external inflammatory resorption due to delay in seeking treatment. Pulp necrosis was observed in 105 teeth (78.9%) and external inflammatory resorption was detected in 17.8% cases of extrusive luxation (10 teeth), 15.9% of lateral luxation (11 teeth) and 25% of intrusive luxation (2 teeth). For lateral luxation, extended delay between the date of injury and initial attendance influenced the occurrence of external inflammatory resorption (p=0.0174). Patients who began treatment 45 days after the injury were 3.4 times more likely to develop external inflammatory resorption than patients who sought treatment after the trauma. Treatment late after the occurrence of dental trauma can impair the prognosis and result in the development of external inflammatory resorption in luxated teeth.

Highlights

Dental trauma is considered a public health problem worldwide, affecting 4-33% of the population [1,2,3]
The date of initial attendance and treatment was found to influence the development of inflammatory resorption in lateral luxation (p=0.0174) (Table 3)
The present study evaluated the occurrence of pulp necrosis and external inflammatory resorption in cases of dental luxation which, like avulsion, is considered a more severe type of trauma

Summary

Introduction

Dental trauma is considered a public health problem worldwide, affecting 4-33% of the population [1,2,3]. Root resorption occurs as a result of clastic cells acting on the tooth surface. This process can be physiological like, for example, resorption of deciduous teeth, or pathological, especially in cases of excessive orthodontic movement, dental trauma and in the presence of periapical lesions [11,12,13]. Among the types of pathological resorption, external inflammatory resorption is the most commonly diagnosed and result in destruction of root cementum and dentin [13,14]. Progression of these lesions may lead to tooth loss

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