Treatment of avulsed immature permanent teeth in Beijing China: A retrospective comparison between 2008 and 2015.

Abstract

The diagnosis and treatment of dental trauma are developing rapidly in China. Therapeutic methods used to treat immature avulsed teeth remain a unique challenge in the clinical setting. The aim of this study was to compare the differences in the survival rate and management of avulsed teeth over two distinct periods. Forty immature permanent avulsed teeth of 34 patients (28 boys, 6 girls) were included in this study between 1 July 2008 and 30 June 2009 (group 1, 17 teeth), and 1 January 2015 and 31 December 2015 (group 2, 23 teeth). The patients' mean age was 8.8 (range 7-11) years. The follow-up period ranged from 1.5 to 10years (group 1/group 2, 1.5-10/1.5-3years). Variables such as extra-alveolar time and storage media, stage of root development, splinting type, splinting duration, endodontic treatment and management of complications were studied. The variables were analysed in relation to post-operative pulp outcomes and periodontal healing. Pulp extirpation was performed in 36 teeth within 0-14weeks (mean: 1.6+2.0). The incidence of ankylosis-related (replacement) resorption was 30.5% and that of infection-related (inflammatory) resorption was 22.5%. Pulp survival rate curves differed significantly between the two periods, indicating improvement (P<.05). Splinting type had changed between the study periods to more flexible splints. The use of storage media prior to replantation had also improved. Multivariate Cox proportional hazard regression showed a cumulative survival rate of 82.5% at 3years and 29.4% at 10years. A significant improvement was observed in the management and prognosis of avulsed teeth between 2008 and 2015.