Abstract
(1) Background: Treating dental luxation injuries is challenging for the clinician. Dental luxations account for 18–33% of injuries to permanent teeth and can be addressed using different therapeutic approaches. The present work was conducted with two aims: (i) to evaluate, through a scoping review, current knowledge of the orthodontic methods (repositioning and stabilization splinting) that can be used at the time of the trauma, and (ii) to investigate the frequency and type of pulp consequences arising after these traumatic injuries. (2) Methods: The literature search was conducted in the period June 2020–December 2020 using the PubMed/MEDLINE, SCOPUS and Web of Science databases. The research questions were formulated according to the PICO (Population, Intervention, Comparison, Outcomes) method and considered the following aspects: type of luxation injury and stage of root development; use of orthodontic repositioning and splinting techniques; frequency and type of pulp consequences; and compliance of treatments with international guidelines. (3) Results: The initial screening of the databases, using the selected search keywords, yielded a total of 587 articles, just 8 fully met the inclusion criteria. Closer analysis of these 8 publications revealed that they would not produce clear meta-analytical data. This made it necessary to limit the data collected to the following six items: number and type of injuries, initial therapeutic intervention, duration of follow-up, number, and type of different pulp consequences. (4) Conclusions: While orthodontic techniques are commonly used to treat dental intrusions, in the case of extrusive and lateral luxation injuries, they are less frequently used and the orthodontic approach is generally confined to the stabilization phase. Among the various possible pulp consequences, many authors consider only pulp canal obliteration (PCO) and pulp necrosis (PN), often tending to overlook physiological healing (pulp survival) and the possible development of PN after PCO. There is therefore a clear need for new, high-quality clinical studies of this topic based on systematic and standardized data collection.
Highlights
We examined the pulp consequences of these traumatic events and their distribution between teeth with open apex (OA) versus closed apex (CA); we analyzed the frequency with which traumatized teeth showed different outcomes: pulp canal obliteration (PCO), pulp necrosis (PN), physiological healing, and PN after PCO
We considered the number of cases of PCO and of PN in teeth affected by intrusive, extrusive, and lateral luxations; we considered the number of teeth that showed physiological healing and the appearance of PN after PCO in the three types of trauma
The benefits of orthodontic repositioning are linked to three key factors: (a) the application of extremely light and controlled forces; (b) the tissue reorganization permitted by the application of light forces [26,28]; and (c) the fact that there is no need for local anesthesia
Summary
Epidemiological studies show that 10.5–17.3% [1,2] of people suffer traumatic injuries to their teeth. These injuries can occur at any age, but youngsters aged 11–15 years are the group most frequently affected, accounting for around 13% of cases [3]. Luxation involving the pulp and/or supporting tissue constitutes a severe dental trauma and accounts for. 18–33% [4,5] of injuries to permanent teeth. A luxation is a “displacement of a tooth from its original position in the alveolus, without total avulsion, resulting from acute trauma” [6] and it can be intrusive, extrusive, or lateral
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