Avulsed Permanent Teeth Research Articles

Appropriate Terminology for the Time Elapsed From Avulsion of a Permanent Tooth to Replantation: A Scoping Review and Delphi Consensus.

The prognosis of an avulsed permanent tooth depends on the time elapsed from injury to replantation in the injured socket. Wide variability exists in the terminologies used to describe this period. Hence, the aim of this study was to identify and categorize the terminologies related to this aspect of tooth avulsion, grade the explanations provided by the authors, and develop a consensus about the most appropriate terminology through a Delphi approach. This study involved a scoping review to identify and analyze the terminologies. It was performed according to PRISMA-ScR with a systematic search performed in PubMed, Scopus, EMBASE, LILACS, and Web of Science. The terminologies were extracted, categorized, and evaluated for correctness. On the basis of the results of the review and expert group discussion, an ideal terminology was proposed. A Delphi study with 20 global experts in dental traumatology was conducted to develop a consensus for the proposed terminology and its description. A total of 92 studies were included. They were distributed into five categories according to the terminology used: (a) dry period alone, (b) total period with dry and/or wet times, (c) extra-alveolar period, (d) extraoral period, and (e) miscellaneous. The explanations provided were correct in 37.5% of the studies that used an extraoral period. In the Delphi study, the lowest scores were given to the term dry period. There was an agreement of 95% for the proposed terminology. A wide variation in terminologies was observed that could be distributed into five categories. The correctness of explanations was highest in the studies that described total periods with dry and wet times. The Delphi study revealed excellent agreement for the proposed term "total extra-alveolar period," with precise and clear recordings of both nonphysiologic (dry) periods and physiologic (wet) periods.

Assessment of the effects of citric acid and EDTA on cell viability of cultured human periodontal ligament cells attached to simulated avulsed permanent tooth using a spectrofluorometer-An invitro study.

The delayed re-implantation of avulsed teeth results in ankylosis, followed by replacement resorption and eventual loss of the tooth within 2-4 years. To prevent tooth loss, the root surface can be etched with acid to expose the collagen fibers present in the cementum layer. This process facilitates normal reattachment and regeneration of the periodontal ligament. This in-vitro study aimed to assess the viability and number of attached cultured Human Periodontal Ligament Cells (HPLC) on the dehydrated root surface of simulated avulsed teeth treated with citric acid and EDTA solutions. Sound human permanent teeth were included in the study. The root portions of the teeth were sectioned into slices, air-dried for 1 h, and divided into the following three groups: Group A-control; Group B-Citric acid treated for 30 min; Group C-EDTA treated for 5 min. The slices were then placed in cultured HPLC. After a 24-h incubation period, the slices were visualized under the microscope and prepared for reading the viable and dead HPLC using a spectrofluorometer, as well as for counting HPLC in a Neubauer Chamber. The spectrofluorometer intensity for viable and dead HPLC showed a statistically significant difference (p = .003 and p = .002), with the mean intensity for viable HPLC greater in citric acid group (69.52 ± 74.51), followed by EDTA group (31.39 ± 9.12), and control group (-130.93 ± 30.99). The dead HPLC intensity was greater in the EDTA group (19.43 ± 47.31), followed by the citric acid group (1.28 ± 1.85), and the control group (-2.77 ± 0.76). The total number of cells in the Neubauer chamber showed a statistically significant difference (p < 0.001), with a higher count in the citric acid group (10.83 ± 4.08) followed by EDTA group (2.92 ± 2.92). The application of citric acid for 30 min on the dehydrated root surface of avulsed teeth demonstrated superior outcomes compared to both EDTA treatment for 5 min and the control group.

Evaluation of ChatGPT as a Multiple-Choice Question Generator in Dental Traumatology

Aim: This study aims to evaluate the ability of ChatGPT-4 to generate clinical case-based multiple-choice questions in dental traumatology. Material and Method: International Association of Dental Traumatology guidelines for the management of traumatic dental injuries were introduced to ChatGPT-4 as an information source and ChatGPT-4 was prompted to 20 generate questions in fractures and luxations, avulsion of permanent teeth, injuries in the primary dentition. Sixty questions in total were generated by ChatGPT and the questions were evaluated by 2 endodontists using a 3-point scale. The One-way analysis of variance and Post Hoc Tukey test were used to analyze the data and the significance was P

Knowledge, Attitude and Practice Towards Emergency Management of Avulsed Tooth among Dental Practionator in Pakistan: A Questionnaire-Based Survey

Background: The management of dental traumatic injuries, particularly avulsed permanent teeth, necessitates a comprehensive understanding and proficient clinical skills among dental practitioners. With the increasing prevalence of dental injuries due to various factors, the knowledge and practices of dentists in emergency and clinical management are pivotal for successful outcomes. This study aims to evaluate the current state of knowledge, attitudes, and practices among Pakistani dentists regarding the management of avulsed teeth, highlighting areas for improvement and adherence to international guidelines. Objective: To assess the knowledge, attitudes, and practices of dental practitioners in Pakistan concerning the emergency management of avulsed permanent teeth and to identify gaps in knowledge and practice compared to the International Association of Dental Traumatology (IADT) guidelines. Methods: A cross-sectional survey was conducted among 120 dental professionals in Pakistan, using an online questionnaire from August to September 2022. The survey comprised three sections: demographic information, knowledge and attitudes towards dental trauma education, and practices in the emergency management of avulsed teeth. Descriptive statistics were employed to analyze the data, utilizing SPSS version 25.0 for statistical analysis. Results: The survey revealed that 47.5% of respondents felt they received enough information during their undergraduate education, yet a significant proportion reported forgetting much of this knowledge over time. Regarding post-graduation knowledge sources, conferences and medical journals were the most cited (26.7% and 24.2%, respectively). In terms of practice, 79.2% correctly identified HBSS as the optimal storage medium for avulsed teeth, and 60% adhered to rinsing the tooth with saline before replantation. Awareness of the critical extra-oral dry time being under 60 minutes was noted in 59.2% of participants, and a majority were in favor of initiating root canal treatment 7 to 10 days post-replantation for teeth with a closed apex, aligning with IADT recommendations. However, a preference for rigid splints over flexible ones was observed in 54.2% of respondents, indicating a deviation from best practices. Conclusion: The study identified a satisfactory level of knowledge among Pakistani dentists regarding some aspects of avulsed tooth management but also highlighted significant gaps, particularly in the use of flexible splints and recollection of undergraduate training. Continuous education and adherence to IADT guidelines are essential for improving the management of dental traumatic injuries.

Evaluation of attitude and awareness among parents with regards to avulsed permanent tooth and its management

To determine the attitude and awareness among parents of different educational level, socioeconomic status and geographic background with regard to avulsed permanent tooth and its management. 400 parents of children, aged between 6-12 years, in the rural and urban areas of Kozhikode District were randomly selected. The participant’s awareness regarding the avulsed permanent tooth and its management was evaluated based on questionnaire. The questionnaire was essentially be comprised of two parts: First part included the general demographic data and the second part contained closed questions which assessed the knowledge, attitude and previous experience of the participants toward the first-aid management of avulsed permanent tooth. Statistical significance of factors influencing good awareness of groups were calculated using Pearson Chi-Square test.Regardless of educational background, socio-economic status and geographical background, parental awareness regarding the first aid measures to be taken in the case of dental avulsion was inadequate. But at the same time they exhibited positive attitude toward receiving more informations on emergency management of avulsed permanent tooth.

Replacement of Avulsed Tooth in the Esthetic Zone Using Chair-side Fabricated Resin Composite Pontic: A Case Report

Avulsion of permanent teeth is a complex traumatic dental injury (TDI) where a tooth is completely displaced out of its socket without fracturing. The resultant esthetic and functional compromises are distressing for the patient and require immediate attention. The emergency management of an avulsed permanent tooth is to replant it in its socket or preserve it in suitable storage media (saliva, milk, Hanks’ Balanced Salt Solution) within 60 minutes of injury. However, if the tooth is lost or is not replanted within 60 minutes, alternative methods to address the patient’s esthetic concerns must be sought. This case report describes the replacement of a lost avulsed permanent tooth with a chairside fabricated resin composite pontic and a 6-month follow-up period. Keywords: Artificial tooth; Immediate partial denture; Resin-bonded fixed partial denture; Temporary dental restoration; Fibre-reinforced bridge

Assessment of knowledge and attitude of parents on emergency management of avulsion of permanent teeth, in Kottayam district - A cross sectional study

Assessment of knowledge and attitude of parents on emergency management of avulsion of permanent teeth, in Kottayam district - A cross sectional study

Storage medium for avulsed teeth: A narrative review

Dental avulsion is the most severe type of traumatic tooth injury, resulting in the complete displacement of the tooth from its socket in the alveolar bone. Immediate replantation of an avulsed permanent tooth is recommended for successful treatment and a good prognosis. However, replantation is not always feasible. The biological properties of the storage medium, which must preserve the viability, clonogenic capacity, and mitogenic potential of the periodontal ligament (PDL) cells, are crucial for successful reimplantation. If the root surface dries out excessively due to prolonged extraoral time before replantation, the damaged PDL cells can trigger an inflammatory response across the root surface, leading to ankylosis. There are various types of storage media, both synthetic and natural. Therefore, selecting the appropriate storage medium in an emergency is critical for improving the outcome of teeth that cannot be immediately replanted. This review examines research on various storage media for avulsed teeth, focusing on their properties and effectiveness, based on articles from electronic databases. Keywords: Dental Trauma; Periodontal Ligament; Storage media; Tooth Avulsion; Traumatic Dental Injuries

Awareness, Knowledge and Attitudes Toward Management of Avulsed Permanent Incisors Among Primary School Teachers.

Dental trauma is known as main concern for public health and is a prevalent issue among children as it leads to functional, aesthetic, and psychological complications. This study aimed to evaluate the awareness and knowledge of primary school teachers regarding emergency first aid management for tooth avulsion at Agadir. The study was conducted in 46 randomly selected primary schools in Agadir and included all teachers from these schools. Data collection was carried out through a self-administered questionnaire focusing on teachers' socio-demographic characteristics, understanding of the importance of emergency management and familiarity with emergency procedures. Data analysis was performed using Jamovi Version 2.3.21.0. A total of 202 teachers participated in the study, 61% being female and 39% male. It has been found that 59.4% of the teachers had encountered an avulsed tooth accident at school. Of these, 23.9% indicated they would immediately replant the avulsed tooth, while 76.7% would contact the child's parents. Regarding storage, 6.8% would preserve the avulsed tooth in milk, while 30.1% preferred using paper. No significant differences were found in term of seniority and age groups (p>0.05). An educational programs is needed to enhance the management and prognosis of permanent tooth avulsion among children in Morocco.

Systemic Antibiotics therapy in delayed replantation of avulsed tooth- A Systematic Review

Aim - This systematic review aimed to analyse the practising trends of clinicians on using Systemic Antibiotic Therapy (SAT) in delayed replantation of avulsed permanent anterior teeth. Materials and Method - A search was performed for case reports and case series related to delayed replantation of avulsed permanent anterior teeth on databases like Medline/PubMed, Google Scholar, and Cochrane from 2000 to 2020. Articles were selected after applying inclusion and exclusion criteria for this systematic review. The Prisma guidelines 2009 were followed, and the protocol was registered on Prospero. Data were extracted and analysed. Results- In this study, four case reports showed the primary use of systemic Penicillin, and others reported different antibiotic combinations. In comparison, only 1 case said the use of tetracycline as SAT, despite it being the drug of choice as per the guidelines. Five case reports observed Ankylosis, resorption, and infra-occlusion as procedural complications. Successful treatment outcome was highly variable, ranging from no complication in 6 months to 2 years. Conclusion- This study could conclude that the clinicians prescribed the same antibiotics for delayed replantation, similar to use in routine endodontics. The use of antibiotics in case of avulsion could be attributed to their easy availability and knowledge of clinicians regarding these antibiotics. However, the follow-up period for most of the cases was insufficient to observe the complications. Thus, the effect of antibiotics on treatment outcome of delayed replantation of an avulsed tooth mandates more studies with more extended follow-up period. Keywords- Antibiotics, Avulsion, Ankylosis, Amoxicillin, Phenoxy penicillin, Sytematic Review, Tetracycline.

Computational modelling and analysis of hard tissue behavior around 0.5 mm and 0.85 mm platform switched abutment using 3D finite element analysis

Permanent tooth avulsion is a common but extremely serious dental injury that can negatively affect both economic output and lifestyle. Even though it is not a disease, no one is ever completely safe from the possibility of suffering from these disastrous injuries. Dental implants play a vital role in the treatment of such injuries (tooth loss). This work was focused on to find the effects of two different platform switched abutment-implant assembly on hard tissues (Cortical and cancellous) bone. Materialized Mimics Medical Software was used for processing clinical imaging (CBCT) data of mandibular bone and micro-CT data of implant (5.5 × 9.5 mm), Abutments (Pt. sw. I and Pt. sw. II) and final 3D model of all parts were obtained by Fusion 360 CAD software and implanted into a right mandible bone block. Implant-Abutment with different switching assembly as platform switched-I (Pt. Sw. I) Ø5.5-mm implant and Ø3.8-mm abutment and the platform switched-II (Pt. Sw. II) Ø5.5-mm implant and Ø4.5-mm abutment were compared. Each model was subjected to 50 N, 100 N and 150 N longitudinal and lateral loads at occlusal surface of the abutment to evaluate the mechanical parameters. ANSYS 2020R1 was used to conduct the computational analysis. Mechanical characteristics such as von-Mises stresses and total deformation were measured in the hard tissues using finite element modelling. Under the application of different loads the cancellous bone experiences maximum von misses stress 4.7 MPa and 5.4 MPa for Pt. Sw. I and Pt. Sw. II respectively under longitudinal load and 7.4 MPa and 8.7 MPa for Pt. Sw. I and Pt. Sw. II respectively under lateral load. Similar trends were observed for cortical bone. While maximum total deformation of 2.1 µm (Pt. Sw. I) and 2.2 µm (Pt. Sw. II) under longitudinal load and 4.4 µm and 4.6 µm in cancellous bone and cortical bone under longitudinal load and 4.4 µm (Pt. Sw. I) and 4.6 µm (Pt. Sw. II) under lateral load in cancellous and 7.5 µm (Pt. Sw. I) and 8 µm (Pt. Sw. II) in cortical bone were recorded. The analysis may help to prevent the progression of marginal bone loss (MBL) because lower results for these variables indicated for higher platform switching in marginal bone. The findings of computational frameworks can help clinicians and other medical professionals make more informed decisions when selecting a treatment strategy from the many options available.

Assessing Knowledge, Perception, and Management Toward Traumatic Tooth Avulsion Among Dentists in Jeddah, Saudi Arabia: A Cross-Sectional Study.

The long-term prognosis of teeth that have experienced traumatic avulsion is highly dependent on appropriate and prompt emergency management taken immediately after the avulsion. The main goal in the treatment of traumatic permanent tooth avulsion is to replant as soon as possible in its correct anatomical position to maintain the viability of the periodontal ligament and neurovascular supply while restoring aesthetic and preserving the functional integrity of the tooth. General dentists can deal properly with emergency cases, such as tooth avulsion, and also should be aware of appropriate management to take care of avulsions and to determine the prognosis especially since such incidents often occur at times when dental professionals are least prepared to address them. The primary aim of this study was to evaluate the knowledge of dentists who are working in various hospitals, clinics, and dental schools in Jeddah, Saudi Arabia, with respect to traumatic permanent tooth avulsion and the appropriate methods for its management. The study design is a cross-sectional study with dentists working in various clinical settings in Jeddah, Saudi Arabia.The questionnaire used in the study consists of a total of 19 items: nine items about demographic data, including training background, and 10 multiple-choice questions regarding dental trauma and its management. Higher dental education and post-graduate training gave the dentists better judgment in dealing with dental emergencies compared to general dentists. Thus, the recommendation of this study is to include the comprehensive treatment of avulsion emergencies in the dental school curriculums and increase the exposure of dental students to such cases.

Parents' knowledge of emergency management of avulsed permanent teeth in children and adolescents in the State of Qatar: a questionnaire cross-sectional study.

To elucidate the level of parental knowledge in Qatar regarding the management of avulsed teeth. A self-administered questionnaire was completed by 400 parents attending their children's routine dental appointments. The questionnaire comprised of items on sociodemographics, parents' prior knowledge on management of avulsion, parents' willingness to replantavulsed teeth at the site of injury, and parents' opinion as to the best format for future parental education on the management of dental trauma. Univariate and multivariate logistic regressions were employed to assess the association between sociodemographic status and knowledge in the management of avulsion. The overall mean score of parents' knowledge was (23%). Only 23.3% (n = 93) of parents thought that it was possible to reinsert an avulsed permanent tooth. Out of those, only 12.9% (n = 12) indicated willingness to reinsert the tooth back into its socket, while 48.4% (n = 49) indicated that an avulsed tooth should be stored using physiological media. Less than one third (27.8%) indicated that they would seek professional help within 30min. Males were less likely to give favourable answers when compared to females (OR = 0.43, 95% CI = 0.22-0.84). Age groups "31-40" years and "41-50" years were more likely to give favourable answers when compared to 20-30years age group (OR = 2.8, 95% CI = 1.05-8.0and OR = 3.8, 95% CI = 1.3-11.48; respectively). This study highlights critical deficiencies in parental knowledge on the management of tooth avulsion and the need to improve parents' knowledge by developing easily accessible onsite emergency management tools.

Management of traumatic dental injuries: a survey of paediatric emergency department health professionals

ObjectiveTo assess paediatric emergency department (PED) health professionals’ confidence, experience and awareness in managing traumatic dental injuries (TDIs).DesignA cross-sectional online survey.SettingPED at Alder Hey Children’s Hospital and Birmingham Children’s Hospital.Results94...

Characteristics, treatment outcomes and direct costs of tooth avulsion in children treated at a major hospital.

Avulsion of a permanent tooth is one of the most severe traumatic dental injuries, comprising an estimated 0.5%-16% of all dental injuries. The aim of this study was to estimate the direct financial costs of tooth avulsion in children based on stage of root maturity and the occurrence of ankylosis and to report patients' characteristics and outcomes of treatment. A retrospective review of the dental records of children ages 6-18 who sustained a permanent tooth avulsion from 2010 to 2020 was completed. Relative Value Units (RVUs) were used to calculate the estimated cost of dental trauma care over the 2-year post-injury period for five different scenarios of avulsed teeth based on the stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted. There were 452 avulsed permanent teeth in 348 patients. Of those, 157 teeth were included in the cost analysis. Overall, the average direct dental cost of avulsion was 46.4 RVUs equal to $1619 USD based on the 2021 conversion rate ($34.89 per RVU). Direct costs ranged between 40 RVUs ($1396) and 52.8 RVUs ($1842) depending on the root maturation and ankylosis status or whether the tooth was replanted; however, ANOVA test did not show any statistically significant differences between the mean RVUs of different groups (p=.85). Patients returned 9.5 times on average over the 2-year study period for dental trauma care after avulsion. The average direct cost of tooth avulsion within the limits of this study was $1619 USD. On average, patients returned for 9.5 follow-up visits after the avulsion. The stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted or not were not significantly associated with the direct cost of dental care.

An Overview of Pediatric Dental Emergencies

Pediatric dental emergencies encompass a wide range of acute oral health issues in children that require immediate attention. These emergencies can result in pain, functional impairment, and long-term dental problems if not addressed promptly. They account for a significant portion of children's first dental visits. Life-threatening dental emergencies in children include situations where a child's life or health is at immediate risk. These can involve airway compromise due to severe facial swelling, cavernous sinus abscess, periorbital inflammation, high fever, uncontrolled bleeding, dislodgment of intraoral appliances, or avulsed permanent teeth in children with underlying medical conditions. Immediate intervention is crucial in these cases to prevent life-threatening complications. Urgent dental emergencies, while not immediately life-threatening, require prompt attention to alleviate pain, prevent complications, and restore oral health. These include severe toothaches, dental infections, dental abscesses, and orthodontic emergencies like broken braces or protruding wires. Soft tissue injuries, foreign body impaction, and traumatic dental injuries like dental fractures, avulsion, tooth intrusions, extrusions, and dental luxations also fall under this category. Timely treatment is essential to prevent further complications and ensure the best possible outcome for affected teeth and tissues. Traumatic dental injuries can vary in severity, from minor enamel cracks to complete avulsions, and may require treatments like dental bonding, veneers, crowns, or reimplantation of avulsed teeth. Fractures of supporting bones or jaws may accompany these injuries, necessitating immobilization or surgical intervention. Mouthguards are recommended for individuals engaging in activities with a risk of dental trauma to reduce the likelihood of injuries.

Replantation of an avulsed permanent central incisor: a case report with an 8-month follow-up

Background: Avulsion accounts occur in young children. An avulsed permanent tooth that is dropping out from its socket causes a breakdown of the periodontal ligament (PDL) surrounding the tooth root. An avulsed tooth can be replanted and saved if replantation is performed within 30 minutes to 1 hour of the incident. Case Presentation: The case of an 8-year-old male patient with a central incisor in a glass of milk after a fall for 2 hours. The tooth was slowly replanted in the socket and stabilized using a flexible wire and resin composite splint. The patient came for the second appointment, the splint was removed, and a radiograph was taken to ensure no inflammation or root resorption had occurred in the replanted tooth for 8-month follow-ups. The tooth developed ankylosis with a positive response to the cold test and electronic pulp tester, indicating that the tooth was vital and sensory nerve supply was regenerated. Conclusion: The prognosis of avulsed teeth depends on receiving proper emergency care at the right time. A proper storage medium is important to keep the dental pulp and PDL viable.

Evaluation of Turkish emergency medicine physicians' knowledge on emergency management of tooth avulsion.

Tooth avulsion is a type of trauma that requires emergency intervention, and a significant number of patients apply to the emergency. The aim of this study is to evaluate the level of knowledge and the awareness about tooth avulsion among emergency medicine physicians throughout Turkiye. The study was conducted with 545 physicians, working in emergency departments. An online questionnaire about tooth avulsion was applied to the participants. The questionnaire consisted of 3-section which evaluated personal information, the level of knowledge of avulsion cases in primary and permanent dentition, and the level of training on this subject. Of the physicians, 61.3% had not previously received education on dentoalveolar traumas, 58.7% would replant an avulsed permanent tooth, 28.3% would prefer replantation to be performed "immediately", and 28% would prefer milk as the ideal storage medium. The mean±SD and median(min-max) values of the correct answer scores on a scale of 0 to 35 were 16.42±7.08 and 17(0-32), respectively. 45.6% of the physicians' level of knowledge was below the median score. The level of knowledge about tooth avulsion among Turkish emergency medicine physicians is not sufficient and there is a need to improve the knowledge level of physicians with comprehensive educational programs. This study indicates that the training of the physicians about the subject will reflect positively on the treatment of dental trauma patients.

Gambaran tingkat pengetahuan dokter gigi terhadap tata laksana kasus avulsi gigi permanen di wilayah dki jakarta (Laporan Penelitian)

Background: Avulsion of permanent teeth is one of the most serious dentoalveolar injuries. Appropriate emergency management and a treatment plan are important for a good prognosis. Therefore general dental practitioners (GDPs) must have adequate knowledge regarding the management of permanent avulsed teeth. Objective: Evaluate the knowledge base and preferred methods of general dental practitioners regarding the management of avulsed teeth. Methods: Observativational descriptive with cross-sectional was employed for sample selection. A pre-tested 13-item online questionnaire was distributed to 98 Jakarta GDPs. The data obtained were then categorized into 3 levels which are high (≥76%), moderate (56-75%), and low (≤55%). Results: This study revealed that the majority of GDPs' knowledge is moderate. 21,4% of participants showed good knowledge, while 53,1% are moderate, and the other 24,5% lack the knowledge needed to manage avulsions. Mann-Whitney U test results showed that there was no statistically significant difference between males and females (p = 0.296) nor between the length of practice 0-10 years and &gt;10 years (p = 0.134). Conclusions: The study findings showed that the Jakarta GDPs need to improve their knowledge about the management of permanent avulsed teeth.

Knowledge and Attitudes of Saudi Medical Students about Emergency Management of Traumatic Dental Injuries.

Several studies indicate that physicians lack emergency management knowledge concerning traumatic dental injuries (TDIs), emphasizing the fact that medical students are not taught about this topic. This study aimed to assess the basic knowledge and attitudes of medical students in Saudi Arabia about emergency TDI management. This cross-sectional study recruited a convenience sample of medical students in their clinical years through social networking sites and asked them to answer a pretested internationally accepted questionnaire that included demographic questions, two case scenarios about crown fractures and avulsion of permanent teeth, and self-assessment questions. The data were analyzed statistically using descriptive statistics and the chi-squared test (p < 0.05). A total of 761 medical students responded. Only 5.8% of the students reported receiving information about TDIs in their curriculum. Medical students, mainly those ready to graduate, were more knowledgeable of the emergency management of a crown fractured permanent tooth than an avulsed permanent tooth (p < 0.0001). However, more than half of the students were unable to differentiate between a primary versus permanent fractured tooth and would manage an avulsed primary or permanent tooth similarly. Regarding students' attitudes, less than one-quarter of the students (13.5%) were confident about diagnosing TDIs and/or providing emergency management when required (18.1%). Furthermore, only about one-tenth of the students (9.3%) were satisfied with their self-perceived knowledge, and most (71%) reported needing further education about the topic. Medical students in Saudi Arabia have insufficient knowledge about the emergency management of TDIs. Gaps in students' knowledge of emergency management of avulsion injury were identified in addition to their low confidence level to either diagnose or immediately treat TDIs if required. Students felt dissatisfied with their current knowledge level, this being most prominent among graduating students. There is a need to elaborate the undergraduate medical curriculum in Saudi Arabia to include emergency management of TDIs.