Replantation Of Avulsed Teeth Research Articles

Physiological occlusal force attenuates replacement root resorption of replanted teeth: an experimental animal study

BackgroundTooth avulsion represents the most severe form of dental trauma, necessitating tooth replantation as the primary treatment. However, the risk of replacement root resorption (RRR) poses a significant threat to tooth retention following replantation. This study preliminarily aimed to investigate the effect of physiological occlusal force on RRR after the replantation of avulsed teeth and to explore the potential underlying mechanisms.MethodsThirty-six 4-week-old male Sprague-Dawley rats underwent extraction and immediate replantation of their left maxillary molars. The rats were randomly divided into two major groups: the occluded (n = 18) group, where the opposite mandibular teeth were preserved; non-occluded (n = 18) group, where the opposite mandibular teeth were extracted. Within each major group, there were three subgroups corresponding to 7 days, 14 days, and 2 months, resulting in a total of six subgroups, (n = 6 per subgroup). The right maxillary first molars served as the normal control. Various periodontal characteristics were assessed using haematoxylin-eosin (H&E), tartrate-resistant acid phosphatase (TRAP) staining, and micro-computed tomography (micro-CT).ResultsHistological staining revealed that under occlusal force, the early stage (day 7) after tooth replantation mainly manifested as root surface resorption, especially in the non-occluded group, which gradually diminished over time. Cementum and periodontal ligament (PDL) repair was observed on day 14. Micro-CT analysis indicated a significant decrease in PDL width in the non-occluded group two months after replantation, consistent with the histological findings, signifying severe RRR in the non-occluded group.ConclusionsThis study provides preliminary evidence that physiological occlusal force may attenuate osteoclastogenesis during the early stage of tooth replantation, thereby reducing the occurrence of RRR and promoting periodontal healing.

Harnessing Mechanical Stress with Viscoelastic Biomaterials for Periodontal Ligament Regeneration.

The viscoelasticity of mechanically sensitive tissues such as periodontal ligaments (PDLs) is key in maintaining mechanical homeostasis. Unfortunately, PDLs easily lose viscoelasticity (e.g., stress relaxation) during periodontitis or dental trauma, which disrupt cell-extracellular matrix (ECM) interactions and accelerates tissue damage. Here, Pluronic F127 diacrylate (F127DA) hydrogels with PDL-matched stress relaxation rates and high elastic moduli are developed. The hydrogel viscoelasticity is modulated without chemical cross-linking by controlling precursor concentrations. Under cytomechanical loading, F127DA hydrogels with fast relaxation rates significantly improved the fibrogenic differentiation potential of PDL stem cells (PDLSCs), while cells cultured on F127DA hydrogels with various stress relaxation rates exhibited similar fibrogenic differentiation potentials with limited cell spreading and traction forces under static conditions. Mechanically, faster-relaxing F127DA hydrogels leveraged cytomechanical loading to activate PDLSC mechanotransduction by upregulating integrin-focal adhesion kinase pathway and thus cytoskeletal rearrangement, reinforcing cell-ECM interactions. In vivo experiments confirm that faster-relaxing F127DA hydrogels significantly promoted PDL repair and reduced abnormal healing (e.g., root resorption and ankyloses) in delayed replantation of avulsed teeth. This study firstly investigated how matrix nonlinear viscoelasticity influences the fibrogenesis of PDLSCs under mechanical stimuli, and it reveals the underlying mechanobiology, which suggests novel strategies for PDL regeneration.

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.

Effect of icariin surface treatment on the resorption of denuded roots after replantation in rat.

Limiting the incidence of resorption associated with delayed replantation of avulsed teeth is critical for long-term tooth survival. In this study, we assessed whether icariin, a natural product with anti-osteoclastic properties, could reduce root resorption in a rat model of tooth replantation. Cytocompatibility of icariin (10, 20, 40 and 80 μM) was evaluated by CCK-8 proliferation assay in vitro, and an osteoclastogenesis assay was performed to evaluate the effect of icariin on the differentiation of rat bone marrow macrophages and human peripheral blood monocytes into tartrate-resistant acid phosphatase-stained (TRAP+ ) multinucleated giant cells (MNGCs). Differentiation of human periodontal ligament stem cells (hPDLSCs) treated with icariin (10 μM) was also evaluated at 5, 10 and 21 days of osteogenic induction. The first maxillary molars of five-week-old male Sprague-Dawley rats were extracted, denuded of PDL, then treated either with neutralized collagen solution (Carrier control) or icariin in collagen (3 μg/μL) before replantation into their sockets. The animals were euthanized 2 weeks post-surgery for micro-computed tomography (micro-CT) imaging and histological analyses. Icariin was cytocompatible and significantly reduced the differentiation of TRAP+ MNGCs in a dose-dependent manner compared to the control. Moreover, icariin enhanced alkaline phosphatase activity, expression of osteogenic marker genes and proteins, and calcium deposition in hPDLSCs. Micro-CT imaging of the replanted samples demonstrated a significantly higher volume of remaining roots in the icariin-treated group than in the control group. Histological analysis revealed a marked number of resorptive lacunae with TRAP activity in the control group, whereas icariin-treated samples showed signs of functional healing and reduced osteoclastic activity. Icariin was biocompatible and demonstrated potent anti-osteoclastic and pro-osteogenic properties that reduced resorption and promoted functional healing of denuded roots in a rat maxillary first molar model of replantation. These findings indicate that root surface treatment with icariin may be a clinically relevant and practical method for improving the retention and survival of teeth with compromised PDL after delayed replantation following traumatic avulsion.

Success of replantation of avulsed teeth using human colostrum as an interim storage medium

ObjectivesTooth avulsion is defined as total tooth displacement from the alveolar socket; the best treatment is replantation of the tooth. Human milk influences body health, growth, and development related to the presence of micro and macro nutrient components. This study assessed the effects of human colostrum as a storage medium on the success of tooth replantation. MethodsThe upper left incisor of 30 adult male Wistar rats was extracted, and the rats were divided into three groups according to the storage medium of the extracted tooth for replantation: Hank's balanced salt solution (HBSS), tap water, and colostrum groups. The MTT cell viability assay was conducted, and histological evaluation and histomorphometric analyses were performed on postoperative day 45 for identification of pulp necrosis, periodontal hyalinization, percentage of resorbed area, and the periodontal ligament attachment. ResultsThe colostrum medium showed a higher percentage of cell viability followed by HBSS with statistical significance. Histological findings of the replanted avulsed tooth that soaked in tap water as storage medium showed obvious external and internal root resorption. Pulp necrosis and periodontal ligament hyalinization and with a significant differences values in comparison to HBSS and colostrum groups (p > 0.05), whereas the colostrum group showed new well-reattached periodontal ligament with normal pulp and no evidence of root resorption. ConclusionTooth loss is minimized by using human colostrum as storage medium in replantation of an avulsed tooth after a 1 h period compared to HBSS and water.

Deferoxamine Reduces Inflammation and Osteoclastogenesis in Avulsed Teeth.

Replacement and inflammatory resorption are serious complications associated with the delayed replantation of avulsed teeth. In this study, we aimed to assess whether deferoxamine (DFO) can suppress inflammation and osteoclastogenesis in vitro and attenuate inflammation and bone resorption in a replanted rat tooth model. Cell viability and inflammation were evaluated in RAW264.7 cells. Osteoclastogenesis was confirmed by tartrate-resistant acid phosphatase staining, reactive oxygen species (ROS) measurement, and quantitative reverse transcriptase–polymerase chain reaction in teeth exposed to different concentrations of DFO. In vivo, molars of 31 six-week-old male Sprague–Dawley rats were extracted and stored in saline (n = 10) or DFO solution (n = 21) before replantation. Micro-computed tomography (micro-CT) imaging and histological analysis were performed to evaluate inflammation and root and alveolar bone resorption. DFO downregulated the genes related to inflammation and osteoclastogenesis. DFO also reduced ROS production and regulated specific pathways. Furthermore, the results of the micro-CT and histological analyses provided evidence of the decrease in inflammation and hard tissue resorption in the DFO group. Overall, these results suggest that DFO reduces inflammation and osteoclastogenesis in a tooth replantation model, and thus, it has to be further investigated as a root surface treatment option for an avulsed tooth.

Low-intensity pulsed ultrasound attenuates replacement root resorption of avulsed teeth stored in dry condition in dogs

This study aimed to investigate the effects of low-intensity pulsed ultrasound (LIPUS) on replacement root resorption after replantation of avulsed teeth stored in a dry condition in dogs. A total of 73 premolar roots from four male mongrel dogs were intentionally avulsed with forceps and divided into four groups—HN, HL, DN, and DL—according to storage conditions and whether or not they received LIPUS treatment. Thirty-eight roots were kept in Hanks’ Balanced Salt Solution for 30 min (HN and HL groups), whereas the remaining 35 roots were left to dry in the air for an hour (DN and DL groups) prior to replantation. Following replantation, the roots in the HL and DL groups (21 and 18 roots, respectively) received a 20-min daily LIPUS treatment for 2 weeks. The animals were euthanized 4 weeks after the operation. Micro-computed tomography images were acquired for each root and the amount of replacement root resorption was measured three-dimensionally. Histological assessments were also carried out. There was significantly less replacement root resorption for the roots in the DL group compared to the DN group (p < 0.01). Histological findings in the DN group demonstrated evident replacement root resorption, whereas the DL group revealed less severe resorption compared to the DN group. Within the limitations, these results suggest that LIPUS could attenuate the replacement resorption of avulsed teeth stored in a dry condition, thereby improving their prognosis.

Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies

BackgroundPulpal and periodontal healing are two main concerns of delayed replantation of avulsed teeth. The objective of this review was to evaluate the effectiveness of topical and systemic application of tetracyclines on pulpal and periodontal healing after tooth replantation.MethodsA comprehensive electronic search was conducted in six databases. This systematic review was carried out according to Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.ResultsAfter exclusion of 246 irrelevant papers, 14 animal studies and one human study were included in this review. The human study showed that avulsed permanent teeth treated with doxycycline did not show a better clinical outcome for pulp and periodontal healing compared with treatment with normal saline. As for animal studies, significant more pulpal healing was observed in immature teeth treated with topical doxycycline in two researches, while another one study showed that there is no difference between teeth treated with normal saline and teeth treated with doxycycline. Systemic doxycycline exerted no significant effect on pulpal revascularization illustrated by one research. Only one out of four articles illustrated the positive effect of systemic tetracyclines on periodontal healing. One paper reported that intracanal application of demeclocycline promoted favorable periodontal healing. Two articles showed topical doxycycline contributed to favorable periodontal healing, while five studies showed no significant effect of topical tetracyclines on periodontal healing.ConclusionsAs a result of data heterogeneity and limitations of the studies, the effect of topical or systemic application of tetracyclines on pulpal and periodontal healing is inconclusive. More studies are required to get more clinically significant conclusions.

Cell-Based Therapy for Tooth Replantation Following Avulsion: A Systematic Review.

The management of avulsed teeth undergoing delayed replantation remains a clinical challenge as there are currently no effective interventions that can improve periodontal healing and prevent replacement root resorption. While several preclinical studies have reported varied success using cell-based tissue engineering to improve periodontal healing, a consensus is required before further clinical translation. Therefore, this systematic review seeks to evaluate the efficacy of cell-based therapy in promoting periodontal healing following delayed replantation in animal models. MEDLINE (PubMed) and Embase were searched on September 27, 2020. Ten studies involving rodent and dog models met the inclusion criteria. Cell sources included gingiva, periodontal ligament (PDL), bone marrow, and adipose tissues. Generally, cell-based therapy had increased the proportion of root surfaces displaying periodontal healing and concomitantly reduced the proportion presenting with replacement root resorption and ankylosis. The best outcomes were observed following treatment with PDL-derived cells of various potency. Future preclinical studies will benefit from adopting measures to minimize bias during the conduct of animal experiments and the standardization of the outcome measures reporting. This will facilitate future reviews with possible pooling of results in the form of meta-analyses, allowing a consensus to be obtained from the literature. In addition, further research will be required to shed light on the implications of using allogeneic cells as well as the optimization of cell delivery protocols. The findings of this systematic review demonstrated the therapeutic potential of certain cell-based therapies in promoting periodontal healing following delayed replantation, thus highlighting their prospective clinical benefits and translational value. Impact statement Current therapies cannot predictably promote periodontal healing following delayed replantation of an avulsed tooth, especially when there is already significant root surface damage. This review systematically assessed the literature for preclinical studies employing cell-based therapies to promote periodontal healing following delayed replantation. The results showed that certain cell-based therapies significantly increased the formation of new periodontal ligament and reduced adverse healing outcomes of replacement root resorption and ankylosis. This highlights the potential clinical benefits and translational value of cell-based therapy for the replantation of avulsed teeth.

Delayed Replantation of Avulsed Teeth: A Case Report

Introduction: Dental avulsion is a severe injury in which the tooth is totally displaced out of its alveolar socket. Replantation of avulsed teeth is a standard procedure. The success of the treatment of traumatized teeth revolves around the status of periodontium since it is a vital structure. Furthermore, other factors, including extra-alveolar time period, choice of storage media, and contamination of the avulsed tooth, can determine the success of replantation. Delay in the replantation of avulsed incisors increases the risk of dentoalveolar ankylosis and replacement root resorption. Case Presentation: This case report presented a 9-year-old girl with tooth avulsion subjected to a 3-year follow-up after the replantation of avulsed maxillary central incisors kept in dry conditions for seven days. The avulsed mature permanent teeth were managed through the application of treatment guidelines with prolonged extra-oral time. The avulsed teeth were replanted and splinted for four weeks. The canals of both teeth were filled with calcium hydroxide and replaced by mineral trioxide aggregate after six months. Two months after replantation, there were signs of external root resorption in tooth 21. Conclusions: In the third year of follow-up, both teeth were infraoccluded, although they had an acceptable level of functionality and appearance. These ankylosed incisors can be managed successfully with the decoronation technique in the future.

Modulated cementogenic genes upregulation in human buccal fat pad-derived stem cells by strontium-ranelate

Cementogenesis plays a pivotal role in some critical clinical complications including replantation of avulsed teeth. Strontium-ranelate has been shown to affect bone regeneration. Despite the resemblance of bone and dental cementum, there are a few studies regarding the impact of strontium-ranelate on cementogenic differentiation. Current study aimed to investigate the proliferation and cementoblastic differentiation of human buccal fat pad-derived stem cells (BFPSCs) while treated by strontium-ranelate in comparison to its osteogenic differentiation. To do this, BFPSCs were treated with different concentrations of strontium ranelate (0, 6, 12.5, 25, 50, 100 and 200 μM). MTT assay, Alizarin red staining, and real-time RT-PCR were performed to evaluate cementoblastic and osteoblastic markers. The highest expression of cementoblast markers including: cementum protein-1 and cementum attachment protein were observed at concentrations of 50 and 100 μM after 7 and 14 days of induction. The results demonstrated that strontium-ranelate could dose-dependently affect the proliferation and cementoblastic differentiation of BFPSCs. Taking together, strontium-ranelate could be used in combination with BFPSCs to improve root resorption following orthodontic therapy.

Systematic Review on Relation Between Surface Treatment and Outcome of Delayed Replantation of Permanent Anterior Avulsed Teeth

Introduction: One of the most severe dental injury is Tooth Avulsion or exarticulation. Tooth avulsion is the complete displacement of tooth out of the socket. The common treatment employed for avulsed teeth is replantation, the prognosis of which depends on the handling of the tooth specimen and time lag between avulsion and replantation of the teeth. Surface treatment of root surface of avulsed teeth prior to delayed replantation is a common practice and a variety of agents and methods have been used for the same. The literature lacks evidence that establishes a definitive relation between surface treatment and prognosis of delayed replantation of avulsed teeth. Aim: To understand the effect of surface treatment and outcome after replantation of avulsed anterior permanent teeth with an extraoral dry time of more than 60 minutes. Materials and Methods: The protocol for systematic review was registered on PROSPERO, registration number was CRD42020222919. A search was performed on case reports and case series available on delayed replantation of avulsed anterior permanent teeth on databases like Medline/PubMed, Google Scholar, and Cochrane from the year 2000 to 2018.The MESH terms and keywords like tooth avulsion*, tooth fractures*, tooth injuries*, traumatology*, delayed replantation methods and delayed replantation standards with Boolean operators were used for data identification and screening. After applying inclusion and exclusion criteria, total five articles were included. Results: The duration of storage of the teeth were variable with cases reported from 24 hours to 72 hours of extraoral dry time. All five reports used different methods for surface treatments. No complications were reported after 12 months in three cases. No complication was reported after 24 months in one case. After 12 weeks, one article reported ankylosis and infraocclusion after replantation. Conclusion: As a result of data heterogenicity and a short follow-up period of the articles, a clear relation between surface treatment and delayed replantation of an avulsed teeth could not be established. However, it can be safely concluded that surface treatment of avulsed teeth prior to delayed replantation results in a better prognosis and predictable outcomes.

Survival of human periodontal ligament fibroblast cells in Cornisol and HBSS for transportation of avulsed teeth: a comparative ex vivo study

Objective Viability of periodontal ligament fibroblast cells (PDFC) is one of the key factors in determining the success of replantation of avulsed teeth. Extra-oral time and transport media are closely related to the same. The present study aims to evaluate and compare the efficiency of Cornisol, Hank’s balanced salt solution (HBSS) and normal saline in preserving the viability of PDFC. Materials and methods The human PDFC were isolated from primary culture from freshly extracted human premolars. Effect of Cornisol, HBSS and normal saline on viability of isolated PDFC was assessed using standard MTT assay. The cells were exposed to the experimental solutions (Cornisol/HBSS/normal saline) for varying time points (30 min, 1 h, 24 h, 48 h and 96 h) and viability was determined by colorimetric MTT method by quantifying the amount of formazan crystal formed (optical density). Experiment was performed in triplicates and the data were subjected to statistical analysis. Results Statistical analysis was performed using the Kruskal–Wallis ANOVA with post hoc Bonferroni’s test with a significance level of p value ≤.05. Cornisol ≥ HBSS > saline. Conclusion Cornisol can be used as a storage media for avulsed teeth and is significantly more effective than HBSS in maintaining the periodontal ligament cell viability at tested time intervals.

Effect of laser treatment on outcomes of tooth replantation - A systematic review.

ObjectivesOver the last few years, several studies have investigated the effect of laser treatment on the replantation of avulsed teeth. We conducted this study to systematically analyse and assess the outcomes and quality of these studies.MethodsUsing the keywords ‘laser’, ‘tooth’, and ‘replantation’, two investigators conducted an electronic search of the PubMed, MEDLINE, Embase, ISI Web of Knowledge and Google Scholar databases. Any studies not meeting the inclusion criteria were excluded. The focused question was ‘Does laser treatment influence the outcomes of tooth replantation?’ResultsNine studies were included and assessed in this review. In the majority of the selected studies, laser treatment had a positive outcome on preventing root resorption and in promoting periodontal regeneration. However, only three studies were given a quality score of ‘medium’, while six were marked as ‘low’.ConclusionLaser irradiation may reduce root resorption and favour periodontal regeneration following replantation of the avulsed tooth. However, more well-designed long-term animal and human studies are needed before lasers can be used clinically to improve the outcomes for replanted teeth.

Geomorphologic Study on Root Surface of Human Avulsed Teeth by Scanning Electron Microscopy

Dental avulsion from alveolar socket is the most severe type of traumatic tooth injuries. Immediate replantation after avulsion provides the highest success, whereas delayed replantation in storage of long time dehydration always results in ankylosis, absorption and loss of teeth eventually. Maintaining the vitality of periodontal ligament (PDL) cells on root surface is regarded as a crucial step deciding the long term survival of avulsed teeth. In present study, the geomorphology on the root surface from immediate to delayed replantation of avulsed teeth was inspected by scanning electron microscopy (SEM). Fibrous “vegetation” covering cementum was observed in fresh wound of PDL, that was transformed into “Gobi desert” on root surface because of the extinguishment of the fibers in long time air dry storage. Reutilization of the PDL embedded in the cementum was attempted to simulate the fresh root surface to improve prognosis of delayed replantation. Fibers protected by mineralized stroma were decalcificated and exposed again that reversed the deteriorated geomorphology for the regeneration of PDL on root surface. The direct evidences from SEM give a new sight for the etiology and therapy to delayed replantation of tooth avulsion. Funding Statement: This study was supported by grants from the National Nature Science Foundation of China (Nos. 81100765, 81570990). Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: his study was approved by the Local research ethics committee number CMUSH-IRB-KJ-PJ-2019-17.

Periapical Cyst Following Replantation of Avulsed Teeth: A Case Report

Introduction: Avulsion has been described as the traumatic displacement of the tooth out of the socket, and it accounts for 0.5% to 16% of traumatic injuries in the permanent dentition. Many complications have been associated with avulsed tooth following replantation. This paper aimed at presenting a case of the large cystic lesion following replantation of avulsed teeth.&#x0D; Case Presentation: A case of a 17-year-old undergraduate student who presented in the dental clinic for medical screening as a mandatory exercise upon gaining admission. During the examination, a purulent pus discharge was noticed on the labial sulcus about tooth 11. History revealed that she had avulsion of teeth 11 and 12 about 4-years earlier that was replanted and splinted for 2-3 weeks and subsequently she was discharged from the clinic without any further treatment. Radiographic examination revealed periapical radiolucency without well define margin about teeth 11 and 12. Periapical surgery was carried out and two large cystic cavities were seen at about teeth 11 and 12 during surgery. The histology report of the specimen revealed a benign lesion suggesting periapical cyst.&#x0D; Conclusion: There is the need for adequate follow-up and monitoring of replanted teeth the following avulsion to arrest any complication that might arise from the procedure. Also, the importance of endodontic treatment following replantation of the avulsed tooth cannot be overemphasized.

Survival of avulsed permanent incisors in children following delayed replantation

Replantation of avulsed teeth is an invasive treatment approach where patient cooperation is required after the risks are explained to the patient or family. Although replantation of an avulsed permanent teeth is an accepted treatment approach, the long-term prognosis of the replanted teeth is still controversial. This report describes the survival of delayed replanted 15 incisors that was stored in unfavorable conditions after avulsion. Nine patients, aged 8-12 years, were referred to the Inonu University, Pediatric Dentistry Department with traumatically avulsed incisors. The parents were informed about the possible complications of a delayed replantation. Forty percent of the teeth were splinted with flexible orthodontic wire and composite. The follow-up periods were varied from 24 to 48 months. The mean follow-up periods were 33.3 ± 8 months. 40% of the teeth were retained in the mouth for at least 3 years and contributed to alveolar bone development. In these cases, the most common complication (9 teeth, 60%) was replacement root resorption. Two of the 15 teeth which had wide open apices, continued to the root development. In this study, replanted teeth were retained in the mouth for at least 2 years and contributed to the patient's development. Therefore, this study has shown that delayed replantation of an avulsed tooth for a child is still worthwhile, even in cases of poor prognosis where the tooth had extended extra-alveolar dry storage. We believe that delayed replantation should be done because of its importance for the child's jaw and facial development.

Assessment of knowledge, attitude, and practices toward orofacial injuries among students engaged in sports from Davangere city: A cross sectional survey

Context: Traumatic dental injury (TDI) is a common occurrence during sports practice and training sessions which can be determined by the intensity and frequency of the contact. To prevent sport-related oral and facial injuries, the sports personnel should have adequate knowledge regarding occurrence, severity, and prevention of trauma. Studies with regard to awareness about orofacial injuries among sports personnel in Davangere city were not found. Aim: The aim is to assess the knowledge, attitude, and practices toward orofacial injuries among students of sports academy in Davangere city. Settings and Design: Sports academy and Hostel, Davangere; cross-sectional survey. Subjects and Methods: A descriptive cross-sectional survey was conducted among 305 sports students in sports academy in Davangere city. A twenty items self-designed structured, close-ended questionnaire was administered to the participants. Statistical Analysis Used: Results were generated in terms of frequencies and percentages using the Statistical Package for the Social Sciences Software 20 version IBM 20. Results: Out of 305 students, majority of the students were males. Forty-four percent of the participants had suffered from injuries to the face while playing sports. The most common type of injury was the fracture of a part of the tooth (51.4%). Falling during sports was the major cause of injury (48.81). Many of the participants were unaware of the fact about replantation of an avulsed tooth. Only 32.1% of the participants had used mouth guards. Seventy-two percent have never interacted with medical or dental experts regarding safety measures for the face and mouth during the sport activities. Conclusions: The study participant's knowledge was inadequate; attitude was moderate and poor practice toward prevention and management for orofacial injuries. Hence, they should be sensitized to the knowledge of sports-related injuries and its prevention and treatment.

Parents' awareness and attitude toward urgent management of avulsed permanent tooth in AL-Baha city

Objective: This study was conducted to evaluate the parents' awareness and attitude toward emergency management of avulsed tooth in AL-Baha city. Materials and Methods: Eleven-item questionnaire form was designed and sent randomly to parents with different demographic characteristics in Al-Baha city. A total of 263 questionnaires were collected. Data were statistically analyzed using SPSS program. Results: The majority of the respondents (n = 227; 86.3%) were females. The result revealed insufficient awareness among parents regarding the emergency management of tooth avulsion. One hundred fifty-two (58%) of the respondents think that replantation of an avulsed tooth is impossible where 76% (n = 202) of the parents were not aware of the transportation medium for the avulsed tooth. The demographic characteristics showed a nonsignificant impact on the awareness and attitude toward emergency management of the avulsed tooth in this study (P Conclusion: This study showed an insufficient awareness regarding tooth avulsion among Saudi subpopulation.

Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review.

Calcium hydroxide (CH) is the gold-standard intracanal dressing for teeth subjected to traumatic avulsion. A common complication after the replantation of avulsed teeth is root resorption (RR). The current review was conducted to compare the effect of CH with that of other intracanal medications and filling materials on inflammatory RR and replacement RR (ankylosis) in replanted teeth. The PubMed and Scopus databases were searched through June 2018 using specific keywords related to the title of the present article. The materials that were compared to CH were in 2 categories: 1) mineral trioxide aggregate (MTA) and endodontic sealers as permanent filling materials for single-visit treatment, and 2) Ledermix, bisphosphonates, acetazolamide, indomethacin, gallium nitrate, and enamel matrix-derived protein (Emdogain) as intracanal medicaments for multiple-visit management of avulsed teeth prior to the final obturation. MTA can be used as a single-visit root filling material; however, there are limited data on its efficacy due to a lack of clinical trials. Ledermix and acetazolamide were comparable to CH in reducing RR. Emdogain seems to be an interesting material, but the data supporting its use as an intracanal medication remain very limited. The conclusions drawn in this study were limited by the insufficiency of clinical trials.