Avulsed Teeth Research Articles

What is the impact of primary dental avulsion injuries on the permanent dentition?

Design Retrospective cohort study.Cohort selection Records of 2,922 patients, who attended a reference centre between 1998 and 2019 with primary dental trauma and who had radiographs and photographs, were screened to identify primary dental avulsion injuries that were followed-up until complete eruption of the permanent successors. 240 records were eligible and 194 fulfilled the inclusion criteria.Data analysis Exploratory descriptive analysis was carried out to map the occurrence and type of sequelae to the permanent tooth following primary avulsion, comparing this to the control group of permanent anterior teeth from the same children where the predecessor teeth had not suffered any type of dental trauma. Exploratory descriptive analysis was also used to link the age the primary avulsion occurred to the type of sequelae to permanent dentition. Multilevel Poisson regression analysis was performed and relative risk values and respective 95% confidence intervals were calculated to evaluate the association between avulsion and occurrence of sequelae. Confounders were included in the model to calculate their effect.Results Of the 194 patients included, there were 266 avulsed primary teeth and 115 of the permanent successors presenting with sequelae (43.2%), compared to 15.4% in the control group. Demarcated opacities were most common in both groups. Primary tooth avulsions occurring in children under two years old had a higher risk of sequelae to the permanent successor. There was also a higher risk of successor sequelae with avulsions of the lower arch compared to the upper and when three or more teeth were affected by the trauma compared to a single tooth. Avulsions in children over three years old had a lower risk of hypoplasia and those over four years old had a low risk of opacities to the successor.Conclusions Following avulsions of primary teeth, there is a higher risk of sequelae to the permanent successor in children younger than two years, where the lower jaw is involved and when multiple teeth are involved.

Propolis and Its Implications in Dentistry: A Review

Propolis is a resinous substance obtained from the beehives that has antioxidant, anti-bacterial, anti-viral, antifungal, and anti-inflammatory activity. Its diverse chemical content is responsible for many valuable properties. Multiple applications of propolis have been studied and described in detail for centuries. Propolis has been used for surgical wound healing, caries prevention, treatment of dentin hypersensitivity, treatment of aphthous ulcers and propolis as a storage medium for avulsed teeth, root canal irrigating solution, and mouthwash. This paper aims to indicate the uses of Propolis in various fields of dentistry. Keywords: Dentistry, Propolis, Oral health.

Emergency management of maxillary dentoalveolar fracture: A case report

Dentoalveolar trauma occurs in relation to injuries of fall, road traffic accidents, sports injury or physical violence. There may be injury limited to the tooth, or may involve the periodontium around, or in severe cases, alveolar bone or oral mucosa may be traumatised. There can be myriad injuries of the same structure depending upon the severity of impact. The injuries of tooth most commonly being crown fractures, followed by root fractures, luxation or complete avulsion of the tooth. Every type of dentoalveolar injury requires a specific set of clinical protocols to be followed in order to successfully diagnose and manage the particular case.We hereby report a case of a 29-year-old male patient with a history of fall under the influence of alcohol, who had fallen flat on his face and had suffered intrusive luxation of permanent maxillary right central incisor and avulsion of permanent maxillary left central and lateral incisors. The exarticulated teeth still had slight soft tissue attachment to the socket. On the patients first visit to dental OPD, being a dental emergency, the avulsed teeth were immediately restored back into the socket under local anaesthesia after adequately irrigating and debriding the socket, followed by repositioning of the internally luxated tooth, so that all were in their correct anatomical position. After checking for occlusion, they were splinted in position with Erich’s arch bar and 26 gauge SS wire and after giving post-operative instructions patient was asked to follow up after 6 weeks. At 6 weeks, the affected teeth were found to be firm and so arch bar were removed. Patient was advised to follow up further. At periodic follow ups, the patient was asymptomatic and maintained adequate oral functioning of the injured teeth, thus with good patient compliance and proper diagnosis and treatment, dentoalveolar fractures can be managed successfully. The main purpose of this article is to lay emphasis on the timing of treatment of the dentoalveolar injuries. The earlier they are managed, the better is the outcome.

Dental and general injuries among ski and snowboard instructors in Switzerland, Germany, and Austria-A questionnaire-based study.

ObjectivesData on the injury rate of skiers and snowboarders are currently limited. The aim of this study was, therefore, to assess the frequency of general and dental injuries among snow sports instructors, to investigate the use of protective gear and mouthguards, and to evaluate snow sports instructors' dental first aid know‐how.Material and MethodsA questionnaire‐based, cross‐sectional study comprising 603 ski and snowboard instructors from Austria, Germany, and Switzerland was conducted in the timeframe December 2019 to May 2020. The survey gathered data on general and dental injuries sustained by instructors, protective gear usage, and know‐how in dental first aid. The statistical analysis included χ 2 tests, Wilcoxon rank‐sum and Kruskal–Wallis tests, and linear regression analysis. The level of significance was set at α = .05.ResultsOut of the 603 instructors, 326 (54.1%) sustained an injury while skiing or snowboarding. Forty (6.6%) reported a snow sports‐related dental injury. The rates of injuries related to skiing and snowboarding showed no significant difference (p = .0952). Compared with snowboarding on slopes, backcountry snowboarding entailed fewer risks of injury for snowboard instructors (p = .012). Knowledge of dental first aid was limited, with 45.8% of instructors uninformed about the possibility of replanting avulsed teeth. 10.1% of instructors were familiar with tooth rescue boxes. None of the instructors surveyed had a tooth rescue box in their first aid equipment. Helmet usage was high (95.6%) among snow sports instructors, whereas mouthguard usage was rare (3.5%).ConclusionsProtective gear usage among snow sports instructors is high. The risk of dental injury while skiing or snowboarding is lower compared with other sports. Dental first aid know‐how ought to be enhanced in snow sports communities to ensure that appropriate first aid is provided in case of a dental injury related to skiing or snowboarding.

Trends and seasonality in public interest in dental trauma: Insights from Google Trends

To assess trends and seasonal variation of dental trauma by using the Google Trends data. Google Trends was used to obtain relative search volume (RSV) of search terms such as dental trauma, broken tooth, chipped tooth, knocked-out tooth, avulsed tooth, and gum trauma. The search strategy was set to the time period (January 2004 to December 2019), region (worldwide, the United States, the UK, Australia, Canada, New Zealand, Ireland, and Turkey), Web search, and all categories. Seasonal variation was evaluated using the cosinor analysis. The worldwide RSV values of broken tooth, chipped tooth, knocked-out tooth, and avulsed tooth have shown a general increase in recent years with an upward forecast line. The RSV values of dental trauma have shown a general increase in recent years with a plateau forecast line, and gum trauma has shown a stable trend with a plateau forecast line. Seasonal variation of chipped tooth, broken tooth, dental trauma, knocked-out tooth, avulsed tooth, and gum trauma was not found statistically significant in any of the countries (p>.025). The top related queries of chipped tooth and broken tooth were about pain, fix/repair, and cost. The top related topics for avulsed tooth and knocked-out tooth are about infant, child, toddler, and primary tooth. People's interest on dental trauma, broken tooth, chipped tooth, knocked-out tooth, and avulsed tooth has shown a general increase in recent years without showing a seasonal pattern. Healthcare professionals should pay more attention to people's concerns and informational needs.

Emergency management of dental avulsion and replantation

Dental replantation is a major problem in public health. Its prognosis depends on emergency care, but there is a lack of knowledge on it. So, this study aims to evaluate the knowledge of undergraduate students of Dentistry, Speech Therapy, Physical Education, Pedagogy, and Technologist in Radiology. One hundred and fifty one students answered 10 questions about emergency replantation care. Then, an educational lecture was performed. The same questions were asked again to the same students to reevaluate their answers. The statistical tests were employed at a significant level of p<0.05. There was a significant difference (p<0.05) on the answers before and after the lecture. The dental students had a higher knowledge of the subject (p<0.05). The educational presentation reached its objective, since there was an improvement in the index of all answers of the post-lecture questionnaire, demonstrating that the people must be informed and trained in the emergency management of dental avulsion.

Knowledge and Attitude of Guardians in Management of Avulsion of Primary and Permanent Teeth of Children: A Questionnaire-Based Study

Aims: This study aims to assess knowledge and attitude of guardians in management of dental avulsion of the children.
 Materials and Methods: This cross-sectional study was carried out at Altamash Institute of Dental Medicine, Pakistan, from April to May 2021. A total of 400 parents were recruited. An online self-administered questionnaire was circulated to the parents after taking the informed consent. 17 questions regarding demographics, knowledge and attitude were included. Chi-square test was used for association between demographics and responses of the participants.
 Results: Of the 400 participants, there were 140 (35%) males and 260 (65%) females. Most of the 180 (45%) participants belonged to 18-30 years age bracket. About 63% of the children did not have past dental trauma history. Predominantly, 80% chose dentists being most appropriate of emergency treatment. 33% believed to visit the dentist within 30minutes for treatment. About 50% participants agreed avulsed teeth can be placed back into its original position. More than half knew different transport mediums, with milk (21%) and Hanks Balanced Salt Solution (19%) being commonly selected. Younger age group and females were more knowledgeable regarding emergency management.
 Conclusion: Dental avulsion is a common finding in childhood, which mandates proper knowledge for the guardians. There is still a gap present in adequate knowledge for management of such emergencies which mandates organizations of education and awareness programs for both children and adults.

Effect of Photobiomodulation on Periodontal Ligament Cells Under Inflamed and Nutrient-Deficient Conditions Simulating Damaged Cells of Avulsed Teeth: An In Vitro Study.

Background: The prognosis of replanted teeth is depended on the vitality of periodontal ligament cells residual on the root surface. Photobiomodulation has photobiological effects that can promote cell vitality. The study aimed to explore the effect of photobiomodulation on the periodontal ligament cells under inflamed or starved conditions mimicking clinically damaged periodontal ligament cells of avulsed teeth and provide the adjuvant procedure for tooth replantation. Materials and methods: Normal, starved, or inflamed periodontal ligament cells were irradiated with an 808 nm laser at densities of 0, 1, 3, 5, or 10 J/cm2. The cell counting kit-8 (CCK-8) assay and scratch test were applied to determine the effects on the proliferation and migration of cells. Anti-inflammatory effects were assessed according to the mRNA expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) measured by reverse-transcription polymerase chain reaction. Osteogenic capacity was evaluated by alkaline phosphatase (ALP) staining, ALP activity assay, Alizarin Red S staining, and ALP and osteocalcin (OCN) mRNA expression. Results: The CCK-8 assay and scratch test demonstrated that the 808 nm laser significantly promoted proliferation and migration of normal condition periodontal ligament cells at a density of 3 J/cm2 versus 5 J/cm2 under the starved and inflamed conditions. Moreover, the 808 nm laser had anti-inflammatory effects and promoted osteogenesis of periodontal ligament cells at 3 J/cm2 under normal conditions, while photobiomodulation at 5 J/cm2 upregulated the osteogenesis of periodontal ligament cells under starved and inflamed conditions. Conclusions: The photobiomodulation of 808 nm laser reduced inflammation and improved the proliferation, migration, and osteogenesis of normal, starved, and inflamed periodontal ligament cells. These effects required a higher energy density under starved or inflamed conditions compared with normal conditions. The photobiomodulation of 808 nm has a potential application in root surface treatment for replanted teeth.

Knowledge and skills of emergency physicians in managing traumatic dental injuries

PurposeEmergency departments are frequently confronted with traumatic dental injuries (TDIs). The prognosis of the injured tooth is related to early dental trauma management. For this reason, physicians must be familiar with the appropriate management of TDI. This study aimed to investigate the knowledge and skills of German emergency physicians regarding TDI.MethodsAn electronic questionnaire was sent to 438 emergency departments throughout Germany. Four hundred and twenty seven questionnaires were evaluated and included in the analysis. The survey contained questions about physician characteristics and assessed their knowledge and skills of managing dental trauma. For statistical analysis, the Kruskal–Wallis, Mann–Whitney U test or ANOVA test was used as appropriate. Rank correlations were performed with the Spearman’s rank correlation.ResultsOut of 427 participants, 256 (59.95%) stated they had no or insufficient knowledge, and 266 (71.12%) stated they had no skills in dental trauma management. Almost 76% of the participants had no previous knowledge of dentistry. Only 7.28% knew the right procedure for replanting an avulsed tooth. Just 26.06% would choose the right medium for temporary tooth storage. Having a dentist in the family (p = 0.0074) or clinical exposure to patients with dental trauma (p = 0.0384) influenced the results of the knowledge score.ConclusionThe knowledge and skills in dental trauma management among German emergency physicians are generally inadequate. Targeted training courses are necessary to ensure early and adequate TDI treatment to reduce the resulting medical and societal costs as much as possible.

Odontogenesis-related developmental microenvironment facilitates deciduous dental pulp stem cell aggregates to revitalize an avulsed tooth

Harnessing developmental processes for tissue engineering represents a promising yet challenging approach to regenerative medicine. Tooth avulsion is among the most serious traumatic dental injuries, whereas functional tooth regeneration remains uncertain. Here, we established a strategy using decellularized tooth matrix (DTM) combined with human dental pulp stem cell (hDPSC) aggregates to simulate an odontogenesis-related developmental microenvironment. The bioengineered teeth reconstructed by this strategy regenerated three-dimensional pulp and periodontal tissues equipped with vasculature and innervation in a preclinical pig model after implantation into the alveolar bone. These results prompted us to enroll 15 patients with avulsed teeth after traumatic dental injuries in a pilot clinical trial. At 12 months after implantation, bioengineered teeth led to the regeneration of functional teeth, which supported continued root development, in humans. Mechanistically, exosomes derived from hDPSC aggregates mediated the tooth regeneration process by upregulating the odontogenic and angiogenic ability of hDPSCs. Our findings suggest that odontogenic microenvironment engineering by DTM and stem cell aggregates initiates functional tooth regeneration and serves as an effective treatment for tooth avulsion.

Network Meta-Analysis of 10 Storage Mediums for Preserving Avulsed Teeth.

Many storage mediums are available for the storage of avulsed teeth to preserve the viability of periodontal ligament (PDL) cells before replantation; however, it is unclear which medium is the optimal option. We performed this network meta-analysis to answer this question. A comprehensive search was conducted in PubMed, EMBASE, and the Cochrane library to capture eligible studies investigating the comparative efficacy of Hank's balanced salt solution (HBSS), aloe vera gel (AVG), oral rehydration solution (ORS), coconut water, egg white, green tea, propolis, saline, milk, and water. Statistical analysis was conducted using Review Manager v5.3 and ADDIS v1.16.8. In total, 20 RCTs involving 31 reports were included finally. Direct meta-analysis suggested that HBSS was superior to ORS, milk, saline, and water, ORS was superior to milk but inferior to coconut water and propolis, egg white was superior to milk but inferior to AVG and propolis, propolis was superior to AVG, milk, and saline, and coconut water and water was inferior to saline and milk, respectively. Network meta-analysis suggested that AVG was inferior to the other nine mediums, and propolis was superior to HBSS (SMD, −5260.24; 95% CrI, −10447.39 to −70.37) and milk (SMD, −5461.11; 95% CrI, −10574.99 to −328.51). Moreover, ranking probabilities indicated the highest probability for propolis, followed by saline, ORS, HBSS, milk, egg white, water, green tea, and AVG successively. Propolis may be the optimal media for storing avulsed teeth before replantation. However, given the availability of propolis and HBSS and the hypotonic properties of saline, ORS or milk should also be preferentially selected.

Knowledge and practice of health workers to tooth avulsion in a teaching hospital in Lagos, Nigeria


 
 
 
 Objective: The health care workers (HCW) may be the first contact of a tooth avulsion case. This study aimed to assess their knowledge and practice of emergency management of tooth avulsion.
 Methods: The cross-sectional study was carried out among health care workers in a teaching hospital, using a self-administered questionnaires containing closed and open-ended questions, on their knowledge and practice of management of tooth avulsion. Data collected was analyzed using EPI info version 7 statistical software.
 Results: A total of 362 questionnaires were administered with a response rate of 90.4%. The health care workers were 331 between the ages of 18 years to 64years. There were 200 (60.4%) females and 131(39.6%) males (ratio 3:2). Less than half (41.7%) of the respondents rated their knowledge on avulsion as fair. About half of the respondents 156 (47.1%) reported that primary tooth should be replaced into the socket. The knowledge of how to hold avulsed tooth among 217 (65.6%) of the respondents was incorrect. More than half 185 (55.9%) answered that avulsed teeth, will be stored in a dry medium. Less than half, 146 (44.1%) knew the appropriate storage media to be used. Only a third 122 (36.9%) were confident in their knowledge to replant an avulsed tooth. About a third 114 (34.4%) of HCW had encountered an avulsion case, most were dentists and nurses. More than a quarter 92 (27.7%) referred the avulsion while (16.1%) did nothing to the avulsed tooth.
 Conclusion: There is a need to increase the knowledge and practice of HCW, so that immediate replantation can be practiced thereby improving the prognosis for replanted teeth.
 
 
 

The Influence of Dental Trauma Education on Undergraduate Students at Ajman University, United Arab Emirates: An Interventional Study.

Background and ObjectivesThe main objective of this study was to assess the impact of a lecture on dental trauma on the knowledge of undergraduate dental students at Ajman University in the United Arab Emirates (UAE).MethodsFourth-year dental students were asked to attend a lecture on dental trauma and then respond to an online questionnaire containing 10 close-ended questions related to their approach to managing dental trauma cases and tooth avulsion before (T0) and directly after (T1) the lecture. They were given 5 min for filling the questionnaire either time. McNemars test was used to compare the accuracy of their answers based on the correct or incorrect response for each question. The level of significance was set at p < 0.05.ResultsThe questionnaire was sent to 164 students, out of which 157 responded, giving a response rate of 95.7%. After receiving the educational intervention, the students showed a significant improvement in their knowledge on managing permanent tooth avulsion, especially regarding the handling of an avulsed tooth before replantation, extra-alveolar time, and media used for the storage and transportation of avulsed teeth (< 0.001).ConclusionThe study reveals that the lecture on dental trauma had an excellent outcome on the knowledge of the students. Therefore, it is essential to emphasize the importance of this information among undergraduate dental students in order to save teeth exposed to trauma and to reduce the social burden of such cases. This study contributes to better understanding of the effect of dental trauma education on undergraduate dental students’ knowledge of the subject.

Paediatrician's Perspective and Awareness Regarding Dental Trauma and Its Emergency Management

Background: Traumatic injuries to dentoalveolar tissues in children are considered the most grievous oral health problem and the prognosis of these injured teeth depends on the primary care. Pediatricians must hold sufficient knowledge on primary management of dental injuries such as tooth avulsion before referring to dentists as they experience such type of dental trauma in an emergency more routinely. Objectives: To evaluate the knowledge and perception of the practicing pediatricians of New Delhi about dental trauma and its emergency management in children and adolescents and to understand the experience of Paediatricians in the primary therapy of dental trauma. Results: Fifty-seven of 60 respondents completed the questionnaire, of which 87.7% had encountered dental trauma in their career. Although 89% of respondents had received training regarding oral injuries and their management; still they felt that their knowledge was incomplete and they wanted to attend further training. Conclusion: More and more workshops and short-term courses should be conducted to improve the current knowledge of pediatricians. In the current scenario, the management of dental and dentofacial trauma should be included in the undergraduate and postgraduate programs.

Extra-oral approach to lower third molar: a rare surgical indication.

The avulsion of the impacted lower third molar is one of the most common procedures in oral surgery. Even though it is characterized by possible complications due to the lesion of lingual and inferior alveolar nerves, the intra-oral surgical approach represents the first-choice strategy when planning surgery. However, in case of ectopic tooth in the mandibular basal bone, it is appropriate to consider an extra-oral transcutaneous surgical approach. The ectopia of the inferior wisdom tooth represents a very rare clinical condition and sometimes it is even unknown by patients and dentists: further evidence of this fact is represented by the paucity of paper related to the topic that can be found in the international scientific literature. The experience of the Department of Maxillofacial Surgery of San Gerardo Hospital in Monza (Italy) in management and treatment of ectopic impacted lower third molar is exposed through the presentation of three cases of ectopic third molar. Two out of three patients, aware of the risks related to the surgical procedure, refused the treatment proposed. One patient underwent surgical avulsion of the wisdom tooth through extra-oral transcervical approach. No early or late complications have been observed. Extra-oral surgical approach for ectopic lower third molar should be considered for selected cases. Given the rarity of the clinical condition and the procedure-related risks, accurate preoperative information has to be provided to the patient by physician and the procedure should only be performed by expert and competent surgeons.

Are student knowledge levels and attitudes about avulsion dental trauma adequate in the faculty of medicine?

Aim: The aim of this study was to measure the knowledge levels and attitudes of medical students in Kahramanmaraş city on traumatic dental injuries, particularly dental avulsion.&#x0D; Methodology: A total of 224 students studying at the medical school in Kahramanmaraş province were included in this research. The students filled out two-part questionnaire forms containing 17 items in total. We used descriptive frequency analysis, crosstabs, and the chi-square test.&#x0D; Results: Only 7.6% of the students had received relevant training on dental injuries; however, 70.6% did not find the training sufficient. In the case report on replanting a primary tooth, 70.1% of the participants agreed that the primary tooth should not be replanted. In the case report on replanting a permanent tooth, 70.5% of them stated that, although they knew the fallen tooth to be a permanent tooth, they would refer the patient to a dentist immediately because they did not have relevant knowledge for the case. Additionally, 7.6% of the participants stated that if a permanent tooth was avulsed, they would keep the tooth in milk.&#x0D; Conclusion: We concluded that students majoring in medicine had insufficient knowledge levels and attitudes regarding dental injuries leading to avulsion, and we believe this subject needs to be covered by the relevant curriculum.&#x0D; &#x0D; How to cite this article: İpek S, Soğukpınar Önsüren A. Are student knowledge levels and attitudes about avulsion dental trauma adequate in the faculty of medicine? Int Dent Res 2021;11(Suppl.1):143-51. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.22&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.&#x0D;

Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports

Aim: Traumatic dental injuries at the anterior region of the maxilla occur frequently in children and adults. In this case report, we aimed to describe the temporary aesthetic restoration of the upper lateral incisor with a fiber-reinforced bridge by using the original tooth crown, which had avulsed after dental trauma.&#x0D; Methodology: Case 1: A 14-year-old girl with an avulsion in tooth #11 due to trauma visited our clinic. During the examination, it was seen that the wound had healed, and there was no luxation in teeth #21 and #12. Since the patient could not undergo prosthetic procedures, for reasons including implants, and did not want a removable prosthesis, a single crown supported by acrylic tooth fibers was constructed.&#x0D; Case 2: A 17-year-old male patient was referred to our clinic because of an avulsed left lateral incisor tooth, which was traumatized 15 days before visiting the clinic. His medical history revealed that his parents had found the tooth two hours after the trauma. However, the emergency clinic that he had previously visited did reimplant that tooth and repaired it with fiber-reinforced composite.&#x0D; Case 3: In the examination of a 12-year-old male patient who applied to our clinic due to trauma, it was observed that tooth #11 had an avulsion and tooth #12 had a crown fracture. Root canal treatment was performed. A crown was made for the patient by supporting the fiber inside the canals of tooth #11 and tooth #21. It was revised aesthetically with the support of the crown of the other tooth.&#x0D; Conclusion: Avulsion after anterior trauma affects patients’ appearance aesthetically; thus, patients want to be treated as soon as possible. Function, phonation, and aesthetics must be quickly provided for a loose anterior tooth. Fiber-reinforced adhesive bridge techniques may be considered as a temporary treatment for providing an aesthetically appealing appearance until the completion of permanent prosthetic treatment.&#x0D; &#x0D; How to cite this article: Şahin M, Toptancı İR. Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports. Int Dent Res 2021;11(Suppl.1):285-91. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.42&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Bacterial Biofilm Growth on Various Dental Stabilization Systems for Avulsed and Luxated Teeth

With the increased incidence of traumatic injuries and the advanced understanding of the periodontal and alveolar healing process, teeth splinting has become a common practice for stabilizing traumatized teeth. Consequently, several splinting materials and techniques have been introduced in the past few years. Despite the detrimental role of bacterial biofilm on healing, the level of biofilm development on these material surfaces has not been well investigated. Bacterial biofilms are severely detrimental for periodontal healing of avulsed and luxated teeth. Thus, biofilm growth becomes a critical factor in selecting the material of choice for dental splints. In this study, we aim to assess the level of oral biofilm growth on four different splinting systems: Ribbond©, orthodontic NiTi wire, monofilament fishing line, and Titanium Trauma Splint. A total of 72 extracted anterior teeth were divided into four groups. We splinted six rows of three teeth each per group. The teeth selected were caries-free and periodontitis-free at the time of extraction. To assess biofilm growth, a supragingival dental plaque sample was cultured and directly inoculated into all groups. After 7 days, bacterial growth was quantified by live/dead fluorescent microscopy assay and colony forming unit counts (CFU). Using one-way ANOVA and Bonferroni’s post hoc tests, we demonstrated that all splint systems allowed for bacterial growth. However, the Titanium Trauma Splint (TTS) allowed for the least amount of biofilm growth compared to other splint systems.

Causes of primary tooth avulsion and replantation treatment

During primary dentition, the etiology changes by age group. For instance, traumas secondary to collisions and falls are attributable to early movement within the first six years, while accidents secondary to frequent playing are the main reason within the following nine years, and violence is the most common etiology until the age of 25 years old. Previous studies have estimated that traumas from falls, sporting activities, bicycling, traffic accidents, and violence were the most common causes of dental injuries in children. Iatrogenic causes also contribute to 0.04-12% of dental injuries, including avulsions. According to the current evidence, whether to use reimplantation or not is still controversial and further investigations are needed. Among the various case reports, damage to the permanent successors, root resorption, clot formation, and pulp necrosis were documented as potential complications and adverse events with intended reimplantation. However, many techniques were reported to overcome these problems. Besides, favorable outcomes following reimplantation could be hypothetically obtained as sound articulation, proper mastication, and proper dentition. Therefore, this encourages reimplantation, however, further evidence is still needed to validate the proposed advantages and disadvantages of the approach.

Infraposition or infraocclusion– Is it time to rename?

AbstractDental infraposition and dental infraocclusion, hereinafter referred to as infraposition and infraocclusion respectively, are terms that are often used interchangeably. This can be noted in the International Association of Dental Traumatology guidelines for the management of traumatic dental injuries, where infraocclusion is listed as an injury‐specific outcome following avulsion of permanent teeth. Infraposition and infraocclusion are terms that have been used in the dental literature to describe teeth that interfere with the normal eruption and development of the permanent dentition. While teeth described in this manner share certain clinical characteristics that give rise to these terms being used interchangeably within the dental traumatology field, this may not necessarily be correct and may be confusing. The aim of this short communication is to start a discussion in the dental trauma community regarding the need for a more adequate term, particularly in relation to replanted teeth.