Treatment Of Avulsed Teeth Research Articles

Combination of Revascularization and Apexification in the Treatment of an Avulsed Tooth: A Case Report

To demonstrate an exceptional result in the treatment of an avulsed tooth that had been stored in a dry environment for over 2 hours before being replanted. Sixteen percent of all traumatic injuries to the permanent dentition are avulsions. Maxillary central and lateral incisors are most commonly affected. In this report, a 7-year-old girl sustained trauma to the upper right maxillary incisor during a bicycle accident. The tooth was avulsed and remained outside the oral cavity for more than 2 hours in a dry napkin before eventual reimplantation in the emergency room. Upon presentation to the endodontic clinic at the University of Southern California, the case was assessed, and the available treatment options discussed with the patient's parents. Revascularization using BC putty was the chosen mode of treatment. At a 6-month recall appointment, the patient presented with a sinus tract. A decision was then made to perform apexification using the mineral trioxide aggregate (MTA) as an apical filling material. To date, the tooth remains intact and functional. Although both of the described treatment modalities are acceptable and commonly used in modern endodontics, apexification of a tooth following a failed attempt of a regenerative procedure has not been described. In this case, a chronic abscess formed and the ultimate goal of revascularization was not achieved. However, the performance of the revascularization procedure was not without benefit since it allowed the tooth to develop in both length, dentinal volume, and aided in the partial closure of the apical foramen. Additional studies are needed regarding the treatment of avulsed teeth. This case study may provide a viable treatment alternative in a number of clinical situations. The procedures described in this case report may be of clinical significance in the treatment and retention of teeth, which may otherwise be considered to have a poor prognosis and extracted.

Dental implants practice of general dentists influences the treatment of avulsed teeth in adults

Dental implants practice of general dentists influences the treatment of avulsed teeth in adults

Parental Knowledge and Attitudes Toward Dental Trauma and Prevention in Handball and Basketball Athletes in Rijeka, Croatia

The aim of this study was to investigate parental knowledge and attitudes about emergency treatment of avulsed teeth, the potential of using mouth guards during children’s sports, and the importance of education on this subject. Method and materials. This study was conducted on a sample size of 127 parents of athletes 8-15 years old, who were all members of handball and basketball teams in Rijeka, Croatia. Results. Approximately 68% of parents had not received education about dental injuries and were not informed about it. A small proportion of the children wore mouth guards, regardless of whether their parents were educated in terms of dental trauma or not. In the analysis of emergency procedure method used on avulsed tooth, no statistically significant difference was found between those who were previously educated about dental trauma and those who were not. Conclusion. Mouth guards should definitely become part of the mandatory equipment in sports, and this awareness should be raised in athletes as well as their parents. It is necessary to educate the public about emergency procedures in the event of dental injury.

Periodontal Tissue Engineering After Tooth Replantation

Blood-derived products, platelet-poor plasma (PPP) and platelet-rich plasma (PRP), constitute an approach in the enhancement of tissue healing. PRP has also been used as a scaffold for bone marrow stem cells in tissue engineering. This study evaluates the effect of PPP, calcium chloride-activated PRP (PRP/Ca), calcium chloride- and thrombin-activated PRP (PRP/Thr/Ca), and bone marrow mononuclear cells and PRP/Ca (BMMCs/PRP/Ca) on the healing of replanted dog teeth. After 30 minutes of extraction, teeth were replanted with 1) no material (control); 2) PPP; 3) PRP/Ca; 4) PRP/Thr/Ca; or 5) BMMCs/PRP/Ca. Histologic, histomorphometric, and immunohistochemical analysis was assessed 120 days after replantation. Data from histomorphometric analysis were analyzed statistically (analysis of variance, Tukey; P <0.05). Quantitative immunohistochemical analysis was analyzed by Kruskal-Wallis and Dunn post hoc test (P <0.05). Flow cytometry analysis showed 55.98% of CD34(+) and 32.67% of CD90/Thy-1 for BMMCs sample. BMMCs/PRP/Ca presented the largest areas of replacement resorption characterized by osseous ingrowth into cementum (P <0.05), with intense immunomarcation for tartrate-resistant acid phosphatase. The PRP/Ca group also showed areas of replacement resorption with significant immunomarcation for osteopontin. PRP/Thr/Ca presented no replacement resorption. PPP showed areas of inflammatory resorption, with immunomarcation for tartrate-resistant acid phosphatase. The results suggest that platelets activated with thrombin play an important role in the healing of tissues after tooth replantation. Additional studies are necessary to test other materials, because PRP/Ca did not present an appropriate scaffold for undifferentiated cells in the treatment of avulsed teeth.

Treatment of avulsed teeth with Emdogain®– a case report

The present case report describes the reimplantation of avulsed teeth with the treatment of Emdogain. Case was avulsed right maxillary permanent central and lateral incisor in a 9-year-old girl suffering from a traumatic injury. After pretreatment of avulsed teeth, Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical percussion sound and periapical radiographs. At 1-2-6-12-month follow-up period, the clinical and radiographic appearance of the teeth showed resolution of mobility and no signs of replacement resorbption.

Treatment and prognosis of avulsed teeth: A discussion and case report

A documented case that involves avulsion of an incisor is reported. Calcium hydroxide failed to prevent progressive irreversible root resorption. The importance of extraoral time, transport media, duration and type of splinting, as well as the rationale for the use of calcium hydroxide in the treatment of avulsed teeth are discussed. This case could serve as a reminder to practitioners, that patient compliance, timing and sequencing of endodontic therapy, and regular recalls is critical in the prevention or treatment of root resorption in avulsed teeth. It also emphasizes the frustration of many clinicians in treating avulsed immature teeth. The reporting of long-term documented cases should be encouraged so that replantation techniques may be evaluated.

Emergency treatment of avulsed teeth.

Emergency treatment of avulsed teeth.

The treatment of avulsed teeth

More than 2 million teeth are accidentally avulsed each year in the United States. Most of the victims are children. Almost all of these teeth can be saved if the proper treatment is instituted. Regardless of the frequency with which it occurs, every pediatric health care provider must be prepared for patients who have avulsed teeth. By instituting the proper treatment, the provider may help to save a victim's tooth, thus saving the family and child the expense of dental treatment and the possible psychologic problems associated with false teeth. Each health care provider should take the following steps: 1. Inform all health care personnel that avulsed teeth can and should be saved. 2. Teach all health care personnel what action should be taken if a tooth is avulsed. 3. Fabricate or purchase tooth-preserving devices such as the Emergency Tooth Preserving System, which can safely store, preserve, and transport avulsed teeth. 4. Place these tooth-preserving devices at strategic locations such as in emergency kits or at nurses' stations.

The Effect on Periodontal and Pulpal Tissues of Various Cleansing Procedures Prior to Replantation of Extracted Teeth

The effect of cleansing the root surface of extracted teeth in either saliva or tap water prior to replantation was studied in green Vervet monkeys (Cercopithecus aethiops). Maxillary central- and mandibular lateral incisors and mandibular first molars were extracted. The extra-alveolar period before replantation was 10 sec. During this period the root surface was cleaned with either saliva or tap water. The replanted teeth were examined histologically after 8 weeks. The histometric analysis showed significantly more normal periodontium and significantly less inflammatory root resorption in teeth cleaned in tap water than in teeth cleaned in saliva. The beneficial effect of this rinsing procedure in clinical practice in case of mature teeth is dubious, as inflammatory resorption is normally controlled by pulp extirpation and a root canal filling. Furthermore, the abovementioned finding is based on the use of tap water with only a moderate chlorine concentration, leading one to suspect that tap water with higher chlorine concentrations may be detrimental to healing. Provisional guidelines for the immediate treatment of avulsed teeth are suggested.