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Sheng K, Ding N, Zhao SM, Chen H, Lai GY, Wang J. Outcome of regenerative endodontic procedures in delayed replanted immature permanent teeth with apical periodontitis: A retrospective study. Int J Paediatr Dent 2025; 35:540-550. [PMID: 39245892 DOI: 10.1111/ipd.13265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 08/10/2024] [Accepted: 08/24/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Regenerative endodontic procedures (REPs) is effective for treating young permanent teeth with pulp necrosis. However, its efficacy on delayed replanted avulsed teeth is unclear. AIM This retrospective study aimed to assess the efficacy of REPs in treating delayed replanted immature permanent teeth with apical periodontitis. DESIGN Avulsed teeth receiving REPs were systematically screened based on predetermined criteria. This study assessed the REP outcomes, postoperative periodontal healing, and overall treatment efficacy. Samples were grouped by REP outcomes and root development stage, with Fisher's exact tests used to compare outcomes among different groups. RESULTS Among the included 17 teeth, 47.1% exhibited successful REPs and periodontal healing. Another 47.1%, due to replacement resorption or REP failure, were categorized as tooth survival. Healing of periapical lesions was observed in 88.2% of the cases, but only 41.2% demonstrated continued root development. Although differences were not significant (p = 0.05), teeth with continued root development had a higher rate of functional healing (85.7%) compared to those without (30%). CONCLUSION Within the limitations of this study, REPs presented reliable outcomes for treating delayed replanted immature permanent teeth with apical periodontitis mainly in periapical lesion healing. Teeth with continued root development after REPs exhibited a higher rate of functional healing. Further investigation is required to explore potential synergies between REP outcomes and periodontal healing.
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Affiliation(s)
- Kai Sheng
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Ning Ding
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Shi-Min Zhao
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hui Chen
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Guang-Yun Lai
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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Maloney B, O'Connell AC, Leith R. An evaluation of the knowledge, attitudes and treatment approaches of general dental practitioners in Ireland in the management of traumatic dental injuries. Eur Arch Paediatr Dent 2025; 26:329-340. [PMID: 39648263 DOI: 10.1007/s40368-024-00981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 11/22/2024] [Indexed: 12/10/2024]
Abstract
INTRODUCTION Traumatic Dental Injuries (TDIs) are a common oral health problem worldwide. Prompt and accurate diagnosis and treatment maximises the chances of favourable outcomes. This study aimed to evaluate the knowledge and attitudes of Irish Dentists regarding the management of TDIs based on different trauma scenarios. METHODOLOGY Following ethical approval, a cross-sectional, 22-item self-administered questionnaire was distributed electronically to members of the Irish Dental Association between January and March 2024. RESULTS A total of 245 complete responses were obtained, representing a 17% response rate. The results demonstrated a correlation between self-reported knowledge and number of correct answers. Overall 80% of respondents chose the correct storage medium for avulsed teeth. The majority of dentists aged > 46 years were unaware of the updated IADT guidelines. A large proportion of dentists showed inadequate knowledge with regard to the management of intruded permanent teeth (65%) and the endodontic management of an immature avulsed permanent tooth (50%). Management of intruded teeth and knowledge of root fractures was not as good as other injury types. The majority of respondents (85%) correctly answered that a tooth with negative sensibility tests following subluxation does not require endodontic treatment immediately. CONCLUSIONS The survey had an acceptable response rate and demonstrated overall good knowledge in the management of TDIs. However, there was still confusion over management of certain scenarios which could have negative repercussions for patients entering an unnecessary restorative cycle. There is a need to improve practitioner confidence and experience in the management of certain TDIs and improve awareness of the IADT guideline as a resource, especially in dentists with more years of experience.
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Affiliation(s)
- B Maloney
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Dublin, Ireland.
| | - A C O'Connell
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Dublin, Ireland
| | - R Leith
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Dublin, Ireland
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Wu S, Lui JN. Intentional Replantation of C-shaped Mandibular Second Premolar with Radicular Groove. J Endod 2025:S0099-2399(25)00144-X. [PMID: 40118269 DOI: 10.1016/j.joen.2025.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Revised: 03/10/2025] [Accepted: 03/10/2025] [Indexed: 03/23/2025]
Abstract
C-shaped roots with radicular grooves are uncommon in mandibular premolars. Bacteria residing in the radicular groove and associated accessory canals can contribute to persistent periradicular infections. Eradicating bacteria in these less accessible areas remains a significant challenge in endodontic procedures. This report describes the successful management of a left mandibular second premolar (#20) with a persistent lesion related to a lingual radicular groove through an intentional replantation procedure. A 31-year-old Chinese male complained of a gum swelling related to tooth #20 which was endodontically treated and crowned 6 years ago. Clinical examination revealed a lingually located sinus tract and a clinically intact crown restoration. The tooth was not tender to percussion or palpation, with probing depths not exceeding 4 mm, and showed physiological mobility. A periapical radiograph showed the lingual sinus tract traced to the mid third of the root, which had an adequate root canal filling and an intact periodontal ligament around the apical region. A cone-beam computed tomography image revealed radiolucency at the mid third region and on the lingual aspect related to the radicular groove of this C-shaped premolar. Intentional replantation was performed due to the location of the mid-root lesion related to the lingual radicular groove. Tooth #20 was extracted atraumatically, a stained radicular groove was identified, cleansed and sealed with Biodentine, and the tooth replanted. At 2.5-year follow-up, the patient was clinically asymptomatic. Tooth #20 presented with normal probing depths and mobility and healing was observed on the cone-beam computed tomography images.
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Affiliation(s)
- Siwen Wu
- National Dental Centre Singapore (NDCS), Singapore, Singapore.
| | - Jeen Nee Lui
- National Dental Centre Singapore (NDCS), Singapore, Singapore
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Vitali FC, Sumar GR, Savaris JM, Marin C, da Fonseca Roberti Garcia L, da Silveira Teixeira C. Clinical Management of Orofacial Trauma Including Multiple Avulsions, Lateral Luxation, and Alveolar Fracture: A Case Report with 7-Years of Follow-Up. J Endod 2025; 51:213-221.e1. [PMID: 39617294 DOI: 10.1016/j.joen.2024.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 11/19/2024] [Accepted: 11/24/2024] [Indexed: 12/13/2024]
Abstract
The occurrence of different types of trauma concomitantly can complicate the establishment of the most appropriate treatment. This report describes the clinical management of orofacial trauma including multiple avulsions, lateral luxation, alveolar fracture, and their sequelae after 7 years of follow-up. A 19-year-old woman presented to emergency care 4 hours after an accidental fall that resulted in the avulsion of teeth #8, #9, and #25; a complicated crown fracture and lateral luxation of tooth #7; an uncomplicated crown fracture of tooth #10; and a fracture of the maxillary alveolar bone. Only teeth #8 and #9 were located by the patient. The immediate treatment included surgical reduction and extrusion of the lateral luxation, delayed replantation of the avulsed central incisors, nonrigid splint stabilization, and suturing of gingival lacerations. Subsequent visits involved removal of the splint, root canal treatment of the maxillary incisors, implant placement to replace the avulsed mandibular incisor, and esthetic rehabilitation with composite resin. At the 5-year follow-up, cone beam computed tomography revealed advanced surface root resorption in the replanted incisors. At the 7-year follow-up, an aggravation of inflammatory resorption in the replanted incisors was observed. This report demonstrates that adequate knowledge of trauma management by clinicians is essential for the effective management of more complex cases. It also highlights the importance of long-term follow-up in cases of avulsion and replantation due to potential long-term sequelae.
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Affiliation(s)
- Filipe Colombo Vitali
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Gabriela Ribeiro Sumar
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Julia Menezes Savaris
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Charles Marin
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Wikström A, Brundin M, Mohmud A, Anderson M, Tsilingaridis G. Outcomes of apexification in immature traumatised necrotic teeth and risk factors for premature tooth loss: A 20-year longitudinal study. Dent Traumatol 2024; 40:658-671. [PMID: 38840386 DOI: 10.1111/edt.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND/AIM To evaluate the long-term survival of immature traumatized incisors with pulp necrosis and apical periodontitis after endodontic treatment with two apexification techniques (calcium hydroxide apexification and MTA-apical plug) and to identify major factors affecting the survival of these teeth. MATERIALS AND METHODS Records of 2400 children and adolescents were screened for presence of traumatic dental injuries to immature incisors where endodontic treatment with the two apexification techniques was performed during January 2003 and December 2022, compared to a control group of mature teeth treated with conventional endodontic techniques. The studied variables were age; sex; apexification technique, presence of luxation and hard tissue injuries; preoperative root development stage (RDS), preoperative and postoperative periapical index (PAI), the time-point for tooth loss, and overall survival time in years. Kaplan-Meier estimates were used to graphically present the survival functions and Cox proportional hazard model to calculate hazard ratios (HR, 95% CI). RESULTS The median survival time was 10 years for calcium hydroxide apexification, 16.1 for MTA-apexification, for luxation injuries other than intrusions and avulsions 15.5 years, for intrusions 12.5 years and for avulsions 6.8 years. The variables with significant negative impact on tooth survival were calcium hydroxide apexification, avulsion and postoperative PAI 3-5. No significant relationships were found for the variables MTA apexification, concussion; subluxation; lateral luxation; extrusion, intrusion, hard tissue injuries, preoperative RDS and PAI scores and postoperative PAI 1-2. After adjustment, the risk for premature tooth loss was 13.5 times higher in calcium hydroxide apexification, approximately 2 to 4 times higher in PAI 3-5, and 5.6 times higher in avulsions. CONCLUSIONS Calcium hydroxide apexification, avulsion, and postoperative PAI 3-5 were identified as prognostic variables with significant negative impact on the risk for premature tooth loss.
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Affiliation(s)
- Alina Wikström
- Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre of Paediatric Oral Health, Stockholm, Sweden
- Department of Endodontics, Eastmaninstitutet, Folktandvården Stockholm AB, Public Dental Services, Stockholm, Sweden
| | - Malin Brundin
- Department of Endodontics, Umeå University, Umeå, Sweden
| | - Afrah Mohmud
- Department of Endodontics, Eastmaninstitutet, Folktandvården Stockholm AB, Public Dental Services, Stockholm, Sweden
| | - Maria Anderson
- Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre of Paediatric Oral Health, Stockholm, Sweden
- Department of Paediatric Dentistry, Eastmaninstitutet, Folktandvården Stockholm AB, Public Dental Services, Stockholm, Sweden
| | - Georgios Tsilingaridis
- Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre of Paediatric Oral Health, Stockholm, Sweden
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Bradshaw J, Kahler B, Nanayakkara S, Prabhu N. Permanent tooth avulsions: A retrospective analysis of the demographics and aetiology of cases at a tertiary hospital in Sydney, Australia. AUST ENDOD J 2024; 50:640-648. [PMID: 39297708 PMCID: PMC11636057 DOI: 10.1111/aej.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/05/2024] [Accepted: 09/08/2024] [Indexed: 12/13/2024]
Abstract
This retrospective analysis reviewed the demographics of patients sustaining dental avulsion injuries at a tertiary dental hospital in Sydney, Australia. Data were extracted from dental records of patients who presented with avulsed permanent anterior teeth and were treated between 1 January 2001 and 30 June 2021. Demographic, clinical and radiographic data from 91 patients with 117 avulsed permanent anterior teeth were available for analysis. The median age of the patients was 12 years (IQR 9.0-17.0). Males accounted for 68.4% of avulsion injuries. Non-organised sports were the most common cause of injury (42.7%). Maxillary central incisors were the most frequently avulsed tooth (83.3%). Peak prevalence of injuries occurred on the weekend. The findings from this study may reflect regional factors such as climate and participation in sport. Anticipatory guidance should be provided to patients at elevated risk of dental avulsion.
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Affiliation(s)
- Julia Bradshaw
- School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Department of Paediatric DentistryWestmead Centre for Oral HealthWestmeadNew South WalesAustralia
| | - Bill Kahler
- School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Shanika Nanayakkara
- School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Neeta Prabhu
- School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Department of Paediatric DentistryWestmead Centre for Oral HealthWestmeadNew South WalesAustralia
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Leidenz J, Soto Perez SC. Utility of Orthodontic Braces as Flexible Splint for Stabilizing an Avulsed Tooth: A Case Report. Case Rep Dent 2024; 2024:3913304. [PMID: 39364291 PMCID: PMC11449548 DOI: 10.1155/2024/3913304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 08/27/2024] [Indexed: 10/05/2024] Open
Abstract
Dental avulsion is a traumatic dental injury with complete displacement of the tooth outside the bony socket. Both primary and permanent teeth are predisposed to such traumatic incidents. The most effective treatment in such cases is tooth replantation. Additionally, a short-term flexible splint is needed to stabilize the avulsed/replanted tooth. This case report describes orthodontic braces as a standardized flexible splint option for the treatment of tooth avulsion. Herein, the case of a 9-year-old female patient who presented to a private dental clinic with an avulsed upper left central incisor, 1 h after the accident has occurred. Once the tooth was replanted with all the necessary precautions, orthodontic braces and wire were utilized to stabilize the tooth. Most dental splints are custom-made, requiring thorough professional knowledge and expertise for their fabrication and placement. The protocol described in this report is aimed at easing tooth stabilization using materials within the scope of a basic dental setup consultation room.
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Affiliation(s)
- J. Leidenz
- Dentistry DeparmentKings Dental Center, Doha, Qatar
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8
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Cernochova P, Cernoch C, Klimo Kanovska K, Tkadlec E, Izakovicova Holla L. Treatment options for impacted maxillary canines and occurrence of ankylotic and resorptive processes: a 20-year retrospective study. BMC Oral Health 2024; 24:877. [PMID: 39095765 PMCID: PMC11297751 DOI: 10.1186/s12903-024-04662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND This 20-year retrospective study aimed to evaluate the treatment methods used in patients with impacted maxillary permanent canines and to determine the occurrence of ankylotic and resorptive processes and their association with potential risk factors. METHODS The cohort consisted of 351 consecutive Caucasian patients (120 males and 231 females, mean age 18.4 and 19.9 years, respectively) with 420 impacted maxillary permanent canines. CT and CBCT findings were subsequently confirmed during surgery. Statistical analyses were performed by the generalized linear models, Pearson x2 and Fisher exact tests using the statistical programs R and Statistica v. 14. RESULTS A total of 273 (65.0%) impacted canines were aligned in the dental arch by orthodontic traction after surgical exposure, this treatment was predominant in patients under 20 years of age. Surgical extraction was performed in 115 (27.2%) impacted canines and was more common in older patients. Ankylotic changes were recorded in 61 (14.5%) impacted canines. The probability of ankylosis increased with age, particularly after the patient's 20th year of life (p < 0.001). Patients were 1.2% likely to develop ankylosis at age 15 years, 4.3% at age 20 years, 14.1% at age 25 years, and 96.8% at age 45 years. Invasive cervical root resorption (ICRR) was found in 8 (1.9%) canines. In 4 canines (1.0%), root ankylosis in addition to ICRR was observed. In contrast to ankylosis, whose frequency of occurrence increased with age, the occurrence of ICRR resulting from PDL damage during surgery was more typical in younger patients. Canines in a high position above the root apices of the adjacent teeth, with a horizontal inclination of the longitudinal axis, with the crown located deep in the center of the alveolar bone and with labiopalatal position, should be considered critically impacted canines with a high risk to failure of orthodontic traction. CONCLUSION In conclusion, the treatment of impacted canines depends mainly on the age of the patient, and the position and inclination of the longitudinal axis of the impacted tooth. To select an adequate treatment method, we recommend CBCT examination, which allows a precise analysis of the position of impacted canines.
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Affiliation(s)
- Pavlina Cernochova
- Clinic of Stomatology, Institution Shared with St. Anne´s University Hospital, Faculty of Medicine, Masaryk University, Pekařská 53, Brno, 656 91, Czech Republic.
| | - Cenek Cernoch
- Clinic of Stomatology, Institution Shared with St. Anne´s University Hospital, Faculty of Medicine, Masaryk University, Pekařská 53, Brno, 656 91, Czech Republic
| | - Karin Klimo Kanovska
- Clinic of Stomatology, Institution Shared with St. Anne´s University Hospital, Faculty of Medicine, Masaryk University, Pekařská 53, Brno, 656 91, Czech Republic
| | - Emil Tkadlec
- Faculty of Science, Palacky University Olomouc, 17. listopadu 1192/12, Olomouc, 779 00, Czech Republic
| | - Lydie Izakovicova Holla
- Clinic of Stomatology, Institution Shared with St. Anne´s University Hospital, Faculty of Medicine, Masaryk University, Pekařská 53, Brno, 656 91, Czech Republic
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Blum JS. The various forms of tooth resorption. AUST ENDOD J 2024; 50:191-201. [PMID: 38798140 DOI: 10.1111/aej.12857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024]
Abstract
Tooth resorption refers to the loss of the organic and inorganic components of tooth structure by clastic cells. The complex and multifaceted nature of its aetiology, along with the several classification schemes published in the area, are likely to create confusion amongst researchers and clinicians, and may lead to compromised treatment decisions. Therefore, this paper will categorise and address tooth resorption based on aetiology in order to help clinicians diagnose and filter treatment options based on the pathophysiology of the resorption at hand. With recent advancements in the literature, the purpose of this paper is to provide clinicians with a current, clinically relevant summary of the various forms of tooth resorption, with a focus on aetiologically driven treatment strategies and suggestions that facilitate their recognition, diagnosis and management.
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Affiliation(s)
- Jordan Samuel Blum
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Elmsmari F, González Sánchez JA, Delgado LM, Espina M, Duran-Sindreu F, García ML, Sánchez-López E. Development of clobetasol-loaded biodegradable nanoparticles as an endodontic intracanal medicament. Int Endod J 2024; 57:1147-1164. [PMID: 38687284 DOI: 10.1111/iej.14072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
AIM The aim of current study is the development and optimization of biodegradable polymeric nanoparticles (NPs) to be used in the field of Endodontics as intracanal medication in cases of avulsed teeth with extended extra-oral time, utilizing PLGA polymers loaded with the anti-inflammatory drug clobetasol propionate (CP). METHODOLOGY CP-loaded nanoparticles (CP-NPs) were prepared using the solvent displacement method. CP release profile from CP-NPs was assessed for 48 h against free CP. Using extracted human teeth, the degree of infiltration inside the dentinal tubules was studied for both CP-NPs and CP. The anti-inflammatory capacity of CP-NPs was evaluated in vitro measuring their response and reaction against inflammatory cells, in particular against macrophages. The enzyme-linked immunosorbent assay (ELISA) was used to examine the cytokine release of IL-1β and TNF-α. RESULTS Optimized CP-NPs displayed an average size below 200 nm and a monomodal population. Additionally, spherical morphology and non-aggregation of CP-NPs were confirmed by transmission electron microscopy. Interaction studies showed that CP was encapsulated inside the NPs and no covalent bonds were formed. Moreover, CP-NPs exhibited a prolonged and steady release with only 21% of the encapsulated CP released after 48 h. Using confocal laser scanning microscopy, it was observed that CP-NPs were able to display enhanced penetration into the dentinal tubules. Neither the release of TNF-α nor IL-1β increased in CP-NPs compared to the LPS control, displaying results similar and even less than the TCP after 48 h. Moreover, IL-1β release in LPS-stimulated cells, decreased when macrophages were treated with CP-NPs. CONCLUSIONS In the present work, CP-NPs were prepared, optimized and characterized displaying significant increase in the degree of infiltration inside the dentinal tubules against CP and were able to significantly reduce TNF-α release. Therefore, CP-NPs constitute a promising therapy for the treatment of avulsed teeth with extended extra-oral time.
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Affiliation(s)
- Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Luis M Delgado
- Bioengineering Institute of Technology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Marta Espina
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
| | - Fernando Duran-Sindreu
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maria Luisa García
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
- Networking Research Centre of Neurodegenerative Disease (CIBERNED), Instituto de Salud Juan Carlos III, Madrid, Spain
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, Barcelona, Spain
- Networking Research Centre of Neurodegenerative Disease (CIBERNED), Instituto de Salud Juan Carlos III, Madrid, Spain
- Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, Barcelona, Spain
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Ohshima J, Abe S, Morita M, Tanaka N, Yamaguchi M, Hayashi M. Time-course study of genetic changes in periodontal ligament regeneration after tooth replantation in a mouse model. Sci Rep 2024; 14:15502. [PMID: 38969768 PMCID: PMC11226448 DOI: 10.1038/s41598-024-66542-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024] Open
Abstract
This research focused on analyzing gene expression changes in the periodontal ligament (PDL) after tooth re-plantation to identify key genes and pathways involved in healing and regeneration. Utilizing a mouse model, mRNA was extracted from the PDL at various intervals post-replantation for RNA sequencing analysis, spanning from 3 to 56 days. The results revealed significant shifts in gene expression, particularly notable on day 28, supported by hierarchical clustering and principal component analysis. Gene ontology (GO) enrichment analysis highlighted an upregulation in olfactory receptor and G protein-coupled receptor signaling pathways at this time point. These findings were validated through reverse transcription-quantitative PCR (RT-qPCR), with immunochemical staining localizing olfactory receptor gene expression to the PDL and surrounding tissues. Moreover, a scratch assay indicated that olfactory receptor genes might facilitate wound healing in human PDL fibroblasts. These results underscore the importance of the 28-day post-transplant phase as a potential "tipping point" in PDL healing and regeneration. In conclusion, this research sheds light on the potential role of olfactory receptor genes in PDL regeneration, providing a foundation for developing new therapeutic approaches in tooth replantation and transplantation, with broader implications for regenerative medicine in oral health.
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Affiliation(s)
- Jun Ohshima
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Shotaro Abe
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masayoshi Morita
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Nobutake Tanaka
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masaya Yamaguchi
- Bioinformatics Research Unit, Osaka University Graduate School of Dentistry, Osaka, Japan
- Bioinformatics Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Microbiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Center for Infectious Diseases Education and Research, Osaka University, Osaka, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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12
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Jogezai U, Kalsi A. Long-term complications and management of dental trauma in the adult patient - Part 1: fractured teeth, pulpal complications and resorption. Br Dent J 2024; 237:95-105. [PMID: 39060587 DOI: 10.1038/s41415-024-7641-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 03/23/2024] [Accepted: 04/08/2024] [Indexed: 07/28/2024]
Abstract
Dental trauma is one of the most common injuries encountered in the younger population. This can have a long-term impact on the patient's overall quality of life as they may have to deal with the sequelae of these injuries for years to come. Young boys experience dental trauma more frequently than young girls and one of the most common outcomes of these injuries are fractured teeth. This first paper in a two-part review series aims to provide an overview of dental trauma followed by a discussion on management of fractured teeth, associated pulpal complications and resorption. These can be uncomplicated fractures involving enamel and/or dentine, or complicated fractures involving enamel, dentine and pulp. They can involve the crown, the crown and root together, or present solely as root fractures. Pulpal complications can lead to pulp necrosis or pulp canal obliteration. Resorption can be internal or external, inflammatory, or replacement type. The management of each of these injuries begins with a thorough assessment followed by initiating emergency treatment to stabilise the presenting condition. This is followed by a long-term treatment plan which aims to address the patients' aesthetic and functional requirements and provide the patient with the most suitable treatment outcome in the hope to improve their sense of wellbeing and overall quality of life.
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Affiliation(s)
- Ursala Jogezai
- Specialty Registrar in Restorative Dentistry, Royal National ENT and Eastman Dental Hospitals, UK.
| | - Amardip Kalsi
- Consultant in Restorative Dentistry, Cambridge University Hospitals, UK
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13
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Wikström A, Romani Vestman N, Rakhimova O, Lazaro Gimeno D, Tsilingaridis G, Brundin M. Microbiological assessment of success and failure in pulp revitalization: a randomized clinical trial using calcium hydroxide and chlorhexidine gluconate in traumatized immature necrotic teeth. J Oral Microbiol 2024; 16:2343518. [PMID: 38665416 PMCID: PMC11044761 DOI: 10.1080/20002297.2024.2343518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Aim To compare differences in the disinfection efficacy of calcium hydroxide (CH) and chlorhexidine gluconate (CHD) dressings in pulp revitalization (PR) of traumatized immature necrotic teeth; to investigate the microflora in successful/failed PR and whether bacterial persistence influences the outcomes of PR. Methods Microbiological assessment of the average bacterial load (CFU/sample) and bacterial diversity (taxa/sample) was performed on 41 teeth at three timepoints (S2-before, S3-after debridement and S5- after root canal dressing). Results The primary microflora was more diverse in successful cases than in failed. Decreases in CFU/sample and taxa/sample occurred S2 - S3, though new increases occurred at S5 in the CHD subgroup (successful and failed) and CFU/sample in the CH subgroup (failed). At S5, the successful cases showed more bacterial decreases. No specific species was associated with the outcomes with no statistical differences between the disinfection efficacy. Conclusions There were no statistical differences in CH and CHD efficacy. At S5, microflora persisted in both successful and failed outcomes, but the abundance and diversity increased significantly only in the failed cases. The successful outcomes presented higher diversity and higher decreases of the primary microflora at S5 than the failed outcomes. The abundance and diversity increased significantly at S5 only in failed cases.
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Affiliation(s)
- Alina Wikström
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Endodontics, Public Dental Health Services, Eastmaninstitutet, Stockholm, Sweden
- Centre of Paediatric Oral Health, Huddinge, Sweden
| | - Nelly Romani Vestman
- Department of Odontology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | | | - David Lazaro Gimeno
- Department of Plant Physiology, Umeå Plant Science Centre, Umeå University, Umeå, Sweden
| | - Georgios Tsilingaridis
- Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
- Centre of Paediatric Oral Health, Huddinge, Sweden
| | - Malin Brundin
- Department of Odontology, Umeå University, Umeå, Sweden
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14
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Li K, Qin H, Wang J, Xing X. Unusual approach to treat malocclusion with traumatically missing and hopeless maxillary unilateral incisors: A case report. AUST ENDOD J 2024; 50:163-175. [PMID: 38411368 DOI: 10.1111/aej.12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/16/2024] [Accepted: 02/11/2024] [Indexed: 02/28/2024]
Abstract
Orthodontic cases requiring tooth extraction sometimes involve post-traumatic incisors. For adolescent cases in which trauma causes the maxillary unilateral incisors to be missing or have poor prognoses, it is worth considering these teeth as candidates for extraction, and this unusual approach is seldom reported in the literature. An adolescent patient with a missing maxillary left lateral incisor and an ankylosed maxillary left central incisor sought treatment for dental protrusion and crowding. An unusual orthodontic approach was used, which involved the extraction of the maxillary left central incisor and mandibular first premolars. After treatment, the maxillary right central incisor was successfully translocated across the midpalatal suture and transformed into the left central incisor. Additionally, well-aligned teeth and enhanced smile aesthetics were achieved, and the treatment outcomes remained stable throughout the follow-up period.
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Affiliation(s)
- Kun Li
- Fushan Division, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Hanglin Qin
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Junjie Wang
- Wolong Division, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Xiujin Xing
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
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15
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Gul A, Lauridsen E, Gerds TA, Andersson L. Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation: A long-term clinical study. Dent Traumatol 2024; 40:137-143. [PMID: 37864425 DOI: 10.1111/edt.12898] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND/AIM There are few long-term clinical follow-up studies on human teeth replanted immediately or after storage in a suitable storage medium prior to replantation. This study aimed to assess the risk of ankylosis in avulsed human teeth replanted immediately or after storage in physiological media for a short time. MATERIAL Data from 116 patients with 145 replanted avulsed permanent teeth were selected from a comprehensive dental trauma database in Copenhagen University Hospital. The following teeth were selected: Group 1 comprised 36 teeth replanted immediately (dry time <6 min; wet time <6 min). Group 2 comprised 61 teeth replanted after physiologic storage media (saliva and saline) (dry time <6 min; wet time >5 min; wet time ranged from 7 to 170 min, and mean wet time was 59 min). Group 3 (control) included 48 teeth replanted after dry storage (dry time > 60 min). METHOD Clinical and radiographic registrations were carried out according to a standardized protocol; follow-up ranged from 7 months to 23 years. Ankylosis was diagnosed by percussion test and radiographs and related to the conditions prior to replantation and stage of root development. RESULTS The overall risk of ankylosis was 17.2% [95% CI: 4.61; 29.79] for immediately replanted teeth, 55.3% [95% CI: 42.54; 68.00] for teeth stored in physiologic media before replantation, and 85.7% [95% CI: 75.70; 95.73] for teeth stored dry more than 1 h. Mature teeth showed a significantly higher risk of ankylosis than immature teeth. CONCLUSION This clinical long-term study has verified earlier experimental studies showing that immediate reimplantation has the lowest risk of ankylosis. Physiologic storage media are good alternatives that also reduce the risk of ankylosis compared to dry storage, where ankylosis is more likely although not always seen. Mature teeth are significantly more likely to develop ankylosis.
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Affiliation(s)
- Abdulaziz Gul
- Department of Oral and Maxillofacial Surgery, Malmö University, Malmö, Sweden
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Eva Lauridsen
- Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark
| | - Thomas A Gerds
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Lars Andersson
- Department of Oral and Maxillofacial Surgery, Malmö University, Malmö, Sweden
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16
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Ko MJ, Kim MS, Lee HS, Nam OH, Chae YK, Choi SC. Effects of Doxycycline-Loaded NO-Releasing Nanomatrix Gel on Delayed Replanted of Rat Molar. Gels 2024; 10:213. [PMID: 38667632 PMCID: PMC11049325 DOI: 10.3390/gels10040213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND/AIM Tooth avulsion and delayed replantation may cause inflammatory responses and root resorption of the tooth. The aim of this study is to investigate the effect of a doxycycline-loaded nitric oxide-releasing nanomatrix (DN) gel on the delayed replantation of avulsed rat teeth, with a focus on assessing the gel's potential to promote regeneration and inhibit complications associated with the replantation process. MATERIALS AND METHODS Twenty-four right maxillary first molars from male Sprague-Dawley rats were atraumatically extracted using sterile extraction forceps. The molars were dried for 1 h at room temperature (approximately 23 °C) and divided into four groups according to the root conditioning methods after extra-alveolar 60-min drying: Group 1, no root conditioning treatment prior to replantation; Group 2, soaking in 2% NaF solution for 5 min before replantation; Group 3, 5-min soaking in NO gel and injection of the gel into the alveolar socket; Group 4, 5-min soaking in DN gel and injection of the gel into the alveolar socket before replantation. The animals were euthanized four weeks after the operation and the specimens were evaluated histologically. RESULTS The use of NO gel alone showed better anti-inflammatory and periodontal effects than the control group, but it did not show a significant effect compared to the group using NaF. When using NO gel loaded with doxycycline, it showed a significant anti-inflammatory effect compared to the control group and showed a similar inhibitory effect to the group using NaF. CONCLUSIONS Within the limits of this study, in delayed replantation situations, the control of inflammatory resorption and replacement resorption is an important factor for achieving a better prognosis of replanted teeth. Root surface treatment with DN gel decreased root resorption after delayed replantation.
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Affiliation(s)
- Mi Ja Ko
- Children Loving Dental Clinic, Seosan 31978, Republic of Korea;
| | - Mi Sun Kim
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea;
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (H.-S.L.)
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (H.-S.L.)
| | - Yong Kwon Chae
- Department of Pediatric Dentistry, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea;
| | - Sung Chul Choi
- Department of Pediatric Dentistry, College of Dentistry, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (H.-S.L.)
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17
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Rai A, Koirala B, Dali M, Shrestha S. Delayed replantation of avulsed permanent maxillary central incisor: Case report with 6-year follow-up. Clin Case Rep 2024; 12:e8487. [PMID: 38328488 PMCID: PMC10847390 DOI: 10.1002/ccr3.8487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/10/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
Replantation should be attempted in any case of avulsion, be it immediate or delayed. Retention of the replanted tooth helps in preservation of adjacent alveolar bone. Despite the occurrence of replacement resorption, the tooth can stay healthy and functional in the arch for a longer duration.
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Affiliation(s)
- Amita Rai
- Department of Pediatric and Preventive DentistryPeople's Dental College and HospitalKathmanduNepal
| | - Bandana Koirala
- Department of Pedodontics and Preventive DentistryCollege of Dental Surgery, B.P. Koirala Institute of Health SciencesDharanNepal
| | - Mamta Dali
- Department of Pedodontics and Preventive DentistryCollege of Dental Surgery, B.P. Koirala Institute of Health SciencesDharanNepal
| | - Sneha Shrestha
- Department of Pedodontics and Preventive DentistryCollege of Dental Surgery, B.P. Koirala Institute of Health SciencesDharanNepal
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18
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Takagi BAR, Kopper PMP, Zajkowski LA, Pinheiro LS, Scarparo RK. Histological effects of photobiomodulation on delayed tooth replantation: a systematic review. Lasers Med Sci 2024; 39:35. [PMID: 38233594 DOI: 10.1007/s10103-024-03978-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
This systematic review evaluated preclinical studies to assess whether PBM has a more favorable histological response than other treatments used before delayed replantation of avulsed teeth. This review followed the PRISMA checklist and was registered in PROSPERO. MEDLINE (PubMed), Embase, Scopus and Web of Science were searched from their inception to July 14, 2022. Data were independently extracted by two reviewers. Data were collected about species, number of animals, number and type of teeth, groups evaluated, extra-alveolar time, parameters for PBM and other study groups, presence and characteristics of containment, observation time points, evaluation methods, characteristics evaluated, and significant results. The ARRIVE and SYRCLE tools were used to assess the methodological quality and risk of bias (RoB) of the studies. After screening, six studies were included in the review synthesis. Three of the four studies that evaluated root resorption as an outcome found that PBM decreases its occurrence after delayed tooth replantation. A meta-analysis was not conducted because some data were missing in the included studies. Half of the studies evaluating ankylosis found an increase in its occurrence after PBM. Two studies evaluated inflammatory responses and found a reduction of inflammation after PBM. In general, studies had high methodological heterogeneity, intermediate reporting quality and high RoB. Despite the methodological quality and RoB limitations of the studies, the histological responses after delayed tooth replantation were more favourable in the PBM groups. Preclinical studies supported by guidelines should define laser parameters for future clinical studies.
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Affiliation(s)
- Brenda Ai Refosco Takagi
- Graduate Program, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - Luciéli Andréia Zajkowski
- Graduate Program, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Lucas Siqueira Pinheiro
- Graduate Program, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
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19
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Ogle OE. Controversies in Dental Traumatology. Dent Clin North Am 2024; 68:151-165. [PMID: 37951631 DOI: 10.1016/j.cden.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
The management of traumatic dental injuries is more a shade of gray than it is black and white because not all treatment procedures used for dental trauma management are fully evidence based. This chapter has highlighted some of the gray areas related to the treatment and outcome of traumatic dental injuries. Significant controversies in the management of luxation and avulsive injuries have been brought out. Adjunctive treatment such as antibiotic usage, tetanus vaccination, and pain management is also addressed.
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Affiliation(s)
- Orrett E Ogle
- Oral and Maxillofacial Surgery, Woodhull Hospital, Brooklyn, NY 11206, USA.
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20
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Silva MT, Costa LC, Moura MS, Lima CCB, Almeida de Deus Moura LDF, Martins-Júnior PA, Lima MDDM. The Top 100 Most-Cited Articles on Permanent Teeth Avulsion: A Bibliometric Analysis. J Endod 2023; 49:1595-1604. [PMID: 37690496 DOI: 10.1016/j.joen.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/22/2023] [Accepted: 09/02/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Knowledge of bibliometric indices on the avulsion of permanent teeth can help researchers to identify gaps in the literature. The aim of this study was to analyze the bibliometric characteristics of the 100 most-cited articles on the avulsion of permanent teeth. MATERIALS AND METHODS Two researchers conducted an unfiltered search in the Core Collection section of the Web of Science (WoS-CC) database. The following data were extracted: position in the citation list, total number and density of citations, title, authors, institution, country, year of publication, journal, keywords, study design, tooth storage medium, and other topics of interest. Bibliometric networks were generated and analyzed using the VOSviewer software. Descriptive analysis and a Poisson regression analysis were performed (P < .05). RESULTS The number of citations per article varied between 31 and 407. The average was 70.05, and 13 articles received more than 100 citations. J.O. Andreasen (n = 13) and M. Trope (n = 15) were the authors who contributed most often to publications. The United States was the country with the highest number of articles (n = 31). Authors associated with the University of Copenhagen, Denmark (n = 9) and University of North Carolina, USA (n = 10) showed higher productivity. In vitro/animal model studies were the most frequent study designs (n = 50), and the most-discussed topic of interest was prognosis (n = 47). There was strong clustering among 13 research groups. CONCLUSION Observational studies, published by authors from Europe and about prognosis or treatment presented more citation ratio in WoS-CC. Clinical studies on permanent tooth avulsion are needed to increase the quality of scientific evidence and provide insights for health professionals and public policy makers.
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Affiliation(s)
| | - Lara Carvalho Costa
- Postgraduate Program in Dentistry, Federal University of Piauí (UFPI), Teresina, Brazil
| | - Marcoeli Silva Moura
- Department of Pathology and Dental Clinic, Federal University of Piauí (UFPI), Teresina, Brazil
| | | | | | - Paulo Antônio Martins-Júnior
- Department of Child and Adolescent Oral Health, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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21
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Philip N, Nazzal H, Duggal MS. Critical appraisal of the 2020 IADT Guidelines: A personal commentary. Dent Traumatol 2023; 39:509-516. [PMID: 37408436 DOI: 10.1111/edt.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 07/07/2023]
Abstract
The 2020 International Association of Dental Traumatology (IADT) Guidelines feature several important changes in the treatment recommendations for traumatic dental injuries (TDIs) from the previous 2012 iteration of these Guidelines. This evidence-based narrative review aims to provide a detailed appraisal of five specific changes incorporated in the 2020 IADT Guidelines, based on the available literature evidence that may have prompted these changes. The paper discusses three excellent additions/changes to the new Guidelines: (i) inclusion of a core outcome set for reporting TDIs; (ii) more conservative management of primary dentition TDIs including the changed recommendations for radiation exposure and managing primary dentition luxation injuries; and (iii) the changes in the treatment recommendations for permanent dentition avulsion injuries. The paper further debates whether two other changes made in the current IADT Guidelines for-(i) intrusion injuries in immature teeth; and (ii) complicated crown-root fractures in mature teeth-have sufficient evidence to support the changed recommendations.
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Affiliation(s)
- Nebu Philip
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hani Nazzal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
- Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
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22
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Graf T, Stimmelmayr M, Gutmann P, Güth JF, Krennmair G, Edelhoff D, Schubert O. Forced surgical extrusion using an axial tooth extraction system as a practicable technique for preserving severely destroyed teeth? - Clinical outcomes up to 4.8 years. J ESTHET RESTOR DENT 2023; 35:1152-1161. [PMID: 37096865 DOI: 10.1111/jerd.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE Several extrusion techniques have been described to restore teeth with insufficient coronal tooth structure and to avoid their extraction. Still, there is little evidence for a treatment concept combining surgical extrusion using an atraumatic axial extraction system. MATERIALS AND METHODS A total of nine patients, each with an iso- or subgingival fractured tooth, were retrospectively examined. Treatment of the damaged tooth comprised an atraumatic forced surgical extrusion performed with an axial tooth extraction system and a more coronal positioning within the socket. The teeth were initially splinted and subsequently restored. The follow-up period was up to 57.1 months and averaged 36.5 (SD: ±13.5) months. RESULTS All nine teeth were still in situ, without signs of inflammation. During the period of the provisional restoration, six prosthetic complications occurred, which were resolved with little effort, whereas, success rate for the definitive restoration was 100%. No biological complications were observed concerning the root apex or soft tissue. The radiographically measured mean extrusion distance was 3.4 (SD: ±1.0) mm, so that a sufficient prosthetic ferrule could be reestablished. CONCLUSIONS Surgical extrusions using an axial tooth extraction system demonstrate low biological and prosthetic complications rates over observation time. CLINICAL SIGNIFICANCE The presented extrusion approach preserves soft and hard tissue and is an efficient treatment option for severely destroyed teeth. Saving hopeless teeth by this relatively predictable and feasible procedure has hardly any disadvantages for patients, and in case of failure, an implant or fixed partial denture are still an option.
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Affiliation(s)
- Tobias Graf
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Pauline Gutmann
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan-Frederik Güth
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Health, Goethe University Frankfurt, Frankfurt, Germany
| | - Gerald Krennmair
- Dental School, Siegmund Freud University of Vienna, Vienna, Austria
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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23
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Li K, Sun P, Sun J, Wang T. Combined orthodontic and prosthodontic treatment in an adolescent patient with traumatically ankylosed incisors: A case report. Dent Traumatol 2023; 39:495-508. [PMID: 37283243 DOI: 10.1111/edt.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/08/2023]
Abstract
Symmetric extraction of premolars is a frequently used orthodontic treatment for dental crowding and protrusion. However, when a patient has incisors with ankylosis, the establishment of a treatment protocol often plagues orthodontists. An adolescent patient with a history of incisor trauma sought treatment for dental protrusion and crowding. Upon percussion of his infrapositioned maxillary central incisors, characteristic dull metallic sounds were noted, and a lack of normal mobility of these teeth under the application of external forces was detected. Follow-up radiographs after the trauma showed replacement root resorption of the maxillary central incisors. Based on clinical and radiological findings, ankylosis of the maxillary central incisors was tentatively diagnosed. A combination of orthodontic and prosthodontic treatment options involving extraction of the maxillary central incisors and mandibular first premolars was chosen to resolve the functional and esthetic problems. After treatment, well-aligned dentition, improved smile esthetics, and a more harmonious facial profile were achieved, and these outcomes remained stable during the follow-up period. This case report illustrates a viable treatment strategy for tackling predicaments caused by ankylosed incisors, which is unusual in the literature.
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Affiliation(s)
- Kun Li
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Peng Sun
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Jing Sun
- Wolong Division, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Tiejun Wang
- Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
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24
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Albassam AA. Assessing Knowledge, Perception, and Management Toward Traumatic Tooth Avulsion Among Dentists in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e46337. [PMID: 37794886 PMCID: PMC10545971 DOI: 10.7759/cureus.46337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION 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. OBJECTIVE 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. METHODS 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. CONCLUSION 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.
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Affiliation(s)
- Abdullah A Albassam
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Al Sheeb M, Al Jawad FA, Nazzal H. Parents' knowledge of emergency management of avulsed permanent teeth in children and adolescents in the State of Qatar: a questionnaire cross-sectional study. Eur Arch Paediatr Dent 2023; 24:643-650. [PMID: 37651072 PMCID: PMC10600271 DOI: 10.1007/s40368-023-00829-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/01/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE To elucidate the level of parental knowledge in Qatar regarding the management of avulsed teeth. METHODS 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 replant avulsed 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. RESULTS 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 30 min. 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 20-30 years age group (OR = 2.8, 95% CI = 1.05-8.0and OR = 3.8, 95% CI = 1.3-11.48; respectively). CONCLUSION 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.
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Affiliation(s)
- M Al Sheeb
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
| | - F A Al Jawad
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
| | - H Nazzal
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar.
- College of Dental Medicine, Qatar University, Doha, Qatar.
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Plotino G, Abella Sans F, Bastos JV, Nagendrababu V. Effectiveness of intentional replantation in managing teeth with apical periodontitis: A systematic review. Int Endod J 2023; 56 Suppl 3:499-509. [PMID: 35294790 DOI: 10.1111/iej.13727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Intentional replantation (IR) to treat disease of endodontic origin remains controversial. While IR has been advocated by some clinicians as another valid treatment option, others consider it as a treatment procedure of last resort. OBJECTIVE To systematically review and critically evaluate the effectiveness of IR compared with nonsurgical root canal treatment/retreatment or apical surgery in terms of clinical and patient-related outcomes in managing permanent teeth with apical periodontitis (AP). METHODS A literature search of five databases (PubMed, Embase, Scopus, Web of Science and Cochrane Central register of Controlled Trials), and the grey literature (Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, DART-Europe E-theses Portal, British Library E-Theses Online Service), from inception to November 2021, was conducted. Randomised clinical trials, comparative clinical trials (CCTs), nonrandomised, retrospective, and prospective comparative cohort and case-control two arm studies which evaluated clinical and/or patient-related outcomes of permanent teeth with AP treated with IR compared with nonsurgical root canal treatment/retreatment or apical surgery were identified. The quality of the studies was appraised using the Cochrane risk of bias tool for randomized trials (RoB 2.0), the Robins-I for nonrandomized controlled clinical trials and the Newcastle-Ottawa scale for observational studies. Two independent reviewers were involved in the literature selection, performed the data extraction and the appraisal of the studies identified; disagreements were resolved in conjunction with a third reviewer. RESULTS No comparative study was identified from the literature search. Four longitudinal studies (one prospective and three retrospective) were identified during the screening of titles and abstracts but were excluded after reading the full text, because only IR was evaluated (single arm studies). DISCUSSION The available evidence on IR is mainly based on observational studies, which reported high overall mid- to long-term survival, and low complication rates. The results suggest that IR may represent an alternative treatment procedure to solve problems of endodontic origin. However, in the absence of high-quality evidence from CCTs, clinical decision-making should be on a case-by-case basis and in accordance with the clinician's experience and the patient's preference. CONCLUSION Clinical studies showed that IR may be a treatment modality to manage problems of endodontic origin. However, clinical trials comparing the effectiveness of IR with nonsurgical root canal treatment/retreatment or apical surgery are still required given the paucity of evidence.
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Affiliation(s)
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Juliana Vilela Bastos
- Department of Restorative Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Javed F, Zafar K, Khan FR. Outcome of intentional replantation of endodontically treated teeth with periapical pathosis: A systematic review and meta-analysis. AUST ENDOD J 2023; 49 Suppl 1:494-507. [PMID: 36354086 DOI: 10.1111/aej.12707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 08/02/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022]
Abstract
The purpose of the present review was to examine success, survival and failure following intentional replantation of endodontically treated teeth with existing periapical pathosis and to determine the factors that might affect the outcome of replantation. Clinical trials, longitudinal studies, case series with >10 cases and at least 1-year follow-up were included. The average rate of success following intentional replantation was 77.23%. Meta-analysis revealed the mean weighted survival to be 85.9% (95% CI: 79.6-91.2) Common complications include inflammatory root resorption (0%-27%) and ankylosis (0%-25%). Variables influencing successful outcome include extra alveolar dry time <15 min; root-end resection (2-3 mm) and cavity preparation (3 mm); manipulation of the tooth using the crown only; and use of an appropriate storage media. The review concludes that intentional replantation is a viable treatment option with acceptable survival rates for endodontically treated teeth with periapical pathosis.
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Affiliation(s)
- Faizan Javed
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
| | - Kamil Zafar
- Endodontics, Baqai Dental College, Karachi, Pakistan
| | - Farhan R Khan
- Operative Dentistry & Endodontics, The Aga Khan University, Karachi, Pakistan
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Van Gorp G, Declerck D. Long-term Outcome of Endodontically Treated Traumatized Immature Upper Incisors. J Endod 2023; 49:1106-1119. [PMID: 37385539 DOI: 10.1016/j.joen.2023.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION In a growing child, preservation of traumatized immature permanent upper incisors is challenging. This study aimed to evaluate the long-term outcome of endodontically treated traumatized immature upper incisors and associated variables. METHODS A total of 183 traumatized immature upper incisors treated with pulpotomy, apexification, or regenerative endodontic procedure (REP), with follow-up between 4 and 15 years, were assessed for presence of pulpal responses or periodontal/bone responses using standardized clinical and radiologic criteria. Logistic regression, including stage of root development, type and complexity of traumatic event, type of endodontic intervention, and history of orthodontic management, were used to estimate impact on tooth survival and occurrence of tissue responses. Study approved by Ethics Committee Research UZ/KU Leuven (S60597). RESULTS After a median follow-up of 7.3 years (interquartile range, 6.1-9.2), 159 teeth (86.9%) were still functional. From these teeth, 58 (36.5%) developed tissue responses. This was significantly associated with stage of root development at moment of trauma (root length <¾) and type of endodontic intervention (REP presenting worst outcome). Tooth loss (24 teeth, 13.1%) occurred after a mean time span of 3.2 years (±1.5) and was significantly associated with type and complexity of the traumatic event and type of endodontic intervention, with apexification showing better results than REP (odds ratio, 0.30; 95% confidence interval, 0.11-0.79). CONCLUSIONS A large number of endodontically treated traumatized immature teeth could be kept functional. Very immature teeth, teeth with periodontal tissue damage, and teeth treated with REP were at highest risk for an unfavorable outcome.
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Affiliation(s)
- Gertrude Van Gorp
- Unit of Paediatric Dentistry and Special Dental Care, KU Leuven Department of Oral Health Sciences and Department of Dentistry, University Hospitals Leuven, Leuven, Belgium.
| | - Dominique Declerck
- Unit of Paediatric Dentistry and Special Dental Care, KU Leuven Department of Oral Health Sciences and Department of Dentistry, University Hospitals Leuven, Leuven, Belgium
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Cathro P, Smith M, Ratnayake J, Heithersay G. Micro-CT Evaluation of Spontaneous Apexification of an Immature Tooth following Trauma. Case Rep Dent 2023; 2023:3779225. [PMID: 37448878 PMCID: PMC10338130 DOI: 10.1155/2023/3779225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
This case reports on the micro-computerised tomography (CT) images of a periapical calcified dome following spontaneous apexification as a subsequence of trauma. An immature, maxillary central incisor was found to be non-vital one month following trauma. The tooth had minimal signs of structural damage; however, there was radiographic evidence of spontaneous apexification. The tooth suffered a second traumatic episode two years later and was decoronated to facilitate bone retention during osseous development. The patient presented with swelling and pain 36 months later, and the tooth root was extracted. The root was embedded in resin, and cross-sectional images were obtained using micro-CT. Analysis of the images provided insight into the structure of the calcified dome that formed following the first traumatic injury.
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Affiliation(s)
- Peter Cathro
- Faculty of Dentistry, The University of Otago, 310 Great King Street, Dunedin 9016, New Zealand
| | - Mike Smith
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide SA, Australia
| | - Jithendra Ratnayake
- Faculty of Dentistry, The University of Otago, 310 Great King Street, Dunedin 9016, New Zealand
| | - Geoffrey Heithersay
- School of Dentistry, Faculty of Health Science, The University of Adelaide, Adelaide SA, Australia
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Roskamp L, Perin CP, Castro JPD, Mattos NHR, Campos MCBPD, Gabardo MCL, Ignácio SA, Locks MEN, Westphalen VPD, Baratto-Filho F. Retrospective analysis of survival of avulsed and replanted permanent teeth according to 2012 or 2020 IADT Guidelines. Braz Dent J 2023; 34:122-128. [PMID: 37194850 DOI: 10.1590/0103-6440202305255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/18/2023] [Indexed: 05/18/2023] Open
Abstract
This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p <0.05) in the extra-alveolar time (< one hour), but without difference between the guidelines in late replantation (p > 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket.
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Affiliation(s)
- Liliane Roskamp
- Department of Dentistry. Universidade Tuituti do Paraná, Curitiba, PR, Brazil
| | - Camila Paiva Perin
- Department of Dentistry. Universidade Tuituti do Paraná, Curitiba, PR, Brazil
| | | | | | | | | | | | | | | | - Flares Baratto-Filho
- Department of Dentistry. Universidade da Região de Joinville, Joinville, SC, Brazil
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Kotsanos IN, Tzika E, Economides N, Kotsanos N. Intentional replantation and management of avulsion related ankylosis and external cervical resorption. A 10-year follow up case report. Dent Traumatol 2023. [PMID: 36740825 DOI: 10.1111/edt.12828] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/22/2023] [Accepted: 01/22/2023] [Indexed: 02/07/2023]
Abstract
Replantation is the treatment of choice for avulsed permanent teeth; ankylosis and cervical root resorption are among survival complications. A 9.5-year-old boy presented with an avulsed maxillary permanent central incisor with an open root apex following a school accident. The tooth was kept in milk, after a dry time of 15-20 min. Its replantation was performed 60 min after the accident. At 8 months, apexification with apical plug was attempted upon radiographic evidence of apical periodontitis. Ankylosis sound with infraocclusion and radiographic evidence of external cervical root resorption (ECR) were evident at 3 years and 3 months. At the patient's return one year later with esthetic concerns (2 mm infraocclusion) there was a 5 mm diameter ECR cavity. After intentional atraumatic extraction the resorptive cavity was debrided and restored with Biodentine; subsequently the tooth was reimplanted and splinted at an extruded position. At the 10-year follow up since the first avulsion the tooth remains esthetically pleasing, asymptomatic, non-ankylotic and functional. The present case supports intentional replantation as an option in managing infraoccluded teeth with advanced ECR.
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Affiliation(s)
| | - Eleftheria Tzika
- Department of Pediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Economides
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Kotsanos
- Department of Pediatric Dentistry, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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32
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Yang Y, Liu YL, Jia LN, Wang JJ, Zhang M. Rescuing “hopeless” avulsed teeth using autologous platelet-rich fibrin following delayed reimplantation: Two case reports. World J Clin Cases 2023; 11:635-644. [PMID: 36793624 PMCID: PMC9923869 DOI: 10.12998/wjcc.v11.i3.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Tooth avulsion is one of the most severe types of dental trauma. Most avulsed teeth undergo long-term ankylosis and replacement resorption after delayed reimplantation and exhibit a poor prognosis. The aim of this work was to improve the success rate of avulsed teeth after delayed reimplantation using autologous platelet-rich fibrin (PRF).
CASE SUMMARY Case 1 was a 14-year-old boy who fell and knocked out his left upper central incisor 18 h prior to his arrival at the department. The diagnoses were avulsion of tooth 21, lateral luxation of tooth 11 and alveolar fracture of teeth 11 and 21. In case 2, a 17-year-old boy fell 2 h prior to his presentation to the hospital, and his left upper lateral incisor was completely knocked out of the alveolar socket. The diagnoses included avulsion of tooth 22, complicated crown fracture of tooth 11 and complicated crown-root fracture of tooth 21. The avulsed teeth were reimplanted along with autologous PRF granules and splinted using a semiflexible titanium preshaped labial arch. The root canals of the avulsed teeth were filled with calcium hydroxide paste, and root canal filling was performed 4 wk after reimplantation. The reimplanted teeth showed no symptoms of inflammatory root resorption or ankylosis at the 3-, 6-, and 12-mo follow-up examinations after reimplantation with autologous PRF. In addition to the avulsed teeth, the other injured teeth were treated using corresponding conventional treatment methods.
CONCLUSION These cases provide examples of the successful use of PRF to reduce pathological root resorption of the avulsed teeth, and the application of PRF may provide new healing opportunities for traditionally “hopeless” avulsed teeth.
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Affiliation(s)
- Yang Yang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Yan-Li Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Lie-Ni Jia
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Jun-Jun Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
| | - Min Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
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Evaluation of delphinidin as a storage medium for avulsed teeth. BMC Oral Health 2023; 23:21. [PMID: 36641447 PMCID: PMC9840347 DOI: 10.1186/s12903-023-02713-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Delphinidin (DP), an anthocyanidin found in blueberries, has antioxidant and anti-inflammatory effects. This study aimed to investigate the efficacy of DP as a storage medium for avulsed teeth. METHODS Human periodontal ligament cells were cultured and exposed to DP solution (10, 50, and 100 μM), Dulbecco's modified Eagle's medium, Hank's balanced salt solution and tap water. Cell counting kit-8 assays were performed after 0.5, 1, 6, and 24 h to measure the cell viability. Nitric oxide assays and gelatin zymography were performed to evaluate the anti-inflammatory effects of DP. Reverse transcription-polymerase chain reaction was used to determine the expression levels of inflammatory cytokines. RESULTS The viability of periodontal ligament cells was greatest at 100 μM DP. At 1 h, 100 μM DP decreased nitric oxide synthesis (p < .0167). Matrix metallopeptidase-9 activity was inhibited by DP in a dose-dependent manner (p < .0167). Moreover, treatment with 100 μM DP decreased the expression levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-8 in periodontal ligament cells (p < .0167). CONCLUSIONS Within the limits of this study, DP preserved the viability and suppressed the inflammatory response of periodontal ligament cells. These findings suggest that DP could be promising for preservation of avulsed teeth.
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Andreyashkina LY, Korolenkova MV, Vasilyev AV. [Treatment options for external inflammatory root resorption]. STOMATOLOGIIA 2023; 102:91-95. [PMID: 37622309 DOI: 10.17116/stomat202310204191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
THE AIM OF THE STUDY Was to compare the efficacy of various treatment options for external inflammatory root resorption according to literature data. MATERIALS AND METHODS Literature was searched in electronic databases «eLibrary» and «PubMed» for key words «external inflammatory resorption treatment», «external inflammatory resorption management». Inclusion criteria comprised publications in Russian or English, clinical and experimental studies, full description of treatment protocol and obtained results. Studies with no full text, describing root resorption of orthodontic origin, clinical cases and clinical case series were excluded from the study. RESULTS The problem of external inflammatory root resorption is poorly described in the Russian scientific literature. There are no registered protocols for its prevention and treatment or therapeutic agents with proved efficacy available in Russia. The only accessible approach for external inflammatory root resorption remains timely pulp extirpation after dental trauma which importance is underlined by all authors involved in the field of dental trauma studies. MTA and calcium hydroxide being popular as intracanal medications still have significant inconveniences as they potentially provoke root dentine fractures or replacement resorption. CONCLUSION There is a need for elaboration and implementation of new prevention and treatment options for external inflammatory root resorption after dental trauma.
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Affiliation(s)
- L Y Andreyashkina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M V Korolenkova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Moscow Regional Research Institute named after M.F. Vladimirskiy, Moscow, Russia
| | - A V Vasilyev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
- Research Centre for Medical Genetics, Moscow, Russia
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Lin S, Moreinos D, Wisblech D, Rotstein I. Regenerative endodontic therapy for external inflammatory lateral resorption following traumatic dental injuries: Evidence assessment of best practices. Int Endod J 2022; 55:1165-1176. [PMID: 35947093 PMCID: PMC9828210 DOI: 10.1111/iej.13811] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND External inflammatory lateral resorption (EILR) following dental trauma is a severe complication that can lead to significant root loss and tooth extraction. OBJECTIVE The aim of this project was to review current evidence in the literature on regenerative endodontic therapy (RET) for EILR following traumatic injuries and assess the best treatment practices. METHODS Publications appearing in PubMed, from January 1, 2001 to January 9, 2022 were studied. Inclusion criteria were: (a) Publications in English; (b) Publications on RET and EILR; (c) Teeth subjected to dental trauma; and (d) Presence of intracanal bleeding and blood clots. Exclusion criteria were: (a) Conference proceedings; (b) Lectures; (c) Abstracts; and (d) Letters to editor; (e) Non-English publications. RESULTS 355 publications were analysed. Nine met all inclusion criteria. In 10 (58.8%) teeth, triple antibiotic paste was used for an average of 26 days. Double antibiotic paste was used in 3 (17.6%) teeth for an average of 14 days. In 3 (17.6%) cases, calcium hydroxide (Ca(OH)2 ) was used for 14 days and negative pressure irrigation was applied once on 1 (6%) tooth. DISCUSSION Using RET to treat EILR has some advantages compared to long term CA(OH)2 dressing. RET requires shorter dressing time compared to CA(OH)2 . This can significantly improve patient compliance. Additionally, in immature teeth, RET helps to arrest root resorption leading to continued root maturogenesis and revascularization. It is recommended that a meticulous follow-up should be conducted when RET is performed to assure early detection of treatment failure. CONCLUSIONS RET appears to be a good treatment modality producing biologic repair and improving prognosis in cases of EILR in post-traumatic tooth/pulp injuries. The key limitation of this study is that all publications included were either case reports or case series that usually tend to report successful outcome.
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Affiliation(s)
- Shaul Lin
- The Israeli National Center for Trauma & Emergency Medicine ResearchGertner InstituteTel HashomerIsrael,Department of EndodonticsRambam Health Care CampusHaifaIsrael,The Ruth and Bruce Rappaport Faculty of MedicineTechnion ‐ Israel Institute of TechnologyHaifaIsrael
| | - Daniel Moreinos
- Endodontic DepartmentOral and Maxillofacial Institute, Galilee Medical CenterNahariyaIsrael,The Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael
| | - Dekel Wisblech
- Department of EndodonticsRambam Health Care CampusHaifaIsrael
| | - Ilan Rotstein
- University of Southern CaliforniaLos AngelesCaliforniaUSA
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Kohsar AH, Yousefi MJ, Hali H. The Effects of Different Regenerative Treatments after Tooth Avulsion. CURRENT STEM CELL REPORTS 2022. [DOI: 10.1007/s40778-022-00218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Liu H, Lu J, Jiang Q, Haapasalo M, Qian J, Tay FR, Shen Y. Biomaterial scaffolds for clinical procedures in endodontic regeneration. Bioact Mater 2022; 12:257-277. [PMID: 35310382 PMCID: PMC8897058 DOI: 10.1016/j.bioactmat.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 12/14/2022] Open
Abstract
Regenerative endodontic procedures have been rapidly evolving over the past two decades and are employed extensively in clinical endodontics. These procedures have been perceived as valuable adjuvants to conventional strategies in the treatment of necrotic immature permanent teeth that were deemed to have poor prognosis. As a component biological triad of tissue engineering (i.e., stem cells, growth factors and scaffolds), biomaterial scaffolds have demonstrated clinical potential as an armamentarium in regenerative endodontic procedures and achieved remarkable advancements. The aim of the present review is to provide a broad overview of biomaterials employed for scaffolding in regenerative endodontics. The favorable properties and limitations of biomaterials organized in naturally derived, host-derived and synthetic material categories were discussed. Preclinical and clinical studies published over the past five years on the performance of biomaterial scaffolds, as well as current challenges and future perspectives for the application of biomaterials for scaffolding and clinical evaluation of biomaterial scaffolds in regenerative endodontic procedures were addressed in depth.
Overview of biomaterials for scaffolding in regenerative endodontics are presented. Findings of preclinical and clinical studies on the performance of biomaterial scaffolds are summarized. Challenges and future prospects in biomaterial scaffolds are discussed.
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Bourgeois J, Carvalho JC, De Bruyne M, Declerck D, Eloot A, Leroy R. Antibiotics at replantation of avulsed permanent teeth? A systematic review. J Evid Based Dent Pract 2022; 22:101706. [DOI: 10.1016/j.jebdp.2022.101706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 11/15/2021] [Accepted: 02/16/2022] [Indexed: 11/26/2022]
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Wikström A, Brundin M, Romani Vestman N, Rakhimova O, Tsilingaridis G. Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long-term outcomes-A longitudinal cohort study. Int Endod J 2022; 55:630-645. [PMID: 35332566 PMCID: PMC9325385 DOI: 10.1111/iej.13735] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
AIM This prospective cohort study evaluates clinical and radiographical outcomes of endodontic pulp revitalization (PR) of traumatized necrotic incisors. METHODOLOGY Pulp revitalization was performed in 75 traumatized necrotic immature incisors from 71 patients. The radiographic outcome measures were continued root formation (width and length), root resorption, apex closure, periapical index, and root development stage. The clinical outcome measures were percussion pain, palpation pain, pathological tooth mobility, swelling, sinus tract, ankylosis, crown discolouration, response to pulp sensitivity test, and subjective pain. Treatment outcomes were categorized as a success based on the absence of clinical symptoms and when radiographic evidence was present for apical healing and continued root development. The performed statistical tests were repeated measures anova, pairwise comparisons of interactions (t-test), McNemar's test, and linear regression model. RESULTS In 45 of 75 teeth (60%), PR was successful with the resolution of clinical and radiographic signs and continued root development. PR failed due to the absence of bleeding (n = 19) and persistent infection (n = 11). PR showed statistically significant increases in root length (11%), and dentinal wall thickness (30%), root maturation (pre-operative 3.38 [CI 1.88; 4.88]; post-operative 4.04, [CI 2.56; 5.52]) apical closure (71.4%), healing of pre-operative apical periodontitis (100%), and healing of pre-operative inflammatory root resorptions (100%). Three predictive variables for continued root maturation were identified - root development stage at entry (p = .0001, β 0.649), [CI 0.431; 0.867], trauma to the soft tissues (p = .026, β -0.012), [CI -0.0225; -0.015], and pre-operative dentinal wall thickness (p = .009, β -0.001); [CI -0.001; 0.0001]. CONCLUSIONS Our findings indicate that PR provides satisfactory clinical and radiographical outcomes in traumatized necrotic incisors. The failed cases were related to lack of bleeding and persistent infections, indicating that new techniques are needed to improve the predictability of PR.
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Affiliation(s)
- Alina Wikström
- Division of Orthodontics and Paediatric DentistryDepartment of Dental MedicineKarolinska InstituteStockholmSweden
- Department of EndodonticsPublic Dental Health ServicesEastmaninstitutetStockholmSweden
- Centre of Paediatric Oral HealthHuddingeSweden
| | | | - Nelly Romani Vestman
- Department of EndodonticsCounty Council of VästerbottenUmeåSweden
- Wallenberg Centre for Molecular MedicineUmeå UniversityUmeåSweden
| | | | - Georgios Tsilingaridis
- Division of Orthodontics and Paediatric DentistryDepartment of Dental MedicineKarolinska InstituteStockholmSweden
- Centre of Paediatric Oral HealthHuddingeSweden
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Abbott PV, Lin S. Tooth resorption-Part 2: A clinical classification. Dent Traumatol 2022; 38:267-285. [PMID: 35605161 PMCID: PMC9543863 DOI: 10.1111/edt.12762] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently there is no universal classification for the different types of tooth resorption. This lack of a universal classification leads to both confusion amongst practitioners and poor understanding of the resorptive processes occurring in teeth which can result in incorrect/inappropriate diagnoses and mis‐management. When developing a classification of diseases and/or conditions that occur within the body, several criteria should be followed to ensure a useful classification. The classification should not only include pathological conditions but also physiological conditions. Since tooth resorption can be either pathological or physiological, a classification of tooth resorption should include both of these categories. Any classification of diseases should be possible to use clinically, meaningful, useful, clear and universal. It should enable easy storage, retrieval and analysis of health information for evidenced‐based decision‐making. It should also be possible to share and compare data and information between different institutions, settings and countries. A classification of tooth resorption should be developed by combining anatomical, physiological and pathological approaches. For some types of resorption, the aetiological approach should also be incorporated. A classification of tooth resorption that uses simple, relevant and appropriate terminology based on the nature and location of the resorptive process occurring in teeth is proposed. There are two broad categories of internal and external tooth resorption which are sub‐divided into three types of internal tooth resorption (surface, inflammatory, replacement) and eight types of external tooth resorption (surface, inflammatory, replacement, invasive, pressure, orthodontic, physiological, idiopathic). The clinician's understanding, diagnosis and management of tooth resorption can be facilitated by using this simple classification which should ideally be used universally by the entire dental profession to ensure clarity and to avoid confusion.
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Affiliation(s)
- Paul V Abbott
- UWA Dental School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Shaul Lin
- Department of Endodontic and Dental Trauma, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.,The Israeli National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Canter, Tel Hashomer, Israel
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James N, Kini S, Pai S, Shenoy N, Kabekkodu SP. Comparative Evaluation of Corneal Storage Medias Used as Tooth Avulsion Medias in Maintaining the Viability of Periodontal Ligament Cells Using the Cell Counting Kit-8 Assay. Clin Cosmet Investig Dent 2022; 14:87-94. [PMID: 35411190 PMCID: PMC8994560 DOI: 10.2147/ccide.s314478] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 02/24/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The prime factor in determining the success of reimplantation of an avulsed tooth is the maintenance of the viability of periodontal ligament fibroblast cells (PDFC). This study aims to evaluate and compare Mc Carey Kaufman media (MK), Cornisol, Dulbecco's Modified Eagles Medium (DMEM), Hanks Balanced Salt Solution (HBSS) and distilled water in preserving the viability of the PDFC using the Cell Counting Kit-8 assay (CCK-8). METHODS Cryopreserved PDFC were suspended in DMEM and incubated in CO2 incubator at 370C with 95% humidity and 5% CO2 for attachment. Once cells attained 80% confluence, they were trypsinised and passed into T-25 culture flasks to expand the culture population. Cells from passage 5 were pooled for experimentation. Trypan blue exclusion test was performed before each experiment to measure cell viability and batches showing more than 95% viability were used in the experiment. The viable PDFC with 1×105 were seeded in 96 well plates and incubated in CO2 incubator at 370C, 95% humidity and 5% CO2 for 24 hours to allow cell attachment. A 100µL of the experimental media were added in the wells and the cells were exposed for 1, 24 and 48 hours respectively. The viability was determined using the CCK-8. Experiment was performed in triplicates and data was subjected to statistical analysis. RESULTS Statistical analysis was performed using repeated measure ANOVA, ANOVA, and post-hoc Bonferroni test with the significance level p<0.05. The values are as follows: MK (1.3146 ±0.0588, 1.9012±0.0511, 2.0723±0.1211) > Cornisol (1.2399±0.0548, 1.9596±0.0652, 1.9592±0.1361) >DMEM (1.1914±0.0691, 1.8479±0.0116, 2.0718±0.0795) > HBSS (0.3665±0.0814, 0.0184±0.0010, 0.0248±0.0042) >distilled water (0.0122±0.0033, 0.0225±0.0085, 0.0104±0.0008) at 1 hour, 24 hours and 48 hours respectively. MK >Cornisol>DMEM>HBSS>distilled water. CONCLUSION It can be concluded that the corneal preservation solutions showed promising results in preserving periodontal ligament cell viability for extended time periods.
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Affiliation(s)
- Nidhi James
- Department of Conservative Dentistry and Endodontics, MCODS, MAHE, Manipal, Karnataka, India
| | - Sandya Kini
- Department of Conservative Dentistry and Endodontics, MCODS, MAHE, Manipal, Karnataka, India
| | - Swathi Pai
- Department of Conservative Dentistry and Endodontics, MCODS, MAHE, Manipal, Karnataka, India
| | - Neetha Shenoy
- Department of Conservative Dentistry and Endodontics, MCODS, MAHE, Manipal, Karnataka, India
| | - Shama Prasada Kabekkodu
- Department of Cell and Molecular Biology, School of Life Sciences, MAHE, Manipal, Karnataka, India
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42
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Almulhim B. Knowledge and Awareness of School Teachers Regarding Emergency Management of Tooth Avulsion in the Kingdom of Saudi Arabia: A Cross-Sectional Study. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2112231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aim:
This study aimed to assess the general knowledge and awareness of school teachers regarding the first aid emergency dental management of tooth avulsion in the kingdom of Saudi Arabia.
Materials and Methods:
A self-administered, anonymous, close-ended structured questionnaire was given to school teachers in Saudi Arabia. It included information regarding gender, knowledge, and awareness [three parts: basic demographic characteristics focusing on the gender (part one), questions regarding knowledge of school teachers toward emergency management of tooth avulsion (part two), and questions regarding awareness of school teachers toward emergency management of tooth avulsion (part three)].
Results:
A total of 615 school teachers (58% males and 42% females) completed the questionnaire. Approximately 54.3% of the school teachers preferred to immediately refer the child to the dentist if trauma affects permanent teeth (p < 0.05), and only 2.1% opined regarding reposition of the tooth in a normal position. Another 22.9% responded that they would scrub the tooth to clean the dirt and rinse with water, while 19.7% reported that they would keep the tooth in a wet handkerchief until they reach the dentist.
Conclusion:
The knowledge and awareness of schoolteachers regarding the management of avulsed teeth are insufficient; thus, education programs on traumatic dental injuries are essential.
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Plotino G, Abella Sans F, Duggal MS, Grande NM, Krastl G, Nagendrababu V, Gambarini G. Present status and future directions ‐ Surgical extrusion, intentional replantation, and tooth autotransplantation. Int Endod J 2022; 55 Suppl 3:827-842. [DOI: 10.1111/iej.13723] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Gianluca Plotino
- Department of Endodontics "Sapienza" ‐ University of Rome Rome Italy
| | - Francesc Abella Sans
- Department of Endodontics Universitat Internacional de Catalunya Barcelona Spain
| | - Monty S Duggal
- Faculty of Dentistry National University Health System Singapore
| | - Nicola M Grande
- Department of Endodontics Catholic University of Sacred Heart Rome Italy
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology University Hospital of Würzburg Würzburg Germany
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Aksel H, Zhu X, Gauthier P, Zhang W, Azim AA, Huang GTJ. A new direction in managing avulsed teeth: stem cell-based de novo PDL regeneration. Stem Cell Res Ther 2022; 13:34. [PMID: 35090556 PMCID: PMC8796335 DOI: 10.1186/s13287-022-02700-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023] Open
Abstract
Management of avulsed teeth after replantation often leads to an unfavorable outcome. Damage to the thin and vulnerable periodontal ligament is the key reason for failure. Cell- or stem cell-based regenerative medicine has emerged in the past two decades as a promising clinical treatment modality to improve treatment outcomes. This concept has also been tested for the management of avulsed teeth in animal models. This review focuses on the discussion of limitation of current management protocols for avulsed teeth, cell-based therapy for periodontal ligament (PDL) regeneration in small and large animals, the challenges of de novo regeneration of PDL on denuded root in the edentulous region using a mini-swine model, and establishing a prospective new clinical protocol to manage avulsed teeth based on the current progress of cell-based PDL regeneration studies.
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Affiliation(s)
- Hacer Aksel
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, USA
| | - Xiaofei Zhu
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Endodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA.,VIP Dental Service and Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Philippe Gauthier
- Department of Endodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA.,Département d'endodontie, Faculté de Médecine Dentaire, Université Laval, Québec, QC, G1V 0A6, Canada
| | - Wenjing Zhang
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Adham A Azim
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, USA.,Department of Endodontics, Arthur A Dugoni School of Dental Medicine, University of Pacific, San Francisco, California, USA
| | - George T-J Huang
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA. .,Department of Endodontics, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA. .,Cancer Research Building, University of Tennessee Health Science Center, 19 S. Manassas St. Lab Rm 256, office 255, Memphis, TN, 38163, USA.
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45
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Wang X, Tewari N, Sato F, Tanimoto K, Thangavelu L, Makishima M, Bhawal UK. Biphasic Functions of Sodium Fluoride (NaF) in Soft and in Hard Periodontal Tissues. Int J Mol Sci 2022; 23:ijms23020962. [PMID: 35055148 PMCID: PMC8780524 DOI: 10.3390/ijms23020962] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/04/2023] Open
Abstract
Sodium fluoride (NaF) is widely used in clinical dentistry. However, the administration of high or low concentrations of NaF has various functions in different tissues. Understanding the mechanisms of the different effects of NaF will help to optimize its use in clinical applications. Studies of NaF and epithelial cells, osteoblasts, osteoclasts, and periodontal cells have suggested the significant roles of fluoride treatment. In this review, we summarize recent studies on the biphasic functions of NaF that are related to both soft and hard periodontal tissues, multiple diseases, and clinical dentistry.
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Affiliation(s)
- Xingzhi Wang
- Department of Biochemistry, Nihon University School of Medicine, Tokyo 173-8610, Japan;
| | - Nitesh Tewari
- Centre for Dental Education and Research, Division of Pedodontics and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Fuyuki Sato
- Shizuoka Cancer Center, Pathology Division, Shizuoka 411-8777, Japan;
| | - Keiji Tanimoto
- Department of Translational Cancer Research, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Lakshmi Thangavelu
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India;
| | - Makoto Makishima
- Department of Biochemistry, Nihon University School of Medicine, Tokyo 173-8610, Japan;
- Correspondence: (M.M.); (U.K.B.)
| | - Ujjal K. Bhawal
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India;
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Correspondence: (M.M.); (U.K.B.)
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Alamoudi R, Alamoudi R. Assessment of youth knowledge and attitude toward managing avulsed tooth across Saudi Arabia: A cross sectional study. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_24_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dentoalveolar Trauma of Children and Adolescents. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Krastl G, Weiger R, Ebeleseder K, Galler K. Present status and future directions: Endodontic management of traumatic injuries to permanent teeth. Int Endod J 2021; 55 Suppl 4:1003-1019. [PMID: 34862800 DOI: 10.1111/iej.13672] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/02/2021] [Indexed: 12/26/2022]
Abstract
The prognosis of traumatized teeth depends largely on the fate of the pulp and its treatment. This review aims to update the present status on the endodontic management of traumatic injuries to permanent teeth and to identify relevant research areas that could contribute to an improvement in diagnosis and treatment of traumatized permanent teeth. Future research should pay greater attention to (1) diagnostic methods to assess the perfusion of the pulp and enhance detection of tooth cracks and initial signs of root resorption; (2) improved materials for vital pulp treatment; (3) studies focusing on type and duration of splinting after root fractures; (4) antiresorptive intracanal medication in case of posttraumatic pulp necrosis and infection-related resorption and (5) long-term data on the apical barrier technique compared to revitalization.
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Affiliation(s)
- Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Kurt Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - Kerstin Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Llaquet M, Pascual A, Muñoz-Peñalver J, Abella Sans F. Periodontal and Periapical Outcomes of Surgical Extrusion: A Prospective Clinical Volumetric Study. J Endod 2021; 48:213-222. [PMID: 34848250 DOI: 10.1016/j.joen.2021.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/27/2021] [Accepted: 11/20/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Outcome predictors for the restoration of endodontically treated teeth mainly include cavity wall integrity and the presence of a 1.5-2 mm ferrule. However, in some clinical situations, the aforementioned predictors cannot be achieved. Three different techniques have been proposed to obtain an adequate ferrule respecting the supracrestal tissue attachment: surgical crown lengthening, orthodontic forced eruption, and surgical extrusion. There are little published prospective data evaluating periodontal changes after surgical extrusion. Therefore, the aims of this study were to report the outcome of surgical extrusion in single-rooted teeth, to digitally evaluate soft tissue volumetric changes after surgical extrusion, and to observe patient satisfaction regarding the treatment after a minimum of 1 year. METHODS This prospective clinical study was performed between 2017 and 2020. Thirteen patients referred for surgical extrusion met the following inclusion criteria: nonsmokers; systemically healthy with at least 1 straight, single-rooted tooth with an insufficient ferrule; a favorable tooth crown-to-root ratio, and no periodontal pathology. Preoperative clinical variables included patient age, sex and phenotype, tooth number, tooth mobility, crown-to-root ratio, gingival index (GI), probing pocket depths at 6 sites, bleeding on probing (BOP), and mesial and distal interproximal papillae volume. Surgical extrusion was performed by a single operator who completed the root canal treatment/retreatment and restored the teeth with a crown. One year later, all patients were controlled, and the following variables were recorded: tooth mobility, crown-to-root ratio, GI, pocket depth, BOP, interproximal papillae aspect, soft tissue rebound, periapical healing, marginal bone loss, and patient-reported outcome measures of the treatment. All variables were analyzed using a descriptive method (mean, %). The Wilcoxon test was used to evaluate pre- and postoperative clinical parameters at a significance level of .05. RESULTS At a mean follow-up period of 18.8 months, no teeth were extracted. Compared with preoperative GI and BOP, a significant reduction was observed at 1 year after surgery. Likewise, no significant differences in probing depths were shown, and only 1 tooth presented a type 2 mobility. The mean soft tissue rebound was -0.46 ± 0.69 mm. Overall, no significant interproximal papillae height loss was observed.Apical lesions were completely healed after surgery. The tooth crown-to-root ratio was favorable in all cases before extrusion, whereas in 3 cases it was appropriate (1 = 1), and only 1 case presented >25% of marginal bone loss during the follow-up period. The reported success rate was 92.3%, and patients were generally satisfied with the outcome. CONCLUSIONS Surgical extrusion of single-rooted teeth was successful with minimal or no soft tissue loss, and patients were satisfied with the surgical procedure and the esthetic result.
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Affiliation(s)
- Marc Llaquet
- Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Andres Pascual
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jesús Muñoz-Peñalver
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Francesc Abella Sans
- Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
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50
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Morgan E, Fox K, Jarad F, Albadri S. An investigation of transitional care pathways for young people following traumatic dental injuries. Br Dent J 2021:10.1038/s41415-021-3471-4. [PMID: 34616028 DOI: 10.1038/s41415-021-3471-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/16/2020] [Indexed: 11/09/2022]
Abstract
Introduction Traumatic dental injuries (TDIs) can cause severe and complex dento-alveolar problems. Management of TDIs frequently extends into adulthood; therefore, a clear transitional care pathway (TCP) is important. Failure of this can prevent engagement in adult dental services and negatively influence treatment outcomes.Aims To assess the availability of TCPs from paediatric and adult specialist care for young people with TDIs.Materials and methods An anonymous, postal survey was designed and administered to all UK specialists in paediatric dentistry registered with the General Dental Council. Quantitative and qualitative data were gathered.Results The response rate was 58% (n = 130). Fifty-five percent (n = 72) stated that there was a dental trauma clinic for children within their locality, while only 22% (n = 29) stated that there was a dental trauma clinic for adults. Sixty-nine percent (n = 90) stated that there was no clear TCP within their locality and 41% (n = 37) of these highlighted a need for a TCP. Thematic analysis of opinions with regards to need for a TCP identified three main themes: pathway availability, access to resources and clinician experience. Following a course of treatment for a patient aged 12 years or above, 24% (n = 31) refer to specialist adult services, with 43% (n = 95) continuing to provide follow-up within paediatric dentistry.Conclusion Follow-up arrangements for young people with TDIs differ across the UK, with inconsistent availability of TCPs. Informal pathways involving referral to multidisciplinary teams may be utilised for follow-up care. Development of a TCP may aid in developing a consistent approach to long-term management of TDIs.
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Affiliation(s)
- Emma Morgan
- School of Dentistry, University of Liverpool, Pembroke Place, Liverpool, L3 5PS, UK.
| | - Kathryn Fox
- School of Dentistry, University of Liverpool, Pembroke Place, Liverpool, L3 5PS, UK
| | - Fadi Jarad
- School of Dentistry, University of Liverpool, Pembroke Place, Liverpool, L3 5PS, UK
| | - Sondos Albadri
- School of Dentistry, University of Liverpool, Pembroke Place, Liverpool, L3 5PS, UK
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