Background
During the first years of life, when children begin to walk and socialize, they are particularly vulnerable to traumatic injuries to the primary teeth; indeed, after dental caries, such injuries are the second most frequent cause of pediatric dental consultation. Nonetheless, the reported prevalence of trauma to the primary teeth varies depending on the literature source, type of injury, the patient's age, and the most common associated complications.
Aim
To analyze new epidemiological data and complications associated with traumatic injuries to the primary teeth of Spanish children.
Material and methods
A retrospective study was carried out in a subpopulation of 879 Spanish children in southern Europe aged between one and 7 years old, with primary and early mixed dentition. Clinical and radiological records were obtained from all pediatric patients who presented trauma to the primary teeth, with a follow‐up period of 3–5 years.
Results
A total of 21.72% of children examined had some kind of dental trauma and the most common age range for injuries to the primary teeth was 1–3 years old. The most common injuries in deciduous teeth were subluxation (47.29% of injuries affected the periodontal ligament), intrusion (23.15%), and avulsion (13.63%). On the other hand, comparatively more complications were recorded as a result of intrusion (32 of 47 intruded teeth).
Conclusions
In this Spanish subpopulation, a pediatric dental consultation as a result of traumatic dental injuries in primary dentition is most frequent in 1‐ and 2‐year‐olds, and subluxation is the commonest injury in the primary dentition. In turn, intrusion is associated with an increased frequency of complications in both the deciduous and the permanent teeth.
Variations in the interleukin 1 receptor antagonist gene (rs419598) - and not only in the IL1B gene (rs1800587) - are determinants of a predisposition to postorthodontic EARR.
Autotransplantation of donor teeth, at the stage of ½ to ¾ of their expected root length, can provide a successful treatment solution for over 14 years.
The aim of this minireview was to identify and review the scientific evidence regarding regenerative endodontic protocols claiming to revascularize permanent immature teeth with apical periodontitis. The literature was identified using the PubMed/MEDLINE, Scopus, Scirus, EMBASE and Cochrane databases up to February 2013. Studies were selected independently by two different researchers (kappa index: 0.88), based on established inclusion/exclusion criteria. The methodological quality of the reviewed papers was classified as high, medium or low (HQ, MQ, LQ). The search strategy identified 285 titles. Nine studies, both human and animal based, were selected after application of the criteria (LQ:5; MQ:4). In most of these studies (seven of nine), the revascularization protocol included a triple antibiotic combination as canal disinfectant for a period of 1-4 weeks after blood clot formation (LQ:5; MQ:4), although there is no clear consensus about the treatment protocol. Two studies reported tooth discoloration after the revascularization process (LQ:2), and only three (LQ:1; MQ:2) reported a success rate of 54.9% in dogs and 73.6% and 80% in humans, respectively. Revascularization of immature permanent teeth with apical periodontitis is possible and preferable to apexification. Nevertheless, there is a widespread lack of randomized clinical trials and blinded measures. In addition, the small sample sizes that are common in these studies as well as the generally low quality of the analysed publications require the results to be viewed with caution. There is a high risk of bias, with a low quality of available information, for developing clinical guidelines for regenerative endodontic protocols; rigorous randomized clinical trials are therefore needed.
Genetic variations in the interleukin-1β gene (rs1143634) predispose root filled teeth to EARR for matched pairs secondary to orthodontic treatment in a different way from their control teeth with vital pulps in subjects homozygous for allele 2 [2/2(TT)].
Variations in the osteopontin gene (rs9138 and rs11730582) are determinants of a genetic predisposition to suffer EARR secondary to orthodontic treatment.
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