Multidisciplinary Treatment Options of Tooth Avulsion Considering Different Therapy Concepts

Abstract

Background: Avulsion of permanent front teeth is a rare accident, mostly affecting children between seven and nine years of age. Replanted and splinted, these teeth often develop inflammation, severe resorption or ankylosis affecting alveolar bone development and have to be extracted sooner or later. Objectives:The purpose of this study was to evaluate different therapy concepts to create a structured concept for the treatment of avulsions.Results: Based on existing therapy concepts, a concept for different initial conditions (dry time, age, growth, tooth, hard and soft tissues) was developed and is presented here. Conclusion: A great deal of research has been performed during recent years and guidelines for the management of avulsions have been published. With the help of this literature it is possible to identify the best treatment procedure for each tooth.Clinical Relevance:The prognosis of avulsed teeth can be improved by considering evidence-based therapy concepts. Resorption, ankylosis and tooth loss could be minimized.

Protocolos e condutas para diferentes situações clínicas de avulsão de dentes permanentes

“…Quando o dente permanece fora do alvéolo, em ambiente desidratado, por um período superior a 60 minutos é possível esperar um prognóstico não favorável. Neste caso, a conduta requer a utilização solução de soro fisiológico e fluoreto de sódio, objetivando desacelerar o processo de reabsorção radicular e reduzir a substituição óssea 31 . Flores et al 32 recomendam utilização desta técnica no reimplante tardio.…”

Delayed Replantation of an Avulsed Permanent Incisor Tooth

“…Replanted incisors with open apices had a significantly reduced survival, and the relative risk of failure was 4.2 times greater in immature than in mature incisor 8 . In these two cases, since the extra oral time was more than 24 hours, it was possible that the tooth had lost its vitality, hence root canal treatment was completed before replantation of tooth in the socket.…”

Reabsorción radicular externa inflamatoria resultado no deseado en la reimplantación tardía de una avulsión dental. Reporte de un caso

“…14 Tanto la duración del tiempo extra alveolar y el tipo de conservación son factores significativos que pueden afectar la supervivencia a largo plazo de los dientes reimplantados. 31 Cuando se produce un exceso de deshidratación antes de la reimplantación la mayoría de las células del ligamento periodontal sufrirán necrosis y provocarán una respuesta inflamatoria severa. Un área extensa se verá afectada y deberá ser reparada por un nuevo tejido.…”