Treatment of traumatized primary teeth: a conservative approach

Abstract

This retrospective study examined some different types of treatment to primary teeth. The aim of this study was to assess the treatment of traumatized primary teeth and the importance of a long-term follow up. Brazilian children in the age group of 1-4 years from a baby clinic took part in the study. Three hundred and fifteen patients suffered some type of traumatic injury, a total of 338 affected teeth. Data were registered in specific records and submitted to statistic analysis. The most prevalent type of treatment was monitor only (85%) followed by tooth extraction and endodontic procedure. Invasive treatments were performed in case of severe traumas, usually 6 months after the injury. We verified that a careful follow up might be the preferential choice to the treatment of traumatic primary teeth even in some severe cases.

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition

“…Furthermore, children with dental injuries are not always brought in for treatment immediately, which may be due the to lack of access to dental care . While some reports advocate routine tooth extraction, others stress the importance of a more conservative approach by saving primary teeth whenever possible . Traumatic pulp exposures of primary incisors are rare but can be treated with partial pulpotomy .…”

Avaliação Clínica e Radiográfica de Dentes Decíduos Intruídos por Traumatismo Alvéolo-Dentário

“…Esses dados estão de acordo com a literatura, que aponta os incisivos centrais superiores como os dentes mais suscetíveis a traumatismos alveolodentários 2,6,7,[21][22][23] . Entre as etiologias, a queda da própria altura foi a mais comum (58,6%), indo ao encontro da literatura 15,16,24 . Tanto as quedas quanto a colisão com objetos são acontecimentos normais durante o período de desenvolvimento, no qual as crianças são mais atingidas pelos traumatismos alveolodentários.…”

“…Concluiu-se que o grau de intrusão não foi um fator significativamente influenciador na habilidade de o dente reeruptar 10 . Assim, o tratamento de escolha deve ser aguardar a reerupção do dente, caso ele esteja deslocado para vestibular 3,4,12,24 . Em 100% dos casos, os dentes intruídos foram deslocados em direção à parede vestibular, pois os incisivos centrais decíduos apresentam inclinação do ápice radicular nessa direção.…”

Crown-Root Fractures in Primary Teeth: A Case Series Study of 28 Cases

“…Total extractions were not performed in this cases series in two situations: 1-when the possibility of pulp treatment and tooth restoration was recognized after the removal of the mobile fragment, which occurred primarily with diagonal fractures after the removal of the coronal fragment followed by a supragingival restoration to allow gingival healing (14); and 2-a partial extraction was conducted when the radicular fragment was very apical, in order to prevent permanent tooth bud damage during the removal of the apical root portion. Professional expertise, a well-conducted treatment, and most importantly a longterm follow-up are fundamental for the future health of traumatized primary teeth (15).…”