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Complications and survival rates of teeth after dental trauma over a 5-year period

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Abstract

Objectives

The purpose of this study was to evaluate whether the current guidelines of the International Association of Dental Traumatology (IADT) for emergency care of traumatised teeth result in lower complication rates.

Materials and methods

Therapeutic strategies of 361 dental injuries in 291 patients treated at a university dental hospital over a 5-year period were investigated by evaluating the patients' records. Adherence to the guidelines of the IADT (Flores et al. Dent Traumatol 17:1–4, 2001; 49–52, 2001; 97–102, 2001; 145–148, 2001; and 193–196, 2001; Flores et al. Dent Traumatol 23:66–71, 2007; 130–136, 2007; and 196–202, 2007) was evaluated. Complications were also recorded according to the patients' records and analysed relative to the treatment and injury pattern. During follow-up visits, the teeth were inspected regarding pulp vitality and overall function of the injured tooth. The Kaplan–Meier survival analysis of pulps and teeth was performed for different injury categories.

Results

The majority of injuries (322/361; 89.2 %) were treated according to the guidelines. When IADT guidelines were followed, complication rates were significantly lower than for cases treated without adherence to the guidelines. The most frequent complication was the loss of restoration, followed by pulp necrosis, abnormal mobility, and tooth loss. The overall survival analysis showed that in the permanent dentition, the loss of pulp vitality and tooth occurs within the first 6 months but may also occur later.

Conclusions

The results of this study indicate that traumatised teeth that were treated according to the recommendations had a lower complication rate. In addition, the majority of pulp necrosis and tooth losses in the permanent dentition occurred within the first 6 months after trauma. These results indicate that early follow-up visits are essential to promptly treat complications.

Clinical relevance

Adherence to the IADT guidelines for treatment of dental trauma may lead to more favourable outcomes when compared to cases treated without compliance to the guidelines.

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References

  1. Flores MT, Andreasen JO, Bakland LK (2001) Guidelines for the evaluation and management of traumatic dental injuries. Dent Traumatol 17(1):1–4. doi:10.1034/j.1600-9657.2001.170101.x

    Article  PubMed  Google Scholar 

  2. Flores MT, Andreasen JO, Bakland LK (2001) Guidelines for the evaluation and management of traumatic dental injuries. Dent Traumatol 17(2):49–52. doi:10.1034/j.1600-9657.2001.017002049.x

    Article  PubMed  Google Scholar 

  3. Flores MT, Andreasen JO, Bakland LK (2001) Guidelines for the evaluation and management of traumatic dental injuries. Dent Traumatol 17(3):97–102. doi:10.1034/j.1600-9657.2001.017003097.x

    Article  PubMed  Google Scholar 

  4. Flores MT, Andreasen JO, Bakland LK (2001) Guidelines for the evaluation and management of traumatic dental injuries. Dent Traumatol 17(4):145–148. doi:10.1034/j.1600-9657.2001.170401.x

    Article  PubMed  Google Scholar 

  5. Flores MT, Andreasen JO, Bakland LK (2001) Guidelines for the evaluation and management of traumatic dental injuries. Dent Traumatol 17(5):193–196. doi:10.1034/j.1600-9657.2001.170501.x

    Article  PubMed  Google Scholar 

  6. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F et al (2007) Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol 23:66–71. doi:10.1111/j.1600-9657.2007.00592.x

    Article  PubMed  Google Scholar 

  7. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F et al (2007) Guidelines for the management of traumatic dental injuries. II. Avulsion of Permanent Teeth. Dent Traumatol 23:130–136. doi:10.1111/j.1600-9657.2007.00605.x

    Article  PubMed  Google Scholar 

  8. Flores MT, Malmgren B, Andersson L, Andreasen JO, Bakland LK, Barnett F et al (2007) Guidelines for the management of traumatic dental injuries. III. Primary teeth. Dent Traumatol 23:196–202. doi:10.1111/j.1600-9657.2007.00627.x

    Article  PubMed  Google Scholar 

  9. DiAngelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A, Andersson L, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Pohl Y, Tsukiboshi M (2012) International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 28:2–12. doi:10.1111/j.1600-9657.2011.01103.x

    Article  PubMed  Google Scholar 

  10. Andreasen JO, Andreasen FM, Skeie A, HjØrting-Hansen E, Schwartz O (2002) Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries—a review article. Dent Traumatol 18:116–128. doi:10.1034/j.1600-9657.2002.00079.x

    Article  PubMed  Google Scholar 

  11. Stewart CJ, Elledge RO, Kinirons MJ, Welbury RR (2008) Factors affecting the timing of pulp extirpation in a sample of 66 replanted avulsed teeth in children and adolescents. Dent Traumatol 24:625–627. doi:10.1111/j.1600-9657.2008.00691.x

    Article  PubMed  Google Scholar 

  12. Roskamp L, Westphalen VP, Carneiro E, Fariniuk LF, Silva Neto UX (2011) The positive influence of atopy on the prognosis of avulsed and replanted teeth despite differences in post-trauma management. J Endod 37:463–465. doi:10.1016/j.joen.2010.12.013

    Article  PubMed  Google Scholar 

  13. Sandalli N, Cildir S, Guler N (2005) Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 years. Dent Traumatol 21:188–194. doi:10.1111/j.1600-9657.2005.00309.x

    Article  PubMed  Google Scholar 

  14. Petrovic B, Markovic D, Peric T, Blagojevic D (2010) Factors related to treatment and outcomes of avulsed teeth. Dent Traumatol 26:52–59. doi:10.1111/j.1600-9657.2009.00836.x

    Article  PubMed  Google Scholar 

  15. Hecova H, Tzigkounakis V, Merglova V, Netolicky J (2010) A retrospective study of 889 injured permanent teeth. Dent Traumatol 26:466–475. doi:10.1111/j.1600-9657.2010.00924.x

    Article  PubMed  Google Scholar 

  16. Ravn JJ (1981) Follow-up study of permanent incisors with enamel-dentin fractures after acute trauma. Scand J Dent Res 89:355–365

    PubMed  Google Scholar 

  17. Andreasen JO (1987) Experimental dental traumatology: development of model for external root resorption. Endod Dent Traumatol 3:269–287. doi:10.1111/j.1600-9657.1987.tb00636.x

    Article  PubMed  Google Scholar 

  18. Andreasen FM, Andreasen JO (2007) Luxation injuries of permanent teeth: general findings. In: Andreasen JO, Andreasen FM, Andersson L (eds) Textbook and color atlas of traumatic injuries to the teeth, 4th edn. Blackwell, Oxford, pp 372–403

    Google Scholar 

  19. Andreasen JO, Bakland LK, Andreasen FM (2006) Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth. Dent Traumatol 22:90–98. doi:10.1111/j.1600-9657.2006.00422.x

    Article  PubMed  Google Scholar 

  20. Wigen TI, Agnalt R, Jacobsen I (2008) Intrusive luxation of permanent incisors in Norwegians aged 6–17 years: a retrospective study of treatment and outcome. Dent Traumatol 24:612–618. doi:10.1111/j.1600-9657.2008.00686.x

    Article  PubMed  Google Scholar 

  21. Borum MK, Andreasen JO (1998) Sequelae of trauma to primary maxillary incisors. I. Complications in the primary dentition. Endod Dent Traumatol 14:31–44. doi:10.1111/j.1600-9657.1998.tb00806.x

    Article  PubMed  Google Scholar 

  22. Robertson A, Andreasen FM, Andreasen JO, Noren JG (2000) Long-term prognosis of crown-fractured permanent incisors. The effect of stage of root development and associated luxation injury. Int J Paediatr Dent 10:191–199. doi:10.1046/j.1365-263x.2000.00191.x

    Article  PubMed  Google Scholar 

  23. Robertson A (1998) A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries. Endod Dent Traumatol 14:245–256. doi:10.1111/j.1600-9657.1998.tb00848.x

    Article  PubMed  Google Scholar 

  24. Demarco FF, Fay RM, Pinzon LM, Powers JM (2004) Fracture resistance of re-attached coronal fragments—influence of different adhesive materials and bevel preparation. Dent Traumatol 20:157–163. doi:10.1111/j.1600-4469.2004.00221.x

    Article  PubMed  Google Scholar 

  25. Rappelli G, Massaccesi C, Putignano A (2002) Clinical procedures for the immediate reattachment of a tooth fragment. Dent Traumatol 18:281–284. doi:10.1034/j.1600-9657.2002.00099.x

    Article  PubMed  Google Scholar 

  26. Reis A, Francci C, Loguercio AD, Carrilho MR, Rodrigues Filho LE (2001) Re-attachment of anterior fractured teeth: fracture strength using different techniques. Oper Dent 26:287–294

    PubMed  Google Scholar 

  27. Farik B, Munksgaard EC, Andreasen JO, Kreiborg S (2002) Fractured teeth bonded with dentin adhesives with and without unfilled resin. Dent Traumatol 18:66–69. doi:10.1034/j.1600-9657.2002.180203.x

    Article  PubMed  Google Scholar 

  28. Farik B, Munksgaard EC, Andreasen JO, Kreiborg S (1999) Drying and rewetting anterior crown fragments prior to bonding. Endod Dent Traumatol 15:113–116. doi:10.1111/j.1600-9657.1999.tb00766.x

    Article  PubMed  Google Scholar 

  29. Yilmaz Y, Guler C, Sahin H, Eyuboglu O (2010) Evaluation of tooth-fragment reattachment: a clinical and laboratory study. Dent Traumatol 26:308–314. doi:10.1111/j.1600-9657.2010.00907.x

    Article  PubMed  Google Scholar 

  30. Andreasen JO (1970) Luxation of permanent teeth due to trauma. Scand J Dent Res 78:273–286

    PubMed  Google Scholar 

  31. Andreasen FM, Vestergaard Pedersen B (1985) Prognosis of luxated permanent teeth—the development of pulp necrosis. Endod Dent Traumatol 1:207–220. doi:10.1111/j.1600-9657.1985.tb00583.x

    Article  PubMed  Google Scholar 

  32. Kinirons MG, Sutcliffe J (1991) Traumatically intruded permanent incisors: a study of treatment and outcome. Br Dent J 170:144–146. doi:10.1038/sj.bdj.4807449

    Article  PubMed  Google Scholar 

  33. Donaldson M, Kinirons MJ (2001) Factors affecting the onset of resorption in avulsed and replanted incisor teeth in children. Dent Traumatol 17:205–209. doi:10.1034/j.1600-9657.2001.170503.x

    Article  PubMed  Google Scholar 

  34. Majorana A, Bardellini E, Conti G, Keller E, Pasini S (2003) Root resorption in dental trauma: 45 cases followed for 5 years. Dent Traumatol 19:262–265. doi:10.1034/j.1600-9657.2003.00205.x

    Article  PubMed  Google Scholar 

  35. Chappuis V, von Arx T (2005) Replantation of 45 avulsed permanent teeth: a 1-year follow-up study. Dent Traumatol 21:289–296. doi:10.1111/j.1600-9657.2005.00330.x

    Article  PubMed  Google Scholar 

  36. Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM (1995) Replantation of 400 avulsed permanent incisors. 1. Diagnosis and healing complications. Endod Dent Traumatol 11:51–58. doi:10.1111/j.1600-9657.1995.tb00461.x

    Article  PubMed  Google Scholar 

  37. Stålhane I, Hedegård B (1975) Traumatized permanent teeth in children aged 7-15 years. Part II. Sven Tandlak Tidskr 68:157–169

    PubMed  Google Scholar 

  38. Zadik D, Chosack A, Eidelman E (1979) The prognosis of traumatized permanent anterior teeth with fracture of the enamel and dentin. Oral Surg Oral Med Oral Pathol 47:173–175

    Article  PubMed  Google Scholar 

  39. Nikoui M, Kenny DJ, Barrett EJ (2003) Clinical outcome for permanent incisor luxations in a pediatric population. III. Lateral Luxations. Dent Traumatol 19:280–285. doi:10.1034/j.1600-9657.2003.00209.x

    Article  PubMed  Google Scholar 

  40. Andreasen JO, Ahrensburg SS, Tsilingaridis G (2012) Root fractures: the influence of type of healing and location of fracture on tooth survival rates—an analysis of 492 cases. Dent Traumatol. doi:10.1111/j.1600-9657.2012.01132.x

  41. Humphrey JM, Kenny DJ, Barrett EJ (2003) Clinical outcome for permanent incisor luxations in a pediatric population. I. Intrusions. Dent Traumatol 19:266–273. doi:10.1034/j.1600-9657.2003.00207.x

    Article  PubMed  Google Scholar 

  42. Tsilingaridis G, Malmgren B, Andreasen JO, Malmgren O (2011) Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. Dent Traumatol. doi:10.1111/j.1600-9657.2011.01088.x

  43. Al-Badri S, Kinirons M, Cole BOI, Welbury RR (2002) Factors affecting resorption in traumatically intruded permanent incisors in children. Dent Traumatol 18:73–76. doi:10.1034/j.1600-9657.2002.180205.x

    Article  PubMed  Google Scholar 

  44. Barrett EJ, Kenny DJ (1997) Survival of avulsed permanent maxillary incisors in children following delayed replantation. Endod Dent Traumatol 13:269–275. doi:10.1111/j.1600-9657.1997.tb00054.x

    Article  PubMed  Google Scholar 

  45. Lee R, Barrett EJ, Kenny DJ (2003) Clinical outcomes for permanent incisor luxations in a pediatric population. II. Extrusions. Dent Traumatol 19:274–279. doi:10.1034/j.1600-9657.2003.00208.x

    Article  PubMed  Google Scholar 

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Conflict of interest

This research work was funded by the institutional source with no conflict of interest.

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Authors and Affiliations

  1. Department of Conservative Dentistry, Ludwig–Maximilians University, Goethestrasse 70, Munich, 80336, Germany

    Katharina Bücher, Claudia Neumann, Reinhard Hickel & Jan Kühnisch

  2. Institute of Epidemiology I, Helmholtz Zentrum, German Research Center for Environmental Health, Munich, Germany

    Elisabeth Thiering

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  1. Katharina Bücher
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  2. Claudia Neumann
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  3. Elisabeth Thiering
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  4. Reinhard Hickel
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Correspondence to Katharina Bücher.

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Bücher, K., Neumann, C., Thiering, E. et al. Complications and survival rates of teeth after dental trauma over a 5-year period. Clin Oral Invest 17, 1311–1318 (2013). https://doi.org/10.1007/s00784-012-0817-y

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  • DOI: https://doi.org/10.1007/s00784-012-0817-y

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