Post-traumatic complications of severe luxations and replanted teeth

J Contemp Dent Pract. 2015 Jan 1;16(1):13-9. doi: 10.5005/jp-journals-10024-1628.

Abstract

Aim: The aim of this study was to evaluate the main post-traumatic complications of severe luxation and replanted teeth using clinical and radiographic analyses.

Materials and methods: Eighty-three patients aged between 7 and 55 years old presenting 180 traumatized teeth that suffered extrusive luxation (n=67), lateral luxation (n=69), intrusive luxation (n=10) and tooth avulsion (n=34) followed by replantation were evaluated. The follow-up period was 24 months. The complications examined were: pulp canal obliteration, pulp necrosis and root resorption (infammatory and replacement). Furthermore, the relationship between time elapsed before receiving dental attendance and development of infammatory resorption was observed.

Results: Pulp necrosis was the main complication, occurring in 147 teeth (82.7%). All of the teeth that suffered intrusive luxation and tooth avulsion were diagnosed with pulp necrosis, with significant difference in comparison with another traumas (p<0.001/Fisher's exact test). Infammatory root resorption was observed in 20.5% of the cases and replacement resorption was more related to tooth replantation (94.1%), showing significant prevalence among tooth luxations (p<0.001/Fisher's exact test). In addition, it was noted that patients who seek treatment 9 weeks after the trauma episode presented 10 times more chance of developing infammatory resorption when compared with patients who seek treatment soon after dental trauma (Odds ratio test).

Conclusion: It may be concluded that pulp necrosis was the main post-traumatic complication observed in traumatized teeth and that delay in seeking treatment may damage the prognosis of severe luxation and replanted teeth.

Clinical significance: Clinical studies describing the main complications that may affect traumatized teeth present great relevance to make the population aware of the importance of seeking immediate treatment and to alert the professional to the need for follow-up. When traumatic injuries are diagnosed and treated early, post-traumatic complications may be controlled, allowing conservation of the tooth in oral cavity.

Keywords: Tooth injury; Root resorption; Dental pulp necrosis.

Publication types

  • Comparative Study

MeSH terms

  • Accidental Falls
  • Adolescent
  • Adult
  • Aged
  • Bicycling / injuries
  • Child
  • Cuspid / injuries
  • Dental Pulp Calcification / diagnostic imaging
  • Dental Pulp Calcification / etiology
  • Dental Pulp Necrosis / diagnostic imaging
  • Dental Pulp Necrosis / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Incisor / injuries
  • Male
  • Middle Aged
  • Radiography, Bitewing / methods
  • Root Resorption / diagnostic imaging
  • Root Resorption / etiology
  • Splints
  • Time-to-Treatment
  • Tooth Avulsion / complications*
  • Tooth Avulsion / diagnostic imaging
  • Tooth Avulsion / therapy
  • Tooth Replantation / methods*
  • Young Adult