Retrospective study on sequelae in traumatized permanent teeth

ABSTRACT

Objective: This study aimed to identify possible associations of the presence or absence of posttrauma sequelae with the factors inherent to the traumatized tooth and treatment. Materials and Methods: This retrospective study was performed through the evaluation of records and radiographs of a center of reference for dental trauma between January 2008 and December 2014. The factors were analyzed and associated with posttrauma sequelae, such as pulp necrosis and root resorption. Statistical Analysis Used: A binomial logistic regression model was fit (P < 0.05). Results: In luxations, it was possible to observe 37% pulp necrosis, 16% inflammatory root resorption, and 8% replacement resorption. The binomial logistic regression revealed that male gender (P = 0.0392, odds ratio [OR] = 2.79), avulsion injury (P = 0.0009, OR = 12.27), and elapsed time >16 days between the time of trauma to the beginning of the endodontic treatment (P = 0.0450, OR = 7.53) showed a greater chance of presenting a posttrauma complication. Conclusions: Gender, type of injury, stage of root development, and time after trauma until the beginning of the endodontic intervention were related to the appearance of sequelae.

Key words:

Dental pulp necrosis - dental trauma - tooth resorption

• REFERENCES

• 1 Kinirons MJ, Boyd DH, Gregg TA. Inflammatory and replacement resorption in reimplanted permanent incisor teeth: A study of the characteristics of 84 teeth. Endod Dent Traumatol 1999; 15: 269-72
• 2 Cortes MI, Marcenes W, Sheiham A. Impact of traumatic injuries to the permanent teeth on the oral health-related quality of life in 12-14-year-old children. Community Dent Oral Epidemiol 2002; 30: 193-8
• 3 Lam R. Epidemiology and outcomes of traumatic dental injuries: A review of the literature. Aust Dent J 2016; 61 (Suppl. 01) 4-20
• 4 Breik O. Discuss how the management of trauma to the dentition is influenced by the type and severity of injury. Aust Endod J 2008; 34: 120-5
• 5 Andreasen JO. Luxation of permanent teeth due to trauma. A clinical and radiographic follow-up study of 189 injured teeth. Scand J Dent Res 1970; 78: 273-86
• 6 Al-Badri S, Kinirons M, Cole B, Welbury R. Factors affecting resorption in traumatically intruded permanent incisors in children. Dent Traumatol 2002; 18: 73-6
• 7 Hecova H, Tzigkounakis V, Merglova V, Netolicky J. A retrospective study of 889 injured permanent teeth. Dent Traumatol 2010; 26: 466-75
• 8 Andreasen FM, Pedersen BV. Prognosis of luxated permanent teeth-the development of pulp necrosis. Endod Dent Traumatol 1985; 1: 207-20
• 9 Andreasen JO, Bakland LK, Andreasen FM. 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 2006; 22: 90-8
• 10 Petrovic B, Markovic D, Peric T, Blagojevic D. Factors related to treatment and outcomes of avulsed teeth. Dent Traumatol 2010; 26: 52-9
• 11 Bastos JV, Ilma de Souza CôrtesM, Andrade Goulart EM, Colosimo EA, Gomez RS, Dutra WO. Age and timing of pulp extirpation as major factors associated with inflammatory root resorption in replanted permanent teeth. J Endod 2014; 40: 366-71
• 12 Humphrey JM, Kenny DJ, Barrett EJ. Clinical outcomes for permanent incisor luxations in a pediatric population. I. Intrusions. Dent Traumatol 2003; 19: 266-73
• 13 Hermann NV, Lauridsen E, Ahrensburg SS, Gerds TA, Andreasen JO. Periodontal healing complications following concussion and subluxation injuries in the permanent dentition: A longitudinal cohort study. Dent Traumatol 2012; 28: 386-93
• 14 Hinckfuss SE, Messer LB. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part I: Timing of pulp extirpation. Dent Traumatol 2009; 25: 32-42
• 15 Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, Diangelis AJ. et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2012; 28: 88-96
• 16 Jacobsen I. Criteria for diagnosis of pulp necrosis in traumatized permanent incisors. Scand J Dent Res 1980; 88: 306-12
• 17 Andreasen FM, Zhijie Y, Thomsen BL. Relationship between pulp dimensions and development of pulp necrosis after luxation injuries in the permanent dentition. Endod Dent Traumatol 1986; 2: 90-8
• 18 Tronstad L. Root resorption-etiology, terminology and clinical manifestations. Endod Dent Traumatol 1988; 4: 241-52
• 19 Hosmer DW, Lemeshow S, Sturdivant RX. Applied Logistic Regression. 3rd ed.. New Jersey; John Wiley & Sons: 2013
• 20 Andreasen JO, Andreasen FM. Texto e Atlas Colorido de Traumatismo Dental. 3rd ed. São Paulo; Artmed Editora: 2013
• 21 Sandalli N, Cildir S, Guler N. Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 years. Dent Traumatol 2005; 21: 188-94
• 22 Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO. Combination injuries 1. The risk of pulp necrosis in permanent teeth with concussion injuries and concomitant crown fractures. Dent Traumatol 2012; 28: 364-70
• 23 Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO. Combination injuries 2. The risk of pulp necrosis in permanent teeth with subluxation injuries and concomitant crown fractures. Dent Traumatol 2012; 28: 371-8
• 24 Lee R, Barrett EJ, Kenny DJ. Clinical outcomes for permanent incisor luxations in a pediatric population. II. Extrusions. Dent Traumatol 2003; 19: 274-9
• 25 Ferrazzini Pozzi EC, von Arx T. Pulp and periodontal healing of laterally luxated permanent teeth: Results after 4 years. Dent Traumatol 2008; 24: 658-62
• 26 Tsilingaridis G, Malmgren B, Andreasen JO, Wigen TI, Maseng Aas AL, Malmgren O. et al. Scandinavian multicenter study on the treatment of 168 patients with 230 intruded permanent teeth-a retrospective cohort study. Dent Traumatol 2016; 32: 353-60
• 27 Andersson L, Bodin I. Avulsed human teeth replanted within 15 minutes-a long-term clinical follow-up study. Endod Dent Traumatol 1990; 6: 37-42
• 28 American Association of Endodontics Recommended Guidelines of the American Association of Endodontists for the Treatment of Traumatic Dental Injuries. Chicago: 2013. Available from: http://www.nxtbook.com/nxtbooks/aae/traumaguidelines [Last accessed on 2016 Oct 08]
• 29 Kling M, Cvek M, Mejare I. Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors. Endod Dent Traumatol 1986; 2: 83-9
• 30 Ozer S, Yilmaz EI, Bayrak S, Tunc ES. Parental knowledge and attitudes regarding the emergency treatment of avulsed permanent teeth. Eur J Dent 2012; 6: 370-5