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Tooth avulsion and replantation
Scientific Programme (On Demand)
Session Description
Where are we today in research and clinic?
Tooth avulsion is one of the most serious types of traumatic dental injuries to permanent teeth often resulting in serious complications. Research has given us knowledge about the two types of tissue, pulp and periodontal ligament, subjected to injury and complications if not properly managed. The vascular supply to the pulp is immediately interrupted at the moment of avulsion resulting in a sterile necrotic tissue which runs a high risk of being infected and subjected to infection related root resorption. Replanted teeth with open apexes can revascularize and should be given a chance to do so. Teeth with closed apices cannot revascularize and should proactively be subjected to endodontic treatment within a few weeks after trauma. The periodontal membrane is often severely damaged which will result in complications, such as infection related root resorption and/or ankylosis with osseous replacement. In growing patients, inhibition of development of the alveolar process is seen with infraposition. Recent research has given us strategies to prevent, diagnose manage some of these situations.
Avulsed permanent teeth should always be replanted and the condition of the cells of the periodontal ligament (PDL) of the replanted tooth is of importance for which treatment to choose. In cases with short extra-alveolar time, or teeth stored in physiologic storage media such as milk, emphasis is put on optimizing the conditions for healing of the PDL and for revascularization of the pulp in cases where the tooth has an open apex. Infection related root resorption should by all means be prevented or early treated. In cases with delayed replantation (>60 minutes dry storage) the PDL is necrotic and ankylosis is expected and although ankylosis cannot be avoided, the situation can today be managed. In growing individuals infraposition is expected and decoronation of the replanted tooth often must be carried out to preserve the horizontal and vertical bone width. A paradigm shift is seen in recent years where we today focus more on methods preserving the alveolar bone rather than saving the tooth.
Learning Objectives
• Have an update on important research and present status in this field.
• Learn about clinical implications and of importance.
• Get familiar with interactive internet guide for treatment of avulsed teeth.
Tooth avulsion is one of the most serious types of traumatic dental injuries to permanent teeth often resulting in serious complications. Research has given us knowledge about the two types of tissue, pulp and periodontal ligament, subjected to injury and complications if not properly managed. The vascular supply to the pulp is immediately interrupted at the moment of avulsion resulting in a sterile necrotic tissue which runs a high risk of being infected and subjected to infection related root resorption. Replanted teeth with open apexes can revascularize and should be given a chance to do so. Teeth with closed apices cannot revascularize and should proactively be subjected to endodontic treatment within a few weeks after trauma. The periodontal membrane is often severely damaged which will result in complications, such as infection related root resorption and/or ankylosis with osseous replacement. In growing patients, inhibition of development of the alveolar process is seen with infraposition. Recent research has given us strategies to prevent, diagnose manage some of these situations.
Avulsed permanent teeth should always be replanted and the condition of the cells of the periodontal ligament (PDL) of the replanted tooth is of importance for which treatment to choose. In cases with short extra-alveolar time, or teeth stored in physiologic storage media such as milk, emphasis is put on optimizing the conditions for healing of the PDL and for revascularization of the pulp in cases where the tooth has an open apex. Infection related root resorption should by all means be prevented or early treated. In cases with delayed replantation (>60 minutes dry storage) the PDL is necrotic and ankylosis is expected and although ankylosis cannot be avoided, the situation can today be managed. In growing individuals infraposition is expected and decoronation of the replanted tooth often must be carried out to preserve the horizontal and vertical bone width. A paradigm shift is seen in recent years where we today focus more on methods preserving the alveolar bone rather than saving the tooth.
Learning Objectives
• Have an update on important research and present status in this field.
• Learn about clinical implications and of importance.
• Get familiar with interactive internet guide for treatment of avulsed teeth.