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Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted.
1Department of Paediatric Dentistry, Leeds Dental Institute, Clarendon Way, Leeds, UK, LS2 9LU.
The Cochrane Database of Systematic Reviews
|January 22, 2010
Summary
Replanting avulsed permanent teeth quickly is crucial. While extra-oral endodontics shows no harm, thymosin alpha 1 and gentamycin sulphate with hyperbaric oxygen may improve healing, but require more research.
Area of Science:
- Dental Trauma Management
- Oral Surgery
- Reconstructive Dentistry
Background:
- Dental avulsion, a severe tooth injury, necessitates prompt replantation.
- Optimal preparation methods for replanted avulsed teeth remain uncertain.
Purpose of the Study:
- To evaluate interventions for managing traumatized permanent teeth with avulsion injuries.
- To compare the effectiveness of different pre-replantation and post-replantation treatments.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) with a minimum 12-month follow-up.
- Searched multiple databases including Cochrane, MEDLINE, and EMBASE up to October 2009.
- Data extraction and risk of bias assessment conducted independently by two reviewers.
Main Results:
- Three RCTs (162 patients, 231 teeth) were included, all with moderate to high risk of bias.
- Extra-oral endodontics showed no significant difference in resorption compared to intra-oral endodontics for teeth with >60 minutes dry time.
- Thymosin alpha 1 and gentamycin sulphate with hyperbaric oxygen showed potential benefits in periodontal healing, but require further validation.
Conclusions:
- Extra-oral endodontics appears safe for avulsed teeth with extended dry times.
- Emerging treatments like thymosin alpha 1 and gentamycin sulphate warrant further investigation.
- High-quality, low-risk-of-bias evidence from multicenter trials is needed to confirm optimal management strategies.
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