Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted.

Area of Science:

• Dental Traumatology
• Oral Surgery
• Regenerative Medicine

Background:

• Traumatic dental injuries, particularly avulsion of permanent teeth, are common occurrences.
• Prompt replantation is crucial for tooth survival, yet optimal management strategies remain uncertain.
• This review updates previous findings on interventions for avulsed permanent teeth.

Purpose of the Study:

• To compare the effectiveness of various interventions for managing traumatized permanent front teeth following avulsion injuries.
• To assess the impact of different treatments on the survival and repair of replanted teeth.

Main Methods:

• Systematic review of randomized and quasi-randomized controlled trials with a minimum 12-month follow-up.
• Searched multiple databases including Cochrane Library, MEDLINE, and Embase up to March 2018.
• Four studies involving 183 participants and 257 teeth were included; data extraction and risk of bias assessment were performed independently.

Main Results:

• All included studies assessed different interventions, preventing numerical synthesis of data.
• Evidence quality was rated as very low due to risk of bias and imprecision, leading to high uncertainty.
• Some studies suggested potential benefits for hyperbaric oxygen and thymosin alpha 1, but findings were inconclusive due to study limitations.

Conclusions:

• Insufficient evidence exists to support or refute the effectiveness of interventions for avulsed and replanted permanent front teeth.
• The very low quality of existing evidence necessitates extreme caution when interpreting results.
• There is an urgent need for well-designed randomized controlled trials to establish effective management protocols.