Experts consensus on management of tooth luxation and avulsion

Area of Science:

• Pediatric Dentistry
• Dental Traumatology
• Oral Surgery

Background:

• Traumatic dental injuries (TDIs) are common in children and adolescents.
• TDIs affecting periodontal and alveolar tissues include luxation and avulsion.
• Effective management of soft tissues (periodontal ligament, dental pulp) is vital for tooth longevity.

Purpose of the Study:

• To provide a streamlined guide for clinicians managing TDIs in immature teeth.
• To discuss factors influencing trauma management and prognosis for luxation and avulsion injuries.
• To differentiate management strategies for adolescent (Nolla stage 9) and very young (Nolla stage ≤8) immature teeth.

Main Methods:

• Review of current literature and clinical consensus on TDI management.
• Analysis of factors influencing luxation injuries (maturation stage, mobility, displacement, fractures).
• Analysis of factors influencing avulsion injuries (maturation stage, extra-alveolar time, storage, PDL status).

Main Results:

• Specific factors significantly impact the prognosis of luxation and avulsion TDIs.
• Immature teeth require tailored management based on developmental stage (Nolla 8/9).
• A systematic approach from evaluation to orthodontic treatment is proposed for optimal outcomes.

Conclusions:

• Clinicians need to consider tooth maturation, displacement, and extra-alveolar time for effective TDI management.
• This consensus provides a structured approach to improve clinical decision-making for luxation and avulsion injuries.
• Optimized management strategies enhance the long-term function and survival of traumatically injured immature teeth.