Transient Apical Breakdown: Incidence, Pathogenesis, and Healing

Area of Science:

• Dentistry
• Oral Surgery
• Endodontics

Background:

• Transient apical breakdown (TAB) is a temporary periodontal destruction and root resorption following luxation injuries.
• First reported by Andreasen in 1986, TAB affects approximately 4.2% of luxation injuries.
• Previous literature lacks data on TAB incidence across different luxation injury types.

Purpose of the Study:

• To assess the incidence and pathogenesis of dental trauma-induced TAB.
• To suggest a potential mechanism for subsequent healing in TAB cases.
• To analyze the frequency of TAB in various luxation injury types.

Main Methods:

• A retrospective study analyzing 56 mature teeth from 49 patients (aged 9-30 years).
• Data collected from a private dental office over a 10-year period (2012-2022).
• Investigated the incidence and healing sequelae of TAB in luxation injuries.

Main Results:

• TAB was observed in 43.8% of subluxation, 62.5% of extrusive luxation, and 75% of lateral luxation injuries.
• The average age of patients who developed TAB was 14.5 years (range: 9-28 years).

Conclusions:

• TAB is common in mild luxation injuries (subluxation, extrusion, lateral luxation).
• These injuries may exhibit spontaneous healing, including crown discoloration reversal and radiographic lesion resolution.
• Postponing endodontic treatment until infection evidence emerges is advisable for mild luxation injuries with TAB.