Dental Trauma - Avulsion

Prospective Study on Therapeutic Approaches in Dental Traumatology: Management of Traumatic Tooth Avulsion

Dental traumatology is a field of dentistry , especially in pediatric age, but also in adulthood with permanent dentition. Dental trauma has a higher incidence in preschool, school-age, and adolescent patients, accounting for about 5% of injuries for which the intervention of a specialist physician is required. Traumatic avulsion of permanent teeth accounts up to 0.5-16% of all dental injuries and is considered one of the true emergencies in dentistry.The treatment of choice in case of traumatic avulsion of permanent teeth is the quickest-as-possible replantation. The primary objectives of this prospective study were to evaluate the incidence of complications and survival rates of replanted teeth over time. The secondary objectives were to assess and to examine the correlation between the development of complications and factors such as extra-oral time, storage media, root maturity and the presence of alveolar fractures.

Study Overview

• Status: Active, not recruiting
• Conditions: Dental Trauma
• Intervention / Treatment: Other: Tooth replantation

• Study Type: Observational
• Enrollment (Actual): 13

Contacts and Locations

Study Locations

• Italy
  • Pisa
    • Pisa, Pisa, Italy, 56100
      • University Hospital of Pisa

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All adult and pediatric patients who experienced a traumatic avulsion of one or more permanent teeth and were treated at the University Hospital of Pisa

Description

Inclusion criteria

• Adult and pediatric patients who experienced a dental trauma
• Adult and pediatric patients who experienced a traumatic avulsion of one or more permanent teeth
• Patients treated with dental replantation following the International Association of Dental Traumatology (IADT) guidelines
• Availability of clinical and radiographic follow-up for at least one year

Exclusion criteria

- Patients with absolute contraindications to dental replantation

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Dental avulsion; Adult and pediatric patients who experienced a traumatic avulsion of one or more permanent teeth	Other: Tooth replantation; Avulsed teeth were replanted according to the International Academy of Dental Traumatology guidelines (IADT)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following IADT guidelines.	2 weeks after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	4 weeks after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	3 months after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	6 months after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	12 months after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	24 months after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	36 months after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	48 months after trauma
Tooth survival	Tooth survival was defined as the presence of the tooth in the oral cavity at the time of follow-up. Tooth survival is assessed at each follow-up visit after replantation following the IADT guidelines.	60 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	2 weeks after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	4 weeks after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	3 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	6 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	12 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	24 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	36 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	48 months after trauma
Incidence of complications	Evaluated as presence/absence of a dental complication following trauma.	60 months after trauma

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	2 weeks after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	4 weeks after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	3 months after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	6 months after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	12 months after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	24 months after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	36 months after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	48 months after trauma
Dental mobility	Tooth mobility clinically evaluated from 0 to 3	60 months after trauma
Complication - root resorption	Radiographic signs of root resorption	2 weeks after trauma
Complication - root resorption	Radiographic signs of root resorption	4 weeks after trauma
Complication - root resorption	Radiographic signs of root resorption	3 months after trauma
Complication - root resorption	Radiographic signs of root resorption	6 months after trauma
Complication - root resorption	Radiographic signs of root resorption	12 months after trauma
Complication - root resorption	Radiographic signs of root resorption	24 months after trauma
Complication - root resorption	Radiographic signs of root resorption	36 months after trauma
Complication - root resorption	Radiographic signs of root resorption	48 months after trauma
Complication - root resorption	Radiographic signs of root resorption	60 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	2 weeks after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	4 weeks after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	3 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	6 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	12 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	24 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	36 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	48 months after trauma
Complication - ankylosis	Clinical and radiographic signs of ankylosis (loss of periodontal space, absence of physiological tooth mobility)	60 months after trauma
Extra-oral time	Evaluated in minutes from the avulsion to the replantation	At baseline (toorh replantation after avulsion)
Storage medium	Storage medium of the avulsed tooth (milk, water, saline, etc)	At baseline (tooth replantation following avulsion)
Alveolar fracture	Presence of alveolar fractures associated to tooth avulsion	At baseline (tooth replantation following avulsion)

Collaborators and Investigators

• Sponsor: University of Pisa

Study record dates

Study Major Dates

• Study Start (Actual): November 20, 2020
• Primary Completion (Actual): November 20, 2025
• Study Completion (Estimated): November 20, 2031

Study Registration Dates

• First Submitted: December 18, 2025
• First Submitted That Met QC Criteria: January 5, 2026
• First Posted (Estimated): January 12, 2026

Study Record Updates

• Last Update Posted (Estimated): January 12, 2026
• Last Update Submitted That Met QC Criteria: January 5, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: trauma; avulsion; permanent tooth
• Additional Relevant MeSH Terms: Fractures, Bone; Fractures, Avulsion; Wounds and Injuries; Surgical Procedures, Operative; Transplantation; Dentistry; Oral Surgical Procedures; Endodontics; Replantation; Tooth Replantation
• Other Study ID Numbers: Dental Trauma - Tooth avulsion

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No