International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations

Cecilia Bourguignon, Nestor Cohenca, Eva Lauridsen, Marie Therese Flores, Anne C O'Connell, Peter F Day, Georgios Tsilingaridis, Paul V Abbott, Ashraf F Fouad, Lamar Hicks, Jens Ove Andreasen, Zafer C Cehreli, Stephen Harlamb, Bill Kahler, Adeleke Oginni, Marc Semper, Liran Levin, Cecilia Bourguignon, Nestor Cohenca, Eva Lauridsen, Marie Therese Flores, Anne C O'Connell, Peter F Day, Georgios Tsilingaridis, Paul V Abbott, Ashraf F Fouad, Lamar Hicks, Jens Ove Andreasen, Zafer C Cehreli, Stephen Harlamb, Bill Kahler, Adeleke Oginni, Marc Semper, Liran Levin

Abstract

Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations of these teeth are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning, and follow up are important for achieving a favorable outcome. Guidelines should assist dentists and patients in decision making and in providing the best care possible, both effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. These Guidelines represent the best current evidence based on literature search and expert opinion. The primary goal of these Guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines cover the management of fractures and luxations of permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.

Keywords: avulsion; luxation; prevention; tooth fracture; trauma.

© 2020 The Authors. Dental Traumatology published by John Wiley & Sons Ltd.

References

REFERENCES

    1. Moule A, Cohenca N. Emergency assessment and treatment planning for traumatic dental injuries. Aust Dent J. 2016;61(Suppl 1):21-38.
    1. Andreasen FM, Andreasen JO, Tsukiboshi M, Cohenca N. Examaination and diagnosis of dental injuries. In: Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth, 5th edn. Oxford, UK: Wiley Blackwell; 2019. p. 295-326.
    1. Andreasen JO, Bakland L, Flores MT, Andreasen FM, Andersson L. Traumatic dental injuries. A manual, 3rd edn. Chichester, UK: Wiley-Blackwell; 2011.
    1. Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO. Combination injuries 1. The risk of pulp necrosis in permanent teeth with concussion injuries and concomitant crown fractures. Dent Traumatol. 2012;28:364-70.
    1. Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO. Combination injuries 2. The risk of pulp necrosis in permanent teeth with subluxation injuries and concomitant crown fractures. Dent Traumatol. 2012;28:371-8.
    1. Lauridsen E, Hermann NV, Gerds TA, Ahrensburg SS, Kreiborg S, Andreasen JO. Combination injuries 3. The risk of pulp necrosis in permanent teeth with extrusion or lateral luxation and concomitant crown fractures without pulp exposure. Dent Traumatol. 2012;28:379-85.
    1. Kenny KP, Day PF, Sharif MO, Parashos P, Lauridsen E, Feldens CA, et al. What are the important outcomes in traumatic dental injuries? An international approach to the development of a core outcome set. Dent Traumatol. 2018;34:4-11.
    1. Molina JR, Vann WF Jr, McIntyre JD, Trope M, Lee JY. Root fractures in children and adolescents: diagnostic considerations. Dent Traumatol. 2008;24:503-9.
    1. Cohenca N, Silberman A. Contemporary imaging for the diagnosis and treatment of traumatic dental injuries: a review. Dent Traumatol. 2017;33:321-8.
    1. Cohenca N, Simon JH, Mathur A, Malfaz JM. Clinical indications for digital imaging in dento-alveolar trauma. Part 2: root resorption. Dent Traumatol. 2007;23:105-13.
    1. Cohenca N, Simon JH, Roges R, Morag Y, Malfaz JM. Clinical indications for digital imaging in dento-alveolar trauma. Part 1: traumatic injuries. Dent Traumatol. 2007;23:95-104.
    1. Fulling HJ, Andreasen JO. Influence of maturation status and tooth type of permanent teeth upon electrometric and thermal pulp testing. Scand J Dent Res. 1976;84:286-90.
    1. Fuss Z, Trowbridge H, Bender IB, Rickoff B, Sorin S. Assessment of reliability of electrical and thermal pulp testing agents. J Endod. 1986;12:301-5.
    1. Gopikrishna V, Tinagupta K, Kandaswamy D. Comparison of electrical, thermal, and pulse oximetry methods for assessing pulp vitality in recently traumatized teeth. J Endod. 2007;33:531-5.
    1. Bastos JV, Goulart EM, de Souza Cortes MI. Pulpal response to sensibility tests after traumatic dental injuries in permanent teeth. Dent Traumatol. 2014;30:188-92.
    1. Dummer PM, Hicks R, Huws D. Clinical signs and symptoms in pulp disease. Int Endod J. 1980;13:27-35.
    1. Kaletsky T, Furedi A. Reliability of various types of pulp testers as a diagnostic aid. J Am Dent Assoc. 1935;22:1559-74.
    1. Teitler D, Tzadik D, Eidelman E, Chosack A. A clinical evaluation of vitality tests in anterior teeth following fracture of enamel and dentin. Oral Surg Oral Med Oral Pathol. 1972;34:649-52.
    1. Zadik D, Chosack A, Eidelman E. The prognosis of traumatized permanent anterior teeth with fracture of the enamel and dentin. Oral Surg Oral Med Oral Pathol. 1979;47:173-5.
    1. Alghaithy RA, Qualtrough AJ. Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: a critical review. Int Endod J. 2017;50:135-42.
    1. Gopikrishna V, Tinagupta K, Kandaswamy D. Evaluation of efficacy of a new custom-made pulse oximeter dental probe in comparison with the electrical and thermal tests for assessing pulp vitality. J Endod. 2007;33:411-4.
    1. Kwan SC, Johnson JD, Cohenca N. The effect of splint material and thickness on tooth mobility after extraction and replantation using a human cadaveric model. Dental Traumatol. 2012;28:277-81.
    1. Kahler B, Heithersay GS. An evidence-based appraisal of splinting luxated, avulsed and root-fractured teeth. Dent Traumatol. 2008;24:2-10.
    1. Oikarinen K, Andreasen JO, Andreasen FM. Rigidity of various fixation methods used as dental splints. Endod Dent Traumatol. 1992;8:113-9.
    1. Andreasen JO, Andreasen FM, Mejare I, Cvek M. Healing of 400 intra-alveolar root fractures. 2. Effect of treatment factors such as treatment delay, repositioning, splinting type and period and antibiotics. Dental Traumatol. 2004;20:203-11.
    1. Hammarstrom L, Blomlof L, Feiglin B, Andersson L, Lindskog S. Replantation of teeth and antibiotic treatment. Endod Dent Traumatol. 1986;2:51-7.
    1. Andreasen JO, Storgaard Jensen S, Sae-Lim V. The role of antibiotics in presenting healing complications after traumatic dental injuries: a literature review. Endod Topics. 2006;14:80-92.
    1. Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod. 1978;4:232-7.
    1. Fuks AB, Cosack A, Klein H, Eidelman E. Partial pulpotomy as a treatment alternative for exposed pulps in crown- fractured permanent incisors. Endod Dent Traumatol. 1987;3:100-2.
    1. Fuks AB, Gavra S, Chosack A. Long-term followup of traumatized incisors treated by partial pulpotomy. Pediatr Dent. 1993;15:334-6.
    1. Bimstein E, Rotstein I. Cvek pulpotomy - revisited. Dent Traumatol. 2016;32:438-42.
    1. Chueh LH, Ho YC, Kuo TC, Lai WH, Chen YH, Chiang CP. Regenerative endodontic treatment for necrotic immature permanent teeth. J Endod. 2009;35:160-4.
    1. Hagglund M, Walden M, Bahr R, Ekstrand J. Methods for epidemiological study of injuries to professional football players: developing the UEFA model. Br J Sports Med. 2005;39:340-6.
    1. Huang GT. A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. J Dent. 2008;36:379-86.
    1. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series. J Endod. 2008;34:876-87.
    1. Thibodeau B, Teixeira F, Yamauchi M, Caplan DJ, Trope M. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod. 2007;33:680-9.
    1. Trope M. Treatment of the immature tooth with a non-vital pulp and apical periodontitis. Dent Clin North Am. 2010;54:313-24.
    1. Robertson A, Andreasen FM, Andreasen JO, Noren JG. Long-term prognosis of crown-fractured permanent incisors. The effect of stage of root development and associated luxation injury. Int J Paediatr Dent. 2000;10:191-9.
    1. Holcomb JB, Gregory WB Jr. Calcific metamorphosis of the pulp: its incidence and treatment. Oral Surg Oral Med Oral Pathol. 1967;24:825-30.
    1. Neto JJ, Gondim JO, de Carvalho FM, Giro EM. Longitudinal clinical and radiographic evaluation of severely intruded permanent incisors in a pediatric population. Dent Traumatol. 2009;25:510-4.
    1. Robertson A. A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries. Endod Dent Traumatol. 1998;14:245-56.
    1. Andreasen FM, Andreasen JO, Bayer T. Prognosis of root-fractured permanent incisors-prediction of healing modalities. Endod Dent Traumatol. 1989;5:11-22.
    1. Amir FA, Gutmann JL, Witherspoon DE. Calcific metamorphosis: a challenge in endodontic diagnosis and treatment. Quintessence Int. 2001;32:447-55.
    1. Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta percha. Endod Dent Traumatol. 1992;8:45-55.
    1. Abbott PV. Prevention and management of external inflammatory resorption following trauma to teeth. Aust Dent J. 2016;61(Suppl. 1):S82-S94.
    1. Bryson EC, Levin L, Banchs F, Abbott PV, Trope M. Effect of immediate intracanal placement of ledermix paste on healing of replanted dog teeth after extended dry times. Dent Traumatol. 2002;18:316-21.
    1. Chen H, Teixeira FB, Ritter AL, Levin L, Trope M. The effect of intracanal anti-inflammatory medicaments on external root resorption of replanted dog teeth after extended extra-oral dry time. Dent Traumatol. 2008;24:74-8.
    1. Day PF, Gregg TA, Ashley P, Welbury RR, Cole BO, High AS, et al. Periodontal healing following avulsion and replantation of teeth: A multi-centre randomized controlled trial to compare two root canal medicaments. Dent Traumatol. 2012;28:55-64.
    1. Trope M, Moshonov J, Nissan R, Buxt P, Yesilsoy C. Short vs. Long-term calcium hydroxide treatment of established inflammatory root resorption in replanted dog teeth. Endod Dent Traumatol. 1995;11:124-8.
    1. Andreasen JO, Andreasen FM, Skeie A, Hjorting-Hansen E, Schwartz O. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries - a review article. Dent Traumatol. 2002;18:116-28.
    1. Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 3. A clinical study of the effect of treatment variables such as treatment delay, method of repositioning, type of splint, length of splinting and antibiotics on 140 teeth. Dental Traumatol. 2006;22:99-111.
    1. Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 2. A clinical study of the effect of preinjury and injury factors, such as sex, age, stage of root development, tooth location, and extent of injury including number of intruded teeth on 140 intruded permanent teeth. Dental Traumatol. 2006;22:90-8.
    1. Andreasen JO, Bakland LK, Matras RC, Andreasen FM. Traumatic intrusion of permanent teeth. Part 1. An epidemiological study of 216 intruded permanent teeth. Dental Traumatol. 2006;22:83-9.
    1. Welbury R, Kinirons MJ, Day P, Humphreys K, Gregg TA. Outcomes for root-fractured permanent incisors: a retrospective study. Ped Dent. 2002;24:98-102.
    1. Andreasen JO, Andreasen FM, Mejare I, Cvek M. Healing of 400 intra-alveolar root fractures. 1. Effect of pre-injury and injury factors such as sex, age, stage of root development, fracture type, location of fracture and severity of dislocation. Dental Traumatol. 2004;20:192-202.
    1. Andreasen JO, Hjorting-Hansen E. Intraalveolar root fractures: radiographic and histologic study of 50 cases. J Oral Surg. 1967;25:414-26.
    1. Cvek M, Andreasen JO, Borum MK. Healing of 208 intra-alveolar root fractures in patients aged 7-17 years. Dental Traumatol. 2001;17:53-62.
    1. Bakland LK. Revisiting traumatic pulpal exposure: materials, management principles, and techniques. Dent Clin North Am. 2009;53:661-73.
    1. Bogen G, Kim JS, Bakland LK. Direct pulp capping with mineral trioxide aggregate: an observational study. J Am Dent Assoc. 2008;139:305-15.
    1. Cavalleri G, Zerman N. Traumatic crown fractures in permanent incisors with immature roots: a follow-up study. Endod Dent Traumatol. 1995;11:294-6.
    1. About I, Murray PE, Franquin JC, Remusat M, Smith AJ. The effect of cavity restoration variables on odontoblast cell numbers and dental repair. J Dent. 2001;29:109-17.
    1. Murray PE, Smith AJ, Windsor LJ, Mjor IA. Remaining dentine thickness and human pulp responses. Int Endod J. 2003;36:33-43.
    1. Subay RK, Demirci M. Pulp tissue reactions to a dentin bonding agent as a direct capping agent. J Endod. 2005;31:201-4.
    1. Berthold C, Thaler A, Petschelt A. Rigidity of commonly used dental trauma splints. Dent Traumatol. 2009;25:248-55.
    1. von Arx T, Filippi A, Lussi A. Comparison of a new dental trauma splint device (TTS) with three commonly used splinting techniques. Dent Traumatol. 2001;17:266-74.
    1. Levin L, Day P, Hicks L, O'Connell AC, Fouad AF, Bourguigon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General Introduction. Dent Traumatol. 2020;36309-13.

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