[Effect of stromal cell derived factor-1α combined with autologous platelet poor plasma on avulsion injury of permanent teeth].

PURPOSE: To explore the therapeutic effect of stromal cell derived factor-1α(SDF-1α) combined with platelet-poor plasma(PPP) on permanent tooth avulsion injury. METHODS: One hundred and forty-four patients with permanent tooth avulsion injuries admitted to Hengshui People's Hospital from March 2020 to March 2022, with a total of 152 affected teeth were included. They were randomly divided into experimental group of 72 cases(76 teeth) and control group of 72 cases(76 teeth). The control group underwent routine replantation surgery, and the root tips were soaked and rinsed with PPP biological solution before surgery. On the basis of the control group, the experimental group implanted SDF-1α into the alveolar fossa before in vitro tooth implantation for treatment. The patients were followed up for 12 months after surgery, the success rate of implantation, degree of postoperative occlusal pain, expression of inflammatory factors in gingival fluid, serum growth factor expression, and incidence of postoperative complications were compared between the two groups. Statistical analysis was performed with SPSS 19.0 software package. RESULTS: The success rate of replantation in the control group was 90.79%(69/76), while the experimental group was 98.68%(75/76). The success rate of replantation in the experimental group was significantly higher than that in the control group(P＜0.05). On the 2nd day, 3 months and 12 months after surgery, the pain scores of the two groups of patients gradually decreased (P＜0.05). There was no significant difference in pain scores between the two groups at each time point(P＞0.05). One month after surgery, the CRP and IL-6 levels in both groups decreased(P＜0.05), while the experimental group was significantly lower than the control group(P＜0.05). The soluble intercellular adhesion factor (sICAM-1) in both groups increased, and the experimental group was significantly higher than the control group (P＜0.05). One month after surgery, vascular endothelial growth factor(VEGF), fibroblast growth factor(FGF), transforming growth factor beta(TGF-ß)and platelet derived growth factor(PDGF) were all elevated, and the experimental group was significantly higher than the control group(P＜0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group(P＜0.05). CONCLUSIONS: The combination of PPP and SDF-1α in treating patients with permanent tooth avulsion injury has a high success rate of delayed replantation and a low incidence of postoperative adverse reactions.

Time-course study of genetic changes in periodontal ligament regeneration after tooth replantation in a mouse model.

This research focused on analyzing gene expression changes in the periodontal ligament (PDL) after tooth re-plantation to identify key genes and pathways involved in healing and regeneration. Utilizing a mouse model, mRNA was extracted from the PDL at various intervals post-replantation for RNA sequencing analysis, spanning from 3 to 56 days. The results revealed significant shifts in gene expression, particularly notable on day 28, supported by hierarchical clustering and principal component analysis. Gene ontology (GO) enrichment analysis highlighted an upregulation in olfactory receptor and G protein-coupled receptor signaling pathways at this time point. These findings were validated through reverse transcription-quantitative PCR (RT-qPCR), with immunochemical staining localizing olfactory receptor gene expression to the PDL and surrounding tissues. Moreover, a scratch assay indicated that olfactory receptor genes might facilitate wound healing in human PDL fibroblasts. These results underscore the importance of the 28-day post-transplant phase as a potential "tipping point" in PDL healing and regeneration. In conclusion, this research sheds light on the potential role of olfactory receptor genes in PDL regeneration, providing a foundation for developing new therapeutic approaches in tooth replantation and transplantation, with broader implications for regenerative medicine in oral health.

Effect of Dental Implant System-Assisted Tooth Intentional Replantation in the Treatment of Anterior Teeth with Pathological Tooth Flaring, Drifting and Elongation in Patients with Stage III/IV Periodontitis: a Case Series.

OBJECTIVE: To investigate the clinical effect of implant-assisted dental intentional replantation (IR) for the treatment of "drifted" anterior periodontally hopeless teeth (PHT). METHODS: The present authors recruited 22 patients with stage III/IV periodontitis who suffered drifting of the maxillary anterior teeth, with a total of 25 teeth. The PHT were extracted for in vitro root canal treatment (RCT). The root surface was smoothed and the shape was trimmed, and the alveolar socket was scratched. The dental implant system was used to prepare the alveolar socket according to the direction, depth and shape of the tooth implantation. The PHT were reimplanted into the prepared alveolar socket. The periodontal indicators were analysed statistically before and after surgery. RESULT: Twenty-two patients who completed the full course of treatment, with a total of 25 PHT, had a successful retention rate of 88%. Mean periodontal probing depth (PPD) decreased by 2.880 ± 0.556 mm and 3.390 ± 0.634 mm at 6 months and 1 year, respectively, and clinical attachment loss (CAL) decreased by 2.600 ± 0.622 mm and 2.959 ± 0.731 mm at the same time points, respectively, showing significant improvement (P < 0.05). CONCLUSION: Dental implant system-assisted IR can effectively preserve "drifted" natural PHT in patients with stage III/IV periodontitis.

Physiological occlusal force attenuates replacement root resorption of replanted teeth: an experimental animal study.

BACKGROUND: Tooth avulsion represents the most severe form of dental trauma, necessitating tooth replantation as the primary treatment. However, the risk of replacement root resorption (RRR) poses a significant threat to tooth retention following replantation. This study preliminarily aimed to investigate the effect of physiological occlusal force on RRR after the replantation of avulsed teeth and to explore the potential underlying mechanisms. METHODS: Thirty-six 4-week-old male Sprague-Dawley rats underwent extraction and immediate replantation of their left maxillary molars. The rats were randomly divided into two major groups: the occluded (n = 18) group, where the opposite mandibular teeth were preserved; non-occluded (n = 18) group, where the opposite mandibular teeth were extracted. Within each major group, there were three subgroups corresponding to 7 days, 14 days, and 2 months, resulting in a total of six subgroups, (n = 6 per subgroup). The right maxillary first molars served as the normal control. Various periodontal characteristics were assessed using haematoxylin-eosin (H&E), tartrate-resistant acid phosphatase (TRAP) staining, and micro-computed tomography (micro-CT). RESULTS: Histological staining revealed that under occlusal force, the early stage (day 7) after tooth replantation mainly manifested as root surface resorption, especially in the non-occluded group, which gradually diminished over time. Cementum and periodontal ligament (PDL) repair was observed on day 14. Micro-CT analysis indicated a significant decrease in PDL width in the non-occluded group two months after replantation, consistent with the histological findings, signifying severe RRR in the non-occluded group. CONCLUSIONS: This study provides preliminary evidence that physiological occlusal force may attenuate osteoclastogenesis during the early stage of tooth replantation, thereby reducing the occurrence of RRR and promoting periodontal healing.

Successful Intentional Replantation of a Severely Compromised Tooth Using 3 Types of Phototherapy: A Case Report.

Background: Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. Objective: We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. Methods: The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm2, 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm2, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm2, 30 sec). The total time from extraction to replantation was 14 min 35 sec. Results: The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. Conclusions: This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection.

A novel surgical treatment approach for the vertical root fracture of posterior teeth: a case report with 24-month review.

BACKGROUND: Up to 25% of the tooth extraction after root canal treatment could be attributed to the vertical root fracture (VRF). The treatment choice for teeth with VRF would mostly be the extraction despite some repairing methods were also reported. The repairing treatment result of VRF would mostly depend on the fixation strength and the bioactivity of the repairing materials, especially for the posterior teeth with high masticating stresses. This case report designed a novel surgical treatment approach for the VRF of posterior teeth. METHODS: a maxillary premolar with buccal-palatal complete VRF was treated with a new dual-layered repairing approach using adhesive resin + iRoot BP Plus bioceramic cement to fill the modified fracture line with retention forms through the intentional replantation. RESULTS: At the 24-month review, the tooth showed desirable periodontal healing and normal function. CONCLUSIONS: This case report indicated that the dual-layered repairing approach might be effective for saving the posterior teeth with VRF. Nevertheless, further clinical trials are needed for its long-term result.

Comparison of the Outcome of Intentional Replantation in Teeth with or without Periodontal Involvement: A Retrospective Study.

OBJECTIVE: Intentional replantation (IR) is considered as a viable treatment option to preserve the teeth with apical periodontitis. This study aimed to compare the treatment outcomes of IR in teeth with or without periodontal involvement, and to investigate the influence of related factors. METHODS: A total of 157 teeth with a documented history of IR between September 2012 and November 2022 and a follow-up duration of more than 1 year were included. The samples included 100 teeth with simple apical periodontitis and 57 teeth with combined periodontal-endodontic lesions (CPEL). Clinical and radiographic criteria were used to evaluate treatment outcomes including functional retention and extraction. Chi-square analyses and Fisher's exact tests were used to compare bivariate associations between outcomes and clinical or demographic variables. Kaplan-Meier analyses were used to evaluate the cumulative survival rate of the intentionally replanted teeth. RESULTS: The overall cumulative survival rates were 93.0% at 1 year, 76.7% at 5 years, and 56.2% at 10 years. Among the 100 teeth with simple apical periodontitis, the survival rates were 93.0%, 86.7%, and 78.8% at the same time points. In contrast, 57 teeth with CPEL exhibited survival rates of 93.0%, 65.0%, and 36.9%, respectively. The primary postoperative complications that led to extraction were periodontal involvement (51.9%), tooth fracture (18.5%), external root resorption (18.5%), and persistent apical periodontitis (11.1%). The outcomes of teeth with CPEL were significantly affected by the presence of a sinus tract and crown restoration. In contrast, no significant prognostic factors were identified for teeth without periodontal involvement. CONCLUSION: The long-term prognosis of teeth with CPEL is significantly worse than those with simple apical periodontitis. The main reason of extraction was periodontal involvement. Regular periodontal maintenance and appropriate crown restoration may help to improve the prognosis for teeth with CPEL.

Application of Oxygen Saturation Test after Replantation of Avulsed Immature Permanent Teeth: A Prospective Observational Study.

INTRODUCTION: The evaluation of pulp status is crucial for avulsed immature permanent teeth after replantation. In addition to commonly used clinical and radiographic examinations providing clinical evidence, the oxygen saturation test may offer valuable assistance. The aim of this study was to analyze the efficacy of a pulse oximeter in evaluating pulp status in avulsed and replanted immature permanent teeth. METHODS: A prospective observational study was performed including 51 avulsed and replanted immature permanent teeth. Routine clinical and radiographic examinations were performed and used as the basis for the diagnosis of pulp status during the 1-year follow-up period. Meanwhile, the oxygen saturation values of these teeth were recorded using a modified pulse oximeter at each visit. RESULTS: Seven teeth completed pulp revascularization (success group), whereas 44 teeth failed to revascularize (failure group). Abnormal clinical and/or radiographic manifestations in the failure group were observed at an average period of 42.7 days, which was too late because a high incidence of inflammatory root resorption (43.18%) had occurred. For oxygen saturation tests, teeth in the success group showed an immediate postreplantation oxygen value of 70.71 ± 3.35, then an upward trend starting from the 2-week postreplantation visit, and a significantly increased final value of 81.86 ± 2.34 at the 1-year visit. In contrast, no increase trend was found for teeth in the failure group because abnormal clinical and/or radiographic manifestations emerged. CONCLUSIONS: The oxygen saturation test is a reliable diagnostic method to evaluate pulp status of avulsed teeth as early as 2 weeks after replantation.

Application of intentional replantation in advanced periodontitis involving teeth preservation.

With the development of periodontal regenerative technology, an increasing number of scholars reported that advanced periodontitis involving teeth can be preserved through intentional replantation. Intentional replantation has become the last possible method to preserve natural teeth for advance periodontitis with signs of tooth extraction. However, the indications of intentional replantation are strict, and the success of the operation is closely related to the condition of cases and the operation skills of doctors. In this article, the operation steps and criteria of intentional replantation were summarized by introducing three success cases of advanced periodontitis involving teeth preserved by intentional replantation. The relevant factors that affect the prognosis of intentional replantation in advanced periodontitis involving teeth preservation were analyzed to help clinicians preserve natural teeth.

Intentional Replantation: No Longer a Last Resort for Saving a Natural Tooth.

Intentional replantation (IR) is the intentional extraction of a tooth followed by its replacement back into its socket for the purpose of performing a root-end surgery or other necessary repairs. The procedure may be considered a favorable alternative to conventional microsurgery, especially when surgical access is restricted due to specific anatomical challenges. With advancements in magnification, bioceramics, and instrumentation, IR has become a well-established, scientifically supported treatment modality and is cost-effective when compared to single-implant placement. This article discusses the rationale and indications for IR, describes treatment protocols, and reports on its outcomes.

The effect of fibroblast growth factor-2 on the outcomes of tooth replantation: A systematic review of animal studies.

Background/Aim: The ideal treatment of tooth avulsion is replantation. However, replanting teeth may lead to root resorption. Fibroblast growth factor-2 (FGF-2) is a cytokine that plays an important role in wound repair and tissue regeneration. Recently, FGF-2 has been studied a potential regenerative agent to prevent root resorption and ankylosis. The aim of this review is to analyze and summarize the currently available literature focusing on using FGF-2 based regenerative modalities to improve the outcomes of tooth replantation. Materials and Methods: An electronic search was conducted via PubMed/Medline, Google Scholar and ISI Web of Knowledge, using the Medical Subject Headings (MeSH) terms "Basic fibroblast growth factor," "Fibroblast growth factor-2," "tooth replantation," and "replantation" for studies published between January 2001 and June 2021. Data was extracted and quality assessment was carried using the ARRIVE guidelines. Results: Nine animal studies were included in this review. In six studies, FGF-2 had a favorable effect on the tissue regeneration around roots of replanted teeth when compared to other treatment groups. However, quality assessment of the studies revealed many sources of bias and deficiencies in the studies. Conclusions: Within the limitations of this study, it may be concluded that FGF-2 may improve the outcomes of delayed replantation of avulsed teeth. However, more long-term animal studies, with improved experimental designs, and clinical trials are required to determine the clinical potential of the growth factor in improving the outcomes of delayed tooth replantation.

Awareness about emergency management of avulsed tooth among intern dentists-a cross-sectional observational study.

Tooth avulsion is a frequently encountered dental emergency. Children are commonly reported group due to frequent sports activities, trauma, accidents and falls. Prompt emergency management is vital for long term success and to avoid morbidity. The study was aimed to assess the understanding of intern dentists about the emergency handling of avulsed teeth cases as mostly they are first responders among health care personnel. In this study a fourteen-item questionnaire with predefined responses was shared as online Google survey form with intern dentists of 5 different dental teaching hospitals of Islamabad, Pakistan. The duration of the study was 6 months (01 March 2022 to 31 August 2022). The questions were intended to collect personal information and to check level of knowledge and awareness about the management of avulsed tooth among the dental interns. The data was analyzed by statistical methods and is presented through tables and descriptive methods. In total, 152 participants completed the shared questionnaire. The vast majority (71%) of them were aware of the initial management of avulsed teeth, 49% were aware of the ideal transport medium for an avulsed tooth, (43%) were aware of the critical time for successful replantation, while (62%) had knowledge of the multiple factors responsible for the outcome of the tooth replantation. For majority of the statements, female participants had better knowledge as compared to their male counterparts. Statistically significant difference was noted for the statement "If you found the knocked-out tooth and it is dirty what will be your initial approach?" with female participants having better knowledge as compared to the male (p value = 0.005). Based on our study results, generally dental interns are well-informed but still lack expected level of awareness regarding the proper management protocol for avulsed tooth. Hence, improvement is needed regarding the effective handling of avulsed teeth cases.

Histological effects of photobiomodulation on delayed tooth replantation: a systematic review.

This systematic review evaluated preclinical studies to assess whether PBM has a more favorable histological response than other treatments used before delayed replantation of avulsed teeth. This review followed the PRISMA checklist and was registered in PROSPERO. MEDLINE (PubMed), Embase, Scopus and Web of Science were searched from their inception to July 14, 2022. Data were independently extracted by two reviewers. Data were collected about species, number of animals, number and type of teeth, groups evaluated, extra-alveolar time, parameters for PBM and other study groups, presence and characteristics of containment, observation time points, evaluation methods, characteristics evaluated, and significant results. The ARRIVE and SYRCLE tools were used to assess the methodological quality and risk of bias (RoB) of the studies. After screening, six studies were included in the review synthesis. Three of the four studies that evaluated root resorption as an outcome found that PBM decreases its occurrence after delayed tooth replantation. A meta-analysis was not conducted because some data were missing in the included studies. Half of the studies evaluating ankylosis found an increase in its occurrence after PBM. Two studies evaluated inflammatory responses and found a reduction of inflammation after PBM. In general, studies had high methodological heterogeneity, intermediate reporting quality and high RoB. Despite the methodological quality and RoB limitations of the studies, the histological responses after delayed tooth replantation were more favourable in the PBM groups. Preclinical studies supported by guidelines should define laser parameters for future clinical studies.

Autotransplante dentário: da previsibilidade à técnica cirúrgica e resultados do tratamento / Dental Autotransplantation: from predictability to surgical technique and treatment results

Objetivo: apresentar o relato de duas pacientes com agenesias dentárias em que cinco dentes autotransplantados foram utilizados como modalidade de tratamento. Além disso, objetiva-se mostrar questões sobre a técnica cirúrgica, suas indicações e previsibilidade. Relato de caso: Neste estudo, foram relatados 5 casos de autotransplante dentário em duas pacientes jovens, em que a equipe realizou os procedimentos e o acompanhamento clínico e radiográfico por 5 e 7 anos. Devido à alta sensibilidade da técnica, foram seguidos princípios previamente estabelecidos na literatura envolvendo o autotransplante dentário. Durante o período de acompanhamento, os dentes se mantiveram em posição e em função e as pacientes não apresentavam queixas associadas. Considerações finais: a técnica do autotransplante dentário, quando bem indicada e executada, é capaz de promover resultados bastante satisfatórios, sendo uma ótima alternativa reabilitadora, com taxas de sucesso elevadas e custos reduzidos. No entanto, critérios em relação aos sítios doadores e receptores e a habilidade do cirurgião devem ser levados em conta para o sucesso do técnica.

Objective: presenting the report of two patients with tooth agenesis in which five autotransplanted teeth were used as a treatment modality. Furthermore, the aim is to show questions about the surgical technique and its indications and predictability. Case report: In this study, 5 cases of dental autotransplantation were reported in two young patients, in which the team performed procedures and had clinical and radiographic follow-up for 5 and 7 years. Due to the high sensitivity of the technique, principles previously established in the literature involving dental autotransplantation were followed. During the follow-up period, the teeth remained in position and function and the patients had no associated complaints. Final considerations: the dental autotransplantation technique, when well indicated and executed, is capable of achieving very satisfactory results, being a great rehabilitative alternative, with high success rates and reduced costs. However, criteria regarding donor and receptor sites and the surgeon's skill must be taken into account for the success of the technique.

A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report.

AIM: This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN). BACKGROUND: Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome. CASE DESCRIPTION: A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots. CONCLUSION: This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures. CLINICAL SIGNIFICANCE: Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth. How to cite this article: Alharbi MA, Alghamdi BA, Alswajy WA, et al. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023;24(11):895-901.

Cognition about emergency management of avulsed incisor in children among dentists in Guangdong province / 华西口腔医学杂志

OBJECTIVES@#This study aimed to evaluate and analyze the current situation of dentists in Guangdong pro-vince regarding the management of avulsed incisors, thereby providing a reference for making treatment strategies for avulsed incisors in the future.@*METHODS@#A total of 712 dentists with different educational backgrounds and working conditions in Guangdong province were randomly selected to conduct an online questionnaire survey on the cognition of children with avulsed incisors from April 2022 to May 2022. The data were recorded by Excel software and statistics were analyzed on Stata/SE 15.1.@*RESULTS@#A total of 712 dentists were investigated and 701 questionnaires were collected (98.46%). In addition, 65.9% of investigators came from the Department of Stomatology in a First-class Hospital or Stomatological Hospital. The results showed that the average number of avulsed teeth consulted by dentists was less than 20 per year. Although 99.7% of respondents considered normal saline as a suitable storage medium, 3.1% and 23.8% of them had a misunderstanding that the tap/alcohol could be used for root cleaning. Moreover, 93.4% was the correct selection rate of the treatment plan for processing on root surfaces before replanting by investigators. The correct selection rate of the duration using elastic fixation was only 10.7%. Meanwhile, 42.9% of investigators refused to inoculate tetanus immunoglobulin after teeth replanting. Emergency management of dental avulsion (EM) and clinical management of dental avulsion (CM) answered correctly with average scores of 14.60±11.85 and 14.48±2.67, respectively. Multivariate linear regression analysis revealed that working years were negatively correlated with EM and CM scores (P<0.05). There was a positive correlation between CM and EM scores with the number of avulsion cases treated by physicians each year (P<0.05). In terms of the EM score of dentists' learning attitude, investigators who had received enough knowledge were higher than those who had not and insufficient knowledge reserved, and the difference was statistically significant (P<0.05). The scores of investigators who thought they had a certain degree of knowledge about dental trauma were higher than those who thought they "did not understand", and the difference was statistically significant (P<0.05). In terms of CM scores, investigators who thought the knowledge of dental trauma was "very helpful" had higher scores than those who thought it was "not helpful", and the difference was statistically significant (P<0.05). The scores of the investigators who thought they had "relatively sufficient knowledge" of dental trauma were higher than those who thought they had "no knowledge" or "insufficient know-ledge", and the difference was statistically significant (P<0.05).@*CONCLUSIONS@#The overall accuracy of the management of avulsed incisors among dentists was low in Guangdong province. Dentists were more likely to have a higher rate of accuracy choice in treatment options for luxation injury and avulsion to enhance the prognosis of replanted teeth.

Intentional replantation for the retreatment of mandibular second molar: a case report / 华西口腔医学杂志

When the use of root canal retreatment and apical surgery experiences difficulty in treating endodontic diseases, intentional replantation is an optional clinical technique used to retain the tooth. A 28-year-old female complained of chewing discomfort at the mandibular second molar after undergoing root canal treatment 3 month ago. History record and radiographic examination revealed that a C-shaped root canal system was filled with gutta-percha in the mandibular second molar. A radiolucency area existed at the root furcal area with a thin canal wall in the distal and mesial roots. Intentional replantation was used to treat this tooth. The clinical and radiographic results showed that intentional replantation and nano-biomaterial application facilitated infection control, tooth retention, and periodontal tissue regeneration.

Expert consensus on stabilization with splint in traumatic dental injuries of permanent tooth / 中华口腔医学杂志

Stabilization with splint is an important surgical technology in traumatic dental injuries of permanent tooth. In order to standardize the clinical application of the technique and to improve the therapeutic effects of traumatic injured teeth, the Society of Stomatological Emergency, Chinese Stomatological Association organized relevant professional experts and put forward an expert consensus on the basis of considerable discussion. The contents of the present expert consensus covered indications for tooth fixation, material selection of splints and operation methods, applying to the treatment of tooth loosening, tooth displacement and tooth avulsion replantation caused by traumatic injuries. It is also suitable for preoperative and prognosis evaluations of traumatic injured teeth before tooth fixation.

O YouTube® pode ser considerado uma fonte de informação imediata segura para o manejo correto de uma situação de avulsão dentária evidente? / Is YouTube® a reliable source of immediate information for the correct management of an evident tooth avulsion setting?

O objetivo deste estudo foi avaliar se o YouTube® pode ser considerado uma fonte de informação imediata segura para o manejo correto de uma situação de avulsão dentária evidente. Para isso, o YouTube® foi utilizado para pesquisa a partir da utilização dos termos "como tratar um dente avulsionado", "reimplante de dente avulsionado" e "avulsão dentária". Os vídeos obtidos foram submetidos a critérios de inclusão e exclusão. Os vídeos inclusos foram analisados a partir de oito tópicos variáveis que condizem com as informações adequadas sobre a sequência do manejo da avulsão dentária que independente da atuação do cirurgião dentista, baseadas nos guidelines da Associação Internacional de Traumatologia Dentária (IADT). O engajamento do vídeo e o ano de publicação também foram avaliados. Foi realizada análise descritiva a partir da frequência de repetição dos dados. Ao total, 71 vídeos sobre avulsão foram obtidos na plataforma, sendo que 39 (54,92%) apresentam os critérios de inclusão. A maioria foi publicada por profissionais (74,35%) e em 2021 (23,07%). Três vídeos (7,7%) apresentam todos os tópicos considerados indispensáveis no manejo correto da avulsão, correspondendo ao padrão ouro desejado a ser obtido durante a busca no YouTube®. "Encaminhar imediatamente ao cirurgião dentista" apresenta-se como recomendação em todos os vídeos. Todos os vídeos apresentaram informações verídicas, mesmo na incompletude dos 8 tópicos. A plataforma apresenta poucos vídeos sobre a sequência completa do manejo da avulsão. Mesmo havendo veracidade em todos os vídeos, a ausência de sequer um tópico compromete o prognóstico. O predomínio de conteúdos com ausência de tópicos infere que o YouTube® é insuficiente em vídeos referentes às condutas a serem seguidas em um caso de avulsão dentária evidente que estão de acordo com os tópicos baseados no guideline da IADT, mesmo com a ausência de informações falsas sobre o manejo da avulsão dentária(AU)

The aim of this study was to evaluate whether YouTubeTM can be considered a reliable source of immediate information for the correct management of an evident tooth avulsion setting. YouTubeTM was searched using the terms 'how to deal with an avulsed tooth', 'replantation of an avulsed tooth' and 'tooth avulsion'. The videos obtained were submitted to inclusion-exclusion criteria. The videos included were analyzed based on eight variable topics that are consistent with adequate information on the sequence of tooth avulsion management that is independent of a dentist's performance, based on International Association of Dental Traumatology (IADT) guidelines. Video engagement and year of publication were also evaluated. Descriptive statistics were consequently generated based on the frequency of data repetition. A total of 71 videos were analysed. 39 (54.92%) met the inclusion criteria. Most of the had been upload by professionals (74.35%) and in 2021 (23.07%). Three videos (7.7%) present all the topics considered indispensable in the correct management of avulsion, corresponding to the desired gold standard to be obtained during the search on YouTubeTM. 'Urgent dental referral' is the recommendation in all videos. All videos presented true information even in the incompleteness of the 8 topics. The platform features few videos on the complete sequence of avulsion management. Even with veracity in all videos, the absence of just one topic compromises the prognosis. The predominance of content infers that YouTube™ is insufficient in videos referring to the procedures to be followed in a case of evident tooth avulsion that are in accordance with the topics based on IADT guideline even with the absence of false information on the management of tooth avulsion(AU)

Emergency management of dental avulsion and replantation: knowledge of undergraduate health care students / Manejo emergencial da avulsão dentária e do reimplante: conhecimento dos estudantes degraduação na área de saúde

Dental replantationis a major problem in public health. Its prognosis depends on emergency care, butthere is a lack of knowledge on it. So, this study aims to evaluate the knowledge of undergraduate students of Dentistry, Speech Therapy, Physical Education, Pedagogy,and Technologist in Radiology. One hundred and fifty-onestudents answered tenquestions about emergency replantation care. Then, an educational lecture was performed. The same questions were asked again to the same students to reevaluate their answers. The statisticaltests were employed at a significant level of p<0.05. There wasa significant difference (p<0.05)inthe responsesbefore and after the lecture. The dental students had a higher knowledge ofthe subject (p<0.05). The educational presentation reached its objective, since there was an improvement in the index of all answers of the post-lecture questionnaire, demonstrating thatthe people must be informedand trainedin the emergency management of dental avulsion (AU).

O reimplante dentário é um grande problema de saúde pública. Seu prognóstico depende do atendimento de urgência, mas ainda falta conhecimento.Assim, este estudo tem como objetivo avaliar o conhecimento de graduandos de Odontologia, Fonoaudiologia, Educação Física, Pedagogia e Tecnólogo em Radiologia. Cento e cinquenta e umalunos responderam a 10 perguntas sobre cuidados de reimplante de emergência. Em seguida, foi realizada uma palestra educativa. As mesmas perguntas foram feitas novamente aos mesmos alunos para reavaliar suas respostas. Os testes estatísticos foram empregados em um nível de significância de p <0,05. Houve diferença significativa (p <0,05) nas respostas antes e depois da palestra. Os estudantes de odontologia apresentaram maior conhecimento sobre o assunto (p <0,05). A apresentação educativa atingiu seu objetivo, visto que houve uma melhora no índice de todas as respostas do questionário pós-aula, demonstrando que as pessoas devem ser informadas e treinadas no manejo emergencial da avulsão dentária (AU).