Continuing dental education in the treatment of dental avulsion: Polish dentists' knowledge of the current IADT guidelines.

OBJECTIVES: To evaluate the knowledge and experience of the treatment of avulsed teeth amongst Polish dentists 5 years after the publication of IADT guidelines. METHODS: On the basis of IADT guidelines, a voluntary anonymous 12-item questionnaire was developed to evaluate dentists' knowledge on the treatment of avulsed teeth. The survey was conducted during three continuing education courses, which took place in Bialystok, Poland and covered 133 dentists. Data were analysed with Statistica 6.0 using Mann-Withney U- and Kruskal-Wallis tests (P < 0.05). RESULTS: The study revealed that Polish dentists were not prepared to deal with dental avulsion. 63.2% of respondents have never treated such patients, and 68.45% have never attended any postgraduate course on dental trauma. Sufficient knowledge was presented only according to the way of cleaning a contaminated tooth. Lack of knowledge was observed in fields: method of choice in first aid in dental avulsion (23.3% of correct answers) and critical extra-oral dry time (26.3%). Dentists practising <10 years had better knowledge than those with greater experience (P = 0.0000). Gender, previous experience in the treatment of avulsion, postgraduate education in dental trauma and subjective knowledge assessment were not statistically significant. CONCLUSIONS: There is a gap in the system of continuing dental education in Poland. Polish dentists need to familiarise themselves with the avulsion management procedures.

Replantation of two avulsed teeth after 1 h of storage in adverse extraoral dry conditions: A thought-provoking outcome after a 15-month follow-up.

This article reports a clinical case of an 8-year-old boy who sustained avulsion of the maxillary right central incisor and the maxillary left lateral incisor. The avulsed teeth were kept in adverse extraoral dry conditions for 1 h from the moment of trauma until their replantation. The prognosis of tooth replantation is dependent on multiple factors such as methods of teeth storage in vitro, endodontic intervention, extra-oral time, and type of retention employed. The main reasons for root resorption in this case may be the extra-oral time, the initial replantation, or the delayed endodontic treatment.

An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part I: Timing of pulp extirpation.

BACKGROUND: Clinical guidelines for the management of avulsed teeth recommend pulp extirpation (PE) within 10 to 14 days of replantation. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO Question: (P) For a replanted avulsed permanent tooth, (I) is early PE within 10 to 14 days of replantation, (C) compared with delayed pulp extirpation, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? MATERIALS AND METHODS: A literature search was performed across four internet databases for relevant citations (n = 38,400). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14,729) which were sieved. Relevant titles were selected for abstract assessment (n = 628), and then papers were selected for examination (n = 84). Inclusion criteria were applied and six papers (total 236 teeth) met the final criteria for meta-analysis. RESULTS: Meta-analyses found a statistically significant association between PE performed after 14 days and the development of inflammatory resorption [common odds ratio (COR) = 0.37, standard error (se) = 0.50, 95% confidence interval (CI): 0.14-0.98]. Pulp extirpation within 10 days of replantation was not significantly associated with a decreased likelihood of developing inflammatory resorption. There were no statistically significant differences in PE times for functional healing, acceptable healing without progressive resorption, or the development of replacement resorption. CONCLUSION: There is clinical evidence for an association between PE performed after 14 days following replantation and the development of inflammatory resorption. This investigation supports the current clinical guidelines for PE within 10 to 14 days of replantation.

Effect of a single dental health education on the management of permanent avulsed teeth by different groups of professionals.

INTRODUCTION: Tooth avulsion is the complete displacement of a tooth from its socket due to intentional or non-intentional injuries. Treatment in these cases comprises tooth replantation. This accident is very critical as the success of tooth replantation is directly dependent on several factors, such as extra-alveolar period, storage of the tooth until replantation, type of retention employed, time of endodontic intervention, type of drug prescribed, oral hygiene status as well as general health. This trauma commonly occurs during sports practice, school, and leisure activities. The first measures are critical for the prognosis of the avulsed tooth. Several studies report lack of knowledge of the population, educators, sports professionals, and health professionals in the management of tooth avulsion. This study evaluated the influence of education on different groups of professionals, addressing the knowledge and prevention and emergency management of the avulsed tooth. METHOD: The study was conducted on five different groups of professionals (elementary school teachers, physical education professionals, bank employees, dental doctors, and pediatricians) from the city of Brasília, DF, Brazil. The professionals attended a lecture and were evaluated by a questionnaire applied twice, before and after the lecture. RESULTS: The results of the 479 returned questionnaires were analyzed. The difference between questionnaires before and after the lecture was statistically analyzed by the Wilcoxon test. There was statistically significant change in the performance of professional groups after information was provided (P < 0.0001). CONCLUSION: Education is extremely important to favor the knowledge on prevention and emergency management of an avulsed tooth, and may enhance the prognosis of tooth avulsion.

[Clinical management of the intentional tooth replantation].

Intentional tooth replantation is the last resort for saving natural teeth in treatment of the endodontic diseases. In order to promote the utilization, standardize the operation and improve the success rate of this treatment, this review suggests the indication, discusses the key points of the surgical procedure, proposes the path of the diagnosis and the treatment protocol of the intentional replantation.

[An unusual care--results of replantation]. / Der interessante Fall--Ergebnis einer Replantation.

In the course of the regular ambulatory supervision of orally rehabilitated patients, the author reexamined in a patient the molars 16 and 17 which had been replanted 22 years ago. The problems related to replantation are discussed.

Reimplante dentario: factores que pueden aumentar la posibilidad de éxito. Presentación de casos clínicos / Tooth reimplantation: factors enhancing the chances for success. Report of clinical cases

En esta presentación por un abordaje basado a la luz de la literatura y en la experiencia clínica de los autores, son discutidos los distintos factores que pueden interferir para el éxito de los reimplantes dentarios, que ocurren como secuela de lesiones traumáticas. Estas, a su vez, presentan actualmente un considerable aumento de su frecuencia, por el incremento de la práctica de distintos deportes que propician ese riesgo, abarcando una edad no especificada, pero con mayor prevalencia en los pacientes jóvenes. Componen la ilustración de este trabajo dos casos clínicos con diferentes resultados. Se resaltan aquí además de los innumerables factores que pueden contribuir para el fracaso de los reimplantes, la importancia de los procedimientos realizados por el profesional, el menor tiempo extraalveolar, la posibilidad de generar revascularización del tejido pulpar, la antibioticoterapia, la profilaxis antitetánica, la adecuada contención semirrígida temporaria, entre otros cuidados, pueden ayudar de forma significativa para alcanzar el éxito del tratamiento y justificar, de esa forma, el empleo de estos procedimientos atendiendo los aspectos biológicos y psicológicos (AU)