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Andersson, Lars
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Gul, A., Lauridsen, E., Gerds, T. A. & Andersson, L. (2023). Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation: A long-term clinical study. Dental Traumatology
Open this publication in new window or tab >>Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation: A long-term clinical study
2023 (English)In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND/AIM: There are few long-term clinical follow-up studies on human teeth replanted immediately or after storage in a suitable storage medium prior to replantation. This study aimed to assess the risk of ankylosis in avulsed human teeth replanted immediately or after storage in physiological media for a short time.

MATERIAL: Data from 116 patients with 145 replanted avulsed permanent teeth were selected from a comprehensive dental trauma database in Copenhagen University Hospital. The following teeth were selected: Group 1 comprised 36 teeth replanted immediately (dry time <6 min; wet time <6 min). Group 2 comprised 61 teeth replanted after physiologic storage media (saliva and saline) (dry time <6 min; wet time >5 min; wet time ranged from 7 to 170 min, and mean wet time was 59 min). Group 3 (control) included 48 teeth replanted after dry storage (dry time > 60 min).

METHOD: Clinical and radiographic registrations were carried out according to a standardized protocol; follow-up ranged from 7 months to 23 years. Ankylosis was diagnosed by percussion test and radiographs and related to the conditions prior to replantation and stage of root development.

RESULTS: The overall risk of ankylosis was 17.2% [95% CI: 4.61; 29.79] for immediately replanted teeth, 55.3% [95% CI: 42.54; 68.00] for teeth stored in physiologic media before replantation, and 85.7% [95% CI: 75.70; 95.73] for teeth stored dry more than 1 h. Mature teeth showed a significantly higher risk of ankylosis than immature teeth.

CONCLUSION: This clinical long-term study has verified earlier experimental studies showing that immediate reimplantation has the lowest risk of ankylosis. Physiologic storage media are good alternatives that also reduce the risk of ankylosis compared to dry storage, where ankylosis is more likely although not always seen. Mature teeth are significantly more likely to develop ankylosis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
ankylosis, avulsion, replacement resorption, replantation, root resorption, traumatic dental injury
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-63675 (URN)10.1111/edt.12898 (DOI)001091002600001 ()37864425 (PubMedID)2-s2.0-85174534776 (Scopus ID)
Available from: 2023-11-13 Created: 2023-11-13 Last updated: 2023-12-05Bibliographically approved
Lauridsen, E., Andersson, L. & Suresh, N. (2023). The Dental Trauma Guide: An evidence-based treatment guide. Endodontology, 35(2), 79-84
Open this publication in new window or tab >>The Dental Trauma Guide: An evidence-based treatment guide
2023 (English)In: Endodontology, ISSN 0970-7212, Vol. 35, no 2, p. 79-84Article, review/survey (Refereed) Published
Abstract [en]

Dental trauma is complex, as it includes a wide range of different injury types with each type requiring specific considerations. It constitutes the fifth-most prevalent disease, and nearly 900 million individuals from 7 to 65 years of age are affected. The Dental Trauma Guide (DTG) project was initiated by Dr. Jens Andreasen in 2008 with the intention that all dentists around the world should be able to get access to the best available evidence regarding diagnosis, treatment, and prognosis for a patient with dental trauma within a few minutes. The DTG has been a global success, and today, 40,000 colleagues visit the DTG website every year. The website displays the treatment guidelines developed by the International Association of Dental Traumatology as well as visualized with film animations to make it easy and appealing for the users. The dentist can connect to the DTG Copenhagen database to compare his/her case with similar cases from the database, providing guidance to emergency treatment. Furthermore, DTG provides prognosis estimates for each individual injury type, as well as prognosis estimates for teeth with combinations of fracture and luxation injuries. Today, the DTG is a nonprofit organization with the aim of improving the level of care for dental trauma patients worldwide. Therefore, the DTG team has decided to offer free access for students at all dental schools in India.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-64237 (URN)10.4103/endo.endo_46_23 (DOI)2-s2.0-85164371074 (Scopus ID)
Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2023-12-11Bibliographically approved
Kevci, M., Gerds, T. A., Lauridsen, E. & Andersson, L. (2023). The risk of healing complications in primary teeth with root fractures: A retrospective cohort study. Dental Traumatology, 39(5), 455-461
Open this publication in new window or tab >>The risk of healing complications in primary teeth with root fractures: A retrospective cohort study
2023 (English)In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 39, no 5, p. 455-461Article in journal (Refereed) Published
Abstract [en]

Background/aim: Primary teeth are frequently affected by traumatic dental injuries. Root fractures are rare and have a reported incidence of 2% in the primary dentition. Hence, there is limited evidence on this topic. This study aims to evaluate the risk of healing complications in primary teeth with root fracture and to identify possible sequelae in the permanent dentition following root fracture in the primary dentition.

Materials and methods: A retrospective analysis of a cohort of 53 patients with 74 root fractured primary teeth. The standard follow-up program included clinical and radiographic examination after 4 weeks, 8 weeks, 6 months, and 1 year after the trauma and when the patient was 6 years of age. The following complications were registered: pulp necrosis (PN), pulp canal obliteration (PCO), ankylosis with replacement root resorption (ARR), infection-related root resorption (IRR), premature tooth loss (PTL), and repair-related resorption (RRR).

Statistics: The Kaplan-Meier and Aalen-Johansen estimators were employed. The level of significance was 5%.

Results: A total of 74 teeth were included. 42 teeth were extracted at the initial examination. Risks estimated after 3 years: PTL 45.9% [95% CI: 28.8-63.0], PCO 12.9% [95% CI: 2.3-23.4], PN 14.9% [95% CI: 3.9-25.9], RRR 2.6% [95% CI: 0.0-7.5]. No teeth showed ARR or IRR. All complications were diagnosed within the first year. Most common sequelae in the permanent dentition was demarcated opacities, with an estimated risk of 20% [95% CI: 8.2-41.3].

Conclusions: There is a low risk of healing complications following a root fracture in the primary dentition. Root fractures often result in early extraction of the coronal fragment. The remaining apical fragment will undergo a physiological resorption. Aside from opacities, there is a low risk of sequelae in the permanent dentition.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
dental trauma, primary teeth, pulp necrosis, root fracture, sequelae, tooth loss
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-60573 (URN)10.1111/edt.12853 (DOI)000999217400001 ()37272585 (PubMedID)2-s2.0-85161455577 (Scopus ID)
Available from: 2023-06-13 Created: 2023-06-13 Last updated: 2023-10-11Bibliographically approved
Petti, S., Andreasen, J. O., Glendor, U. & Andersson, L. (2022). NA0D - The new Traumatic Dental Injury classification of the World Health Organization.. Dental Traumatology, 38(3), 170-174
Open this publication in new window or tab >>NA0D - The new Traumatic Dental Injury classification of the World Health Organization.
2022 (English)In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 38, no 3, p. 170-174Article in journal (Refereed) Published
Abstract [en]

An accurate, clear, and easy-to-use traumatic dental injury (TDI) classification and definition system is a prerequisite for proper diagnosis, study, and treatment. However, more than 50 classifications have been used in the past. The ideal solution would be that TDIs are adequately classified within the International Classification of Diseases (ICD), endorsed by the World Health Organization (WHO). TDI classification provided by the 11th Revision of the ICD (ICD-11), released in 2018, and previous Revisions, failed to classify TDIs satisfactorily. Therefore, in December 2018, a proposal was submitted by Dr's Stefano Petti, Jens Ove Andreasen, Ulf Glendor, and Lars Andersson, to the ICD-11, asking for a change of the existing TDI classification. Proposal #2130 highlighted the TDI paradox, the fifth most frequent disease/condition neglected by most public health agencies in the world, and the limits of ICD-11 classification. Namely, injuries of teeth and periodontal tissues were located in two separate blocks that did not mention dental/periodontal tissues; infraction, concussion, and subluxation were not coded; most TDIs lacked description; and tooth fractures were described through bone fracture descriptions (e.g., comminuted, compression, and fissured fractures). These limitations led to TDI mis-reporting, under-reporting, and non-specific reporting by untrained non-dental healthcare providers. In addition, no scientific articles on TDIs, present in PubMed, Scopus, and Web-of-Science, used the ICD classification. Proposal #2130 suggested to adopt the Andreasen classification, the most widely acknowledged classification used in dental traumatology. The Proposal was reviewed by two WHO teams, two scientific Committees, one WHO Collaborating Center, and the Department of Non-Communicable Disease Prevention at WHO headquarters, and it underwent two voting sessions. In March 2022, the Andreasen classification was accepted integrally. A new entity was generated, called NA0D, "Injury of teeth or supporting structures" (https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1413338122). Hopefully, this will contribute to increasing the public awareness, and the dental profession's management, of TDIs.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
ICD-11, World Health Organization, global burden of disease, international classification of diseases, traumatic dental injury
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-51280 (URN)10.1111/edt.12753 (DOI)000790894400003 ()35481941 (PubMedID)2-s2.0-85128900366 (Scopus ID)
Available from: 2022-05-04 Created: 2022-05-04 Last updated: 2024-02-05Bibliographically approved
Al-Melh, M. A., Badr, H. & Andersson, L. (2021). Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study. Journal of Contemporary Dental Practice, 22(6), 637-643
Open this publication in new window or tab >>Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study
2021 (English)In: Journal of Contemporary Dental Practice, E-ISSN 1526-3711, Vol. 22, no 6, p. 637-643Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: The aims of this study were to compare the anesthetic effect of a lidocaine/prilocaine (L/P) topical anesthetic with placebo on pain from needle sticks and to compare the anesthetic effect of the L/P topical anesthetic with an infiltrative anesthetic on pain from orthodontic miniscrew placement. Materials and methods: Pain elimination was analyzed from two interventions: (a) needle stick and (b) miniscrew insertion. When assessing pain from needle stick, one side of the mandible received 2.5% lidocaine/2.5% prilocaine topical anesthetic, and the other side received placebo. When evaluating pain from miniscrew placement, one side of the mandible received L/P topical anesthetic and the other side received infiltrative anesthetic. The findings were recorded on a Visual Analogue Scale after needle stick and after miniscrew placement. Subjective assessment was analyzed by a questionnaire. Results: The L/P topical anesthetic significantly eliminated the pain from needle stick (Mann–Whitney test of medians, 29.0 vs 0.0, respectively, p<0.001). However, the injection anesthetic eliminated the pain from the miniscrew placement better than the L/P topical anesthetic (Mann–Whitney test of medians, 0.0 vs 5.5, respectively, p<0.001). Eighty percent of the subjects felt more comfortable with L/P topical anesthetic than injection anesthetic. Pain from needle stick pain was reported to be the most uncomfortable part of the study. Conclusion: The L/P topical anesthetic efficiently eliminated pain from needle stick. The L/P topical anesthetic did not completely eliminate pain from miniscrew placement as the injection anesthesia, but it did reduce pain to tolerable levels. Clinical significance: L/P topical anesthetics can significantly eliminate pain from needle stick injections, and L/P topical anesthetics can reduce pain from orthodontic miniscrew placement to tolerable levels. © Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Place, publisher, year, edition, pages
Jaypee Brothers Medical Publishers (P) Ltd, 2021
Keywords
Injection anesthesia, Miniscrews, Needle stick, Pain, Topical anesthesia., lidocaine, local anesthetic agent, prilocaine, human, mouth, topical drug administration, Administration, Topical, Anesthetics, Local, Humans, Lidocaine, Prilocaine Drug Combination
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:mau:diva-48805 (URN)10.5005/jp-journals-10024-3107 (DOI)34393120 (PubMedID)2-s2.0-85112823916 (Scopus ID)
Available from: 2021-12-28 Created: 2021-12-28 Last updated: 2023-12-21Bibliographically approved
Farzad, P., Lundgren, T., Al-Asfour, A., Andersson, L. & Dahlin, C. (2021). Integration of Dental Implants in Conjunction with EDTA-Conditioned Dentin Grafts: An Experimental Study. Dentistry Journal, 9(6), Article ID 63.
Open this publication in new window or tab >>Integration of Dental Implants in Conjunction with EDTA-Conditioned Dentin Grafts: An Experimental Study
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2021 (English)In: Dentistry Journal, ISSN 2304-6767, Vol. 9, no 6, article id 63Article in journal (Refereed) Published
Abstract [en]

This study was undertaken to investigate the integration of titanium micro-implants installed in conjunction with previously dentin-grafted areas and to study the morphological appearance, mineral content, and healing pattern of xenogenic EDTA-conditioned dentin blocks and granules grafted to cavities in the tibial bone of rabbits. Demineralized and non-demineralized dentin blocks and granules from human premolars were implanted into cavities prepared on the lateral aspects of the tibias of rabbits. After a healing period of six months, micro-implants were installed at each surgical site. Histological examinations were carried out after 24 weeks. Characterization of the EDTA-conditioned dentin blocks was performed by means of light microscopy, dental X-rays, scanning electron microscopy, and energy dispersive X-ray analysis (EDX). No implants were found to be integrated in direct contact with the dentin particles or blocks. On the EDTA-conditioned dentin surface, the organic marker elements C and N dominated, as revealed by EDX. The hydroxyapatite constituents Ca and P were almost absent on the dentin surface. No statistically significant difference was observed between the EDTA-conditioned and non-demineralized dentin, as revealed by BIC and BA. The bone-inductive capacity of the dentin material seemed limited, although demineralization by means of EDTA indicated higher BIC and BA values in conjunction with the installed implants in the area. A 12 h EDTA treatment did not fully decalcify the grafts, as revealed by X-ray analysis.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
grafted dentin, dental implants, EDTA, experimental study
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-44882 (URN)10.3390/dj9060063 (DOI)000668211300001 ()34206029 (PubMedID)2-s2.0-85108257878 (Scopus ID)
Available from: 2021-08-17 Created: 2021-08-17 Last updated: 2024-02-05Bibliographically approved
Wimalarathna, A. A., Herath, E. M., Senarath, N. H., Fonseka, M. C., Manathunga, M. M., Nawarathna, L. S. & Andersson, L. (2021). Introduction of an interactive tool (the Dental Trauma Guide) in the undergraduate dental teaching to manage traumatic dental injuries. Dental Traumatology, 37(5), 717-724
Open this publication in new window or tab >>Introduction of an interactive tool (the Dental Trauma Guide) in the undergraduate dental teaching to manage traumatic dental injuries
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2021 (English)In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 37, no 5, p. 717-724Article in journal (Refereed) Published
Abstract [en]

Background/Aims Traumatic dental injuries (TDI) are complex problems where lack of proper care may result in serious complications. The need to improve the management of TDI is a frequently addressed concern. Methods of improvement in their diagnosis and management are continuously evolving. The interactive Internet tool, the Dental Trauma Guide (DTG), helps to simplify diagnostic and management dilemmas. However, it is not a freely available tool. The aim of the current study was to assess the knowledge and diagnostic skills of undergraduate dental students with access to the DTG compared with students without such access, in order to validate and promote this tool in dental education. Materials and Methods Two groups of students were randomly selected where one group of final year dental undergraduate students were exposed to lectures, demonstrations, discussions and tutorials on the management of TDI according to the standard undergraduate curriculum in Sri Lanka. Another test group of 21 students were provided with access to DTG during their training in paediatric dentistry. At the end of the study period, students were assessed on their knowledge of TDI using MCQs (Multiple Choice Questions) and OSCEs (Objective Structured Clinical Examination), based on the DTG. Results The students with access to the DTG were more knowledgeable in providing the correct answers to three out of the seven OSCE questions. Evaluation based on the MCQs did not reveal a significant difference (p = .913). However, users of the DTG showed a statistically significant difference with better overall knowledge based on their answers (p = .028). Following this period of evaluation, all of the students were provided with access to the DTG to supplement their learning experience. Conclusion The Dental Trauma Guide is a useful supplementary tool for undergraduate students to arrive at a correct diagnosis and treatment plan for TDI.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
dental trauma guide, knowledge, traumatic dental injuries, undergraduate teaching
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-43929 (URN)10.1111/edt.12687 (DOI)000660886000001 ()34120401 (PubMedID)2-s2.0-85107818476 (Scopus ID)
Available from: 2021-06-22 Created: 2021-06-22 Last updated: 2024-02-05Bibliographically approved
Andersson, L., Bakland, L. K., Heithersay, G. S. & Lauridsen, E. (2021). Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology.. Dental Traumatology, 37(1), 4-16
Open this publication in new window or tab >>Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology.
2021 (English)In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 37, no 1, p. 4-16Article in journal (Refereed) Published
Abstract [en]

The life and professional contributions to dental traumatology of Dr. Jens Ove Andreasen are described in terms of his research, writing, teaching, and leadership.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
ankylosis, auto-transplantation, dental traumatology, healing complications, replantation, root fractures, traumatic dental injuries
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-37781 (URN)10.1111/edt.12641 (DOI)000600692300001 ()33350579 (PubMedID)2-s2.0-85097892691 (Scopus ID)
Available from: 2021-01-05 Created: 2021-01-05 Last updated: 2023-10-24Bibliographically approved
Andersson, L., Bakland, L. K., Heithersay, G. S. & Lauridsen, E. (2021). Reprint of: Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology. Journal of Endodontics, 47(6), 852-861, Article ID S0099-2399(21)00237-5.
Open this publication in new window or tab >>Reprint of: Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology
2021 (English)In: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 47, no 6, p. 852-861, article id S0099-2399(21)00237-5Article in journal (Other academic) Published
Abstract [en]

The life and professional contributions to dental traumatology of Dr Jens Ove Andreasen are described in terms of his research, writing, teaching, and leadership.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Ankylosis, auto-transplantation, dental traumatology, healing complications, replantation, root fractures, traumatic dental injuries
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-42491 (URN)10.1016/j.joen.2021.03.016 (DOI)000654710600002 ()34016476 (PubMedID)2-s2.0-85106184573 (Scopus ID)
Available from: 2021-05-31 Created: 2021-05-31 Last updated: 2024-02-05Bibliographically approved
Albertsson, J., Lauridsen, E., Andreasen, J. O., Gerds, T. A. & Andersson, L. (2021). The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation-A re-evaluation of a long-term clinical study. Dental Traumatology, 37(4), 537-545
Open this publication in new window or tab >>The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation-A re-evaluation of a long-term clinical study
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2021 (English)In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 37, no 4, p. 537-545Article in journal (Refereed) Published
Abstract [en]

Background/Aim: The survival of an avulsed tooth highly depends on the emergency management. The aim of this study was to evaluate the risk of ankylosis for avulsed human teeth stored in saliva preceded by various dry storage conditions prior to replantation. Material and methods: Data include 74 patients (54 male and 20 female) with 89 avulsed and replanted teeth (16 immature teeth, 73 mature teeth). Patient ages ranged from 6 to 36 years (median: 13.0 years). All teeth were stored in saliva before replantation. Treatment and follow-up were performed according to a standardized procedure. Follow-up periods ranged from 7 months to 20 years (mean 5.3 years). The risk of ankylosis over time was estimated by the Aalen-Johansen method in relation to the length of dry storage and the stage of root development. The effect of risk factors (root development and length of dry time) on the risk of ankylosis was analysed by Cox regression analysis. Results: For mature teeth, dry storage for 5 min or less before saliva storage resulted in a 47.4% (95% confidence interval (CI): 32.8-60.7) ankylosis rate. When dry storage was >5 min and <20 min, the risk of ankylosis was 76.8% (95% CI: 45.7-91.5). When dry storage exceeded 20 min prior to saliva storage, ankylosis increased to 89.3% (95% CI: 68.0-96.7). Ankylosis also increased with increasing saliva storage time. Specifically, one additional minute of wet time increased the ankylosis hazard rate (HR) by approximately 1% (CI = [0%, 2%], p = .052). Teeth with mature root development were significantly more frequently affected by ankylosis than teeth with immature root development (HR: 2.4 (95% CI: 1.0-5.5), p = .04). Conclusion: Temporary storage in saliva should be encouraged if an avulsed permanent tooth cannot be immediately replanted or a suitable storage medium such as milk or saline is not immediately available at the place of the accident.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
ankylosis, avulsion, dental trauma, prognosis, replacement resorption, saliva
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-41054 (URN)10.1111/edt.12659 (DOI)000613551300001 ()33527633 (PubMedID)2-s2.0-85100088701 (Scopus ID)
Available from: 2021-03-08 Created: 2021-03-08 Last updated: 2024-02-05Bibliographically approved
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