Background/Aims: Traumatic dental injuries (TDIs) can result in complications that may manifest long after the initial injury. Long-term follow-up is essential. Registration systems must be easy to use. This study aimed to describe and validate a simple registration system for clinician-important TDI outcomes as an index. Materials/Methods: The clinical and radiological outcome findings were formulated with five digits in line with the Eden Baysal Dental Trauma Index. Twenty-five experts (n = 15 in a primary expert panel and n = 10 in a feedback panel) from seventeen countries participated in the validation process using the e-Delphi method. After two rounds to reach consensus, the second version of the proposed system was presented to the feedback group. The revised post-feedback version was re-evaluated by the primary experts. All experts commented freely and answered four questions on the system's use using a three-point Likert-scale. Results: The approved name of the proposed system is “Eden Dental Trauma Outcome Index”. The first digit reports the success of the restoration, and the second digit reports the healing type of root fracture. Coding the first two digits changed from Roman to Arabic numerals after the first round. The third digit records the external root resorption type with capitalised first letters of the two words describing the type. The fourth digit reports the maturity of the apex with lowercase first letters. The fifth digit records pulp status with Arabic numerals. Codes for unclear situations and tooth loss were added to all digits in the final version. All experts in the primary panel and 83.3% in the feedback panel reported that the index is practical but needs experience. Conclusion: After four validation rounds, the “Eden Dental Trauma Outcome Index” for reporting clinician-important outcomes was approved for face and content validity and external validity.

This chapter describes autotransplantation of teeth, which is a viable treatment alternative for replacing traumatically lost or congenitally missing teeth by moving a tooth or a root to a more suitable position within the same individual. Usually, premolars and third molars are considered donor teeth. The chapter presents an overview of important principles for case selection, surgical technique, and tissue healing, which are prerequisites for a successful result. The key to successful autotransplantation has shown to be related to proper selection of donor teeth with adequate root development and applying the proper nontraumatic surgical techniques. Autotransplantation has its optimum success in young patients, that is, a period when implants are generally contraindicated. Given the consideration discussed in this chapter and careful case selection and planning, the possibility of tooth autotransplantation is an excellent treatment option, especially suitable in young individuals with missing teeth.

The maxillofacial region is important, with vital functions such as breathing, eating, talking, smelling, and vision. Moreover, it is also an aesthetically important region. Injuries to the maxillofacial region may, therefore, have profound consequences for the individual's quality of life. Earlier used methods of conservative treatment of maxillofacial fractures with suspension wires and intermaxillary fixation have been replaced by methods aiming at exposing fracture lines, allowing precise alignment and application of osteosynthesis hardware, and enabling a faster return to function. This chapter aims to give an overview of modern treatment principles in the management of fractures of the midface and the upper face by describing surgical approaches, techniques, and strategies for fracture treatment. A section on biodegradable osteosynthesis material is also presented.

Detailed reference on the full scope of oral and maxillofacial surgery for dentists and surgeons Oral and Maxillofacial Surgery, Second Edition is a comprehensive reference to oral and maxillofacial surgery. Suitable for fields of dentistry, surgery, and medicine that treat conditions of the head and neck, this resource Dr.aws together current research, practice, and developments to create a detailed guide for both practicing surgeons and trainees. From pre-operative through to post-operative management, this book’s coverage extends from basic principles such patient evaluation, dental anesthesia, wound healing, infection control, and surgical instrument through to the complex areas of dentoalveolar surgery, oral pathologic lesions, trauma, implant surgery, dentofacial deformities, temporomandibular joint disorders, and salivary gland disorders. The second edition is fully updated throughout with contributions from international experts offering a global perspective. Readers will find includes new chapters on the innovations affecting the care of surgical patients. These include virtual surgical planning, navigation, and tissue engineering for reconstruction. Pediatric-specific chapters have also been added in trauma and temporomandibular joint surgery, as well as an expanded section on cosmetic surgery. All updates are accompanied by images and medical illustrations reflecting the changes in this specialty area of dental and medical care. Oral and Maxillofacial Surgery also includes information on: State of the art clinical practice Technical aspects of minimally invasive cosmetic procedures Diagnosis and treatment of obstructive sleep apnea, and the role of maxillary and mandibular osteotomies Diagnostic strategies, risk assessment, and guidelines for staging as well as surgical and non-surgical management of osteonecrosis of the jaws Clinical and radiographic characteristics of odontogenic and nonodontogenic cysts of the jaws, with strategies for management The second edition of Oral and Maxillofacial Surgery remains an essential landmark in a transforming field and is suitable for oral and maxillofacial specialists, dental surgeons, OMS residents, and trainees.

Background/aim: Alveolar bone process fractures in preschool children are not well documented in the literature. Alveolar process fractures are located very close to primary teeth and permanent tooth germs. This study investigates the risk of healing complications following alveolar process fractures in the primary dentition and potential sequelae in the permanent dentition.

Materials and methods: A retrospective cohort study was conducted involving 21 patients with 49 primary teeth involved in an alveolar fracture. The follow-up protocol included clinical and radiographic examinations at specified intervals up to the age of 6 years. Healing complications in the primary teeth such as pulp necrosis, pulp canal obliteration, ankylosis, infection-related resorption and premature tooth loss were examined. Sequelae in the permanent dentition was also registered when the permanent incisors had erupted.

Results: Over a 3-year follow-up, the incidence of premature tooth loss was 51.2% [95% CI: 34.1%-68.4%], pulp canal obliteration was 42.5% [95% CI: 27.1%-57.8%], and pulp necrosis was 8.9% [95% CI: 0.6%-17.3%] following an alveolar process fracture. No cases of ankylosis were observed. Sequelae in the permanent dentition primarily included demarcated opacities and hypoplasia with a risk estimated at 24% [95% CI: 13%-39%] and 9% [95% CI: 2%-21%] respectively.

Conclusion: Alveolar process fractures in primary dentition are associated with several healing complications in the primary teeth. Although the likelihood of severe complications in the permanent dentition is low, young children are still susceptible to developing sequelae in their permanent teeth. These results highlight the importance of awareness of dental injuries following alveolar process bone fractures in the primary dentition.

Traumatic dental injuries (TDI) are the most frequently occurring injuries to the oral region. It has been shown by Petti et al. in 2018 that 1 billion living people in the world today have been subjected to TDI. The prognosis for some TDIs depends on correct, early emergency management at the place of the accident and at the clinic. This chapter presents how to diagnose, classify, and treat TDI with emphasis on the emergency phase. An overview of pulpal and periodontal healing and complications after TDI is also given.

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.

This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.

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.

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.