ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Treatment Outcome For Avulsed And Replanted Permanent Teeth
Clinical Question In a child with an avulsed permanent incisor, what is the survival rate after replantation?
Clinical Bottom Line A wide range of survival rates was reported. Werdner and colleagues found an 83.3% survival rate after replantation, reporting 7 out of 42 permanent incisors being extracted over a median observation period of 2.8 years. Furthermore, Petrovic and colleagues showed 10 teeth out 32 permanent incisors being extracted over a median observation period of two years. In addition, both studies indicated a more favorable treatment outcome in incisors with closed apices.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19919541Petrovic/201062 avulsed permanent incisors, in 51 children (mean age 10.7 years old, a range of 7-19 years old). Prospective Cohort Study
Key resultsThis study reported that out of the 62 avulsed teeth only 32 teeth could be replanted. Over two-year median observation period, 10 of those replanted teeth had to be extracted. The study also indicated that incisors with open apices had a relative risk of failure that was 6.4 times greater than that of incisors with closed apices (p=0.04).
#2) 21557097Werder/ 201142 avulsed permanent incisors, in 37 patients (mean age of 16.3 years, 81% of patients under 20 years of age).Retrospective Cohort Study
Key resultsOver a 2.8 year median observation period, 7 of the incisors were extracted indicating a survival rate of 35/42 teeth (83.3%).
Evidence Search ("Tooth Avulsion"[Majr] OR "Tooth Replantation"[Majr]) AND "Child"[Mesh] AND (("therapy"[Subheading] OR "therapy"[All Fields] OR "treatment"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields]) AND Outcome[All Fields]) AND ("humans"[MeSH Terms] AND English[lang])
Comments on
The Evidence
Petrovic and colleagues had a follow-up period ranged from one to six years, with a median of two years. For the initial 8 weeks patient follow-up was 100%, however that number decreased to 50% in the first year. Werdner and colleagues had a follow-up period ranged of 1 to 5 years, with a median of 2.8 years. Both of these articles show a low-level of evidence.
Applicability This is applicable to health care providers treating these children as well as parents whose children have avulsed and replanted teeth.
Specialty/Discipline (General Dentistry) (Orthodontics) (Pediatric Dentistry)
Keywords Tooth Avulsion, Tooth Replantation
ID# 2420
Date of submission: 02/28/2013spacer
E-mail huttoa@livemail.uthscsa.edu
Author Ashley Hutto
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Maria Cervantes Mendez, DDS
Faculty mentor/Co-author e-mail CervantesMen@uthscsa.edu
Basic Science Rationale
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