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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) 19919541 | Petrovic/2010 | 62 avulsed permanent incisors, in 51 children (mean age 10.7 years old, a range of 7-19 years old). | Prospective Cohort Study | | Key results | This 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) 21557097 | Werder/ 2011 | 42 avulsed permanent incisors, in 37 patients (mean age of 16.3 years, 81% of patients under 20 years of age). | Retrospective Cohort Study | | Key results | Over 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) (Dental Hygiene) |
| Keywords |
Tooth Avulsion, Tooth Replantation
|
| ID# |
2420 |
| Date of submission: |
02/28/2013 |
| 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
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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