A retrospective evaluation of patients with uncomplicated crown fractures and luxation injuries.
This paper is a review of the clinical findings from my thesis "Pulp survival and hard tissue formation subsequent to dental trauma". Traumatic injuries in children and adolescents are a common problem, and the prevalence of such injuries has increased over the last 10-20 years. The purpose of the present investigations was to evaluate the long-term results following uncomplicated crown fractures and luxations involving subsequent pulp canal obliteration. A total of 241 patients with 545 injured teeth were available for clinical examination, of whom 102 answered a questionnaire and were interviewed before oral examination. In addition, 82 permanent incisors presenting with pulp canal obliteration were followed for a period of 7 to 22 years (mean 16 years). The findings showed little pulpal response to crown fracture and subsequent restorative procedures as long as there was no concomitant periodontal injury (15-year follow-up). Approximately every fourth resin composite filling was rated as unacceptable at clinical examination. The interview showed that half of the individuals were dissatisfied with the color and/or anatomic form of the composite restoration. Pulp canal obliteration was found in all luxation categories, and 69% of the teeth demonstrated yellow crown discoloration. According to the survival curve the 20-year pulp survival rate diagnosed radiographically was 84%. Although the risk of pulp necrosis increased with time, routine endodontic intervention of teeth with ongoing pulp canal obliteration of the root canal did not seem justified.
Robertson
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Department of Pedodontics, Faculty of Odontology, Göteborg University, Sweden.
D000293:Adolescent; D000328:Adult; D002648:Child; D003188:Composite Resins; D003784:Dental Pulp Calcification / Q000209:etiology; D003790:Dental Pulp Necrosis / Q000209:etiology; D003793:Dental Restoration, Permanent; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014084:Tooth Avulsion / Q000150:complications / Q000523:psychology / Q000628:therapy; D019228:Tooth Crown / Q000293:injuries*; D014075:Tooth Discoloration / Q000209:etiology; D014082:Tooth Fractures / Q000150:complications / Q000523:psychology / Q000628:therapy