Evaluation of pulpal blood flow after tooth splinting of luxated permanent maxillary incisors.
Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess whether LDF could be used to detect short- and long-term changes of PBF values of luxated permanent maxillary central incisors after repositioning and splinting. In 18 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in four sessions: on the day of splint removal, and 12, 24, and 36 weeks after splint removal. Analysis of the luxation type-related PBF measurements revealed intrusion type-related PBF values to be associated with a significant decrease in PBF values (P < 0.05), while lateral luxation and extrusion type-related PBF values showed no significant difference between the session-related values (P > 0.05). PBF measurements did not change over time for the contralateral incisors (P > 0.05). Teeth affected by an intrusion-type luxation injury remained unresponsive to sensitivity testing at follow up, while 3 (60%) developed grey discoloration of the crown. LDF may become useful in the detection of ischemic episodes of luxated maxillary central incisors after repositioning and splinting. Further studies are warranted to assess the validity of post-traumatic 'ischemic episodes' by comparing it to histological tooth pulp changes.
Department of Oral and Maxillo-Facial Surgery, University of Innsbruck, A-6020 Innsbruck, Austria.
Heinrich
H
Strobl
Markus
M
Haas
Burghard
B
Norer
Stefan
S
Gerhard
Rüdiger
R
Emshoff
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003782:Dental Pulp / Q000098:blood supply*; D003791:Dental Pulp Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000098:blood supply / Q000293:injuries*; D007511:Ischemia / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008437:Maxilla; D010474:Percussion; D012039:Regional Blood Flow / Q000502:physiology; D013165:Splints; D014084:Tooth Avulsion / Q000503:physiopathology / Q000628:therapy*; D014075:Tooth Discoloration / Q000503:physiopathology; D014086:Tooth Mobility / Q000503:physiopathology / Q000628:therapy