title: Pulp necrosis of teeth retained at the mandibular fracture site and the effect of dexamethasone on its occurrence.
abstract: OBJECTIVE
  The main purpose was to determine the occurrence of pulp necrosis (PN) of teeth retained at the mandibular fracture site. An additional purpose was to investigate whether perioperative use of dexamethasone increases the risk of PN.
  
  
  METHODS
  A follow-up study on 24 adult dentate patients with mandibular body, symphysis or parasymphysis fracture. These patients had been selected from a larger cohort who had participated in a randomized study of maxillofacial fractures and dexamethasone. All patients who were suspected of having a need for endodontic treatment were evaluated by an endodontist.
  
  
  RESULTS
  PN was diagnosed in six patients (25.0%) in one or two teeth. Of a total of 33 teeth situated in the fracture line, six (18.2%) were diagnosed as having PN. PN was more common in teeth in which the fracture line ran through the apex (21.7%) than in those in which the fracture line was in contact with the tooth cranially to the apex (10.0%). The association between PN and dexamethasone was not significant.
  
  
  CONCLUSIONS
  PN is common after mandibular fractures, particularly when the fracture line runs through the apex of the tooth. Use of short-term, high-dose dexamethasone perioperatively did not significantly increase the risk for PN.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Snäll
authors.forename: Eeva
authors.initials: E
authors.lastname: Kormi
authors.forename: Christian
authors.initials: C
authors.lastname: Lindqvist
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Suominen
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Koivusalo
authors.forename: Jyrki
authors.initials: J
authors.lastname: Törnwall
authors.forename: Hanna
authors.initials: H
authors.lastname: Thorén
mesh_terms: D000328:Adult; D003790:Dental Pulp Necrosis / Q000209:etiology* / Q000517:prevention & control*; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008337:Mandibular Fractures / Q000150:complications* / Q000601:surgery*; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: dento-alveolar trauma; root resorption; treatment