Document Detail


Adverse outcomes of dental trauma splinting as related to displacement injury and pulpal blood flow level.
MedLine Citation:
PMID:  18173662     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Splinting of traumatically displaced permanent teeth has been described as an effective modality in the treatment of patients with dental injuries. The purpose of this study was to (i) investigate whether dental injury diagnosis may predict adverse outcomes occurring 96 weeks after splint removal, and (ii) evaluate whether the severity of adverse outcome is related to laser Doppler flowmetry (LDF) measurements of pulpal blood flow (PBF). In 206 trauma patients, 273 permanent maxillary incisors treated by repositioning and splinting, and the respective contralateral homologous control teeth were investigated clinically and radiographically, and by LDF to assess local PBF values. Dental displacement injuries were classified as grade I (subluxation), grade II (lateral or extrusive luxation) and grade III (avulsion or intrusive luxation). Outcomes were classified as 'absence of loss of sensitivity, periapical radiolucency, and/or grey discolouration of crown', type I (loss of sensitivity), type II (loss of sensitivity and periapical radiolucency or grey discoloration of crown) and type III (loss of sensitivity, periapical radiolucency and grey discoloration of crown). An adverse outcome was defined as the presence of 'periapical radiolucency and/or grey discoloration'. A multiple logistic regression analysis was used to compute the odds ratio (OR) for dental displacement injury for adverse outcome (n = 69) vs non-adverse outcome (n = 168). An ordinal stepwise regresssion was completed to assess the degree of association between PBF measurements and outcome groups. Significant increase in risk of an adverse outcome occurred with a grade II dental displacement injury (OR 14.3) (P = 0.000) and a grade III dental displacement injury (OR 19.9) (P = 0.000). PBF measurements that were significantly associated with more severe outcome were PBF levels of < or =3 perfusion units (PU) (OR 399.4) (P = 0.000), those of >3 PU and < or =6 PU (OR 100.5) (P = 0.000), and those of >6 PU and < or =9PU (OR 6.2) (P = 0.000). Diagnoses of displaced teeth predicted dental injury patients who went on to show adverse treatment outcomes of splinting. PBF measurements were related to the severity of adverse outcome.
Authors:
R Emshoff; I Moschen; H Strobl
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Dental traumatology : official publication of International Association for Dental Traumatology     Volume:  24     ISSN:  1600-4469     ISO Abbreviation:  Dent Traumatol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-04     Completed Date:  2008-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101091305     Medline TA:  Dent Traumatol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  32-7     Citation Subset:  D    
Affiliation:
Department of Oral and Maxillo-Facial Surgery, University of Innsbruck, Innsbruck, Austria. ruediger_emshoff@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Dental Bonding / methods
Dental Pulp / blood supply*
Dental Pulp Diseases / etiology
Female
Follow-Up Studies
Forecasting
Humans
Incisor / blood supply,  injuries*
Laser-Doppler Flowmetry
Male
Maxilla
Middle Aged
Orthodontic Wires
Periapical Diseases / etiology
Regional Blood Flow / physiology
Risk Factors
Splints*
Tooth Avulsion / classification,  pathology,  therapy*
Tooth Discoloration / etiology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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