Permanent Tooth Avulsion Injuries
Tooth avulsion is the most extreme form of tooth luxation where the tooth is completely displaced out of the socket. This injury is considered one of the few true dental emergencies because the timing of treatment has such a dramatic effect on the prognosis of the avulsed tooth.
Avulsion of one or more teeth is a relatively uncommon injury. Frequently, the tooth avulsion is only one part of the overall trauma. Because both the pulp and periodontium are injured when a tooth is avulsed, the management needs to focus on both of these cell types. Immediate replantation at the site of the trauma is the ideal first step. Unfortunately, this does not always happen. Placing the tooth in appropriate transport media and getting the child to the dentist as quickly as possible is the next best way to manage this injury. Since this type of injury doesn’t happen very frequently, having a trauma kit on hand and having the guidelines readily available are important for the long-term survival of the tooth.
KeywordsDental trauma Adolescent Permanent teeth Avulsion Pulp regeneration Pulp therapy Trauma guidelines
- 1.Andreasen JO, Andreasen FM, Tsilingaridis G. Avulsions. In: Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth. 5th ed. Hoboken: Wiley-Blackwell; 2019. p. 486–528.Google Scholar
- 2.Ziegler AM. Analysis of a comprehensive dental trauma database: an epidemiologic study of traumatic dental injuries to the permanent dentition. Dissertation, The Ohio State University; 2014.Google Scholar
- 7.Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, Kenny DJ, Sigurdsson A, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Tsukiboshi M. Guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2012;28:88–96.CrossRefGoogle Scholar
- 8.Trope M, Barnett F, Sigurdsson A, Chivian N. The role of endodontics after dental traumatic injuries. In: Hargreaves KM, Berman LH, editors. Cohen’s pathways of the pulp. 11th ed. St. Louis: Elsevier; 2016. p. 758–92.Google Scholar
- 9.Malmgren B, Malmgren O, Andersson L. Dentoalveolar ankylosis, decoronation and alveolar bone preservation. In: Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth. 5th ed. Hoboken: Wiley-Blackwell; 2019. p. 834–52.Google Scholar
- 10.Cully M, Cully J, Nietrt PJ, Titus MO. Physician confidence in dental trauma treatment and the introduction of a dental trauma decision-making pathway for the Pediatric Emergency Department. Pediatr Emerg Care. 2018; https://doi.org/10.1097/PEC.0000000000001479. [Epub ahead of print].
- 14.Andreasen JO, editor. The dental trauma guide. San Diego: International Association of Dental Traumatology; 2012.Google Scholar
- 16.Andreasen JO, Andersson L, Tsukiboshi M, Czochrowska EM. Autotransplantation of teeth to the anterior region. In: Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth. 5th ed. Hoboken: Wiley-Blackwell; 2019. p. 853–77.Google Scholar