Knowledge (XXG)

Dental avulsion

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vitality of the periodontal ligament. In 1980, Blomlof showed that storing the periodontal ligament cells in a biocompatible medium could extend the extra oral time to four hours or more. He found that the best storage medium was a medical research fluid called Hank's Balanced Solution. In this study, it was serendipitously discovered that milk could also maintain cell viability for two hours. In 1981, Andreasen showed that crushing of cells on the tooth root could cause death of the cells and lead to resorption and reduction in prognosis. In 1983, Matsson et al. showed that soaking in Hank's Balanced Solution for thirty minutes prior to reimplantation could revitalize extracted dog's teeth that were dry for 60 minutes. In 1989, a systematic storage device was developed to optimally store and preserve knocked out teeth. In 1992, Trope et al. showed that extracted dog's teeth could be stored in Hank's Balanced Solution for up to 96 hours and still maintain significant vitality. In this study, milk was only able to maintain vitality for two hours.
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to remove debris must be avoided. When placed in a physiologic solution, the tooth should be gently agitated to permit the cleansing of the tooth root. At the same time that this agitation occurs, the bumping of the tooth root against a hard surface such as glass, plastic or even cardboard must also be avoided. For the same reasons, the method in which the knocked-out teeth are transported must be carefully selected. Placing the knocked-out teeth by transporting in tissues and handkerchiefs can be damaging and transporting them in glass or cardboard containers can also be potentially damaging to the cells. In addition to the potential damage that the hard surface can cause, glass containers have the added possibility of breakage or leakage of the physiologic storage fluid. If the glass container does not have a tightly fitting top, then during the transportation, the physiologic storage solution can spill out and the teeth can fall, once again, on the floor and, at the same time, be out of a physiologic environment.
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normal blood supply is cut off and within 15 minutes most of the stored metabolites have been depleted and the cells will begin to die. Within one to two hours, enough cells will die that rejection of the tooth by the body at a later time is the usual outcome. The method by which the body rejects the replanted tooth is a process called "replacement root resorption". During this process, the tooth root cells become necrotic (dead) and will activate the immunologic mechanism of the body to attempt to remove this necrotic layer and literally eats away the tooth root. This is called "root resorption". It is a slow, but non-painful, process that is sometimes not observed by
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content, provides an optimal environment that supports the survival of PDL cells during the critical period before replantation. Research indicates that the type of milk (e.g., whole, skimmed, or low-fat) can play a role in the preservation efficacy, with whole milk often recommended for its balanced nutrient composition. However, any readily available milk can serve as an effective temporary storage medium, making it a practical choice in emergency situations.
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preventing resorption. Storage media serve the critical role of maintaining cell viability by providing an environment with suitable pH, osmolality, and nutrient content, thereby sustaining cell health until the tooth can be properly replanted. The International Association of Dental Traumatology (IADT) guidelines stress the importance of minimizing the tooth's dry time and choosing an effective storage medium to enhance replantation success.
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ligament will reattach, and the tooth can be maintained in its socket. The torn ligament that stays on the socket wall, since it remains connected to the bone and blood supply, is naturally kept alive. However, the ligament cells that remain on the tooth root lose their blood and nutrition supply and must be artificially maintained. They must be protected from two potentially destructive processes: cell crushing and loss of normal
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ongoing research continues to explore the viability of other natural and synthetic substances as potential storage media. The exploration into these alternatives aims to identify solutions that might offer practical benefits similar to or better than those provided by milk, especially in scenarios where milk may not be immediately available.
36: 555:. It is important for laypersons who are related to children, working, or witnessing sports that they be educated on this subject matter. Being educated could aid in minimizing injuries that could do further harm to the victim. Being informed and spreading awareness of dental avulsion, its treatment, and prevention could make an impact. 292:
to other unaffected teeth for a maximum of two weeks for teeth. Properly handled, even replantation of periodontally compromised permanent teeth in older patients under good maintenance have been reported, with splinting extending for over 4 weeks due to the reduced support structure for the root due to
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also reported replanting knocked out teeth. Wigoper in 1933 used a cast gold splint to hold reimplanted teeth in place. In 1959, Lenstrup and Skieller declared that the success rate of replanted knocked out teeth should be considered a temporary procedure because the success rate of less than 10% was
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PDL healing is the primary outcome measure when assessing interventions for tooth avulsion. When the healing of the PDL is unfavorable it means that there is no longer protection for the root from the surrounding alveolar bone. The bone that surrounds the tooth is continually undergoing physiological
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When teeth are knocked out, they end up on an artificial surface: the floor, the ground or material such as carpeting. If the surface is hard, the tooth root cells will be traumatized. Since the cells remaining on the tooth root are very delicate, additional trauma to the PDL cells must be avoided so
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When a patient arrives at the dentist they should be seen immediately. If the tooth has not been placed in a suitable storage medium, the dentist will do this first. A thorough extra-oral and intra-oral examination should be performed. The clinician should consider the age of the patient, the history
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associated with them. If immediate replantation is not possible, the teeth should be placed in an appropriate storage solution and brought to a dentist who can then replant them. The dentist will clean the socket, wash the teeth if necessary, and replant them into their sockets. S/he will splint them
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advise that the best treatment for an avulsed tooth is immediate replantation, for a variety of reasons this can be difficult for the layperson. The teeth are often covered with debris. This debris must be washed off with a physiological solution and not scrubbed. Often multiple teeth are knocked-out
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on the crown. Finger pressure on the tooth root cells will cause cell crushing. Any attempt to clean off any debris should be avoided. Debris should always be washed off gently with, at the very least, a physiologic saline. Even with the use of a physiologic saline, the "scrubbing" of the tooth root
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Avulsed permanent teeth however may be replanted, i.e., returned to the socket. Immediate replantation is considered ideal, but this may not be possible if the patient suffered other serious injuries. If properly preserved, teeth may be replanted up to one hour after avulsion. The success of delayed
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In cases where immediate replantation is not feasible, selecting an appropriate storage medium to preserve the viability of the periodontal ligament (PDL) cells becomes paramount. These cells are essential for the successful reintegration of the tooth into its socket, aiding the healing process and
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Immediate replantation, where the tooth is quickly reinserted into its socket, is the best course of action to preserve the tooth's viability and function. However, due to various factors such as the condition of the avulsed tooth, patient circumstances, or delay in accessing dental care, immediate
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Normally metabolizing tooth root cells have an internal cell pressure (osmolality) of 280–300 mOs and a pH of 7.2. When there is an uninterrupted blood supply, all of the metabolites (calcium, phosphate, potassium) and glucose that the cells require are provided. When the tooth is knocked out, this
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Stabilize the tooth for 2 weeks using a passive and flexible wire (0.016” or 0.4 mm. Alternatively composite, nylon fishing line can be used to create a flexible splint. If associated with alveolar fracture a more rigid splint may be placed for up to 4 weeks. Systemic antibiotic therapy may be
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for several weeks. Failure to re-plant the avulsed tooth within the first 40 minutes after the injury may result in a less favorable prognosis for the tooth. If the tooth cannot be immediately replaced in its socket, follow the directions for any knocked-out (avulsed) teeth kit, or place it in cold
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are not replanted because of the risk of damaging the developing permanent tooth germ. Pulp necrosis with draining fistula, crown discoloration and external root resorption are reported consequences of primary tooth replantation. Tooth dilaceration, impaction and deviation from proper eruption path
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The results of replanting permanent incisor teeth can be divided into short, medium and long-term survival of the tooth. If the tooth is replanted it acts in the short term to maintain space, maintain bone and provide good to excellent aesthetics. If unfavorable healing has occurred, the tooth can
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Saline solution and pure water are discouraged due to their lack of essential nutrients and hypotonic nature, respectively, which can lead to decreased viability of PDL cells. Other alternatives like coconut water, egg white, and various probiotic solutions have shown mixed effectiveness. However,
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Despite their wide availability, the use of mouthguards is relatively uncommon. Many people do not use them even in situations that carry a high risk of dental injury, or when their use is mandated. In addition, mouthguards may be dislodged from the wearer's mouth, leaving the teeth unprotected.
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Such tooth avulsion was the intentional removal of one or more teeth, which was done for ritual or aesthetic reasons. It was also used to denote group affiliation. Typically, the maxillary incisors were the teeth most often selected for removal. This practice is still common in parts of Africa.
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Hank's Balanced Salt Solution (HBSS) is a medically formulated solution containing essential nutrients designed to preserve avulsed teeth until they can be replanted. HBSS is distinguished by its balanced pH and osmolality, closely simulating the natural conditions necessary for the survival of
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Universally considered the most preferred storage medium for avulsed teeth, milk's effectiveness is attributed to its pH level and osmolality, which closely resemble the natural conditions necessary for sustaining PDL cell viability. Milk's widespread availability, combined with its nutritional
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Additionally, the choice of treatment is closely related to the maturity of the root (open or closed apex) and the condition of the PDL cells, which is dependent on the time out of the mouth and the storage medium used. Minimizing the dry time is crucial for the survival of the PDL cells, with
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Every tooth is connected to its surrounding bone by the periodontal ligament. The tooth receives its nourishment through this ligament. When a tooth is knocked out, this ligament is stretched and torn. If the torn periodontal ligament can be kept alive, the tooth can be replanted, and the
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following reimplantation was necessary to prevent resorption of the tooth root. In 1974, Cvek showed that storage of knocked out teeth in saline could improve the success of replanted teeth. In 1977, Lindskog et al. showed that the key to retention of the knocked-out teeth was to maintain the
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Despite its effectiveness, HBSS is not as commonly available for immediate use as household items like milk, which poses a challenge in emergency dental care situations. However, it remains highly recommended in dental trauma care, especially in commercial preparations tailored for dental
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Fouad, Ashraf F.; Abbott, Paul V.; Tsilingaridis, Georgios; Cohenca, Nestor; Lauridsen, Eva; Bourguignon, Cecilia; O'Connell, Anne; Flores, Marie Therese; Day, Peter F.; Hicks, Lamar; Andreasen, Jens Ove; Cehreli, Zafer C.; Harlamb, Stephen; Kahler, Bill; Oginni, Adeleke (2020-06-13).
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last into the medium term for 2-10+ years depending on the speed of bone turnover. Long-term survival of the tooth only happens when favorable healing of the periodontal ligament has occurred. If this happens the tooth can be estimated to survive as long as any other tooth
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of the tooth. Replantation of the tooth within 15 minutes is associated with the best prognosis as periodontal ligament (PDL) cells are still viable.  Total extra-oral dry time of more than 60 minutes, regardless of storage media, has poor prognosis. The avulsed
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on the crown, not the root. Wash the root surface with saline, be careful not to scrub the root surface, as this may crush the delicate cells. Any stubborn debris can be removed by agitating it in the storage medium or by rinsing under a stream of saline.
521:. Dental avulsion is a type of dental trauma, and the prevalence of dental trauma is estimated at 17.5% and varies with geographical area. Although dental trauma is relatively low, dental avulsion is the fourth most prevalent type of dental trauma. 468:
Despite the treatment provided, dental avulsion carries one of the poorest outcomes with 73–96% of the replanted teeth eventually being lost. There are three main factors which significantly influence the prognosis of the tooth. These include:
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emergencies. These preparations are specifically designed to replenish lost metabolites, providing an optimal environment for the temporary storage of avulsed teeth and significantly enhancing the prospect of successful replantation.
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Cvek M, Granath LE, Hollender L (1974). "Treatment of non-vital permanent incisors with calcium hydroxide. 3. Variation of occurrence of ankylosis of reimplanted teeth with duration of extra-alveolar period and storage environment".
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so poor. In 1966 in a retrospective study, Andreasen theorized that 90% of avulsed teeth could be successfully retained if they were replanted within the first 30 minutes of the accident. In 1974, Cvek showed that removal of the
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of the cells left on the tooth root while the tooth is out of the socket. In order to maintain this normalcy, the environment in which the teeth are stored must supply the optimum internal cell pressure, cell nutrients and pH.
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and the person will not know to which tooth socket an individual tooth belongs to. The injured victim may have other more serious injuries that require more immediate attention or injuries such as a severely lacerated bleeding
334: and whether it is in line with clinical findings. It is advisable to check the patient's tetanus status. If there is concern about non-accidental injury, then child protection procedures should be followed. 1771:
Kinirons MJ, Gregg TA, Welbury RR, Cole BO (September 2000). "Variations in the presenting and treatment features in reimplanted permanent incisors in children and their effect on the prevalence of root resorption".
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Research has shown that the critical factor for reduction of the death of the tooth root cells and the subsequent root replacement resorption following reimplantation of knocked-out teeth is maintenance of normal
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recommended. The patient should be asked to avoid contact sports, eat a soft diet, brush their teeth with a soft toothbrush after each meal, and use Chlorhexidine (0.12%) mouth rinse twice a day for 2 weeks.
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for years. Once this process starts, it is irreversible, and the tooth will eventually fall out. In growing children, this can cause bone development problems because the replacement resorption (also termed
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Borzabadi-Farahani A, Borzabadi-Farahani A, Eslamipour F (October 2010). "An investigation into the association between facial profile and maxillary incisor trauma, a clinical non-radiographic study".
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Avulsions of primary teeth are more common in young children as they learn to move independently (walk and run) and also from child abuse. Avulsed deciduous (primary) teeth should not be replanted.
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replantation depends on the survival of the cells remaining on the root surface. Storage in an environment similar to the tooth socket can protect these cells until replantation can be attempted.
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milk or saliva and take it to an emergency room or a dentist. If the mouth is sore or injured, cleansing of the wound may be necessary, along with stitches, local anesthesia, and an update of
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Recent evidence suggests oral rehydration solutions, propolis, rice water, and even cling film might also be beneficial for preserving cell viability, though further validation is needed.
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Andreasen JO, Kristerson L (2009). "The effect of limited drying or removal of the periodontal ligament. Periodontal healing after replantation of mature permanent incisors in monkeys".
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Andreasen JO (2009). "Relationship between cell damage in the periodontal ligament after replantation and subsequent development of root resorption. A time-related study in monkeys".
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Andreasen JO (February 1981). "Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys".
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Borzabadi-Farahani A, Borzabadi-Farahani A (December 2011). "The association between orthodontic treatment need and maxillary incisor trauma, a retrospective clinical study".
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Flores MT, Malmgren B, Andersson L, Andreasen JO, Bakland LK, Barnett F, Bourguignon C, DiAngelis A, Hicks L, Sigurdsson A, Trope M, Tsukiboshi M, von Arx T (August 2007).
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Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, Bourguignon C, DiAngelis A, Hicks L, Sigurdsson A, Trope M, Tsukiboshi M, von Arx T (June 2007).
124:, are associated with a higher risk of dental trauma. These conditions can be corrected by an orthodontist reducing risk of injury due to sports related activities. 487:
From a clinical perspective, assessing the condition of the PDL cells is vital, classifying the avulsed tooth into one of three groups before treatment. These include:
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Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM (April 1995). "Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing".
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Zadik Y, Levin L (February 2009). "Does a free-of-charge distribution of boil-and-bite mouthguards to young adult amateur sportsmen affect oral and facial trauma?".
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Andreasen JO, Hjorting-Hansen E (November 1966). "Replantation of teeth. I. Radiographic and clinical study of 110 human teeth replanted after accidental loss".
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Martins‐Júnior, Paulo Antônio; Franco, Felipe Augusto da Silva; de Barcelos, Ramon Valério; Marques, Leandro Silva; Ramos‐Jorge, Maria Letícia (2013-11-11).
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each year. The occurrence of dental avulsion in school aged children ranges from 0.5 to 16% of all dental trauma. Many of these teeth are knocked-out during
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Andreasen JO (1980). "A time-related study of periodontal healing and root resorption activity after replantation of mature permanent incisors in monkeys".
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Andersson L, Bodin I, Sörensen S (February 1989). "Progression of root resorption following replantation of human teeth after extended extraoral storage".
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or gum that prevent easy visualization of the socket. Pain may be severe, and the person may resist replantation of the teeth. People may, in light of
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within the socket, which could prevent the proper re-positioning of the tooth into its original position. The tooth should always be handled via the
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Lindskog S, Pierce AM, Blomlof L, Hammarstrom L (June 1985). "The role of the necrotic periodontal membrane in cementum resorption and ankylosis".
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In ancient times, ritual dental avulsion was widespread among different cultures around the world. For example, it was common during the Early
71:, such as can be caused by a fall, road traffic accident, assault, sports, or occupational injury. Typically, a tooth is held in place by the 1386:
Matsson L, Klinge B, Hallstrom H (April 1987). "Effect on periodontal healing of saline irrigation of the tooth socket before replantation".
1311: 929: 840:"International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth" 2283:
Trope M, Friedman S (October 1992). "Periodontal healing of replanted dog teeth stored in Viaspan, milk and Hank's balanced salt solution".
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Emerich K, Kaczmarek J (May 2010). "First aid for dental trauma caused by sports activities: state of knowledge, treatment and prevention".
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Andreasen JO, Hjorting-Hansen E (November 1966). "Replantation of teeth. II. Histological study of 22 replanted anterior teeth in humans".
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Newsome PR, Tran DC, Cooke MS (November 2001). "The role of the mouthguard in the prevention of sports-related dental injuries: a review".
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Dental avulsion is more prevalent in males than females. Males are three times more likely to suffer from dental avulsion than females.
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Barrett EJ, Kenny DJ (December 1997). "Survival of avulsed permanent maxillary incisors in children following delayed replantation".
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periodontal ligament (PDL) cells. The solution has demonstrated effectiveness in maintaining PDL cell viability for up to 48 hours.
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Andersson L, Bodin I (February 1990). "Avulsed human teeth replanted within 15 minutes—a long-term clinical follow-up study".
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as to avoid more cell crushing. This damage can occur while picking the tooth up and/or during transportation to the dentist.
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differs from management of permanent teeth; avulsed primary tooth should not be re-planted (to avoid damage to the permanent
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and cells. Once the tooth and mouth are clean an attempt can be made to re-plant the tooth in its original socket within the
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Pinchi, Vilma; Barbieri, Patrizia; Pradella, Francesco; Focardi, Martina; Bartolini, Viola; Norelli, Gian-Aristide (2015).
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Azami-Aghdash S, Ebadifard Azar F, Pournaghi Azar F, Rezapour A, Moradi-Joo M, Moosavi A, Ghertasi Oskouei S (2015-07-10).
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Blomlöf L (1981). "Milk and saliva as possible storage media for traumatically exarticulated teeth prior to replantation".
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should be gently but well rinsed with saline, with care taken not to damage the surface of the root which may have living
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Forsberg CM, Tedestam G (1993). "Etiological and predisposing factors related to traumatic injuries to permanent teeth".
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Krasner PR, Rankow HJ, Ehrenreich A (April 1989). "Apparatus for storing and transporting traumatically avulsed teeth".
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Casterline AC (June 1999). "Replantation of avulsed central incisor with advanced periodontal disease: a case report".
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PDL cells may be viable but compromised, stored in a medium like milk or HBSS with a dry time of less than 60 minutes;
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De Brier, Niels; O, Dorien; Borra, Vere; Singletary, Eunice M.; Zideman, David A.; De Buck, Emmy (2020-06-15).
532: 518: 1363:"Dental Update: Article search – Match list – Article: Immediate Management of Avulsion Injuries in Children" 2782: 2767: 2456: 696:
Zadik Y, Levin L (February 2009). "Oral and facial trauma among paratroopers in the Israel Defense Forces".
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should be administered to both the palatal/lingual tissues to minimize discomfort. Gentle irrigation with a
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Contact sports carry a significant risk of dental injury, which can be reduced by wearing a mouthguard or
2960: 2232:"Ankylosis of experimentally reimplanted teeth related to extra-alveolar period and storage environment" 1362: 113: 2895: 2816: 2611: 1162:
Zadik Y (December 2008). "Algorithm of first-aid management of dental trauma for medics and corpsmen".
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PDL cells are likely non-viable, with a dry time of more than 60 minutes, regardless of storage medium.
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have been reported to have occurred in permanent teeth as a result of reimplantation of primary teeth.
1975:"Prevalence of Traumatic Dental Injuries in Patients Attending University of Alberta Emergency Clinic" 2965: 2931: 2777: 1302:
Trope M, Chivian N, Sigurdsson A, Vann WF (2002). "Traumatic Injuries". In Cohen S, Burns RC (eds.).
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This classification guides dentists in prognosis and treatment decisions, though exceptions occur.
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Adnan, Samira; Lone, Maham M.; Khan, Farhan R.; Hussain, Syeda M.; Nagi, Sana E. (2018-02-06).
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Lenstrup K, Skieller V (2009). "A Follow-up Study of Teeth Replanted After Accidental Loss".
1202:"Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth" 183: 2999: 2989: 2922: 2912: 2905: 2811: 2722: 2693: 2651: 2538: 2362: 2344: 2292: 2204: 2138: 2103: 2076: 2033: 1996: 1986: 1942: 1885: 1845: 1829: 1781: 1745: 1707: 1656: 1606: 1571: 1503: 1433: 1395: 1336: 1254: 1213: 1171: 1106: 1071: 1034: 993: 954: 891: 851: 792: 753: 705: 667: 618: 586: 585:(from around 11,500 BP up to 5,000 BP) in North Africa and was occasionally observed in the 563:
The first reported cases of knocked-out teeth being replanted was by Pare in 1593. In 1706,
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for several days may provide a favorable condition for periodontal ligaments regeneration.
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remodeling. Over time, the root is gradually replaced by bone, which leads to tooth loss.
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Krasner P, Rankow HJ (May 1995). "New philosophy for the treatment of avulsed teeth".
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Research has shown that more than five million teeth are knocked-out each year in the
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Up to 25% of school-aged children and military trainees experience some kind of
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PDL cells are most likely viable, replanted immediately or within a short time;
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Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
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Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
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viability sharply declining after an extra-alveolar dry time of 30 minutes.
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The extent of damage to the periodontal ligament (PDL) at the time of injury
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The duration of time the tooth was out of its socket prior to replantation
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Bioarchaeology of the Near East, 11:76–83 (2017) Short fieldwork report.
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Recommended guidelines for the treatment of the avulsed permanent tooth
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and stops normal tooth eruption and impedes normal jaw growth.
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if the mouth was contaminated with soil. Management of injured
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Day, Peter F.; Duggal, Monty; Nazzal, Hani (5 February 2019).
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Andersson, L., Andreasen, F. M. & Andreasen, J. O., 2007.
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When a tooth is picked up, it should always be grasped by the
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Textbook and Colour Atlas of Traumatic Injuries to the Teeth.
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Biologic basis for success of replantation following avulsion
781:"Replantation of avulsed primary teeth: a systematic review" 179: 1288:. Chicago: American Association of Endodontists. 2008. 2391: 1280: 1278: 190:, and by adding encyclopedic content written from a 75:, which becomes torn when the tooth is knocked out. 3021: 2998: 2979: 2950: 2921: 2870: 2863: 2840: 2797: 2721: 2692: 2683: 2660: 2637: 2572: 2524: 2483: 2395: 1306:(8th ed.). St. Louis: Mosby. pp. 603–37. 1297: 1295: 915: 913: 42: 28: 2230:Matsson L, Andreasen J, Cvek M, Granath L (1982). 350:solution, should be performed as this removes any 1973:Alkhadra T, Preshing W, El-Bialy T (2016-06-15). 1693: 1691: 1557: 1555: 1935:Medical Journal of the Islamic Republic of Iran 1731: 1729: 1195: 1193: 1157: 1155: 2162: 2160: 1871: 1869: 1527: 1525: 1489: 1487: 1459: 1457: 1455: 1419: 1417: 691: 689: 2457: 884:International Journal of Paediatric Dentistry 785:International Journal of Paediatric Dentistry 739: 737: 735: 733: 731: 729: 727: 8: 980:Zadik Y, Jeffet U, Levin L (December 2010). 302:In addition, as recommended in all cases of 1822:The Cochrane Database of Systematic Reviews 476:The storage conditions of the avulsed tooth 437:replantation might not always be possible. 342:Prior to the beginning of the procedure, a 287:), fear handling the teeth or touching the 20:, which is the deliberate removal of teeth. 2867: 2689: 2464: 2450: 2442: 2392: 34: 25: 2366: 2348: 2000: 1990: 1946: 1849: 1258: 1217: 1038: 997: 855: 317:, a soft and cold diet, and avoidance of 210:Learn how and when to remove this message 2319:Human remains from Ali Kosh, Iran, 2017. 920:Andreasen JO (1981). "Exarticulations". 635: 226:in which prompt management affects the 171:contains content that is written like 2285:Endodontics & Dental Traumatology 2197:Endodontics & Dental Traumatology 1968: 1966: 1878:Endodontics & Dental Traumatology 1811: 1809: 1807: 1805: 1803: 1738:Endodontics & Dental Traumatology 1700:Endodontics & Dental Traumatology 1638: 1636: 1634: 1632: 1630: 1628: 1599:International Journal of Oral Surgery 1426:Endodontics & Dental Traumatology 1388:Endodontics & Dental Traumatology 1329:Endodontics & Dental Traumatology 397:Maintenance of normal cell metabolism 7: 2559:Zygomaticomaxillary complex fracture 2317:Arkadiusz Sołtysiak, Hojjat Darabi, 1916:American Association of Endodontists 1685:4th ed. Copenhagen: Wiley-Blackwell. 877: 875: 832: 830: 828: 826: 824: 822: 820: 818: 816: 814: 649: 647: 645: 643: 641: 639: 411:) attaches the tooth firmly to the 2952:Combined tibia and fibula fracture 2297:10.1111/j.1600-9657.1992.tb00240.x 2209:10.1111/j.1600-9657.1985.tb00569.x 1890:10.1111/j.1600-9657.1989.tb00335.x 1750:10.1111/j.1600-9657.1997.tb00054.x 1712:10.1111/j.1600-9657.1995.tb00464.x 1466:Swedish Dental Journal. Supplement 1438:10.1111/j.1600-9657.1990.tb00385.x 1400:10.1111/j.1600-9657.1987.tb00544.x 1341:10.1111/j.1600-9657.1999.tb00771.x 1021:Zadik Y, Levin L (December 2008). 116:characteristics, such as class II 59:is the complete displacement of a 14: 2038:10.2165/11530750-000000000-00000 1260:10.1111/j.1600-9657.2007.00627.x 1219:10.1111/j.1600-9657.2007.00605.x 1176:10.1111/j.1600-9657.2008.00649.x 1111:10.1111/j.1600-9657.2010.00920.x 959:10.1111/j.1600-9657.2008.00708.x 896:10.1046/j.0960-7439.2001.00304.x 710:10.1111/j.1600-9657.2008.00719.x 603: 160: 922:Traumatic injuries of the teeth 330:of the injury, status of tooth 136:An over-jet exceeding 4 mm 2627:Vertebral compression fracture 2131:Acta Odontologica Scandinavica 2096:Acta Odontologica Scandinavica 2069:Acta Odontologica Scandinavica 1834:10.1002/14651858.CD006542.pub3 1564:Acta Odontologica Scandinavica 1496:Acta Odontologica Scandinavica 1: 1611:10.1016/S0300-9785(81)80007-5 1076:10.1016/j.tripleo.2011.05.024 758:10.1016/S1079-2104(05)80105-2 2337:Acta Stomatologica Croatica 1992:10.2174/1874210601610010315 380:Prevention of cell crushing 3098: 2602:Craniocervical instability 1979:The Open Dentistry Journal 1040:10.7205/milmed.173.12.1185 222:Dental avulsion is a true 94: 15: 2937:Le Fort fracture of ankle 2607:Flexion teardrop fracture 2554:Le Fort fracture of skull 2258:Compendium (Newtown, Pa.) 2143:10.3109/00016356609028223 2108:10.3109/00016356609028222 2081:10.3109/00016355908993937 1576:10.3109/00016358109162254 1508:10.3109/00016358109162253 999:10.7205/MILMED-D-10-00150 33: 3077:Acquired tooth disorders 16:Not to be confused with 2783:Essex-Lopresti fracture 2713:Holstein–Lewis fracture 1786:10.1038/sj.bdj.4800740a 1367:www.dental-update.co.uk 589:(14,000 to 11,500 BP). 312:chlorhexidine gluconate 2597:Clay-shoveler fracture 2534:Basilar skull fracture 1774:British Dental Journal 1534:Swedish Dental Journal 1134:Swedish Dental Journal 2961:Trimalleolar fracture 192:neutral point of view 133:Post-normal occlusion 2966:Bimalleolar fracture 2932:Maisonneuve fracture 1304:Pathways of the Pulp 73:periodontal ligament 2617:Holdsworth fracture 2544:Mandibular fracture 2511:Pathologic fracture 2501:Greenstick fracture 2496:Chalkstick fracture 2264:(4): 232–4, 237–8. 2239:Pediatric Dentistry 1912:"Knocked Out Teeth" 1649:Dental Traumatology 1247:Dental Traumatology 1206:Dental Traumatology 1164:Dental Traumatology 1099:Dental Traumatology 947:Dental Traumatology 844:Dental Traumatology 698:Dental Traumatology 660:Dental Traumatology 298:root canal therapy. 294:periodontal disease 281:infectious diseases 184:promotional content 63:from its socket in 2896:Toddler's fracture 2737:Monteggia fracture 2622:Jefferson fracture 2612:Hangman's fracture 2350:10.15644/asc49/1/1 325:Initial assessment 247:(stabilized) by a 186:and inappropriate 3064: 3063: 3017: 3016: 2942:Bosworth fracture 2891:Gosselin fracture 2850:Duverney fracture 2793: 2792: 2662:Shoulder fracture 2582:Cervical fracture 2491:Avulsion fracture 2439: 2438: 2170:Odontologisk Revy 1661:10.1111/edt.12564 1313:978-0-323-01162-4 1027:Military Medicine 986:Military Medicine 931:978-0-7216-1249-2 857:10.1111/edt.12573 797:10.1111/ipd.12075 672:10.1111/edt.12382 533:school activities 237:periodontal fiber 220: 219: 212: 54: 53: 23:Medical condition 3089: 3000:Femoral fracture 2990:Patella fracture 2923:Fibular fracture 2913:Tillaux fracture 2906:Plafond fracture 2868: 2723:Forearm fracture 2694:Humerus fracture 2690: 2652:Sternal fracture 2539:Blowout fracture 2477:cartilage damage 2466: 2459: 2452: 2443: 2393: 2381: 2380: 2370: 2352: 2328: 2322: 2315: 2309: 2308: 2280: 2274: 2273: 2253: 2247: 2246: 2236: 2227: 2221: 2220: 2192: 2186: 2185: 2164: 2155: 2154: 2126: 2120: 2119: 2091: 2085: 2084: 2064: 2058: 2057: 2021: 2015: 2014: 2004: 1994: 1970: 1961: 1960: 1950: 1926: 1920: 1919: 1908: 1902: 1901: 1873: 1864: 1863: 1853: 1813: 1798: 1797: 1768: 1762: 1761: 1733: 1724: 1723: 1695: 1686: 1679: 1673: 1672: 1640: 1623: 1622: 1594: 1588: 1587: 1559: 1550: 1549: 1529: 1520: 1519: 1491: 1482: 1481: 1461: 1450: 1449: 1421: 1412: 1411: 1383: 1377: 1376: 1374: 1373: 1359: 1353: 1352: 1324: 1318: 1317: 1299: 1290: 1289: 1282: 1273: 1272: 1262: 1238: 1232: 1231: 1221: 1197: 1188: 1187: 1159: 1150: 1149: 1129: 1123: 1122: 1094: 1088: 1087: 1059: 1053: 1052: 1042: 1018: 1012: 1011: 1001: 977: 971: 970: 942: 936: 935: 917: 908: 907: 879: 870: 869: 859: 834: 809: 808: 776: 770: 769: 741: 722: 721: 693: 684: 683: 651: 619:Dental emergency 613: 608: 607: 606: 587:Natufian culture 344:local anesthetic 224:dental emergency 215: 208: 204: 201: 195: 173:an advertisement 164: 163: 156: 142:Incompetent lips 38: 26: 3097: 3096: 3092: 3091: 3090: 3088: 3087: 3086: 3067: 3066: 3065: 3060: 3013: 2994: 2975: 2971:Pott's fracture 2946: 2917: 2886:Segond fracture 2881:Bumper fracture 2859: 2855:Pipkin fracture 2842:Pelvic fracture 2836: 2789: 2749:Radius fracture 2717: 2679: 2656: 2633: 2592:Chance fracture 2574:Spinal fracture 2568: 2564:Zygoma fracture 2520: 2516:Spiral fracture 2479: 2470: 2440: 2435: 2434: 2404: 2390: 2385: 2384: 2330: 2329: 2325: 2316: 2312: 2282: 2281: 2277: 2255: 2254: 2250: 2234: 2229: 2228: 2224: 2194: 2193: 2189: 2166: 2165: 2158: 2128: 2127: 2123: 2093: 2092: 2088: 2066: 2065: 2061: 2026:Sports Medicine 2023: 2022: 2018: 1972: 1971: 1964: 1928: 1927: 1923: 1910: 1909: 1905: 1875: 1874: 1867: 1828:(2): CD006542. 1815: 1814: 1801: 1770: 1769: 1765: 1735: 1734: 1727: 1697: 1696: 1689: 1680: 1676: 1642: 1641: 1626: 1596: 1595: 1591: 1561: 1560: 1553: 1531: 1530: 1523: 1493: 1492: 1485: 1463: 1462: 1453: 1423: 1422: 1415: 1385: 1384: 1380: 1371: 1369: 1361: 1360: 1356: 1326: 1325: 1321: 1314: 1301: 1300: 1293: 1284: 1283: 1276: 1240: 1239: 1235: 1199: 1198: 1191: 1161: 1160: 1153: 1131: 1130: 1126: 1096: 1095: 1091: 1061: 1060: 1056: 1020: 1019: 1015: 979: 978: 974: 944: 943: 939: 932: 919: 918: 911: 881: 880: 873: 836: 835: 812: 778: 777: 773: 743: 742: 725: 695: 694: 687: 653: 652: 637: 632: 611:Medicine portal 609: 604: 602: 599: 579: 565:Pierre Fauchard 561: 539:events such as 515: 466: 434: 421:cell physiology 399: 382: 374:cell metabolism 369: 340: 338:Re-implantation 327: 233:permanent tooth 216: 205: 199: 196: 177: 165: 161: 154: 146:Mouth breathing 139:Short upper lip 130: 120:with increased 99: 93: 80:Deciduous teeth 57:Dental avulsion 29:Dental avulsion 24: 21: 18:Dental evulsion 12: 11: 5: 3095: 3093: 3085: 3084: 3079: 3069: 3068: 3062: 3061: 3059: 3058: 3053: 3048: 3043: 3038: 3033: 3027: 3025: 3019: 3018: 3015: 3014: 3012: 3011: 3005: 3003: 2996: 2995: 2993: 2992: 2986: 2984: 2977: 2976: 2974: 2973: 2968: 2963: 2957: 2955: 2948: 2947: 2945: 2944: 2939: 2934: 2928: 2926: 2919: 2918: 2916: 2915: 2910: 2909: 2908: 2901:Pilon fracture 2898: 2893: 2888: 2883: 2877: 2875: 2872:Tibia fracture 2865: 2861: 2860: 2858: 2857: 2852: 2846: 2844: 2838: 2837: 2835: 2834: 2829: 2824: 2819: 2814: 2809: 2803: 2801: 2795: 2794: 2791: 2790: 2788: 2787: 2786: 2785: 2780: 2775: 2770: 2765: 2760: 2746: 2745: 2744: 2739: 2728: 2726: 2719: 2718: 2716: 2715: 2710: 2705: 2699: 2697: 2687: 2681: 2680: 2678: 2677: 2672: 2666: 2664: 2658: 2657: 2655: 2654: 2649: 2643: 2641: 2635: 2634: 2632: 2631: 2630: 2629: 2624: 2619: 2614: 2609: 2604: 2599: 2594: 2589: 2587:Burst fracture 2578: 2576: 2570: 2569: 2567: 2566: 2561: 2556: 2551: 2549:Nasal fracture 2546: 2541: 2536: 2530: 2528: 2522: 2521: 2519: 2518: 2513: 2508: 2503: 2498: 2493: 2487: 2485: 2481: 2480: 2471: 2469: 2468: 2461: 2454: 2446: 2437: 2436: 2433: 2432: 2421: 2405: 2400: 2399: 2397: 2396:Classification 2389: 2388:External links 2386: 2383: 2382: 2323: 2310: 2275: 2248: 2222: 2187: 2156: 2137:(3): 287–306. 2121: 2086: 2075:(4): 503–509. 2059: 2016: 1962: 1921: 1903: 1865: 1799: 1763: 1725: 1687: 1674: 1655:(5): 453–476. 1624: 1589: 1551: 1521: 1483: 1451: 1413: 1378: 1354: 1319: 1312: 1291: 1274: 1253:(4): 196–202. 1233: 1189: 1170:(6): 698–701. 1151: 1124: 1089: 1054: 1033:(12): 1185–7. 1013: 992:(12): 1000–3. 972: 937: 930: 909: 890:(6): 396–404. 871: 850:(4): 331–342. 810: 771: 723: 685: 634: 633: 631: 628: 627: 626: 621: 615: 614: 598: 595: 578: 575: 560: 557: 541:contact sports 514: 511: 499: 498: 495: 492: 481: 480: 477: 474: 465: 462: 433: 430: 398: 395: 381: 378: 368: 365: 339: 336: 326: 323: 304:dental traumas 218: 217: 188:external links 168: 166: 159: 153: 150: 149: 148: 143: 140: 137: 134: 129: 126: 95:Main article: 92: 89: 52: 51: 46: 40: 39: 31: 30: 22: 13: 10: 9: 6: 4: 3: 2: 3094: 3083: 3080: 3078: 3075: 3074: 3072: 3057: 3054: 3052: 3049: 3047: 3044: 3042: 3039: 3037: 3034: 3032: 3029: 3028: 3026: 3024: 3023:Foot fracture 3020: 3010: 3007: 3006: 3004: 3001: 2997: 2991: 2988: 2987: 2985: 2982: 2981:Crus fracture 2978: 2972: 2969: 2967: 2964: 2962: 2959: 2958: 2956: 2953: 2949: 2943: 2940: 2938: 2935: 2933: 2930: 2929: 2927: 2924: 2920: 2914: 2911: 2907: 2904: 2903: 2902: 2899: 2897: 2894: 2892: 2889: 2887: 2884: 2882: 2879: 2878: 2876: 2873: 2869: 2866: 2862: 2856: 2853: 2851: 2848: 2847: 2845: 2843: 2839: 2833: 2832:Broken finger 2830: 2828: 2825: 2823: 2820: 2818: 2815: 2813: 2810: 2808: 2805: 2804: 2802: 2800: 2799:Hand fracture 2796: 2784: 2781: 2779: 2776: 2774: 2771: 2769: 2766: 2764: 2761: 2759: 2756: 2755: 2754: 2753:Distal radius 2750: 2747: 2743: 2742:Hume fracture 2740: 2738: 2735: 2734: 2733: 2732:Ulna fracture 2730: 2729: 2727: 2724: 2720: 2714: 2711: 2709: 2708:Supracondylar 2706: 2704: 2701: 2700: 2698: 2695: 2691: 2688: 2686: 2682: 2676: 2673: 2671: 2668: 2667: 2665: 2663: 2659: 2653: 2650: 2648: 2645: 2644: 2642: 2640: 2636: 2628: 2625: 2623: 2620: 2618: 2615: 2613: 2610: 2608: 2605: 2603: 2600: 2598: 2595: 2593: 2590: 2588: 2585: 2584: 2583: 2580: 2579: 2577: 2575: 2571: 2565: 2562: 2560: 2557: 2555: 2552: 2550: 2547: 2545: 2542: 2540: 2537: 2535: 2532: 2531: 2529: 2527: 2523: 2517: 2514: 2512: 2509: 2507: 2506:Open fracture 2504: 2502: 2499: 2497: 2494: 2492: 2489: 2488: 2486: 2482: 2478: 2474: 2467: 2462: 2460: 2455: 2453: 2448: 2447: 2444: 2431: 2427: 2426: 2422: 2420: 2416: 2415: 2411: 2407: 2406: 2403: 2398: 2394: 2387: 2378: 2374: 2369: 2364: 2360: 2356: 2351: 2346: 2342: 2338: 2334: 2327: 2324: 2320: 2314: 2311: 2306: 2302: 2298: 2294: 2290: 2286: 2279: 2276: 2271: 2267: 2263: 2259: 2252: 2249: 2244: 2240: 2233: 2226: 2223: 2218: 2214: 2210: 2206: 2203:(3): 96–101. 2202: 2198: 2191: 2188: 2183: 2179: 2175: 2171: 2163: 2161: 2157: 2152: 2148: 2144: 2140: 2136: 2132: 2125: 2122: 2117: 2113: 2109: 2105: 2102:(3): 263–86. 2101: 2097: 2090: 2087: 2082: 2078: 2074: 2070: 2063: 2060: 2055: 2051: 2047: 2043: 2039: 2035: 2031: 2027: 2020: 2017: 2012: 2008: 2003: 1998: 1993: 1988: 1984: 1980: 1976: 1969: 1967: 1963: 1958: 1954: 1949: 1944: 1940: 1936: 1932: 1925: 1922: 1917: 1913: 1907: 1904: 1899: 1895: 1891: 1887: 1883: 1879: 1872: 1870: 1866: 1861: 1857: 1852: 1847: 1843: 1839: 1835: 1831: 1827: 1823: 1819: 1812: 1810: 1808: 1806: 1804: 1800: 1795: 1791: 1787: 1783: 1779: 1775: 1767: 1764: 1759: 1755: 1751: 1747: 1744:(6): 269–75. 1743: 1739: 1732: 1730: 1726: 1721: 1717: 1713: 1709: 1705: 1701: 1694: 1692: 1688: 1684: 1678: 1675: 1670: 1666: 1662: 1658: 1654: 1650: 1646: 1639: 1637: 1635: 1633: 1631: 1629: 1625: 1620: 1616: 1612: 1608: 1604: 1600: 1593: 1590: 1585: 1581: 1577: 1573: 1569: 1565: 1558: 1556: 1552: 1547: 1543: 1540:(3): 101–10. 1539: 1535: 1528: 1526: 1522: 1517: 1513: 1509: 1505: 1501: 1497: 1490: 1488: 1484: 1479: 1475: 1471: 1467: 1460: 1458: 1456: 1452: 1447: 1443: 1439: 1435: 1431: 1427: 1420: 1418: 1414: 1409: 1405: 1401: 1397: 1393: 1389: 1382: 1379: 1368: 1364: 1358: 1355: 1350: 1346: 1342: 1338: 1334: 1330: 1323: 1320: 1315: 1309: 1305: 1298: 1296: 1292: 1287: 1281: 1279: 1275: 1270: 1266: 1261: 1256: 1252: 1248: 1244: 1237: 1234: 1229: 1225: 1220: 1215: 1211: 1207: 1203: 1196: 1194: 1190: 1185: 1181: 1177: 1173: 1169: 1165: 1158: 1156: 1152: 1147: 1143: 1140:(5): 183–90. 1139: 1135: 1128: 1125: 1120: 1116: 1112: 1108: 1104: 1100: 1093: 1090: 1085: 1081: 1077: 1073: 1070:(6): e75–80. 1069: 1065: 1058: 1055: 1050: 1046: 1041: 1036: 1032: 1028: 1024: 1017: 1014: 1009: 1005: 1000: 995: 991: 987: 983: 976: 973: 968: 964: 960: 956: 952: 948: 941: 938: 933: 927: 923: 916: 914: 910: 905: 901: 897: 893: 889: 885: 878: 876: 872: 867: 863: 858: 853: 849: 845: 841: 833: 831: 829: 827: 825: 823: 821: 819: 817: 815: 811: 806: 802: 798: 794: 790: 786: 782: 775: 772: 767: 763: 759: 755: 752:(5): 616–23. 751: 747: 740: 738: 736: 734: 732: 730: 728: 724: 719: 715: 711: 707: 703: 699: 692: 690: 686: 681: 677: 673: 669: 665: 661: 657: 650: 648: 646: 644: 642: 640: 636: 629: 625: 624:Dental trauma 622: 620: 617: 616: 612: 601: 596: 594: 590: 588: 584: 576: 574: 571: 566: 558: 556: 554: 550: 546: 542: 538: 534: 530: 529:dental trauma 525: 522: 520: 519:United States 512: 510: 506: 502: 496: 493: 490: 489: 488: 485: 478: 475: 472: 471: 470: 463: 461: 457: 454: 450: 446: 442: 438: 432:Storage media 431: 429: 426: 422: 416: 414: 410: 405: 396: 394: 391: 386: 379: 377: 375: 366: 364: 360: 357: 353: 349: 345: 337: 335: 333: 324: 322: 320: 316: 313: 309: 305: 300: 299: 295: 290: 286: 282: 278: 273: 268: 266: 262: 261:primary teeth 258: 255: 250: 246: 242: 241:alveolar bone 238: 234: 229: 225: 214: 211: 203: 193: 189: 185: 181: 175: 174: 169:This section 167: 158: 157: 151: 147: 144: 141: 138: 135: 132: 131: 127: 125: 123: 119: 118:malocclusions 115: 110: 106: 104: 98: 90: 88: 84: 81: 76: 74: 70: 66: 65:alveolar bone 62: 58: 50: 47: 45: 41: 37: 32: 27: 19: 3009:Hip fracture 2685:Arm fracture 2647:Rib fracture 2423: 2408: 2340: 2336: 2326: 2313: 2291:(5): 183–8. 2288: 2284: 2278: 2261: 2257: 2251: 2242: 2238: 2225: 2200: 2196: 2190: 2176:(1): 43–56. 2173: 2169: 2134: 2130: 2124: 2099: 2095: 2089: 2072: 2068: 2062: 2032:(5): 361–6. 2029: 2025: 2019: 1982: 1978: 1938: 1934: 1924: 1906: 1884:(1): 38–47. 1881: 1877: 1825: 1821: 1780:(5): 263–6. 1777: 1773: 1766: 1741: 1737: 1706:(2): 76–89. 1703: 1699: 1682: 1677: 1652: 1648: 1605:(1): 43–53. 1602: 1598: 1592: 1570:(1): 15–25. 1567: 1563: 1537: 1533: 1499: 1495: 1469: 1465: 1432:(1): 37–42. 1429: 1425: 1391: 1387: 1381: 1370:. 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91:Prevention 3082:Dentistry 3051:Calcaneal 3041:Cuneiform 2817:Bennett's 2473:Fractures 2359:0001-7019 1842:1469-493X 1669:1600-4469 866:1600-4469 805:0960-7439 680:1600-4469 464:Prognosis 409:ankylosis 332:root apex 315:mouthwash 270:Although 228:prognosis 67:owing to 49:Dentistry 44:Specialty 3031:Lisfranc 2807:Scaphoid 2778:Barton's 2758:Galeazzi 2703:Proximal 2675:Scapular 2670:Clavicle 2377:27688380 2245:: 327–9. 2054:41439700 2046:20433209 2011:27398104 1957:26793672 1860:30720860 1794:11048394 1472:: 1–26. 1349:10530158 1269:17635351 1228:17511833 1184:19021668 1119:20831636 1084:21880516 1049:19149336 1008:21265309 967:19208013 904:11759098 718:19208020 597:See also 583:Holocene 545:football 537:sporting 272:dentists 245:splinted 114:occlusal 112:Certain 2827:Busch's 2822:Boxer's 2812:Rolando 2773:Smith's 2763:Colles' 2484:General 2430:D014084 2368:4945341 2305:1302677 2270:2605601 2217:3860382 2182:4522422 2151:5225450 2116:5225449 2002:4920975 1948:4715389 1898:2598883 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Index

Dental evulsion

Specialty
Dentistry
tooth
alveolar bone
trauma
periodontal ligament
Deciduous teeth
Mouthguard
helmet
occlusal
malocclusions
overjet
Mouth breathing
an advertisement
improve it
promotional content
external links
neutral point of view
Learn how and when to remove this message
dental emergency
prognosis
permanent tooth
periodontal fiber
alveolar bone
splinted
dentist
tetanus
immunization

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