Trauma to the upper front teeth of children and young adults is relatively common. The aim of this Cochrane review was to assess the effects of interventions for treating displaced luxated permanent teeth.
Searches of the Medline, Cochrane Oral Health Group’s Trials Register the Cochrane Central Register of Controlled Trials (CENTRAL), Embase and Lilacs databases were undertaken. Dissertations, Theses and Abstracts were searched together with reference lists from articles. There were no language restrictions.
The authors planned to include randomised or quasi-randomised controlled trials of treatment interventions for displaced luxated permanent front teeth. Included trials had to have a minimum follow-up period of 12 months.
Of the 548 articles identified only 6 potentially met the inclusion criteria. However, no randomised or quasi-randomised controlled trials were found.
The authors concluded
We found no randomised or quasi-randomised trials of interventions to treat displaced luxated permanent front teeth. Current clinical guidelines are based on available information from case series studies and expert opinions. Randomised controlled trials in this area of dental trauma are required to robustly identify the benefits of different treatment strategies
Comment
The authors were looking for information in order to answer a number of questions relating to:-
- Types of antibiotics: the effect of using no antibiotics, a placebo or different types of antibiotics.
- Types and duration of fixation: the effect of using no splint or different types of splints and their duration.
- Types of dental repositioning: to compare spontaneous re-eruption, orthodontic repositioning or surgical repositioning.
- Types of root canal medicaments: this was compared with no medicaments, placebo and different types of medicaments.
In their discussion, while calling for more robust studies they point to some of the challenges relating to conducting studies in this area.
While we wait on more robust evidence, the Dental Trauma Guide provided a good on-line summary for the treatment and management of a range of dental trauma injuries based on current guidelines.
Links
Belmonte FM, Macedo CR, Day PF, Saconato H, Fernandes Moça Trevisani V. Interventions for treating traumatised permanent front teeth: luxated (dislodged) teeth. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD006203. DOI: 10.1002/14651858.CD006203.pub2.
