Interventions for treating traumatised permanent front teeth: Avulsed (knocked out) and replanted

Abstract

Traumatic dental injuries are common. One of the most severe injuries is when a permanent tooth is knocked completely out of the mouth (avulsed). Inmost circumstances the tooth should be replanted as quickly as possible. There is uncertainty on which interventions will maximise the survival and repair of the replanted tooth. This is an update of a Cochrane Review first published in 2010. Objectives To compare the effects of a range of interventions for managing traumatised permanent front teeth with avulsion injuries. Search methods Cochrane Oral Healths Information Specialist searched the following databases: Cochrane Oral Healths Trials Register (to 8 March 2018), Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 2) in the Cochrane Library (searched 8March 2018), MEDLINE Ovid (1946 to 8March 2018), and Embase Ovid (1980 to 8March 2018). The US National Institutes of HealthOngoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria We considered randomised and quasi-randomised controlled trials that included a minimum follow-up period of 12 months, for interventions for avulsed and replanted permanent front teeth. Data collection and analysis Two review authors independently selected studies, extracted data and assessed the risk of bias. Authors were contacted where further information about their study was required. Main results Four studies, involving a total of 183 participants and 257 teeth were identified. Each of the interventions aimed to reduce infection or alter the inflammatory response or both at the time of or shortly after the tooth or teeth were replanted. Each study assessed a different intervention and therefore it was not appropriate or possible to numerically synthesise the data. All evidence was rated as being of very.