Dental trauma. Combination injuries 2. The risk of pulp necrosis in permanent teeth with subluxation injuries and concomitant crown fractures

Eva Fejerskov Lauridsen, Nuno Vibe Hermann, Thomas Alexander Gerds, Søren Steno Ahrensburg Christensen, Sven Kreiborg, Jens Ove Andreasen

34 Citationer (Scopus)

Abstract

Background: The reported risk of pulp necrosis (PN) is generally low in teeth with subluxation injuries. A concomitant crown fracture may increase the risk of PN in such teeth.
Aim: To analyze the influence of a concomitant infraction, enamel-, enamel-dentin-, or enamel-dentin-pulp fracture on the risk of PN in permanent teeth with subluxation injury.
Material and methods: The study included 404 permanent incisors with subluxation injury from 289 patients (188 males, 101 females). Furthermore, 137 teeth had suffered a concomitant crown fracture. All the teeth were examined and treated according to a standardized protocol.
Statistical analysis: The risk of PN was analyzed separately for teeth with immature and mature root development by the Kaplan-Meier method, the log-rank test and Cox regression analysis. The level of significance was set at 5%. Risk factors included in the analysis were: gender, patient age, crown fracture type, mobility, and reaction to electric pulp test (EPT) at the time of injury.
Results: Teeth with immature root development: The risk of PN was increased in teeth with a concomitant enamel fracture (log-rank test: p=0.002), enamel-dentin fracture (log-rank test: p<0.0001), enamel-dentin-pulp fracture (log-rank test: p<0.0001) and negative EPT at the time of injury (hazard ratio: 21, (95% CI: 2.5-172.5), p=0.005). Teeth with mature root development: The risk of PN was increased in teeth with an enamel-dentin fracture (hazard ratio: 12.2 (95% CI: 5.0-29.8), p<0.0001) infraction (hazard ratio: 5.1 (95% CI: 1.2-21.4) p=0.04), and negative EPT at the time of injury (hazard ratio: 8 (95% CI: 3.3-19.5), p<0.0001).
Conclusion: A concomitant crown fracture and a negative EPT at time of injury may be used to identify teeth at increased risk of PN following subluxation injury.
OriginalsprogEngelsk
TidsskriftDental Traumatology
Vol/bind28
Udgave nummer5
Sider (fra-til)371-378
Antal sider8
ISSN1600-4469
DOI
StatusUdgivet - okt. 2012

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