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Guidelines for the Evaluation and Management
of Traumatic Dental Injuries
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MT Flores, JO Andreasen, LK Bakland
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Contributors:
B Feiglin, JL Gutmann, K Oikarinen, TR Pitt Ford, A Sigurdsson, M Trope, F.M. Andreasen.
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Or select specific guideline schematic to view:
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Treatment guidelines for tooth and /or bone fractures
in the permanent dentition
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| (2) |
Treatment guidelines for luxated permanent teeth |
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Treatment guidelines for avulsed permanent teeth |
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Follow-up procedures for traumatized permanent teeth |
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Treatment guidelines for tooth and/or bone fractures
in the primary dentition |
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Treatment guidelines for luxated and avulsed primary teeth |
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Follow-up for acute dental trauma - primary dentition |
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Introduction
Epidemiological studies reveal that one out of two children sustained a dental injury, most often between ages 8 and 12. Crown fracture is the most frequent type of trauma, generally resulting from accidents, sport activities, or violence. In most dental trauma, a rapid and appropriate treatment can lessen its impact from both an oral health and a aesthetic standpoint.
New technology and an improved understanding of the inflammatory process have led to a more conservative approach in managing dental trauma. The International Association of Dental Traumatology (IADT), conscious of the variation in the treatment of dental trauma has developed these guidelines as a type of consensus statements. These guidelines reflect much thoughtful discussion among members of the IADT as well as a detailed review of international dental literature. In cases in which the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members.
Guidelines are needed to assist dentists as well as other health care professionals in delivering the best care possible in the most efficient manner. It is very important to promote public awareness and to educate the population at greatest risk for dental injury. Therefore, this report includes basic information on both prevention and first aid. The correct application of these techniques immediately following the trauma should improve short and long-term outcome.
Because the management of injuries to the primary dentition differs significantly from that in the permanent dentition , the following guidelines apply only to cases where permanent teeth are involved; separate guidelines will be developed for children with primary dentition. In addition, these guidelines do not address issues relating to the diagnosis and treatment of major facial trauma of the bone and soft tissue, which is a critical first step in the overall management of trauma patients. The evaluation and treatment of maxillofacial trauma which may coexist with dental trauma, goes beyond the scope of these recommendations.
Classification of Diagnosis and Therapy (*)
The classifications listed below summarize diagnostics steps and therapeutic interventions and will be referenced throughout the guidelines.
x Conditions for which there is evidence and/or general agreement that a given procedure or treatment is beneficial, useful, and effective.
xx Conditions for which there is conflicting evidence and/or a divergence opinion about the usefulness/efficacy of a procedure or treatment.
xxx Conditions for which there is evidence and/or general agreement that a procedure/treatment is not useful/effective and in some cases may be harmful.
(*) Ryan et al. ACC/AHA guidelines for the management of patients with acute miocardial infarction
General References
Andreasen JO, Andreasen FM, Bakland LK, Flores MT: Traumatic dental injuries. a Manual. Copenhaguen, Munksgaard, 1999.
Andreasen JO, Andreasen FM. Textbook and color atlas of traumatic injuries to the teeth. Third Edition.
Copenhaguen, Munksgaard, 1994.
Cvek, M. Endodontic management of traumatized teeth. In: Andreasen JO, Andreasen FM. Textbook and color atlas of traumatic injuries to the teeth.
Third Edition. Copenhaguen, Munksgaard, 1994.
Ryan TJ, Anderson JL, Antman EM, Brannif BA, Brooks NH, Califf RM, Hillis LD, Hizatzjka LF, Rapapport E, Riegell BJ, Russelll RO, Smith EE III, Weaver WD. ACC/AHA guidelines for the management of patients with acute miocardiaal infarction: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Management of Myocardial Infarction). J Amer Coll Cardiol 1996: 28:1328-1428
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Contributors
J.O. ANDREASEN, DDS, ODONT DR. H.C., F.R.C.S.
Department of Oral and Maxillofacial Surgery
University Hospital (Rigshospitalet)
Copenhagen
Denmark
L.K.BAKLAND, DDS
Diplomate, American Board of Endodontics
Professor and Chairman
Department of Endodontics
Associate Dean, Advanced education
School of Dentistry, Loma Linda University
Loma Linda, California
USA
M.T. FLORES, DDS
Professor of Pediatric Dentistry
Graduate Dental Faculty
University of Valparaiso
Valparaiso
Chile
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