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Factors affecting the timing of pulp extirpation in a sample of 66 replanted avulsed teeth in children and adolescents


Dr C Stewart, Lecturer/Specialist in Paediatric Dentistry, Oral Health and Development, Cork University Dental School and Hospital, Wilton, Cork, Ireland
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Abstract –  The management of 66 replanted avulsed permanent teeth in 46 patients over a 4-year period was studied. Treatment was compared with the recommendations in published guidelines for the management of avulsed permanent teeth. For total extra-alveolar times longer than 45 min, the pulps were extirpated in 96% of teeth. Extra-alveolar times longer than 45 min were associated with earlier pulp extirpation (median 16 days) compared with teeth with shorter extra-alveolar times (median 25 days). Endodontic treatment was postponed in teeth with open apices (median 27 days) compared with closed apices (median 15 days). Teeth in which pulps were removed within 10 days post-trauma had a lower prevalence of inflammatory root resorption compared with teeth in which pulps were removed later. Where inflammatory root resorption did occur, onset was significantly delayed when the pulp had been removed within the first 10 days. This study indicates that clinicians are following the guidelines in key areas of endodontic management of traumatized incisors resulting in more favourable outcomes.

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