Advanced Education in General Dentistry

Contents
Catalog Links
Share

Literature Review Abstract Example

February 5, 2004 Dr. Leider

Zadic, D., Chosack, A., and Eidleman, E.: The prognosis of traumatized permanent anterior teeth with fracture of the enamel and dentin. Oral Surg., 47:173-175, Feb. 1979

Problem: diagnosis and treatment of traumatized anterior teeth has not been completely studied.

Purpose: the purpose of this study was to examine the diagnostic and prognostic value of vitality tests in teeth which had suffered fracture of the enamel and dentin without pulp exposure, and to determine the recommended time intervals for follow-up examinations.

Method and Materials: eighty-four children aged 6 to 14 years with 123 traumatized teeth were examined within 10 days after trauma. The tests included vitality tests with ethyl chloride, electric pulp test, percussion, and periapical radiographs. The teeth were examined every week during the first three months, then at three month intervals for two years.

Results: of the 123 teeth examined, 109 gave a positive response to vitality tests, initially. Of these 109 teeth, 71 remained vital through the two years, and 32 remained vital during the one year they were followed. Of the other 6 teeth, three tested non-vital at 3 months and remained non-vital, and the other three became non-vital and showed other signs of pulpal degeneration and underwent root canal therapy at 12 months, 14 months, and 2 years. At the initial exam, 14 teeth did not respond to the vitality tests. Of these, 5 became positive within three months, 7 underwent root canal therapy within 4 months, and 2 teeth at 2 years.

Conclusion:

  1. Most teeth with fractures of the enamel and dentin which were vital immediately after the trauma, remained vital.
  2. Some teeth that test vital initially will develop pathologic changes and should be examined at 3 months, then every 6 months.
  3. If the initial pulpal response is negative the prognosis is unfavorable. Frequent examinations in the first three months are indicated during which time a positive response will be received or more usually root canal therapy will be done.
  4. Root canal therapy is indicated in any tooth which has not regained vitality after 6 months.

Comment: Because this study is a clinical study, I think it has direct application to our own experiences in the clinic. While the prognosis is not always clear-cut, the article does at least give some general guidelines on what to expect.