Saturday 25 February 2012

International Association of Dental Traumatology guidelines for management of Avulsed tooth


Radiographic examination recommended 
• 90 - horizontal angle, with central beam through the tooth in question;
• Occlusal view;
• Lateral view from the mesial or distal aspect of the tooth in question.

Treatment guidelines for avulsed permanent teeth with CLOSED APEX and extraoral dry time is less than60 min

If tooth has been replanted prior to the patient arriving at the dental office or clinic
• Administer systemic antibiotics. Doxcycline 1st coice
• Apply a flexible splint for up to 2 weeks.
• Initiate root canal treatment 7–10 days after replantation and before splint removal
If tooth has been kept in special storage media
• Clean with saline remove coagulum from socket , administer doxycycline,
• Rest same as above

Treatment guidelines for avulsed permanent teeth with CLOSED APEX and extraoral dry time is longer than 60 min

• Remove attached necrotic soft tissue with gauze.
• Root canal treatment can be done on the tooth prior to replantation, or it can be done 7–10 days
• Immerse the tooth in a 2% sodium fluoride solution for 20 min
• Stabilize the tooth a using a flexible splint.

Treatment guidelines for avulsed permanent teeth with OPEN APEX and extraoral time less than 60 min

If tooth has already been replanted prior to the patient arriving in the dental office or clinic.
• Clean the area with water spray, saline or chlorhexidine. Do not extract the tooth
• Administer systemic antibiotics- Penicillin V
• Apply a flexible splint for up to 2 weeks.
• The goal for replanting still-developing (immature) teeth in children is to allow for possible revascularization of the tooth pulp.

The tooth has been kept in special storage media
• Clean with saline remove coagulum from socket
• If available, cover the root surface with minocycline hydrochloride microspheres (Arestin) before replanting the tooth.
• Rest same as above

Treatment guidelines for avulsed permanent teeth with OPEN APEX and extraoral time dry time longer than 60 min
• Root canal treatment can be done on the tooth prior to replantation through the open apex.
• Immerse the tooth in a 2% sodium fluoride solution for 20 min
• Reimplant it and monitor

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