Clinical update quiz

The clinical update online is a free member service providing up to 11 FREE CPD hours per year.

Each month, the clinical update is published online and in the Victorian Dentist. There are 11 clinical updates per year, corresponding with the distribution of the Victorian Dentist from February to December. This service is available to ADAVB and ADATas members only. Members can log in to view and answer the clinical update questions. If you answer at least eight out of 10 questions correctly, you will receive one hour of scientific CPD.

Please note: Each new clinical update will be available from the first business day of each month.

Implant treatment after traumatic tooth loss: A systematic review.

Petersen FN, Jensen SS, Dahl M. Dental Traumatology. 2022; 00:1-12 DOI: 10.1111/edt.12730 

Compiled by Dr Sarah Chin

Introduction

Maxillary central incisors are the teeth most frequently exposed to traumatic dental injuries (TDI). TDI is most common in children aged between eight to twelve years and is affected by factors such as sports, class II div I incisal relationship, short facial profile, low socioeconomic status and not having orthodontic treatment.  Trauma involving intrusion and avulsion is a higher risk for ankylosis related replacement (0.5-2.0%) and inflammatory resorption (0.5-3.0%). When a tooth affected by TDI cannot be saved, replacement options include orthodontic space closure, autotransplantation, a resin-bonded bridge or a tooth or implant supported fixed dental prosthesis.

Implant treatment is a reliable method to replace teeth and avoids relying on sound adjacent teeth but there are technical risks, biological and aesthetic complications associated with implant treatment. Patient health, cost effectiveness and the different surgical procedures need to be considered. Dental implant treatment is contraindicated until growth has completed due to the risk of infraposition. Teeth that have undergone trauma may be preserved and monitored until there are signs of pathology and this is addressed appropriately. Where a tooth cannot be preserved, bonded retainers, and a removable prosthesis can be used. Orthodontic treatment should be considered to increase or decrease the space and timed relative to the implant treatment.

When an anterior tooth is extracted, the bone undergoes resorption due to the high proportion of bundle bone in the buccal plate and TDI may also affect the alveolar hard and soft tissues. Studies have shown that 75% of implants placed in the anterior maxilla required bone augmentation. Soft tissue augmentation may be required due to loss of gingival tissues. No studies have reported on the frequency of soft tissue augmentation when placing implants. The aim of this study was to review the outcome of dental implants after traumatic tooth loss.

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