Complete permanent tooth avulsion – current therapy concept and prognosis

Abstract

Complete permanent tooth avulsion is trauma relating both to teeth not fully developed and the mature ones. The aetiology may vary, but usually it does not determine the choice of treatment method. The current concept of avulsed permanent teeth is based entirely on the decision on the expediency of tooth replantation and its possibly swift performance, as long as there are indications for it. This is aimed at maintaining the tooth in the oral cavity for as long as possible, or as long as it takes to start the further stages of the treatment. It is important to determine the exact time of injury and to establish whether any first-aid operations in the mouth were performed and what they were. The course of action in the dental office depends on the time the tooth spent outside the socket, its maturity and the environment in which the tooth was stored. The role of the dental practitioner, in addition to the professional treatment of the injuries which have already occurred, consists in the prevention, education and the promotion of appropriate attitudes in the patients. In complete avulsion, the prognosis is strictly dependent on these factors and the occurrence of complications is often associated with late treatment initiation or lack of knowledge among the persons present at the injury with respect to the way in which an avulsed tooth should be handled. In order to promote the appropriate behaviour in the society, the International Association of Dental Traumatology (IADT) provides recommendations for patients concerning trauma to the teeth via its website, posters and a mobile application.