Contents

Contributors x Pulp-dentin regeneration after trauma 126

Preface xiii Growing teeth 129

Implant/transplant teeth 130

1 Wound Healing Subsequent to Injury 1 Essentials 130

F. GOTTRUP, S. STORGARDJENSEN & References 131

J. O. ANDREASEN

Definition 1 4 Osteoclastic Activity 137

Nature of a traumatic injury 1 S. F. LINDSKOG,C. W. DREYER,A. M. PIERCE,

Wound healing biology 1 M. TORABINEJAD & S. SHABAHANG

Dynamics of wound repair 4Osteoclast histogenesis 137

Types of wound after injury 8Osteoclast morphology 138

Tissues and compounds in wound healing 9 Odontoclast function 139Inflammatory phase mediators 13

Regulation of osteoclast activity 143Cells in wound healing 18 Identification of osteoclasts and odontoclasts 146Angiogenesis 29

Osteoclast activity in general 148Wound strength development 32 Inflammation and mediators of hard tissueRemodeling phase 35

resorption 148Microenvironnent in wounds 37 Essentials 160Factors affecting the wound healing process 39 References 160Optimizing oral wound healing 43Essentials 43References 44 5 Physical and Chemical Methods to

Optimize Pulpal and Periodontal

2 Response of Oral Tissues to Trauma 62 Healing After Traumatic Injuries 172

J. O. ANDREASEN& H. L0VSCHALLM. TROPE

Repair and regeneration of oral tissues 62 Treatment strategies 173

Developing teeth 63 General strategies 175

Teeth with developed roots 72 Fluoride pre-treatment of the root 189

Dentin-pulp complex 84 Essentials 194

Essentials 95 References 194

References 96

6 Socio-Psychological Aspects of Traumatic3 Stem Cells and Regeneration of Dental Injuries 197

Injured Dental Tissue 114 W. MARCENES & U. RYDA

H. L0VSCHALL,W. V. GIANNOBILE, Introduction 197M. J. SOMERMAN,Q. JIN & J. O. ANDREASEN

Socio-psychological impacts of trauma tic dentalIntroduction 114 injuries 198

The stem cell 114 Stages of psychological development 199

Tissue engineering 121 Implications for treatment 200

Periodontal tissue regeneration 123 Treatment plan 201

Cementum engineering 124 Talking to children 203

v

vi Contents

EssentialsReferences

7 Child Physical AbuseR. R. WELBURY

Child physical abuse - a definitionChild physical abuse - historicalaspectsPrevalence

EtiologyDiagnosisTypes of orofacial injuries in child physical abuseBruisingHuman hand marksBizarre bruisesAbrasions and lacerationsBurnsBite marksDental trauma

Eye injuriesBone fractures

Differential diagnosisThe dentist's role in the management of child

physical abuseEssentialsReferences

8 Classification, Epidemiology and EtiologyU. GLENDOR, W. MARCENES & J. O. ANDREASEN

Classification

EpidemiologyEtiologyUnintentional traumatic dental injuriesIntentional traumatic dental injuriesMechanisms of traumatic dental injuriesEssentialsReferences

9 Examination and Diagnosis of DentalInjuriesF. M. ANDREASEN,J. o. ANDREASEN&M. TSUKIBOSHI

HistoryClinical examination

Radiographic examinationEffect of treatment delayEssentialsReferences

10 Crown FracturesF. M. ANDREASEN& J. o. ANDREASEN

Terminology, frequency and etiologyClinical findingsRadiographic findingsHealing and pathologyTreatment

204 Provisional treatment of crown fractures 288205 Definitive treatment of crown fractures 288

Reattachment of the original crown fragment 290

207 Laminate veneers in the treatment of crownfractures 297

Prognosis of crown fractures 301207 Essentials 303207 References 304207208 11 Crown-Root Fractures 314208 1.o. ANDREASEN,F.M. ANDREASEN& M. TSUKIBOSHI209209 Terminology, frequency and etiology 314

209 Clinical findings 314

210 Radiographic findings 315

210 Healing and pathology 318

211 Treatment 318

211 Essentials 332

211 References 334

211212 12 Root Fractures 337

213 F. M. ANDREASEN,J. O. ANDREASEN& M. CVEK

Terminology, frequency and etiology 337213 Clinical findings 337214 Radiographic findings 338215 Healing and pathology 340

Treatment 351

217 Prognosis 358

Follow-up 358Orthodontic treatment of root fractured teeth 364

217Predictors of healing 364

223 Essentials 366228 References 367229233

13 Luxation Injuries of Permanent Teeth:235

General Findings 372243

F. M. ANDREASEN& J. O. ANDREASEN244

Terminology, frequency and etiology 372

Clinical findings 372

255 Radiographic findings 373

Healing and pathology 374

Periodontalligament (PDL) 374

Pulp 374255 Treatment 376258 Prognosis 376267 Pulp necrosis 377271 Pulp canal obliteration 385273 Root resorption 386274 Loss of marginal bone support 393

Essentials 395280 References 397

28014 Concussion and Subluxation 404

281F. M. ANDREASEN& J. O. ANDREASEN

282 Definitions 404282 Healing and pathology 404285 Concussion 404

Contents vii

Subluxation 404 18 Injuries to tbe Supporting Bone 489

Radiographic findings 404 J. O. ANDREASENTreatment 404

Terminology, frequency and etiologyFollow-up 405489

Complications 405 Clinical findings 489

Predictors for healing 409 Radiographic findings 492

Essentials 410 Pathology 495

References 410Treatment 498Fractures of the mandible or maxilla 500

Prognosis 50415 Extrusive Luxation and Lateral Luxation 411 Fractures of the mandible or maxilla in children 505F. M. ANDREASEN& J. O. ANDREASEN Fractures of the mandible or maxilla in adults 507

Definitions 411 Essentials 511

Healing and pathology 411 References 511

Clinical findings 411

Radiographic findings 411 19 Injuries to tbe Primary Dentition 516

Treatment 412 M. T. FLORES,G. HOLAN,M. BORUM&

Prognosis 415 J. O. ANDREASEN

Pulp necrosis 418 Introduction 516Pulp canal obliteration 418 Epidemiology and etiology 517Root resorption (external) 418 Clinical and radiographic findings and treatmentMarginal bone loss 418 of various injury types 523Predictors of healing 425 Fractures secondary to chin trauma 533Tooth survival 425 Complications in the primary dentition 533Essentials 426 Essentials 537References 427 References 539

16 Intrusive Luxation 428 20 Injuries to Developing Teetb 542

J. O. ANDREASEN& F.M. ANDREASEN J. O. ANDREASEN& M. T. FLORES

Definition 428 Terminology, frequency and etiology 542

Healing and pathology 428 Clinical, radiographic and pathologic findings 546

Clinical findings 428 Treatment 564

Radiographic findings 429 Essentials 569

Treatment 432 References 571

Prognosis 437

Diagnosis of healing complications 438 21 Soft Tissue Injuries 577

Predictors for healing 442 L. ANDERSSON& J. O. ANDREASEN

Essentials 442Terminology, frequency and etiology 577

References 443Types of soft tissue trauma 578

Emergency management 579

17 Avulsions 444 Wound closure materials and principIes 587

J. O. ANDREASEN& F.M. ANDREASEN Antibiotic prophylaxis 592

Tetanus prophylaxis 594Terminology, frequency and etiology 444 Essentials 594Clinical findings 444

References 595Radiographic findings 444

Healing and pathology 44422 Endodontic Management and tbe UseTreatment of the avulsed tooth 459

Prognosis 466 of Calcium Hydroxide in TraumatizedPermanent Teetb 598

Tooth loss 466M. CVEK

Pulp necrosis 466

Root resorption 470 Crown fractures with dentin exposure 598

Root development and disturbances in root growth 475 Crown fractures with pulp exposure 600

Gingival healing and loss of marginal attachment 476 Clinical evaluation of pulp healing 610

Complications due to early loss of teeth 476 Root fractures 611Essentials 478 Luxated or avulsed and replanted teeth 615References 480 Treatment of immature teeth 621

viii Contents

Timing of endodontic procedure after replantation 625 Factors influencing the survival of resin-bondedTreatment of mature teeth 632 bridges 736

External inflammatory root resorption 632 Essentials 736

Late external inflammatory root resorption 636 References 737

Root canal resorption (internal resorption) 638

Pulp necrosis following pulp canal obliteration 639 27 Autotransplantation of Teeth to theCrown malformations 643 Anterior Region 740

Discoloration of non-vital teeth 644 ]. O. ANDREASEN,L. ANDERSSON& M. TSUKIBOSHI

Essentials 645Treatment planning 740

References 647Surgical procedure 743

Orthodontic treatment of transplanted teeth 749

23 New Endodontic Procedures using Prognosis 754

Mineral Trioxide Aggregate (MTA) for Essentials 759

Teeth with Traumatic Injuries 658 References 759L. K. BAKLAND

28 Implants in the Anterior Region 761Introduction 658

]. O. ANDREASEN,]. ODMAN, C. HAMMERLE,Pulp capping and partial pulpotomy 659

D. BUSER, T. VONARX, J. ]ENSEN, S. E. NORHOLT &Apexification 662

O. SCHWARTZRoot fractures 663Essentials 666 Indications for implants in trauma patients 761

References 666 Treatment with implants in a trauma situation -when to give up? 761

24 Orthodontic Management of the Treatment planning 763

Traumatized Dentition 669 Timing of implant insertion in relation to jaw

O. MALMGREN& B. MALMGREN growth 763

Timing of implant placement following toothDiagnosis and treatment planning 669 extraction 764

Factors in treatment planning 670 Biologic and surgical aspects for implant therapyGeneral treatment principIes 675 after loss of traumatized teeth 767

Specific treatment principIes for various trauma Ideal implant position in esthetic sites 769

types 684 The concept of comfort and danger zones 770

Replanted teeth 696 To create and maintain a normal appearing gingiva 771

Prognosis 703 To create and maintain a normal appearing alveolarEssentials 709 process 771References 711 Preoperative evaluation 772

Standard insertion in single gaps with good bone25 Restoration of Traumatized Teeth with volume 773

Resin Composites 716 Surgical procedure in single tooth gaps withU.PALLESEN & ]. W.V.VAN DIJKEN doubtful bone volume 773

Horizontal augmentation 776Long-term prognosis of composite restorations 716

GBR technique: simultaneous approach 777Material considerations 718

GBR technique: staged approach 777Clinical implications 721

Rationale for the described techniques 779Critical points in the restorative procedure 721

Vertical augmentation by bone transplantation 781Essentials 726

Vertical augmentation by alveolar distractionReferences 727

osteogenesis 783

Long-term results 785

26 Resin-related Bridges and Conventional Causes and predictors of failure 785

Bridges in the Anterior Region 729 Patient satisfaction 789N. H.]. CREUGERS& C. M. KREULEN Essentials 789

Treatment planning 729 References 790

The 'dynamic treatment' concept 72929 Esthetic Considerations in Restoring

Direct resin-bonded bridges 731the Traumatized Dentition: a Biologic

Indirect resin-bonded bridges 731Approach 798

Conventional bridges 735

Prognosis of resin-bonded bridges andB. U. ZACHRISSON& S. TORESKOG

comparison with alternative prosthodontic Replacement of a missing maxillary central incisor 798

treatments 735 Orthodontic space closure treatment 798

Autotransplantation of premolarsSingle-tooth implantsFixed prostheticsReplacement of a missing maxillary lateral incisorReplacement of a canine

Replacement after loss of multiple maxillaryanterior teeth

Restoring fractured teethThe Toreskog/Myrin conceptEssentialsReferences

30 Prevention of Dental and OralInjuriesA. SIGURDSSON

Introduction

Means to prevent dental maxillofacial injuriesAppliances to prevent dental injuriesFabrication of custom mouthguardsSpecial considerations for mouthguardsCare of mouthguardsUse of mouthguards and other protective

appliances in various sports activitiesCost-benefit of impact protecting devicesOther applications for the use of mouthguardsPrevention of oral injury from traffic accidentsEssentialsReferences

31 Prognosis of Traumatic Dental Injuries:Statistical ConsiderationsP. K. ANDERSEN, F. M. ANDREASEN &

J. O. ANDREASEN

Identifying prognosis related factorsExpressing prognosis quantitativelyComparing life tablesEssentialsReferences

32 Splinting of Traumatized TeethK. S. OIKARINEN

Influence of splinting on dental tissuesRequirements for an acceptable splintSplinting methodsTesting the mechanical properties of various

splinting types

Contents ix

803 Recommendations for splinting type and805 duration 848807 Essentials 850807 References 850808

33 Bleaching of the Discolored809 Traumatized Tooth 852809 J. E. DAHL & U. PALLESEN810

Etiology of discoloration 852811812

Medicaments 852

Intracoronal bleaching 853

External tooth bleaching 857

814Clinical recommendations 857Essentials 858References 858

814817 34 Economic Aspects of Traumatic817 Dental Injuries 861823 U. GLENDOR, L. ANDERSSON& J. O. ANDREASEN826

Costs of trauma tic dental injuries 861827Time and costs 862

828Essentials 866

829References 866

82935 Information to the Public, Patients and830Emergency Services on Traumatic Dental830

832 Injuries 869M. T. FLORES

Developing a public awareness campaign 869835 Recommendations for specific groups 871

Prevention of sports-related dental trauma 871

Guidelines to the public: first aid and treatment

835 of trauma to primary teeth 871

835 Guidelines to the public: first aid and treatment of

839 trauma to permanent teeth 872

840 Information to emergency services 872

840 Information to patients 872Essentials 874

842References 875

Appendix 1 876842 Appendix 2 880842 Appendix 3 881843 Appendix 4 882

843 Index 883