The effect of topical treatment with doxycycline compared to saline on 66 avulsed permanent teeth--a retrospective case-control study.

BACKGROUND/AIM Tooth avulsion in young growing individuals is an uncommon but very severe dental trauma. The aim of this retrospective case-control study was to evaluate the effect of topical treatment with doxycycline on avulsed permanent teeth compared with treatment with only saline regarding pulp survival and periodontal healing. MATERIAL AND METHOD Sixty-six avulsed teeth in 50 patients (34 boys and 16 girls) between the ages six and 18 years were included in this study. Thirty teeth were soaked in a 0.05 mg ml(-1) doxycycline solution for 5 min, before replantation and 36 teeth in saline solution. Root development was categorized with respect to root formation and development of the apex into three groups, one-half-root formation to full root formation with open apex, full root formation with half-closed apex and full root formation with closed apex. Pulp survival and periodontal healing were assessed as successful when at the end of the observation period no pulp necrosis or ankylosis-related resorption was diagnosed. The mean observation time was 48 months. RESULTS In the doxycycline group, 27 were diagnosed with pulp necrosis, 15 with ankylosis-related resorption and nine were extracted. In the saline group, 30 were diagnosed with pulp necrosis, 23 with ankylosis-related resorption and 11 were extracted. Regarding pulp survival and periodontal healing, no significant differences were found between the two groups. Teeth with immature root development showed significantly less pulp necrosis (P < 0.05) compared to teeth with full root formation regardless if treated topically with doxycycline or not. No significant differences were found between the two groups regarding age, storage, root development, splinting duration and observation time although the saline group had significantly longer extra-oral time (P < 0.001) than the doxycycline group. CONCLUSIONS This study indicates that avulsed permanent teeth soaked in doxycycline do not show a better treatment outcome regarding pulp survival and periodontal healing compared with avulsed teeth placed only in saline solution. This finding is consistent regardless of root development, storage and extra-oral time.

[1]  A. Sigurdsson,et al.  Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth. , 2012, Pediatric dentistry.

[2]  G. Bonini,et al.  Impact of traumatic dental injuries and malocclusions on quality of life of preschool children: a population-based study. , 2015, International journal of paediatric dentistry.

[3]  S. Paiva,et al.  Impact of traumatic dental injuries among adolescents on family's quality of life: a population-based study. , 2014, International journal of paediatric dentistry.

[4]  Yan Jin,et al.  A retrospective study of pediatric traumatic dental injuries in Xi'an, China. , 2014, Dental traumatology : official publication of International Association for Dental Traumatology.

[5]  B. Malmgren.  Ridge preservation/decoronation. , 2013, Journal of endodontics.

[6]  J. Andreasen,et al.  Intrusive luxation of 60 permanent incisors: a retrospective study of treatment and outcome. , 2012, Dental traumatology : official publication of International Association for Dental Traumatology.

[7]  L. Messer,et al.  An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics. , 2009, Dental traumatology : official publication of International Association for Dental Traumatology.

[8]  U. Glendor.  Epidemiology of traumatic dental injuries--a 12 year review of the literature. , 2008, Dental traumatology : official publication of International Association for Dental Traumatology.

[9]  T. Sorsa,et al.  The effect of adjunctive subantimicrobial dose doxycycline therapy on GCF EMMPRIN levels in chronic periodontitis. , 2008, Journal of periodontology.

[10]  A. Sigurdsson,et al.  Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. , 2006, Dental traumatology : official publication of International Association for Dental Traumatology.

[11]  J. Andreasen,et al.  Tooth avulsion in children: to replant or not , 2006 .

[12]  V. Chappuis,et al.  Replantation of 45 avulsed permanent teeth: a 1-year follow-up study. , 2005, Dental traumatology : official publication of International Association for Dental Traumatology.

[13]  K. Stoltze,et al.  A multivariate analysis of the outcome of endodontic treatment. , 2004, European journal of oral sciences.

[14]  A. Sigurdsson,et al.  Pulp revascularization of replanted immature dog teeth after treatment with minocycline and doxycycline assessed by laser Doppler flowmetry, radiography, and histology. , 2004, Dental traumatology : official publication of International Association for Dental Traumatology.

[15]  V. Sae-Lim,et al.  The effect of topical minocycline on replacement resorption of replanted monkeys' teeth. , 2003, Dental traumatology : official publication of International Association for Dental Traumatology.

[16]  B. Malmgren,et al.  Rate of infraposition of reimplanted ankylosed incisors related to age and growth in children and adolescents. , 2002, Dental traumatology : official publication of International Association for Dental Traumatology.

[17]  M. Iqbal,et al.  Effect of enamel matrix derivative (EMDOGAIN) upon periodontal healing after replantation of permanent incisors in beagle dogs. , 2001, Dental traumatology : official publication of International Association for Dental Traumatology.

[18]  G. Payonk,et al.  Adjunctive treatment with subantimicrobial doses of doxycycline: effects on gingival fluid collagenase activity and attachment loss in adult periodontitis. , 2001, Journal of clinical periodontology.

[19]  M. Trope,et al.  Pulp revascularization of replanted immature dog teeth after different treatment methods. , 2000, Endodontics & dental traumatology.

[20]  Z. Metzger,et al.  Local dexamethasone improves periodontal healing of replanted dogs' teeth. , 1998, Endodontics & dental traumatology.

[21]  E Borssén,et al.  Traumatic dental injuries in a cohort of 16-year-olds in northern Sweden. , 1997, Endodontics & dental traumatology.

[22]  C. Rubin,et al.  Tetracycline prevents cancellous bone loss and maintains near-normal rates of bone formation in streptozotocin diabetic rats. , 1997, Bone.

[23]  T. Salo,et al.  A matrix metalloproteinase inhibitor reduces bone-type collagen degradation fragments and specific collagenases in gingival crevicular fluid during adult periodontitis , 1997, Inflammation Research.

[24]  H. Jacobsen,et al.  Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications. , 1995, Endodontics & dental traumatology.

[25]  H. Jacobsen,et al.  Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing. , 1995, Endodontics & dental traumatology.

[26]  H. Jacobsen,et al.  Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. , 1995, Endodontics & dental traumatology.

[27]  M. Cvek.  Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. , 1992, Endodontics & dental traumatology.

[28]  G Sundqvist,et al.  Factors affecting the long-term results of endodontic treatment. , 1990, Journal of endodontics.

[29]  P. Cleaton-jones,et al.  Effect of topical application of doxycycline on pulp revascularization and periodontal healing in reimplanted monkey incisors. , 1990, Endodontics & dental traumatology.

[30]  P. Cleaton-jones,et al.  Pulp revascularization in reimplanted immature monkey incisors--predictability and the effect of antibiotic systemic prophylaxis. , 1990, Endodontics & dental traumatology.

[31]  F. Andreasen.  Pulpal healing after luxation injuries and root fracture in the permanent dentition. , 1989, Endodontics & dental traumatology.

[32]  I. Mejàre,et al.  Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors. , 1986, Endodontics & dental traumatology.

[33]  F. Andreasen,et al.  Prognosis of luxated permanent teeth--the development of pulp necrosis. , 1985, Endodontics & dental traumatology.

[34]  B. Malmgren,et al.  Surgical treatment of ankylosed and infrapositioned reimplanted incisors in adolescents. , 1984, Scandinavian journal of dental research.

[35]  J. Andreasen.  Effect of extra-alveolar period and storage media upon periodontal and pulpal healing after replantation of mature permanent incisors in monkeys. , 1981, International journal of oral surgery.

[36]  J. Andreasen.  Periodontal healing after replantation and autotransplantation of incisors in monkeys. , 1981, International journal of oral surgery.

[37]  J. Andreasen.  A time-related study of periodontal healing and root resorption activity after replantation of mature permanent incisors in monkeys. , 1980, Swedish dental journal.

[38]  A. Ohman.  HEALING AND SENSITIVITY TO PAIN IN YOUNG REPLANTED HUMAN TEETH. AN EXPERIMENTAL, CLINICAL AND HISTOLOGICAL STUDY. , 1965, Odontologisk tidskrift.

[39]  A. Ohman.  [Theoretical and practical clinical aspects of healing and vitality investigation in traumatic tooth injuries]. , 1965, Arsbok. Goteborgs tandlakare-sallskap.