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Evidence-based management of isolated dentoalveolar fractures: a systematic review

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2024, v.50 no.3, pp.123-133
https://doi.org/10.5125/jkaoms.2024.50.3.123
Samriddhi Burman (Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal)
Babu Lal (Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal)
Ragavi Alagarsamy (Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi)
Jitendra Kumar (Department of Dentistry, All India Institute of Medical Sciences, Bhopal)
Ankush Ankush (Department of Radio-Diagnosis, LN Medical College and JK Hospital, Bhopal)
Anshul J. Rai (Department of Dentistry, All India Institute of Medical Sciences, Bhopal)
Md Yunus (Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal)

Abstract

Dentoalveolar (DA) trauma, which can involve tooth, alveolar bone, and surrounding soft tissues, is a significant dentofacial emergency. In emergency settings, physicians might lack comprehensive knowledge of timely procedures, causing delays for specialist referral. This systematic review assesses the literature on isolated DA fractures, emphasizing intervention timing and splinting techniques and duration in both children and adults. This systematic review adhered to PRISMA guidelines and involved a thorough search across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 1980 to December 2022. Inclusion and exclusion criteria guided study selection, with data extraction and analysis centered on demographics, etiology, injury site, diagnostics, treatment timelines, and outcomes in pediatric (2-12 years) and adult (>12 years) populations. This review analyzed 26 studies, categorized by age into pediatrics (2-12 years) and adults (>12 years). Falls were a common etiology, primarily affecting the anterior maxilla. Immediate management involved replantation, repositioning, and splinting within 24 hours (pediatric) or 48 hours (adult). Composite resin-bonded splints were common. Endodontic treatment was done within a timeframe of 3 days to 12 weeks for children and 2-12 weeks for adults. Tailored management based on patient age, tooth development stage, time elapsed, and resource availability is essential.

keywords
Tooth injuries, Tooth avulsion, Tooth fractures, Tooth loss, Systematic review

Journal of the Korean Association of Oral and Maxillofacial Surgeons