Úvod a cíl: Avulze představuje jedno z nejzávažnějších dentálních poranění. Replantací je možné vyražený zub za příznivých okolností dlouhodobě zachovat. Cílem studie bylo zjistit příčiny vedoucí k vyražení zubu a vyhodnotit faktory ovlivňující úspěšnost replantace. Metody: Do studie je zařazeno 46 pacientů, kteří byli po replantaci 49 vyražených zubů (17 zubů s nedokončeným a 32 zubů s dokončeným vývojem zubního kořene) sledováni na Stomatologické klinice FN a LF UK v Plzni. U pacientů se zjišťovaly příčiny úrazu, faktory ovlivňující hojení po replantaci a výskyt komplikací. Statisticky (Fisherův exaktní test) bylo provedeno porovnání výskytu poúrazových následků mezi zuby s dokončeným a nedokončeným vývojem zubního kořene. Výsledky: Z dokumentace bylo zjištěno, že nejčastější příčinou vyražení zubu bývají pády z kola a úrazy při hře a sportu. Včasná replantace do 30 minut byla provedana pouze u pěti zubů. Ve vlhkém prostředí bylo k replantaci doneseno 14 zubů. Profylaktické endodontické ošetření ukázalo, že u všech 32 zubů s dokončeným vývojem zubního kořene došlo k nekróze zubní dřeně. Na základě rentgenového vyšetření byla zjištěna u 15 zubů (31 %) povrchová resorpce, u 21 zubů (43 %) resorpce s náhradou kosti. Zevní zánětlivá resorpce postihla celkově 13 zubů (26 %), statisticky častěji se vyskytla u zubů s nedokončeným vývojem zubního kořene (p = 0,0383). Zuby s nedokončeným vývojem kořene musely být z důvodu resorpce také častěji extrahovány (p = 0,0127). Závěr: Studie ukázala příznivější prognózu u replantovaných zubů s dokončeným vývojem zubního kořene.

Introduction, Aim: Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis of replantation. The aim of this study was to find out the causes that lead to dental avulsion, and to analyze the factors that influenced the success of replantation. Methods: In our study we analyzed the documentation of a sample of 46 patients who had a total of 49 avulsed teeth (17 teeth with open apices, 32 teeth with closed apices) and were treated in Dentistry Department of Medical Faculty in Pilsen. We looked for the causes of the dental injuries, healing after replantation and occurrance of complication. Teeth with closed and open root apices were compared using the Fisher´s exact test. Results: In our study the most common causes of the avulsion of the permanent teeth were cycling and sport or game injuries. Early replantation (within 30 minutes after injury) was performed only in five cases. Only 14 teeth were transported to the replantation in moist transport medium. Prophylactic endodontic treatment showed necrotic pulp in all 32 teeth with closed apices. Based on the x-ray examination superficial resorption was observed in 15 replanted teeth (31%), replacement resorption was found out in 21 teeth (43%). External inflammatory resorption afflicted 13 teeth (26%), more frequently teeth with open apices (p = 0,0383). Extraction of tooth was more often performed in teeth with open apices (p = 0,0127). Conclusions: The study showed better prognosis of the replantation of permanent teeth with closed apices.

• Keywords
• způsob transportu,
• MeSH
• Tooth Avulsion * etiology   therapy   MeSH
• Time Factors MeSH
• Chronic Periodontitis complications   MeSH
• Dentition, Permanent MeSH
• Child MeSH
• Transportation MeSH
• Adult MeSH
• Wound Healing physiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Dental Pulp Necrosis complications   radiography   MeSH
• Tooth Replantation * statistics & numerical data   MeSH
• Alveolar Bone Loss complications   MeSH
• Root Resorption epidemiology   complications   MeSH
• Retrospective Studies MeSH
• Organ Preservation Solutions MeSH
• Statistics as Topic MeSH
• Root Canal Therapy statistics & numerical data   MeSH
• Tissue Preservation MeSH
• Accidents MeSH
• Treatment Outcome MeSH
• Tooth Root growth & development   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH

The aim of this study was to investigate pre-injury factors, causes of dental injuries and healing complications after traumatic injuries to permanent teeth. The analysed sample comprised 889 permanent teeth of 384 patients, who were treated in the Dentistry Department in Faculty Hospital in Pilsen. Enamel-dentin fractures [233 teeth (26.2%)] and lateral luxations [207 teeth (23.3%)] were the most frequent injuries. The age of the patients at the time of injury varied between 7 and 65 years. Predominantly, children were affected [587 injured teeth (66.0%)]. The most frequent causes of injuries in patients older than 11 years were various sport activities, predominantly bicycling. Pulp necrosis was observed in 239 teeth (26.9%). It was the most frequent post-traumatic complication in all types of dental traumas. Teeth with a completed root formation demonstrated a higher prevalence of pulp necrosis than teeth with an incomplete root formation in all types of luxation injuries. External root resorption was observed in 144 teeth. The rate of inflammatory resorption differed between the various types of luxation injuries (extrusive luxation 5.6%, lateral luxation 11.6%, intrusive luxation 33.3%). Following avulsion and replantation, active inflammatory resorptions were diagnosed in 13 (26.5%) of 49 replanted teeth and ankylosis/replacement resorptions were observed in 21 (42.9%) of 49 replanted teeth. After avulsion, primarily, immature teeth were affected by these complications. Within the observation period of 5 years, 39 teeth (4.4%) had to be removed (16 teeth with root fractures, 19 avulsed and replanted teeth, 3 luxated teeth, 1 tooth with crown-root fracture).

• MeSH
• Tooth Avulsion epidemiology   MeSH
• Bicycling injuries   MeSH
• Dentin injuries   MeSH
• Child MeSH
• Adult MeSH
• Tooth Extraction statistics & numerical data   MeSH
• Tooth Fractures epidemiology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Follow-Up Studies MeSH
• Dental Pulp Necrosis epidemiology   MeSH
• Postoperative Complications epidemiology   MeSH
• Tooth Replantation statistics & numerical data   MeSH
• Root Resorption epidemiology   MeSH
• Retrospective Studies MeSH
• Incisor injuries   MeSH
• Aged MeSH
• Athletic Injuries epidemiology   MeSH
• Tooth Injuries epidemiology   MeSH
• Age Factors MeSH
• Tooth Ankylosis epidemiology   MeSH
• Tooth Root injuries   MeSH
• Tooth Crown injuries   MeSH
• Dental Enamel injuries   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic MeSH

The aim of this study was to find out the causes that lead to dental avulsion in children, to analyze the effectiveness of our treatment and the response of the adults when such incidents occur and finally to determine the occurrence of posttraumatic complications some time after the injury, especially the resorption of the affected teeth root. We analyzed the documentations of a sample of patients containing 57 children who had a total of 90 avulsed teeth and were treated in Dentistry Department of Medical Faculty in Pilsen, Czech Republic, in the years between 1995 and 2005. We discovered that most frequently the children experience dental avulsion in the age between 8 and 11 years old, the most affected teeth are the upper central incisors and the most frequent causes are sports and games which are very common in these ages, in various environments, like schools, sport fields and home. The majority of the children were transferred to the Dentistry Department either quite long after the avulsion incident and without the avulsed teeth, or with the avulsed teeth which were carried in an inappropriate transport medium, indicating that there is insufficient knowledge of adult people, especially the ones who are in daily contact with children, on how to provide first aid in cases of dental avulsion.

• MeSH
• Tooth Avulsion MeSH
• Time Factors MeSH
• Child MeSH
• Splints MeSH
• Adult MeSH
• Referral and Consultation statistics & numerical data   MeSH
• Humans MeSH
• Maxilla MeSH
• Adolescent MeSH
• First Aid statistics & numerical data   MeSH
• Tooth Replantation statistics & numerical data   MeSH
• Root Resorption epidemiology   MeSH
• Retrospective Studies MeSH
• Incisor injuries   MeSH
• Organ Preservation Solutions therapeutic use   MeSH
• Athletic Injuries epidemiology   MeSH
• Root Canal Therapy statistics & numerical data   MeSH
• Accidental Falls statistics & numerical data   MeSH
• Accidents, Home statistics & numerical data   MeSH
• Age Factors MeSH
• Health Knowledge, Attitudes, Practice MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Tooth Avulsion pathology   therapy   MeSH
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Periodontium physiology   pathology   MeSH
• Prognosis MeSH
• Tooth Replantation methods   statistics & numerical data   MeSH
• Tooth Resorption etiology   pathology   MeSH
• Dental Pulp physiology   pathology   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH