Periodontal healing complications following extrusive and lateral luxation in the permanent dentition: a longitudinal cohort study.

PURPOSE

To analyze the risk of tooth loss and complications in periodontal ligament (PDL) healing following extrusive and lateral luxation in the permanent dentition.

MATERIALS AND METHODS

Eighty-two permanent teeth (78 patients) with extrusive luxation and 179 teeth (149 patients) with lateral luxation were included in the study. All teeth were examined according to a standardized protocol including clinical, photographic, and radiographic registration. Follow-up controls were performed at regular intervals (3, 6 weeks, 6 months, 1, 5, and 10 years).

STATISTICS

The risk of repair-related resorption (surface resorption), infection-related resorption (inflammatory resorption), ankylosis-related resorption (replacement resorption), marginal bone loss, and tooth loss was analyzed with the Kaplan-Meier method. Differences among subgroups were analyzed with log-rank test and Cox regression.

RESULTS

The risk of periodontal healing complications was estimated after 3 years. Extrusive luxation: For immature root development, infection-related resorption was 2.4% (95% confidence interval (CI): 0-6.9%). For mature root development, repair-related resorption was 15.6% (95% CI: 4.4-26.7%), infection-related resorption was 5.1% (95% CI: 0-11.7%), and marginal bone loss was 17.5% (95% CI: 6.2-28.8%). No teeth showed ankylosis-related resorption, and no teeth were lost in the observation period. Lateral luxation: For immature root development, repair-related resorption was 2.1% (95% CI: 0-6.1%), infection-related resorption was 2.1% (95% CI: 0-6.1%). For mature root development, repair-related resorption was 29.5% (95% CI: 20.5-38.5%), infection-related resorption was 2.6% (95% CI: 0-6.4%), ankylosis-related resorption was 0.8% (95% CI: 0-2.3%), marginal bone loss was 6.9% (95% CI: 2.2-11.6%).

CONCLUSION

The risk of severe periodontal healing complications in teeth with extrusive and lateral luxation injuries is generally low. Marginal bone loss and repair-related resorption occurred significantly more often in teeth with mature rather than immature root development. Marginal bone loss was associated with injuries involving multiple teeth.