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REFERENCE MANUAL

V 36 / NO 6

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Guidelines for the Management of Traumatic Dental


Injuries: 2. Avulsion of Permanent Teeth
Originating Group
International Association of Dental Traumatology

Endorsed by the American Academy of Pediatric Dentistry


2013

Lars Andersson*1 Jens O. Andreasen*2 Peter Day*3 Geoffrey Heithersay*4 Martin Trope*5 Anthony J. DiAngelis6
David J. Kenny7 Asgeir Sigurdsson8 Cecilia Bourguignon9 Marie Therese Flores10 Morris Lamar Hicks11 Antonio R. Lenzi12
Barbro Malmgren13 Alex J. Moule14 Mitsuhiro Tsukiboshi15
Abstract: 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. The International Association of Dental Traumatology (IADT) has developed a
consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians
from various specialties were included in the task group. The guidelines represent the current best evidence and practice
based on literature research and professionals opinion. In cases where the data did not appear conclusive, recommendations
were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving
their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or
urgent care of avulsed permanent teeth. (Dental Traumatology 2012;28:88-96; doi:10.1111/j.1600-9657.2012.01125.x) Accepted
January 30, 2012
KEYWORDS: AVULSION, EXARTICULATION, CONSENSUS, REVIEW, TRAUMA, TOOTH

1Department of Surgical Sciences, Faculty of Dentistry, Health Sciences


Center, Kuwait University, Kuwait City, Kuwait; 2Department of Oral and
Maxillofacial Surgery, Center of Rare Oral Diseases, Copenhagen University Hospital, Rigshopitalet, Copenhagen, Denmark; 3Paedriatic Dentistry,
Leeds Dental Institute and Bradford District Care Trust Salaried Dental
Service, Leeds, UK; 4Faculty of Health Sciences, School of Dentistry, Endodontology, The University of Adelaide, Adelaide, SA, Australia; 5Department of Endodontics, School of Dentistry, University of Pennsylvania,
Philadelphia, PA, USA; 6Department of Dentistry, Hennepin County Medical Center and University of Minnesota School of Dentistry, Minneapolis,
MN, USA; 7Hospital for Sick Children and University of Toronto, Toronto,
ON, Canada; 8Department of Endodontics, UNC School of Dentistry,
Chapel Hill, NC, USA; 9Private Practice, Paris, France; 10Department of
Pediatric Dentistry, Faculty of Dentistry, Universidad de Valparaiso, Valparaiso, Chile; 11Department of Endodontics, University of Maryland
School of Dentistry, Baltimore, MD, USA; 12Private Practice, Rio de
Janeiro, Brazil; 13Division of Pediatrics, Department of Clinical Sciences
Intervention and Technology, Karolinska University Hospital, Stockholm,
Sweden; 14Private Practice, University of Queensland, Brisbane, Qld,
Australia; 15Private Practice, Amagun, Aichi, Japan
Correspondence to Lars Andersson, DDS, PhD, DrOdont, Oral & Maxillofacial Surgery, Department of Surgical Sciences, Health Sciences Center,
P.O. Box 24923, Safat 13110, Kuwait.
Tel.: +965 24986695
Fax: +965 24986732
e-mail: dr.lars.andersson@gmail.com
* Members of the Task Group.
Whenever referring to IADT Guidelines, the original article,
(Dent Traumatol 2012;28:88-96) should always be used as
reference.

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
328

ENDORSEMENTS

AMERICAN ACADEMY OF PEDIATRIC DENTISTRY

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
ENDORSEMENTS

329

REFERENCE MANUAL

V 36 / NO 6

14 / 15

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
330

ENDORSEMENTS

AMERICAN ACADEMY OF PEDIATRIC DENTISTRY

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
ENDORSEMENTS

331

REFERENCE MANUAL

V 36 / NO 6

14 / 15

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
332

ENDORSEMENTS

AMERICAN ACADEMY OF PEDIATRIC DENTISTRY

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
ENDORSEMENTS

333

REFERENCE MANUAL

V 36 / NO 6

14 / 15

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
334

ENDORSEMENTS

AMERICAN ACADEMY OF PEDIATRIC DENTISTRY

Copyright 2012, International Association of Dental Traumatology, www.iadt-dentaltrauma.org.


Reprinted with permission of the International Association of Dental Traumatology (IADT). Dental Traumatology 2012;28:88-96; doi: 10.1111/j.1600-9657.2012.01125.x
Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1600-9657.2012.01125.x/full.
ENDORSEMENTS

335