Periodontal healing complications following concussion and subluxation injuries in the permanent dentition: a longitudinal cohort study

Purpose The purpose of the study was to analyze the risk of periodontal ligament (PDL) healing complications following concussion and subluxation injuries in the permanent dentition. Material and method A total 469 permanent teeth (358 patients) with concussion and 404 permanent teeth with subluxation were included in the study.

All teeth were examined according to a standardized protocol including clinical, photographic, and radiographic registration. Statistics: The risk of repair-related resorption (surface resorption), infection-related resorption (inflammatory resorption), replacement-related resorption (ankylosis), marginal bone loss, and tooth loss were analyzed with the Kaplan–Meier method.

Results Concussion: In teeth with immature root development, no healing complications were observed. For teeth with mature root development, the risk of repair related resorption after 3 years was 3.2% (95% CI: 0.3–6.0%) and occurred only in cases where several teeth were injured simultaneously (multiple-trauma cases).

The risk of marginal bone loss in teeth with mature root development was 0.7% (95% CI: 0–1.6%). Infection-related resorption, replacement resorption, and tooth loss were not observed among teeth with concussion. Subluxation: In teeth with immature root development, the risk of infection-related resorption after 3 years was 1.7% [95% confidence interval (CI): 0–3.8%].

Infection-related resorption occurred significantly more often in teeth with concomitant crown fracture (P = 0.004). For teeth with mature root development, the risk of periodontal healing complications after 3 years was: repair-related resorption, 3.6% (95% CI: 0–7.6%); infection-related resorption, 0.6% (95% CI: 0–1.7%); replacement-related resorption, 0.6% (95% CI: 0–1.7%); and marginal bone loss, 0.6% (95% CI: 0–1.7%).

No teeth were lost in the observation period. Conclusion The risk of periodontal healing complications after concussion as well as subluxation injuries in permanent teeth is very low.