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ESE Pre-congress symposium: Current management of traumatic dental injuries. Led by Gabriel Krastl

The Dental Trauma Symposium will focus on current concepts for the management of traumatic dental injuries.

The key aims are to

• increase the awareness of the pathological parameters that impact on the regeneration of the pulpand the PDL

• discuss the current strategies to prevent root resorption after severe traumatic dental injuries

• demonstrate the current approaches to the treatment of teeth withdeep subgingival fractures

• give an overview of the injuries in the primary dentition and their effects on the permanent successors

COST: 130 + VAT Euros (ESE Registered Postgraduate students 90 + VAT Euros)

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14:00
rightTreating subgingival fractures

Abstract

Teeth with deep subgingival tooth fractures or carious lesions are usually deemed non-restorable. When
tooth preservation is nonetheless essential, all treatment modalities have to be considered. Surgical crown lengthening can be performed to expose the root and allow restorative treatment. However, the reduction of alveolar bone may be associated with unfavorable gingival architecture and poor aesthetic results in the anterior region. Orthodontic extrusion (forced eruption) may be a suitable alternative to transpose the lesion to a more coronal position. Surgical extrusion, also referred to as intra-alveolar transplantation, was introduced as a faster alternative to orthodontic extrusion. Since the tooth is first extracted, deep root injuries can be diagnosed more easily compared with orthodontic extrusion. Prognosis after surgical extrusion was shown to be favourable, however the level of evidence is rather low. To minimize the risk of resorption associated with surgical extrusion, minimally invasive extraction procedures are advantageous. A recent clinical study has shown that this approach may reduce cemental damage and may increase the likelihood of periodontal healing compared with conventional extraction methods. Although the treatment of crown-root fractures is one of the most technically demanding procedures in dental traumatology and is frequently considered as a long-term temporary restoration, tooth conservation up to the age at which implants can be placed may be regarded as a success. However, in many cases even long-term tooth preservation of teeth with deep subgingival fractures seems feasible.

Aims

To discuss the current treatment of teeth with deep subgingival fractures

Objectives

1. Discuss the clinical problems associated with deep subgingival margins 2. Demonstrate how endodontic and restorative treatment can be carried out in difficult cases 3. Demonstrate the use of atraumatic extraction systems to reduce the trauma to the PDL during tooth extraction

rightGabriel Krastl
 Gabriel Krastl

Dr. Gabriel Krastl received his degree in dentistry from the University of Tübingen, Germany in 1998 and has been a staff member and research associate until 2005. From 2005 to 2014 he was a senior research associate at the Clinic of Periodontology, Endodontology and Cariology in Basel, Switzerland. 2006 he co-founded the interdisciplinary Center of Dental Traumatology at the Basel University. Since 2014 Gabriel Krastl is Professor and chair of the Department of Conservative Dentistry and Periodontology at the University Hospital of Würzburg, Germany and directs the Center of Dental Traumatology which he founded in 2015. He published more than 100 papers mostly in the field of endodontology and dental traumatology and serves as a reviewer in several scientific journals.

14:45
Treating the traumatized pulp
rightRoland Weiger
 Roland Weiger

CURRICULUM VITAE Prof. Dr. Roland Weiger

Current positions >Professor and Chair of the Clinic für Periodontology, Endodontology and Cariology, University Center of Dentistry (UZB), Basel (Switzerland) and Director of the University Dental Clinics (UZB) >Co-Chair of Dental Trauma Center at the UZB

1985 Study of dentistry and DDS, University of Tübingen (Germany) 1987 Doctoral dissertation, University of Tübingen 1996 Habilitation thesis and Venia legendi, University of Tübingen 2000 Professor for Endodontology at the Departement of Conservative Dentistry, University of Tübingen Since 2002 Professor and Chair, Departement of Periodontology, Endodontology and Cariology, University of Basel (Switzerland)

2003-10 Chairman of the Research Committee, European Society of Endodontology (ESE)

2012 Director of the Department of Dental Medicine, University Basel

Since 2016 Member of the Executive Board (UZB)

140 publications listed in PubMed covering mainly aspects in the field of endodontology, dental traumatology, and biofilm

15:30
COFFEE BREAK
16:00
rightTreating the traumatized periodontium

Abstract

Beside crown fractures, injuries to the periodontal attachment are the most frequent injuries caused by dentoalveolar trauma. The reason why in a particular case a tooth is displaced and not broken is varying. Combinations of dislocation and fracture (of crowns or roots) are often seen as well.

The periodontium consists of three tissues (cementum, PDL and alveolar bone), and each one of these can get injured. Simple disruption of the PDL fibers is one possibility, bruising of cementum a second one, bruising or fracture of the alveolar bone the third. Extra-alveolar storage of a tooth for more than 15 minutes can cause additional cellular loss. The healing pattern of these injuries includes resorptive as well as productive processes and fits into the general wound healing scheme of the body. Possible healing results are restitution to integrity, healing with ectopic tissue or non-healing due to chronical infection.

Clinically, the involvement of the periodontal tissues can be diagnosed by the application of the WHO tooth dislocation types (Concussion, loosening, extrusion, intrusion, lateral disloaction, alveolar bone fracture and avulsion). Each of these dislocation types shows its own destruction pattern resulting in different healing modes.

Critical issues in the treatment of the traumatized periodontium are reduction, infection control, splinting and mobility control. In some cases, endodontic infection may trigger external root resorption which means that endodontic and periodontal aspects should be followed up synoptically.

Aims

To give a compact overview on acute periodontal trauma, the resulting injuries, healing patterns and long-term results.

Objectives

To give a compact overview on acute periodontal trauma, the resulting injuries, healing patterns and long-term results.

rightKurt Alois Ebeleseder
 Kurt Alois Ebeleseder

Kurt Alois Ebeleseder

Born 1957 in Upper Austria, graduation from High School 1976, Medical promotion from University Graz 1983, General physician 1987, graduation in Dentistry 1989, since 1989 at the Department of Conservative Dentistry in Graz. Since 1990 specialisation on dental trauma and endodontics. Until 2018 treatment of 7000 dental trauma cases, publication of 85 scientific papers (main publication language: German), 300 oral presentations, 13 scientific prizes. Foundation of an own dental trauma working group within the Austrian Dental Association (1995), organization of 11 national congresses on the dental trauma topic. Close collaboration with German and Swiss dental trauma institutions.

16:45
rightTreating the traumatized primary dentition
Trauma and Toddlers

Abstract

Management of traumatic dental injuries is very complex, even under ideal circumstances. Successfully dealing with injuries in young children can be an especially difficult situation and important decisions are required in both emergency and long-term care. The long term implications following injury may differ from child to child and behavioural issues may interfere with ideal management. Current research informs guidelines for management of traumatic injuries in the primary dentition and are based on the biological healing response of oral tissues following injury over time. Critical decisions must be made for the child and careful consideration of basic principles and guidelines can offer a path towards increasing successful outcomes for the child. The current evidence questions if some dental interventions following injury in primary teeth are necessary. This talk will discuss the IADT guidelines and the modern management of traumatic dental injuries in children in the primary dentition. Research must be continually evaluated to support current techniques and to propose new strategies. Developing a positive attitude to the dental setting in the child and parents is must also be considered to maintain follow up visits and prepare the child to be a motivated dental attendee throughout their lifetime.

Aims

AIM: aim is to update participants on the modern management of traumatic injuries to the primary dentition

Objectives

Objectives: The objectives will be 1. to outline the critical differences in traumatic injuries to the primary dentition 2. to review the current evidence that informs the IADT guidelines. 3. to highlight the issues with achieving a comprehensive examination and interpretation of radiographs in young children 4. to discuss the importance of good communication and management of the child and the parents 5. to offer practical advice for clinicians

rightAnne O'Connell
 Anne O'Connell

Anne is President of the International Association of Dental Traumatology. She is also Head of Paediatric Dentistry and Director of the Post-Graduate Programme in Trinity College, Dublin, Ireland. Anne completed specialty training in Paediatric Dentistry at Eastman Dental Center and obtained a further degree in Cariology from the University of Rochester, New York. She continued in academic/research positions in Eastman Dental Center, the University of Maryland and the National Institute of Dental and Craniofacial Research in USA. She is Board certified in Paediatric Dentistry and holds a Fellowship in Dental Traumatology and is a Fellow of AAPD. Anne has numerous peer-reviewed publications in both basic science and clinical dentistry. Her areas of interest include cariology, restorative dentistry for children, trauma, pulp therapy, infant oral health and developmental defects of the dentition. Anne is renowned as speaker both nationally and internationally on these topics. She is an active participant in organised dentistry, both nationally and internationally. Anne serves on numerous national and international scientific committees/organisations including ISDC, AAPD, IAPD, IADR and IADT. She has extensive experience on editorial boards and as a reviewer for many dental journals. In addition to being President of the International Association of Dental Traumatology, she is the Honorary Editor of the International Association of Paediatric Dentistry, and an International Consultant on Scientific Committee of the American Academy of Pediatric Dentistry. Anne also maintains a private practice limited to Paediatric Dentistry in Sandycove, Co Dublin.

17:30
Discussion
18:00
SESSION ENDS
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