Effect of splinting on outcomes of replantation of avulsed permanent teeth in children: A systematic review.
Systematic Review
Tooth avulsion is the complete displacement of a tooth from its socket and is a severe traumatic dental injury. Stabilization using splints is essential for healing. However, there is no consensus regarding the optimal splint type or duration. This systematic review aimed to evaluate the effectiveness of different splinting methods and durations on the outcomes of replanted avulsed permanent teeth in pediatric patients, with the goal of informing evidence-based clinical practice./r/nThe review protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Register of Systematic Reviews (CRD42023414888). A systematic search of PubMed, Cochrane Library, Embase, and Google Scholar was conducted. Eligible studies were selected based on the predefined criteria, and data extraction was carried out using a pretested form. Risk of bias was assessed using the Newcastle-Ottawa Scale. A meta-analysis was performed using RevMan (Version 5.4) where appropriate, and the GRADE approach was applied to assess the quality of evidence./r/nFrom 734 identified records, 7 studies were included in the qualitative synthesis and 4 in the meta-analysis, encompassing 708 participants and 975 avulsed teeth. Replanted teeth were stabilized with various splint types and durations. While trends supported the use of flexible splints and shorter durations for better periodontal and pulp outcomes, most findings lacked statistical significance. GRADE analysis rated the overall evidence as very low./r/nCurrent evidence tentatively supports the International Association of Dental Traumatology guidelines favoring flexible, short-term splinting, but high-quality research is needed to establish definitive protocols.
