Appropriate Terminology for the Time Elapsed From Avulsion of a Permanent Tooth to Replantation: A Scoping Review and Delphi Consensus

Nitesh Tewari; Jhunjhunwala Garima; Anne O'Connell; Nidhi Sharawat; Morankar Rahul; Vijay Prakash Mathur; Partha Haldar

doi:10.1111/edt.12993

Appropriate Terminology for the Time Elapsed From Avulsion of a Permanent Tooth to Replantation: A Scoping Review and Delphi Consensus

Dent Traumatol. 2024 Nov 2. doi: 10.1111/edt.12993. Online ahead of print.

Authors

Nitesh Tewari¹, Jhunjhunwala Garima¹, Anne O'Connell², Nidhi Sharawat¹, Morankar Rahul¹, Vijay Prakash Mathur¹, Partha Haldar³

Affiliations

¹ Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
² Division of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland.
³ Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

PMID: 39487671
DOI: 10.1111/edt.12993

Abstract

Background: The prognosis of an avulsed permanent tooth depends on the time elapsed from injury to replantation in the injured socket. Wide variability exists in the terminologies used to describe this period. Hence, the aim of this study was to identify and categorize the terminologies related to this aspect of tooth avulsion, grade the explanations provided by the authors, and develop a consensus about the most appropriate terminology through a Delphi approach.

Methods: This study involved a scoping review to identify and analyze the terminologies. It was performed according to PRISMA-ScR with a systematic search performed in PubMed, Scopus, EMBASE, LILACS, and Web of Science. The terminologies were extracted, categorized, and evaluated for correctness. On the basis of the results of the review and expert group discussion, an ideal terminology was proposed. A Delphi study with 20 global experts in dental traumatology was conducted to develop a consensus for the proposed terminology and its description.

Results: A total of 92 studies were included. They were distributed into five categories according to the terminology used: (a) dry period alone, (b) total period with dry and/or wet times, (c) extra-alveolar period, (d) extraoral period, and (e) miscellaneous. The explanations provided were correct in 37.5% of the studies that used an extraoral period. In the Delphi study, the lowest scores were given to the term dry period. There was an agreement of 95% for the proposed terminology.

Conclusion: A wide variation in terminologies was observed that could be distributed into five categories. The correctness of explanations was highest in the studies that described total periods with dry and wet times. The Delphi study revealed excellent agreement for the proposed term "total extra-alveolar period," with precise and clear recordings of both nonphysiologic (dry) periods and physiologic (wet) periods.

Keywords: Delphi study; dental avulsion; dental trauma; scoping review; storage time.