Etiological factors related to dental injuries in Norwegians aged 7-18 years

Orthodontic management of traumatic dental injuries in Norway and orthodontists' perceptions of referral routines: A quality assurance survey

BACKGROUND/AIM

Orthodontic treatment of patients with traumatic dental injuries is challenging, with limited evidence of routines and outcomes. The aims of this study were: (i) to describe how orthodontists perceive the information on traumatic dental injuries received by referral from the Public Dental Health Service before orthodontic treatment and (ii) to assess orthodontists' knowledge and working routines in managing traumatic dental injuries.

MATERIALS AND METHODS

Data were obtained through a survey of all practicing orthodontists registered as members of the Norwegian Association of Orthodontists (n = 203).

RESULTS

Eighty-three orthodontists were enrolled, most of whom had received their dental degree (73.0%) and specialist orthodontic training (88.5%) in Norway. They reported examining patients with a history of traumatic dental injury at weekly (34.2%) or monthly (38.0%) basis. In 85.5% of cases, they obtained a history of traumatic dental injury from patients. Half of the respondents (51.3%) favoured two-phase early orthodontic treatment for patients with an overjet ≥6 mm. The observation time and treatment strategy showed considerable discrepancies across traumatic dental injury diagnoses. Most (59.1%) orthodontists considered the information on previous traumatic dental injuries provided by the Public Dental Health Services referral 'inadequate', more commonly in cases of mild (83.5%) than severe (57.5%) traumatic dental injuries.

CONCLUSIONS

Orthodontic management of patients with traumatic dental injuries was characterised by lack of uniformity in both recommended observation time before orthodontic treatment and management strategy. The referral routines by the Public Dental Health Services for patients with traumatic dental injuries were perceived as 'inadequate' in terms of frequency and quality. The results indicate the requirement of standardisation of routines related to orthodontic management of traumatic dental injuries and referral routines by the Public Dental Health Services.

Elementary school teachers' knowledge and attitudes toward emergency management of traumatic dental injuries

The consequences of traumatic dental injuries can be even more serious when their emergency management procedures are inadequate. Since traumatic accidents frequently occur at school, it is crucial that teachers be knowledgeable enough to assist an injured child. This study aimed to assess the knowledge and attitudes of the elementary school teachers of a Brazilian city toward dental trauma in permanent teeth, and its emergency practices. A combination of convenience and snowball sampling methods was used. An online questionnaire was distributed through social media, consisting of three parts: demographic characteristics and professional information; previous experiences and attitudes toward dental trauma; teachers' knowledge of this subject. Descriptive and statistical analyses were carried out. Pearson chi-squared test (p < 0.05) was used. A total of 217 teachers participated in the study. The power of the sample was 95%. Half of the teachers had already witnessed a dental trauma incident involving students, and 70.5% never received any information on the subject. The teachers who were provided previous information were the ones who opted to search for the tooth fragment (p=0.036) in cases of crown fracture, and for the lost tooth (p = 0.025) in cases of avulsion. They were also the ones who chose to wash the tooth in running water (p = 0.018), and look for a dentist in the first 30 or 60 minutes after the trauma (p = 0.026). Most of the teachers assessed did not have adequate knowledge of dental trauma. Having previous information was associated with more assertive practices in trauma management.

Epidemiology and severity of traumatic dental injuries in permanent teeth: A 20-year retrospective study

This study aimed to assess the traumatic dental injuries (TDIs) in permanent dentition among patients who attended at the outpatient clinic of a Brazilian dental school, during the last 20 years, and to investigate factors associated with the severity of these injuries. Clinical records of patients who attended a specialized center for dental trauma care in Brazil presenting at least one TDI in a permanent tooth, between the years 2000 and 2019, were reviewed. The data recorded were sex, age, affected arch, etiology, number, and type of the teeth affected, and classification and severity of the TDIs. The diagnosis and classification of the TDIs were based on the guidelines of the International Association of Dental Traumatology (IADT). The severity of each patient's injuries was defined as mild, moderate, or severe. Descriptive statistics, chi-square and multinomial regression analyses were used to evaluate the results. The significance level was set at 5%. A total of 837 clinical records were included, totaling 2357 teeth. Males were more prevalent than females. The patients' age ranged from 5 to 71 years. The most common traumas were avulsion (n=512) and uncomplicated enamel-dentin fracture (n=488). Univariate analyses showed that there was a statistically significant association between age group (p=0.004), etiology (p=0.000) and number of teeth affected (p=0.000) with severity of dental trauma. In conclusion, TDIs that occurred in Piracicaba and region are epidemiologically similar to those found worldwide, and that more severe injuries are related to age range, etiology and number of teeth affected.

School teachers' knowledge and experience about emergency management of traumatic dental injuries: A questionnaire-based online cross-sectional survey

BACKGROUND/AIM

Dental trauma is one of the critical oral health problems in childhood and adolescence that can affect an individual's quality of life. Teachers may witness a dental injury on many occasions, and they are likely to be involved at the site of an accident. Hence, they should be capable of managing prompt and correct emergency treatment at the accident site. The aim of this cross-sectional study was to assess the level of knowledge and experience of Croatian elementary and high school teachers concerning dental trauma.

MATERIALS AND METHODS

A questionnaire-based cross-sectional online survey was conducted to determine knowledge and experience about traumatic dental injuries among 803 full-time working elementary and high school teachers. The inclusion criteria were full-time employment at the time of data collection with at least 1 year of teaching experience. Retirement (teachers aged ≥65 years) and unwillingness to participate in the survey were the exclusion criteria. The Student t test or one-way ANOVA, with Tukey's post hoc was used to evaluate the obtained data. The level of significance was set at p ≤ .05.

RESULTS

The overall mean level of teachers' knowledge regarding emergency management of dental trauma was 6.6 ± 2.5 points, out of a maximum possible score of 14. There were no significant differences in knowledge among teachers from lower elementary, upper elementary, and high school education (6.9 ± 2.5, 6.5 ± 2.4 vs 6.4 ± 2.6 points, respectively; p = .140). Teachers who had personally experienced dental trauma showed better knowledge (7.2 ± 2.6 vs 6.4 ± 2.5 points; p ≤ .001).

CONCLUSION

The knowledge of emergency management of dental trauma among elementary and high school teachers in Croatia is low. Since most of the participants expressed willingness for future education regarding this subject, educational programs are recommended.

Traumatic dental injuries and pulp sequelae in an adolescent population

BACKGROUND/AIMS

Traumatic dental injuries (TDI) occur frequently and may result in pulp sequelae. This includes pulp necrosis with infection, pulp canal obliteration and root resorption. The aim of this study was to assess the prevalence and risk factors of pulp sequelae after TDI among Norwegian adolescents.

MATERIAL AND METHODS

A retrospective longitudinal study, including historical clinical data, was conducted with 16-year-old pupils in western Norway. All first-grade pupils, born in 1997 (n = 5184), attending public high schools, were invited to participate and to respond to an electronically administered closed-ended questionnaire (response rate 39.6%, n = 2055). Consent was given to access the dental records in the Public Dental Health Service in Hordaland, where information regarding TDI (diagnosis and treatment) and radiographs were interpreted. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible). Outcome variables of TDI were registered and analysed using logistic regression, Kaplan-Meier survival estimates and log-rank test.

RESULTS

The prevalence of TDI in the sample population was 16.4% (338 pupils), with a total of 637 teeth involved. The number of included teeth for analysis was 571 (90.5%). The prevalence of pulp necrosis with infection was 7.5%. Moderate and severe TDI was associated with a higher frequency of pulp necrosis with infection. Pulp canal obliteration and root resorption were found in 2.8% and 2.3% of teeth with TDI, respectively. Dental hard tissue injuries were more prone to the development of pulp necrosis than luxation injuries and combination injuries. The relationship between root development stage and development of pulp necrosis with infection was not statistically significant.

CONCLUSIONS

Occurrence of different pulp sequelae among teeth affected with TDI was low. Moderate and severe TDI were more at risk of developing pulpal complications and hard tissue injuries were at higher risk of developing pulp necrosis with infection.

Traumatic dental injuries presenting to a paediatric emergency department in a tertiary children's hospital, Adelaide, Australia

BACKGROUND/AIM

There is a scarcity of data regarding paediatric traumatic dental injuries (TDI) in tertiary teaching hospitals. Therefore, the aim of this study was to review the TDI presenting to the Women's and Children's Hospital in Adelaide (Australia) on an emergency basis and to identify the characteristics of the presenting patient cohort, their accident, injuries and management.

METHODS

Medical health records of 337 paediatric patients attending the Paediatric Emergency Department (PED) for the management of TDI over 18 months were prospectively reviewed.

RESULTS

TDI were more frequent in children under 5 years of age (56.1%) with a predominance of injuries sustained by males (63.8%). The accident characteristics included weekend occurrence (35.6%), the most common aetiology was falls (64.4%) and many incidents occurred at home (48.5%). Overall, 654 teeth were injured with the majority affecting deciduous teeth (58.4%) and the maxillary central incisors (69.9%). The most frequent injury was lateral luxation (27.5%). The majority of patients were referred to the Paediatric Dentistry Department (60.8%). However, almost half of presenting patients did not require further management locally and were subsequently discharged to their dental practitioners (39.2%). Most patients receiving treatment were managed under general anaesthetic (36.9%), and there was often a delay of 3-12 hours before treatment commenced (49.1%). Similarly, more severe injuries in the permanent dentition (avulsion, extrusion, root fracture, intrusion, alveolar fracture) were more frequently managed between 3 and 12 hours following the accident.

CONCLUSION

The patient, accident, injury and management characteristics are comparable to what has previously been reported in other studies in paediatric populations. Injuries affecting the permanent dentition are more likely to be managed within 3 and 12 hours in an outpatient setting, whereas injuries affecting the deciduous dentition had a delay in management between 12 and 24 hours under general anaesthetic.

Traumatic dental injuries and experiences along the life course - a study among 16-yr-old pupils in western Norway

The study assessed risk factors for traumatic dental injuries (TDI) using experiences along the life course. A retrospective longitudinal study, including historical clinical data, was conducted on 16-yr-old pupils in western Norway. All first-grade pupils born in 1997 and attending public high schools were invited to participate (n = 5,184). Participants responded to an electronically administered closed-ended questionnaire (39.6%, n = 2,055). Information on the occurrence of TDI and events during the life course (categorized as socio-economic, biological, psychosocial, and behavioural indicators) was collected. Variables with a significant bivariate association with three different dependent variables (TDI, severity of TDI, and multiple episodes of TDI) were tested in a hierarchical logistic regression analysis. Traumatic dental injuries were more frequent among boys, adolescents of higher socio-economic status, and adolescents with adverse psychosocial and behavioural scores. Moderate and severe TDIs were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in the sport of wrestling. Multiple episodes of TDI were more frequent among adolescents with adverse psychosocial and behavioural scores and among adolescents participating in sports activities. Incorporation of different life-course indicators is important in evaluating TDI severity and repeated incidents.

Investigation of Stress Level Among Dentistry Students, General Dentists, and Pediatric Dental Specialists During Performing Pediatric Dentistry in Kerman, Iran, in 2017

Background & Aim:

Dentists are exposed to stress and tension as they have a close contact with the patients. The increase in stress may affect the dentists’ performance and can be a major threat to the physical and mental health of the patients. Pediatric dentistry requires experience, without which the amateur dentists and students feel lack of self-confidence, and consequently be unable to deal with problematic patients. There is no study investigating stress during pediatric dentistry among the dentistry students as well as general and pediatric dentists in Iran. Regarding the importance ofthis subject, we aimed to evaluate the stress level among the aforementioned three dental service providers during pediatric dentistry.

Materials & Methods:

This study was conducted on 300 dentistry students, general dentists, and pediatric dental specialists in Kerman, Iran. The data were collected using a questionnaire entailing demographic information and therapeutic practices of pediatric dentistry. After checking the participant’s comments, the data were analyzed using SPSS version 16 (IBM, Texas, USA).

Results:

According to the results, the mean age of the participants was 28±5 years. Out of the 300 participants, 113 (37.7%) and 178 (59.3%) cases were male and female, respectively, and 9 (3%) participants did not fill out this part. Furthermore, 108 (36%), 173 (57.7%), 6 (2%), and 10 (3.3%) subjects were general students, general dentists, residents, and pediatric residents, respectively. Anesthesia injection in the mandible for an anxious child and amalgam restoration in the mandible led to the highest and lowest stress levels in the participants, respectively. Furthermore, the mean stress levels were significantly different between the practices performed in the maxilla and mandible (P<0.001). In addition, the females showed a significantly higher level of stress, compared to the males (P<0.001). The specialists had significantly lower stress than the dentistry students and general dentists (P<0.001).

Conclusion:

As the findings indicated, anesthetic injection to a nervous infant was the most stressful practice in pediatric dentistry. The results also showed that the pediatric dental specialists had lower stress level, compared to the students and general dentists.

Outcomes of necrotic immature open-apex central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh as an apical barrier

BACKGROUND/PURPOSE

Although unset mineral trioxide aggregate (MTA) has some cytotoxicity, MTA is still a biocompatible material suitable for doing apexification. This study assessed the outcomes for 8 necrotic immature open-apex permanent maxillary central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh (PCL-FM) as an apical barrier (so-called PCL-FM/MTA apexification) to prevent extrusion of MTA materials into the periapical tissues of open-apex teeth.

METHODS

Eight necrotic immature open-apex permanent maxillary central incisors with the open apices measuring 2.5 mm-3.5 mm in diameter in 8 patients (6 boys and 2 girls; age range, 8-10 years) were first cleaned using ultrasonic activated irrigation with 2.5% sodium hypochlorite solution and then treated by PCL-FM/MTA apexification procedure.

RESULTS

All the 8 permanent maxillary central incisors showed successful outcomes after PCL-FM/MTA apexification procedure. The mean duration for apical hard tissue barrier formation of the 8 incisors was 6.8 ± 0.5 weeks (range 6-7 weeks). The mean increased root length was 1.8 ± 0.7 mm (range 1-3 mm) at 7 weeks and 3.1 ± 0.6 mm (range 2-4 mm) at 3 months. The mean increased dentinal wall thickness at the most apical portion of the root was 1.3 ± 0.5 mm (range 1-2 mm) at 7 weeks and 2.4 ± 0.6 mm (range 1.5-3 mm) at 3 months. None of the teeth treated by PCL-FM/MTA apexification showed tooth discoloration after a follow-up period of 3 months.

CONCLUSION

PCL-FM/MTA apexification is an excellent technique for treatment of necrotic immature open-apex permanent maxillary central incisors.

Alcohol consumption and interpersonal injury in a pediatric oral and maxillofacial trauma population: a retrospective review of 1,192 trauma patients

The social, financial, and health implications of adult alcohol-related oral and maxillofacial trauma have been recognized for several years. Affordability and widespread accessibility of alcohol and issues of misuse in the pediatric trauma population have fostered concerns alcohol may be similarly implicated in young patients with orofacial trauma. The aim of this study was to review data of pediatric facial injuries at a regional maxillofacial unit, assess the prevalence of alcohol use, and review data of patients sustaining injury secondary to interpersonal violence. This study is a retrospective, 3-year review of a Regional Maxillofacial Unit (RMU) trauma database. Inclusion criterion was consecutive facial trauma patients under 16 years of age, referred to RMU for further assessment and/or management. Alcohol use and injuries sustained were reviewed. Of 1,192 pediatric facial trauma patients, 35 (2.9%) were associated with alcohol intake. A total of 145 (12.2%) alleged assault as the mechanism of injury, with older (12-15 years) (n = 129; 88.9%), male (n = 124; 85.5%) (p < 0.001) patients commonly involved and alcohol use implicated in 26 (17.9%) presentations. A proportion of vulnerable adolescents misuse alcohol to the risk of traumatic facial injury, and prospective research to accurately determine any role of alcohol in the pediatric trauma population is essential.

Post-traumatic complications of severe luxations and replanted teeth

AIM

The aim of this study was to evaluate the main post-traumatic complications of severe luxation and replanted teeth using clinical and radiographic analyses.

MATERIALS AND METHODS

Eighty-three patients aged between 7 and 55 years old presenting 180 traumatized teeth that suffered extrusive luxation (n=67), lateral luxation (n=69), intrusive luxation (n=10) and tooth avulsion (n=34) followed by replantation were evaluated. The follow-up period was 24 months. The complications examined were: pulp canal obliteration, pulp necrosis and root resorption (infammatory and replacement). Furthermore, the relationship between time elapsed before receiving dental attendance and development of infammatory resorption was observed.

RESULTS

Pulp necrosis was the main complication, occurring in 147 teeth (82.7%). All of the teeth that suffered intrusive luxation and tooth avulsion were diagnosed with pulp necrosis, with significant difference in comparison with another traumas (p<0.001/Fisher's exact test). Infammatory root resorption was observed in 20.5% of the cases and replacement resorption was more related to tooth replantation (94.1%), showing significant prevalence among tooth luxations (p<0.001/Fisher's exact test). In addition, it was noted that patients who seek treatment 9 weeks after the trauma episode presented 10 times more chance of developing infammatory resorption when compared with patients who seek treatment soon after dental trauma (Odds ratio test).

CONCLUSION

It may be concluded that pulp necrosis was the main post-traumatic complication observed in traumatized teeth and that delay in seeking treatment may damage the prognosis of severe luxation and replanted teeth.

CLINICAL SIGNIFICANCE

Clinical studies describing the main complications that may affect traumatized teeth present great relevance to make the population aware of the importance of seeking immediate treatment and to alert the professional to the need for follow-up. When traumatic injuries are diagnosed and treated early, post-traumatic complications may be controlled, allowing conservation of the tooth in oral cavity.

Pediatric Dental Trauma:Wide Horizon of Ignored Etiological Factors

Trauma of the oral and peroral structures are one of the most common and frequent complaints after dental caries with which a child is being referred to a dental clinic. As an emergency, we tend to treat the injuries without understanding or neglecting the cause of trauma. The different possible etiological factors are unnoticed, not revealed or not noted while taking the history of the patient. Sometimes negligence of the etiology by the dentist himself or the accompanying person could influence the prognosis and prevention. Thus, this paper is an effort towards exploring the common yet unnoticed etiological factors of pediatric dental trauma which we tend to knowingly ignore.

Preventive strategies for traumatic dental injuries

Traumatic dental and maxillofacial injuries are common occurrences, and affect worldwide approximately 20% to 30% of permanent dentition, often with serious aesthetic, functional, psychological, and economic consequences. With such a high frequency of injuries, prevention becomes a primary goal. A prevention approach relies on the identification of etiologic factors, and on giving rise to measures aimed at avoiding those factors or at reducing their impact. This article reviews the etiology and preventive strategy regarding dental injuries, and examines the role and manufacture of appliances, especially mouthguards, in preventive dentistry.

Dento?alveolar and maxillofacial injures ? a survey of knowledge of the regimental aid providers in the Israeli army

The present study evaluated the knowledge of physicians and emergency medical technicians (EMT) regarding primary treatment for oral and maxillofacial trauma and assessed the experience they have in treating oral and maxillofacial injuries. The study population consisted of 80 military physicians and EMT during their military service. A questionnaire was distributed relating to demographic data such as age, gender, position, and type of military service, as well as past experience in treating or witnessing oral and maxillofacial trauma, former education regarding diagnosis and treatment of oral and maxillofacial trauma, assessment of knowledge regarding oral and maxillofacial trauma, etc. The questionnaire was answered by 76 participants (95% response rate): 32 physicians and 44 EMT. Only 17 (22.4%) received education regarding oral and maxillofacial trauma (eight physicians, 25% and nine EMT, 20.5%). Nevertheless, 23 (30.3%) reported witnessing such an injury during their military service. Oral and maxillofacial injuries were first seen by the EMT in 43.4% of the cases, a physician in 23.7%, and a dentist in only 9.2%. Overall, 66 (86.8%) of the physicians and EMT stated that it was important to educate the primary health care providers regarding diagnosis and treatment of oral and maxillofacial trauma. Special emphasis should be given to providing primary caregivers with the relevant education to improve their knowledge and ability of dealing with diagnosis and treatment of oral and maxillofacial trauma.

Dentoalveolar trauma in Glasgow: an audit of mechanism and injury

Traumatic dental injuries in children often require multiple follow-up visits to the dentist and may have long-term consequences for the developing dentition. The aim of this audit was to examine age, gender, location, time of year, mechanism of injury and type of injury sustained in relation to dentoalveolar trauma in children attending the paediatric dental trauma clinic at Glasgow Dental Hospital from 2002 to 2004, and to compare our findings with data in the published literature. Males suffered 60% of all dental trauma, 79% of sporting injuries and 85% of assaults. The injuries in males were more severe, representing 65% of enamel dentine and pulp fractures, 100% of crown root fractures and 66% of crown root and pulp fractures. A peak for trauma was seen in the 8-11-year-old group (43%). The majority of injuries in the under four age group resulted from falls (87%). Taken as a whole, falls accounted for 49%, sports related injuries 18%, bicycle and scooter 13%, assault 7%, and road traffic accidents 1.5% of all injuries. They also accounted for a far higher percentage of intrusive luxations (67%). The largest proportion of injuries occurred during the summer months (33%). Sixty-four percent of children suffered trauma to more than one tooth. Fifty-eight percent of injuries involved the dental hard tissues and pulp and the majority of these (82%) were crown fractures. Most subjects (82%) suffered trauma to their periodontal tissues, (26% concussion or subluxation, 26% lateral luxation and 23% avulsion). Injuries to the supporting bone were uncommon. Sixty-six percent of all injuries occurred outdoors. Our findings were similar to a number of published studies, but in contrast to several others. More consistency is required in the collection and reporting of trauma data to be able to draw meaningful conclusions by comparison.

Dento-alveolar and maxillofacial injuries ? a retrospective study from a level 1 trauma center in Israel

To evaluate the frequency and causes of dental and maxillofacial trauma in hospitalized patients. From January 1, 2000 to December 31, 2003, data from hospitalized trauma patients in a level 1 trauma center in Israel were analyzed according to age, gender, time, place, and cause of injury. Maxillofacial and tooth injuries were separated and further analyzed according to the above parameters. The analysis was based on data from the Israel Trauma Registry (ITR). Of all 14 040 trauma patients, 1038 (7.4%) involved maxillofacial or dental injuries. Common causes of injury were motor vehicle crashes (41%), falls (27%) and intentional injuries (23%). Fifty percent occurred on the street/road, 17% at home and 14% in public buildings. Surgery was required in 55.5% of all maxillofacial injuries. Males were hospitalized three times more than females, and young people, ages 19-28, were at greatest risk (30.2%). Oral and maxillofacial trauma is common, requiring dental health training for primary caregivers.

A prospective study of dentoalveolar trauma at the Hospital das Clínicas, São Paulo University Medical School

PURPOSE

This prospective study evaluated the profile of patients with dentoalveolar trauma assisted at the emergency room of the Oral and Maxillofacial Trauma and Surgery Service at the Hospital das Clínicas, São Paulo University Medical School (Brazil).

METHODS

A prospective study by a questionnaire applied during the first attendance of those patients, in a period of eight months.

RESULTS

The collected data were statistically analyzed. It was observed that 4.7% of the patients that sought treatment at the Service had sustained dentoalveolar trauma and among these 74% were male. The most affected individuals were children aged 0 to 5 years and fall was the most prevalent etiologic factor. Avulsion and coronal/crown-root fractures were the most common types of dentoalveolar traumatic injures. As the age increases, the most common etiologic factors are traffic accidents and physical assault.

CONCLUSION

The incidence of dentoalveolar trauma decreased with age and the main etiologic factors in adult patients were traffic accidents and physical assault.

Traumatic dental injuries and associated factors among Brazilian preschool children

The main objective of this study was to assess the epidemiology of traumatic dental injuries (TDI) to the primary teeth of preschool children and second, to investigate whether TDI were related to anterior open bite and, third, whether TDI are related to socio-economic circumstances in an urban Brazilian population. A clinical examination was performed during the National Day of Children's Vaccination. TDI were classified according to the modified classification proposed by Ellis. In addition to those criteria the presence of tooth discoloration was recorded. An interview was carried out with mothers or guardians. The data collected included mother's level of education and living conditions. The prevalence of TDI was 9.4%. The maxillary central incisors were the most affected teeth. Most children with a TDI experienced traumatic injuries to one tooth (6.3%), while 2.8% had two and 0.4% had three traumatized teeth. The most common crown fracture was in enamel only (68.8%), followed by crown fracture of enamel and dentin (13.8%). Missing teeth following trauma occurred in 10.9% of those with TDI. The prevalence of tooth discoloration was 5.1%. Children with anterior open bite had twice the level the level of TDI compared to those with normal occlusions (P = 0.001). Socio-economic factors were not statistically significantly associated with the occurrence of TDI. The prevalence of dental injuries in Brazilian preschool children was low. Children with anterior open bite experienced more dental injuries. Neither of the indicators of socio-economic status was related to the prevalence of TDI.

Physician and emergency medical technicians' knowledge and experience regarding dental trauma

The purpose of the present study was to evaluate the knowledge of physicians and emergency medical technicians (EMT) regarding primary treatment for dental trauma and to assess the experience they have in treating dental injuries. The study population consisted of 70 military physicians and EMT during their military service. A questionnaire was distributed relating to demographic data, such as age, gender, position, and type of military service, as well as the following issues: past experience in treating or witnessing dental trauma, former education regarding diagnosis and treatment of dental trauma, assessment of knowledge regarding dental trauma, etc. Of all participants, only 4 (5.9%), all physicians, received education regarding dental trauma. Nevertheless, 42 (61.8%) reported they witnessed such an injury during their military service. Dental injuries were first seen by the EMT in 41.2% of the cases, by the physician in 25%, and by a dentist in only 7.3%. Overall, 58 (85.3%) of the physicians and EMT stated that it was important to educate the primary health care providers regarding diagnosis and treatment of dental trauma. Special emphasis should be given to providing primary caregivers with the relevant education to improve their knowledge and ability of dealing with diagnosis and treatment of dental trauma.

Possibilities of preventing traumatic dental injuries: A prospective study

Introduction The aim of this study was to investigate the most important etiological factors related to traumatic dental injuries, type of required treatment, period from injury to initial treatment and Frequency of recall appointments. Material and methods The sample consisted of 283 children with dental injuries managed at the Department of Dentistry of the Faculty of Medicine in Novi Sad. during the last 7 years. Retrospective data relied on trauma protocols of this department, whereas collected data referred to etiological factors, type of initial treatment, period from injury to initial treatment, recall appointments and complications of traumatic dental injuries. These results were compared with other similar national and international studies, in order to promote implementation of preventive strategies that would reduce the increasing frequency of dental trauma. Results Fall accidents were the most common cause of dental trauma. Injuries were most frequent in autumn, in the street, and in the afternoon hours. Single tooth injury was predominant, while the injured mostly denied previous injuries. Almost half of the injured patients did not seek professional help in the first 24 hours after the injury. 40% of treated patients missed their recall appointment. Conclusion Knowledge of the etiology is important for planning preventive, measures, but because of the complexity of etiological factors, it is difficult to prevent traumatic dental injuries. It is also important to underline the importance of immediate initial treatment of traumatized patients, and significance of their regular professional supervision. Generally speaking, almost all treatment procedures in management of traumatic dental injuries include preventive component.

Restoration of anterior teeth with indirect composite partial coverage crowns: A clinical report

When an esthetic restoration with minimal tooth reduction is desired, for example in patients with uncomplicated tooth fractures, composite partial coverage crowns may be a therapeutic option. The indirect composite restoration allows restoration of the original tooth anatomy, function, and esthetics to be reproduced while preserving tooth structure. The use of composite partial coverage crowns to restore fractured anterior teeth is described.