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Šimunović L, Špiljak B, Vranić L, Negovetić Vranić D. Treatment priorities and arrival time of traumatic dental injuries-An 8-year retrospective study. Dent Traumatol 2024; 40:11-21. [PMID: 37750007 DOI: 10.1111/edt.12889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND/AIM Most of the previous studies in the available literature discussed the time of arrival in general to the healthcare system, while a minority studied the relationship between the type of trauma and arrival. The aim of this retrospective study is to assess the arrival time of traumatic dental injuries (TDIs) depending on the urgency of treatment according to Andreasen. MATERIALS AND METHODS This 8-year retrospective study was carried out at the Department of Pediatric Dentistry at the University Dental Clinic in Zagreb, Croatia. Andreasen's classification was used to define the kind of TDI as well as to divide them by the need for urgent treatment or treatment priorities in three groups: acute, subacute, and delayed. RESULTS The sample consisted of 1040 children (59% male and 41% female) with a median age of 7. Each year, the age group most affected by TDIs was 6-12 years old. While there is a general increase in the prevalence of TDIs overall, there is a decline in TDIs among children aged 6-12 and an increase among preschoolers and adolescents (below 6 and above 12 years old). Throughout the years, 52.73% red/acute and 41.16% yellow/subacute TDIs were not treated on time due to delayed arrival. More patients from Zagreb come in the first 24 h, while more patients from outside Zagreb come to the clinic a month or more after their injuries. Patients which suffered TDI accompanied with soft-tissue injury arrived sooner. CONCLUSIONS It is necessary to introduce monitoring and education of patients under the age of 6 and over 12, as well as their parents/caregivers. New programs should be implemented and new referent centers that specialize in treating TDIs outside of Zagreb should be established.
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Affiliation(s)
- Luka Šimunović
- Department of Orthodontics, School of Dental Medicine Zagreb, University of Zagreb, Zagreb, Croatia
| | - Bruno Špiljak
- School of Dental Medicine Zagreb, University of Zagreb, Zagreb, Croatia
| | - Lara Vranić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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2
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Zhang JL, Peng ZL, Huang J, Pan YJ, Sun ZW, Mai ZH. A two-year retrospective study on traumatic dental injury in the primary dentition. Medicine (Baltimore) 2023; 102:e35750. [PMID: 37960738 PMCID: PMC10637491 DOI: 10.1097/md.0000000000035750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/02/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this study was to analyze the causes, clinical characteristics, social factors, and current status of treatment of traumatic dental injury (TDI) in the primary dentition. A retrospective analysis was performed on 144 children (213 teeth) with TDI in the primary dentition from our hospital between December 2017 and June 2020. Data were analyzed using the chi-square test and the Mann-Withney-Wilcoxon test. Boys accounted for 68.1% (98/144) and girls for 31.9% (46/144) of all 144 children with TDI in the primary dentition, with a boy-girl ratio of 2.13:1. The primary age of TDI in deciduous teeth was 2 to 4 years old, accounting for 59% of all cases. Collision with others and fall were the 2 main causes of trauma to the deciduous teeth, making up 52.1% and 44.4% of all causes, respectively. Crown fracture injury was the most common type of TDI in the primary dentition, accounting for 37% of all cases (53/144). Of the 144 cases, 17.4% (25/144) was accompanied by soft tissue laceration, while 22.2% (32/144) by swelling or contusion of tissue. Maxillary teeth (92.4%) were more vulnerable to injury than mandibular teeth (7.5%), with maxillary incisor being the most vulnerable 1 (91.5%). The percentage of children arrived at the hospital for treatment 24 hours after the injury was the highest (57.0%, 82/144). After the hospital visit, 74.3% of children received treatment for the dental trauma. In terms of the treatment modalities, extraction of the traumatized teeth (27.1%) and pulpectomy + resin filling (or preformed crown) restoration were predominant. Approximately 28.5% (41/144) of cases were reviewed within 2 years, with the proportion of children with pulpitis or periapical infection being the highest (29.3%, 12/41). Age, gender, collision, and fall are the factors linked to a higher risk of TDI in the primary dentition in children under the age of 7. Resin filling (or preformed crown) restoration and pulpectomy are effective in preserving the affected tooth and controlling infection. However, the preservation of the affected tooth and the prevention of infection may be hampered by late visits and low follow-up rates.
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Affiliation(s)
- Jing-Lan Zhang
- Department of Pediatric Dentistry, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zhu-Li Peng
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, P. R. China
| | - Jie Huang
- Department of Pediatric Dentistry, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Yan-Jun Pan
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, P. R. China
| | - Zhi-Wen Sun
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, P. R. China
| | - Zhi-Hui Mai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, P. R. China
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3
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Huang C, Yang Y, Wang Z, Wang W, Liu Y, Zhang M. A retrospective study of emergent traumatic dental injuries in permanent teeth in Xi'an, China. Medicine (Baltimore) 2022; 101:e32588. [PMID: 36596078 PMCID: PMC9803479 DOI: 10.1097/md.0000000000032588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Traumatic dental injury is one of the common injuries seen in the emergency department. To determine the distribution features of emergency traumatic dental injuries in Xi'an, China, data from the medical records of 623 patients (aged 6-78 years) were evaluated and analyzed according to age, gender, etiology, factors predisposing teeth to injury, and types of teeth traumatized. The patient records of 397 males (63.7%) and 226 females (36.3%), with a 1.8:1 male-to-female ratio, were included. The total number of traumatized teeth was 1475. The highest frequency of dental trauma was found in the 19- to 30-year age group (30.7%). The greatest frequency of dental trauma injuries was in May (13%). Over one-third of patients with traumatic injuries to permanent teeth (n = 218, 35%) injured 2 permanent teeth. The most commonly affected teeth were the maxillary central incisors (59.3%). The most common type of trauma was concussion (20.4%). There was statistically significant difference among the type composition ratio of age groups (P < .05). The most common causes of dental trauma were falls (50.2%). There was statistically significant difference among the etiological composition ratio of age groups (P < .05). Combined injuries were present in 120 teeth in 103 patients (16.5%). The epidemiological characteristics of dental trauma in Xi'an shows that the occurrence of dental trauma is closely related to the age, sex, time, type of injury, and cause of injury. There exists cross-correlation among the epidemiological factors. The most common type of trauma is concussion and the most common cause of dental trauma is fall. High incidence of combined injuries needs extra attention.
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Affiliation(s)
- Chao Huang
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Yang Yang
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Ziheng Wang
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | - Wei Wang
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Yanli Liu
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Min Zhang
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
- * Correspondence: Min Zhang, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry & Emergency, School of Stomatology, The Fourth Military Medical University, Xi’an, Shaanxi 710032, China (e-mail: )
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4
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Dezzen-Gomide AC, de Carvalho MA, Lazari-Carvalho PC, de Oliveira HF, Cury AADB, Yamamoto-Silva FP, Silva BSDF. A three-dimensional finite element analysis of permanent maxillary central incisors in different stages of root development and trauma settings. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 207:106195. [PMID: 34082308 DOI: 10.1016/j.cmpb.2021.106195] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/15/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Differences in dental maturation may affect the prognosis and clinical management of traumatized teeth. However, evaluation of the outcomes of dental trauma to the tooth and support structures in an in vivo model involves major methodological and ethical implications. Thus, the aim of the present study was to perform a three-dimensional finite element analysis of permanent maxillary central incisors in different stages of root development under different trauma settings. METHODS The study factors included two trauma conditions (B, buccal; I, incisal) on upper permanent central incisors showing three different stages of root development (CR, complete rhizogenesis; IRA; incomplete rhizogenesis in the apical third of the root; and IRM, incomplete rhizogenesis in the middle third of the root) to yield six models. The complete rhizogenesis model was obtained with a cone-beam computed tomography examination of an extracted tooth. The two incomplete rhizogenesis models were modeled on the basis of similar examinations of patients. Trauma was simulated by applying a 300 N static surface to surface load on the incisal edge or perpendicular to the buccal surface of the tooth. The displacement and equivalent von Mises (σvM) stress values were obtained for alveolar bone, periodontal ligament, apical papilla, and dentin for the quantitative analysis. A σvM color-coded scale was used for qualitative analysis. RESULTS The force direction had a greater influence on the stress than the root-formation stage. Buccal forces resulted in higher stress concentration in the bone and periodontal ligament, especially in B-CR. Lower stress was found on the periodontal ligament as the root formation progressed (decrease of 8% from B-IRA to B-CR and 11% from B-IRM to B-CR). The incomplete rhizogenesis models showed higher σvM stress peak values in dentin in comparison with complete rhizogenesis (increase of 52% from B-CR to B-IRA and 56% from B-CR to B-IRM). CONCLUSIONS Buccal forces yielded greater stress values regardless of the stage of rhizogenesis. Teeth with fully formed roots showed a higher stress concentration in the alveolar bone and periodontal ligament in comparison with immature teeth, with the latter presenting high stresses in the tooth crown.
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Affiliation(s)
| | | | | | | | - Altair A Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | | | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil, and University of Anápolis, Anápolis, GO, Brazil.
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Prieto-Regueiro B, Gómez-Santos G, Diéguez-Pérez M. Prevalence of traumatic injuries in deciduous dentition and associated risk factors in a Spanish children population. J Clin Exp Dent 2021; 13:e678-e684. [PMID: 34306531 PMCID: PMC8291162 DOI: 10.4317/jced.58051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/15/2021] [Indexed: 11/05/2022] Open
Abstract
Background The frequency of traumatic dental injuries (TDI) in primary dentition and those agents that favor them present a great variability. Therefore, the objective of this study was to determine the prevalence of TDI in a population of Spanish preschoolers in temporary dentition and identify the factors associated with these injuries. Material and Methods An epidemiological observational prevalence study was carried out. A total of 343 children aged between 3 and 5 years were selected. A questionnaire was completed in relation to socioeconomic factors, cultural level, dietary habits and oral parafunction. Through an intraoral examination, information was collected on the occlusal characteristics and the presence of TDI. Data analysis was performed using the SPSS Statistics 25.0 program for Windows, using the descriptive and frequencies procedure, contingency tables, Chi-square test, and logistic regression analysis. Results The prevalence of TDI in the total sample was 12.2%. The most frequent lesion was crown discoloration (0.4%) followed by crown fracture (0.1%) and avulsion (0.1%). The most affected tooth was the deciduous upper central incisor. In the multivariate logistic regression analysis the presence of dental trauma did correlate significantly with the age (5 years in reference to 3 years: OR = 4.209; 95% C.I. = 1.591-11.134; p = 0.004) and overjet (OR = 2.609; 95% C.I. = 1.306-5.214; p = 0.007). Conclusions The prevalence of these lesions in a Spanish infant population with temporary dentition is low. Only age and overjet are risk factors. Key words:Dental trauma, deciduous dentition, risk factors.
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Affiliation(s)
- Beatriz Prieto-Regueiro
- Primary Care Odontostomatologist. Health Services Management of the Health Area of Lanzarote. Canary Health Service
| | - Gladys Gómez-Santos
- Stomatologist. Technician of the General Directorate of Public Health. Health Promotion Service. Canary Health Service
| | - Montserrat Diéguez-Pérez
- Adjunct Professor. Department of Preclinical Dentistry. Faculty of Biomedical Sciences and Health Sciences. European University of Madrid. Associate Professor of Pediatric Dentistry. Department of Dental Clinical Specialties. Faculty of Dentistry. Complutense University of Madrid
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Antipovienė A, Narbutaitė J, Virtanen JI. Traumatic Dental Injuries, Treatment, and Complications in Children and Adolescents: A Register-Based Study. Eur J Dent 2021; 15:557-562. [PMID: 33535246 PMCID: PMC8382465 DOI: 10.1055/s-0041-1723066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective
Traumatic dental injury (TDI) is a common dental concern among children worldwide. We performed a retrospective patient register study among children under 18 years to investigate TDIs with respect to causes, treatment, and complications.
Materials and Methods
We collected information on TDIs from the original patient records of 407 child patients visiting dental clinic of Lithuanian University of Health Sciences, Kaunas, Lithuania. We analyzed all child patients’ (
n
= 407) background, cause, type of TDI, treatment, complications, and time elapsed from injury to visit to the dentist.
Statistical Analysis
The
χ2
-test, analysis of variance (ANOVA), and Kruskal–Wallis and Mann–Whitney tests served in the statistical analyses.
Results
A total of 579 TDI cases occurred during 2010 to 2016. Lateral luxation (19.8%) and intrusion (14.8%) occurred more often in the primary than the permanent dentition (
p
< 0.05). The most common cause of TDI was falling (56%). Avulsion occurred in approximately 10% of cases. Follow-up (44.5%) and tooth extraction (48.3%) were the most frequent treatments in the primary and splinting (25.3%) in the permanent teeth. Pulp necrosis was the most frequent complication in primary (92%) and permanent (54%) dentition. About 1% of the patients obtained dental care during the first hour after injury.
Conclusion
The most frequent TDIs included lateral luxation in primary teeth and enamel-dentine fractures in permanent teeth. We observed a delay in patients obtaining emergency dental care.
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Affiliation(s)
- Austė Antipovienė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Julija Narbutaitė
- Department of Preventive and Pediatric Dentistry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jorma I Virtanen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
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7
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Gümüş H, Öztürk G, Kürem B. Profiles of traumatic dental injuries among children aged 0-15 years in Cappadocia, Turkey: A retrospective cohort study. Dent Traumatol 2021; 37:419-429. [PMID: 33406301 DOI: 10.1111/edt.12648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIM Traumatic dental injuries are among the most serious dental public health problems in children. The aim of this retrospective study was to evaluate the dental trauma profile of primary and permanent teeth among children aged 0-15 years who presented to a university hospital. MATERIAL AND METHODS The study included 650 patients (1,000 primary and permanent teeth) who presented with a history of dental trauma to the Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University between 2016 and 2019. Traumatized teeth were assessed according to the Andreasen classification. The following information was recorded: age, gender, teeth affected by trauma, etiologies of trauma, place and season of trauma, type of trauma, type of treatment, and time between the trauma and treatment. RESULTS In total, 650 patients (240 females, 410 males) and 1,000 incisors (212 primary teeth, 788 permanent teeth) were evaluated. The average age of the patients was 8.89 ± 3.41 years, and dental injuries were more frequent between 8 and 10 years of age. The maxillary central incisors, both primary (40.1%) and permanent (42.8%), were the most frequently affected teeth. The main cause of traumatic dental injuries was falls. Most accidents occurred at school and home. The most common type of dental injuries recorded was luxation injuries in the primary teeth (21.5%) and enamel-dentin fractures (35.9%) in the permanent teeth. Only 48 teeth were treated during the first hour after injury. CONCLUSIONS The most common type of traumatic injury affecting permanent teeth was enamel-dentin fractures, and primary teeth were luxation injury. Only 4.8% of teeth were treated within the first hour after trauma.
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Affiliation(s)
- Hüsniye Gümüş
- Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Gülce Öztürk
- Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Büşra Kürem
- Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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8
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Faus-Matoses V, Faus-Matoses I, Ruiz-Sánchez C, Faus-Damiá M, Faus-Llácer VJ. Incidence of traumatic dental injury in Valencia, Spain. Med Oral Patol Oral Cir Bucal 2020; 25:e592-e598. [PMID: 32388517 PMCID: PMC7473440 DOI: 10.4317/medoral.23630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/03/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND While traumatic dental injuries (TDI) are an increasingly frequent occurrence in everyday dental practice, little research on TDIs has been published in Spain. The aim of this study was to determine the incidence of TDIs in a population in Valencia (Spain) and investigate influential variables. In addition, a protocol for TDI data collection is proposed. MATERIAL AND METHODS This retrospective study compiled data from patients attending a private dental clinic between January 2003 and December 2014. The data were collected using a specially-elaborated protocol entitled "Emergency care of acute dental trauma". Patients responded to each item, and data was added from case radiographs and photographs. Data were entered in a Microsoft Office Excel spreadsheet and submitted for analysis by SPSS 15.0 software (Chicago, IL) applying 2-way analysis of variance (ANOVA) (p<0.01). RESULTS 481 TDIs in 251 patients were examined at a private dental practice in Valencia. The population comprised 62.5% men and 37.5% women, aged 1 to 78 years. The highest frequency of tooth injuries occurred in children aged 9 years or younger. The most frequent injury was non-complicated crown fracture (43.2%). Upper central incisors were the most commonly affected teeth. The most frequent place where TDI was produced was in the street (28.7%), tripping over an immobile object being the most common cause (29%). CONCLUSIONS Thanks to the protocol elaborated for the purposes of this work, it was possible to compile a large quantity of data on TDI, facilitating future prevention and comparison with other regions. The results obtained concur with those published in the literature.
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Affiliation(s)
- V Faus-Matoses
- Clínica Odontológica Universitat de Valéncia C/ Gascó Oliag nº 1 46010 Valencia, Spain
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9
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Tan YZ, Levin L, Guo W, Chen Y. Dental injuries at the Xi'an, China Stomatological Hospital: A Retrospective Study. Dent Traumatol 2020; 36:505-509. [PMID: 32450001 DOI: 10.1111/edt.12572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIM In order to enrich epidemiological knowledge regarding traumatic dental injuries (TDI) in China, and to further improve the treatment, prevention and education of TDI, the aim of this study was to retrospectively analyze the TDI that presented to the emergency dental department at the Stomatological Hospital in Xi'an, China. METHODS This retrospective study included all first-visit patients who presented with TDI at the Stomatological Hospital affiliated with the Fourth Military Medical University in Xi'an, China, between January 2013 and June 2019. Data were extracted using the terms of diagnosis of TDI from the hospital database. RESULTS Overall, 965 (606 males and 359 females) files were reviewed. The average age was 22.8 ± 13.4 years. Among the 2059 teeth injured (average of 2.1 teeth per patient), the maxillary incisors (1751; 85.0%) were the most prevalent teeth to present with injuries, while the main types of injuries were concussions (14.8%) enamel-dentin-fractures (14.50%) and enamel-dentin-pulp fractures (14.0%). After initial examination and diagnosis, 4.2% patients refused treatment. CONCLUSIONS The epidemiological statistics of TDI in Xi'an, China show consistency with other studies from around the world, but they also vary in diagnosis proportion and the choice of treatments. This information may further instruct treatment, prevention and emergency resources distribution to target the high-risk groups.
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Affiliation(s)
- Yi-Zhou Tan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Weiwei Guo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yongjin Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, The Fourth Military Medical University, Xi'an, China
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10
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Ng L, Malandris M, Cheung W, Rossi-Fedele G. Traumatic dental injuries presenting to a paediatric emergency department in a tertiary children's hospital, Adelaide, Australia. Dent Traumatol 2020; 36:360-370. [PMID: 32012455 DOI: 10.1111/edt.12548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Lydia Ng
- Dental Department, Hutt Valley District Health Board, Hut Hospital, Wellington, New Zealand.,Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | | | - Wendy Cheung
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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Abstract
This retrospective study aimed to evaluate the dental trauma profile in primary and permanent teeth from patients between 0 and 15 years old who attended the Faculty of Dentistry of the Federal University of Rio de Janeiro. Data regarding gender, age, trauma classification, tooth type, and affected tissues were obtained from dental records. The data were analyzed descriptively and by the χ2 test (p < 0.05). Data associated with 333 traumatized teeth (70% primary and 30% permanent teeth) were included. The mean ages of children with affected primary and permanent teeth were 3.35 ± 2.02 and 9.09 ± 2.43 years, respectively. Males presented more permanent teeth with trauma (64.4%) than primary ones (55.6%; p = 0.085). The upper central incisors, both primary (68.9%) and permanent (69.4%), were the teeth most commonly affected. Primary teeth showed a higher frequency (p < 0.001) of supportive tissue trauma (73.3%) and lower frequency (p = 0.001) of hard tissue trauma (40.7%) than those in permanent ones (51.5% and 60.6%, respectively). The most frequent trauma in the supportive tissue was subluxation (27.2%) and permanent lateral luxation (42.0%). In the hard tissues, permanent teeth presented a higher prevalence of trauma than primary ones (p = 0.001), however this difference was not statistical significant when each type of fracture injury was evaluated individually (p > 0.005). With affected primary teeth, there was a greater frequency of trauma in the gingival mucosa (31.0%; p = 0.022); in the permanent ones, traumatic lesions in the chin region were the most prevalent (20.8%; p = 0.009). Trauma was recurrent in 26.3% of primary teeth and in 20.2% permanent teeth. Therefore, primary and permanent teeth showed distinct trauma profiles, suggesting that distinct preventive and therapeutic approaches are needed for these two groups.
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12
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Vilela ABF, Soares PBF, de Oliveira FS, Garcia-Silva TC, Estrela C, Versluis A, Soares CJ. Dental trauma on primary teeth at different root resorption stages-A dynamic finite element impact analysis of the effect on the permanent tooth germ. Dent Traumatol 2019; 35:101-108. [DOI: 10.1111/edt.12460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Andomar B. F. Vilela
- Department of Operative Dentistry and Dental Materials; Dental School; Federal University of Uberlândia; Uberlândia Minas Gerais Brazil
| | - Priscilla B. F. Soares
- Department of Periodontology and Implantology; Dental School; Federal University of Uberlândia; Uberlândia Minas Gerais Brazil
| | - Fabiana S. de Oliveira
- Department of Pediatric Dentistry; Dental School; Federal University of Uberlândia; Uberlândia Minas Gerais Brazil
| | - Tales C. Garcia-Silva
- Department of Operative Dentistry and Dental Materials; Dental School; Federal University of Uberlândia; Uberlândia Minas Gerais Brazil
| | - Carlos Estrela
- Department of Stomatological Sciences; Dental School; Federal University of Goiás; Goiânia Goiás Brazil
| | - Antheunis Versluis
- Department of Bioscience Research; University of Tennessee Health Science Center; College of Dentistry; Memphis Tennessee
| | - Carlos J. Soares
- Department of Operative Dentistry and Dental Materials; Dental School; Federal University of Uberlândia; Uberlândia Minas Gerais Brazil
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de Almeida Geraldino R, Rezende LVMDL, da-Silva CQ, Almeida JCF. Remote diagnosis of traumatic dental injuries using digital photographs captured via a mobile phone. Dent Traumatol 2017; 33:350-357. [PMID: 28453886 DOI: 10.1111/edt.12347] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Intra-oral photographs have been aided diagnosis of several pathologies in teledentistry. Mobile phone cameras may produce high-quality photographs, presenting itself as a viable tool for remote diagnosis of traumatic dental injuries. AIM To evaluate the levels of interexaminer agreement in cases of traumatic dental injuries when comparing diagnoses conducted in person and remotely. MATERIAL AND METHODS The sample included 40 patients with 73 traumatized teeth, and a total of 90 diagnoses, who had presented to two dental clinics, one private, and the other public, in Brazil's Federal District. The dental history and clinical examination data were registered in electronic forms, and digital photographs were captured with a mobile phone camera and uploaded to a cloud drive. Six remote examiners formulated their diagnoses based solely on photographic analysis. Thereafter, they were provided with additional clinical data and asked to provide a second round of diagnoses. These diagnoses were compared to those conducted in person, which were considered the gold standard. The data were analyzed with Gwet's AC1 interexaminers' measure to evaluate the agreement between the in-surgery and remote diagnoses. RESULTS The levels of interexaminer agreement between the in-surgery and remote diagnoses formulated exclusively with images were 0.83 or higher (95% confidence interval: 0.73-0.91), and 0.93 or higher (95% confidence interval: 0.88-0.97), when clinical information was available. CONCLUSION The precision of the remote diagnoses was comparable to the diagnoses conducted in person. The levels of interexaminer agreement were higher when clinical data were included with the images. Mobile phones may be an effective tool for capturing images that assist in the remote diagnosis of traumatic dental injuries.
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Affiliation(s)
| | | | | | - Júlio César Franco Almeida
- Oral Health Unit - University Hospital, Health Sciences Faculty, University of Brasília, Brasília, Brazil
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Galović J, Vukojević T, Nikolić-Ivošević J, Perin M, Vicko K, Demko-Rihter I, Petrović B. Tooth loss and survival analysis after traumatic injuries in primary dentition. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background/Aim: The aim of the present study was to investigate the treatment options, survival rate of traumatized primary teeth and evaluate the factors influencing the outcome. Material and Methods: The sample consisted of all dental trauma cases treated over a 14 years period at the Department of Pediatric and Preventive Dentistry, Dental Clinic of Vojvodina, Novi Sad. Criteria for inclusion in this study were: dental trauma to primary teeth and age in the moment of injury up to seven years. Dental trauma records were analyzed in order to obtain the following: gender and age of the child at the time of trauma, type of trauma, as well as the type and timing of treatment received. After data analysis a survival rate of traumatized primary teeth was evaluated. Results: The study was designed as retrospective and it included 225 children, with 346 traumatized primary teeth. The occurrence of trauma was higher in male patients (60,4%) and in children up to 4 years of age. Luxations were more frequent (72.8%) compared to isolated teeth fractures (20.8%), while the two types of injury combined were rare (6,3%). One year following dental trauma 231 teeth (0.67%) developed complications. Falls were the main cause of trauma (68.9%) and the presence of more than one traumatized tooth was frequent. A percentage of 48.8 children received dental care during first 24 h after the injury. Conclusions: Survival of injured primary teeth is relatively low, regardless of trauma type, time interval between injury and treatment and the type of provided treatment.
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Abstract
OBJECTIVE The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition. RESULTS We identified 108 children with dental and if present, associated oral injuries. The median age was 12.3 years, the most common tooth injured were the primary (25.9%) or permanent (62%) upper central incisors, and the majority of subjects presented in the afternoon (mean time was 3:50 PM, SD ±24 minutes). A large proportion of dental injuries occurred in patients with permanent dentation (62%) and half of all children had more than 1 tooth injury. The majority of children (75%) were evaluated by either pediatric dental, oral surgery, or otolaryngology services, whereas 3.7% of the cases required multiple services. Twenty-five percent of children had an associated jaw fracture. Eighty-three percent of children were discharged home, of those, 49.1% were prescribed opioids, and 38.3% oral antibiotics. CONCLUSIONS Emergency departments are often relied upon to evaluate and treat simple and complex dental and oral injuries. The ability to use a multidisciplinary team to manage pediatric oral and dental trauma is essential for care.
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Unusual transalveolar and transmuco-gingival root avulsion of a fractured primary central incisor: a case with an 8-year follow-up. Case Rep Dent 2015; 2015:914846. [PMID: 25793129 PMCID: PMC4352502 DOI: 10.1155/2015/914846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 01/23/2015] [Indexed: 11/27/2022] Open
Abstract
The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a “fragment that looks like canine” found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in the dental arch. Clinical and radiological examinations were performed in order to follow up the case: 15 days, one month, and three months after trauma, the crown had a slight mobility without other clinical or radiological signs. After six months, the upper primary central right incisor's crown was exfoliated. Open bite due to the persistence of the pacifier habit favored the crown retention in the mouth. This case emphasizes the importance of primary diagnosis and follow-up of trauma cases. To the best of our knowledge, this kind of dental injury has not been previously described in the literature nor in the current Dental Trauma guidelines for the management of traumatic dental injuries in the primary dentition.
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Viciano J, D'Anastasio R, Capasso L. Timing of maxillofacial-oral injuries in an individual of the ancient city of Herculaneum (79 AD, Naples, Italy): a case report. Dent Traumatol 2015; 31:215-27. [DOI: 10.1111/edt.12170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Joan Viciano
- University Museum; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
| | - Ruggero D'Anastasio
- University Museum; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
- Department of Medicine and Ageing Science; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
| | - Luigi Capasso
- University Museum; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
- Department of Medicine and Ageing Science; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
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Tsilingaridis G, Malmgren B, Skutberg C, Malmgren O. The effect of topical treatment with doxycycline compared to saline on 66 avulsed permanent teeth - a retrospective case-control study. Dent Traumatol 2015; 31:171-6. [DOI: 10.1111/edt.12161] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Georgios Tsilingaridis
- Department of Paediatric Dentistry; Eastmaninstitutet; Stockholm Sweden
- Department of Paediatric Dentistry; Division of Dental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Barbro Malmgren
- Department of Paediatric Dentistry; Division of Dental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Caroline Skutberg
- Department of Paediatric Dentistry; Eastmaninstitutet; Stockholm Sweden
| | - Olle Malmgren
- Orthodontic Clinic Tandregleringen; Huddinge Stockholm Sweden
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19
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Petti S. Over two hundred million injuries to anterior teeth attributable to large overjet: a meta-analysis. Dent Traumatol 2014; 31:1-8. [PMID: 25263806 DOI: 10.1111/edt.12126] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM The association between large overjet and traumatic dental injuries (TDIs) to anterior teeth is documented. However, observational studies are discrepant and generalizability (i.e. external validity) of meta-analyses is limited. Therefore, this meta-analysis sought to reconcile such discrepancies seeking to provide reliable risk estimates which could be generalizable at global level. MATERIAL AND METHODS Literature search (years 1990-2014) was performed (Scopus, GOOGLE Scholar, Medline). Selected primary studies were divided into subsets: 'primary teeth, overjet threshold 3-4 mm' (Primary3); 'permanent teeth, overjet threshold 3-4 mm' (Permanent3); 'permanent teeth, overjet threshold 6 ± 1 mm' (Permanent6). The adjusted odds ratios (ORs) were extracted. To obtain the highest level of reliability (i.e. internal validity), the pooled OR estimates were assessed accounting for between-study heterogeneity, publication bias and confounding. Result robustness was investigated with sensitivity and subgroup analyses. RESULTS Fifty-four primary studies from Africa, America, Asia and Europe were included. The sampled individuals were children, adolescents and adults. Overall, there were >10 000 patients with TDI. The pooled OR estimates resulted 2.31 (95% confidence interval - 95CI, 1.01-5.27), 2.01 (95CI, 1.39-2.91) and 2.24 (95CI, 1.56-3.21) for Primary3, Permanent3 and Permant6, respectively. Sensitivity and subgroup analyses corroborated these estimates. CONCLUSIONS Reliability and generalizability of pooled ORs were high enough and made it possible to assess that the fraction of global TDIs attributable to large overjet is 21.8% (95CI, 9.7-34.5%) and that large overjet is co-responsible for 235 008 000 global TDI cases (95CI, 104,760,000-372,168,000). This high global burden of TDI suggests that preventive measures must be implemented in patients with large overjet.
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Affiliation(s)
- Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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Chen Z, Si Y, Gong Y, Wang J, Liu J, He Y, He W, Nan Z, Zhang Y. Traumatic dental injuries among 8‐ to 12‐year‐old schoolchildren in
P
inggu
D
istrict,
B
eijing,
C
hina, during 2012. Dent Traumatol 2014; 30:385-390. [PMID: 24735156 DOI: 10.1111/edt.12110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Zhuo Chen
- Department of Oral and Maxillofacial Surgery Peking University School and Hospital of StomatologyBeijing China
| | - Yan Si
- Department of Preventive Dentistry Peking University School and Hospital of StomatologyBeijing China
| | - Yi Gong
- Department of Dental Emergency Beijing Stomatological Hospital Capital Medical UniversityBeijing China
| | - Jian‐Guo Wang
- Department of Stomatology Pinggu District Hospital of Capital Medical University Beijing China
| | - Jing‐Xin Liu
- Department of Stomatology Pinggu District Hospital of Capital Medical University Beijing China
| | - Yang He
- Department of Oral and Maxillofacial Surgery Peking University School and Hospital of StomatologyBeijing China
| | - Wen‐Peng He
- Department of Oral and Maxillofacial Surgery Peking University School and Hospital of StomatologyBeijing China
| | - Zhe Nan
- Department of Dental Emergency Beijing Stomatological Hospital Capital Medical UniversityBeijing China
| | - Yi Zhang
- Department of Oral and Maxillofacial Surgery Peking University School and Hospital of StomatologyBeijing China
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