Traumatic dental injury in permanent teeth of young patients attended at the federal University of Rio de Janeiro, Brazil

Orofacial Trauma on the Anterior Zone of a Trumpet's Player Maxilla: Concept of the Oral Rehabilitation-A Case Report

Background: The occurrence of an orofacial trauma can originate health, social, economic and professional problems. A 13-year boy suffered the avulsion of tooth 11 and 21, lost at the scenario. Methods: Three intraoral appliances were manufactured: A Hawley appliance with a central expansion screw and two central incisors (1), trumpet edentulous anterior tooth appliance (2) and a customized splint (3) were designed as part of the rehabilitation procedure. Objectively assessing the sound quality of the trumpet player with these new devices in terms of its spectral, temporal, and spectro-temporal audio properties. A linear frequency response microphone was adopted for precision measurement of pitch, loudness, and timbre descriptors. Results: Pitch deviations may result from the different intra-oral appliances due to the alteration of the mouth cavity, respectively, the area occupied and modification/interaction with the anatomy. This investigation supports the findings that the intra-oral appliance which occupies less volume is the best solution in terms of sound quality. Conclusions: Young wind instrumentalists should have dental impressions of their teeth made, so their dentist has the most reliable anatomy of the natural teeth in case of an orofacial trauma. Likewise, the registration of their sound quality should be done regularly to have standard parameters for comparison.

Endodontic approach in a replanted tooth with an immature root apex and chronic apical periodontitis: a case report

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

The relationship between special needs and dental trauma. A systematic review and meta-analysis

BACKGROUND/AIMS

Understanding the risk factors for dental injuries is essential to develop prevention strategies. The aim of this study was to perform a systematic review and meta-analysis to determine whether people with special needs (SN) have a higher incidence of traumatic dental injury (TDI).

MATERIALS AND METHODS

Electronic searches were performed with no language or date restrictions in the following databases: PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library and Open Gray. According to the PECOS strategy, observational studies that investigated subjects with and without SN and its association with TDI episodes were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies according to the type of SN, with the odds ratio (OR) also being calculated (P ≤ .05). The evidence was quality tested using the GRADE approach.

RESULTS

After titles and abstracts were examined, and full texts were read, 28 studies were included in the qualitative synthesis and 27 in the meta-analysis. Three studies were classified with high methodological quality and the others had methodological problems. No associations were determined between TDI and autism spectrum disorder, epilepsy and mental disability (OR 1.12 [0.70, 1.78], OR 1.28 [0.13, 12.27] and OR 1.04 [0.20, 5.35], respectively, P > .05). A positive association (P < .05) was found between TDI and hyperactivity disorder, cerebral palsy, 21 trisomy, various conditions of SN and in pooled results (OR 2.67 [1.22, 5.87], OR 1.89 [1.06, 3.37], OR 6.18 [2.24, 17.05], OR 1.69 [1.18, 2.41], OR 1.61 [1.16; 2.22], respectively).The certainty of evidence ranged from very low to low.

CONCLUSIONS

In general, people with SN had a higher chance of having TDI with very low certainty of evidence. People with ADHD and cerebral palsy had a higher chance of TDI.

Development of a calcified odontogenic hamartoma following avulsion of a permanent central incisor

The avulsion of a permanent immature tooth is a serious condition and a real emergency in dentistry. The management of a traumatized avulsed tooth is always a challenge to the clinician. This case report concerns the development of a calcified odontogenic hamartoma after the avulsion of an immature central incisor in an eight-year-old female. The patient presented for the treatment four months after the avulsion. Her intraoral examination showed complete healing of the area but an atypical appearance of the alveolar area of the missing tooth was observed in the periapical radiograph. A new radiographic scan performed six months later revealed the formation of a radiopaque irregular structure at the cervical level of the alveolar ridge at the site of the missing tooth. Surgical removal was performed, and the histopathological examination revealed a hamartomatous proliferation of odontogenic tissue with calcification. After healing, the lateral incisor was orthodontically moved mesially and restored to resemble the central incisor. An orthodontic device was installed to improve function and aesthetics of the patient.

Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study

OBJECTIVE

This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors.

METHODS

The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors.

RESULTS

The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05).

CONCLUSION

Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

Risk factors for traumatic dental injuries in the Brazilian population: A critical review

BACKGROUND/AIMS

Strategies for the prevention of traumatic dental injuries (TDI) should consider the risk factors involved for each population studied. The aim of this study was to perform a critical review regarding the risk factors for TDI in the Brazilian population.

MATERIALS AND METHODS

A systematic literature search was performed in the MEDLINE, Scopus, Web of Science, Lilacs, and BBO databases using MeSH terms, synonyms, and keywords, with no language or date restrictions. In the first step, all relevant studies identified, regardless of the type of statistical analysis performed, were grouped according to their geographic location. In a second step, the studies using Andreasen's criteria to classify the injuries and multivariate analysis to identify the risk factors for TDI in Brazilian subjects were included for data extraction.

RESULTS

The search strategy initially identified 3373 articles. However, only 108 articles assessed TDI with predisposing factors and were included in the first step. From those, 28 were deemed eligible for inclusion in the second step. No consensus related to the relationship between gender and TDI in the primary dentition was achieved. Nonetheless, males were found to be more prone to trauma in the permanent dentition. Overjet, inadequate lip sealing and anterior open bite increased the risk for TDI, both in primary and permanent dentitions. Social environment was related to trauma only in primary dentition. For permanent dentition, dental caries, obesity, binge drinking, and drug use were identified as considerable risk factors for TDI.

CONCLUSION

The risk factors for TDI in the Brazilian population are similar to those found worldwide. However, some differences can be observed, such as gender and socioeconomic indicators as predisposing factors.

Factors associated with dental fractures in Brazilian individuals

AIM

The aim of the present study was to assess the association of sex, age, group of teeth, and type of accident (exposure) with dental fractures (outcome: enamel-dentine fracture without [EDF] or with pulp exposure [EDPF] and root fracture RF]).

METHODS

In total, 1046 patients were selected. Logistic binary regression was used.

RESULTS

The findings showed that EDF has less change of affecting individuals ≤9 years of age than ≥40 years of age (odds ratio [OR]: 0.58, 95% confidence interval [CI]: 0.35-0.95). Violence (OR: 3.07, 95% CI: 1.77-5.31), traffic accidents (OR: 1.50, 95% CI: 1.05-2.13), and sporting accidents (OR: 1.70, 95% CI: 1.19-2.44)] were associated with EDF. Regarding EDPF, the mandibular lateral incisors had a 10 times higher chance of being injured than canines and posterior teeth (OR: 10.43, 95% CI: 1.74-62.4). Those aged ≤9 years (OR: 0.21, 95% CI: 0.07-0.58) and 10-19 years (OR: 0.38, 95% CI: 0.17-0.88) had a significantly lower chance of being affected by RF.

CONCLUSION

EDF and RF are associated with individuals ≥40 years of age; violence and traffic and sporting accidents are also associated with EDF, and mandibular incisors have a greater chance of being affected by EDPF.