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Bezerra EDFN, Herkrath FJ, Vettore MV, Rebelo MAB, de Queiroz AC, Rebelo Vieira JM, Pereira JV, da Silva Freitas MO, de Queiroz Herkrath APC. Contextual and individual factors associated with traumatic dental injuries in deprived 12-year-old schoolchildren: A cohort study. Dent Traumatol 2024. [PMID: 38590266 DOI: 10.1111/edt.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 04/10/2024]
Abstract
AIM Traumatic dental injuries (TDIs) among children and adolescents have been acknowledged as of public health concern worldwide. The aim of the study was to assess the relationship between contextual and individual characteristics and TDIs in 12-year-old schoolchildren. MATERIALS AND METHODS A cohort study was conducted with 355 schoolchildren living in deprived communities in the city of Manaus, Brazil. Contextual factors (place of residence and socio-economic indicators) and individual characteristics, including sex, family income, parents/guardians years of schooling, overjet and open bite (Dental Aesthetic Index), self-esteem (Rosenberg Self-Esteem Scale), sense of coherence (Sense of Coherence Scale), oral health beliefs, social support (Social Support Appraisals) were assessed at baseline. TDIs were measured at baseline and at 2-year follow-up using the O'Brien Index. Data were analysed through confirmatory factor analysis and structural equation modeling. RESULTS The baseline prevalence of TDIs was 17.6% and the incidence of TDIs at 2-year follow-up was 26.8%. Better psychosocial status had a direct protective effect on the incidence of TDIs (β = -.184). Better contextual characteristics (β = -.135) and greater overjet (β = -.203) were directly associated with poor psychosocial status. Higher schooling of parents/guardians directly predicted better psychosocial status (β = .154). Psychosocial status mediated the relationship of greater overjet (β = .036), contextual factors (β = .024) and parental/guardian schooling (β = -.027) with TDIs. CONCLUSIONS Contextual factors and individual characteristics predicted TDIs. Psychosocial status was a relevant individual attribute in the causal network of TDIs, due to the direct effect on the incidence of TDIs as well as a mediator on the influence of contextual factors, overjet and parents/guardians schooling on the incidence of TDIs.
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Affiliation(s)
- Emmanuelle de Fátima Noberto Bezerra
- School of Dentistry, Federal University of Amazonas, Manaus, Amazonas, Brazil
- Oswaldo Cruz Foundation, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Fernando José Herkrath
- Oswaldo Cruz Foundation, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
- Superior School of Health Sciences, State University of Amazonas, Manaus, Amazonas, Brazil
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2
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Kenny KP, Pavitt S, Foy R, Day PF. Improving data quality from routine clinical appointments-Development of a minimum dataset for traumatic dental injuries in children and adolescents. Dent Traumatol 2023; 39:531-541. [PMID: 37577937 DOI: 10.1111/edt.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/09/2023] [Accepted: 06/29/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND/AIMS It is currently difficult to evaluate the success or not of treatment for dental injuries due to poor recording of diagnostic and treatment codes in clinical dentistry. A minimum dataset comprises a standardised minimum set of outcomes along with a specified outcome measurement instrument, to allow aggregated use of data from routine clinical care appointments. This study aimed to determine which outcomes should be included in a minimum dataset for traumatic dental injuries (TDI). MATERIALS AND METHODS This is a three-stage sequential, mixed-methods study, using evidence-based best practice for dataset development. Normalisation process theory informed the development of the study protocols. In Stage 1, semi-structured interviews with patients and their parent or guardian were undertaken to identify outcomes of importance to patients. In Stage 2, an online Delphi survey was undertaken to identify outcomes of importance to clinicians. In Stage 3, a National Consensus Meeting was undertaken involving patient representatives, clinicians and other stakeholders, to agree which outcomes should be included in the minimum dataset. RESULTS Stage 1: Eleven participants were recruited, five children and six parents. Two key themes emerged from the analysis-communication and aesthetics. In Stage 2, 34 dentists were recruited, and 32 completed both rounds of the survey (97% retention). Most outcomes were deemed by participants to be of 'critical importance', with three outcomes deemed 'important' and none to be 'of limited importance'. In Stage 3, 15 participants took part in the consensus meeting. Participants agreed that the dataset should comprise a list of clinician-important outcomes (pulp healing, periodontal healing, discolouration, tooth loss) and a list of patient-important outcomes (communication, aesthetics, pain, quality of life). CONCLUSION A Minimum Dataset for TDI has been developed using a robust and transparent methodology.
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Affiliation(s)
- Kate P Kenny
- School of Dentistry, University of Leeds, Leeds, UK
| | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Robbie Foy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Peter F Day
- School of Dentistry, University of Leeds, Leeds, UK
- Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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3
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Philip N, Nazzal H, Duggal MS. Critical appraisal of the 2020 IADT Guidelines: A personal commentary. Dent Traumatol 2023; 39:509-516. [PMID: 37408436 DOI: 10.1111/edt.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 07/07/2023]
Abstract
The 2020 International Association of Dental Traumatology (IADT) Guidelines feature several important changes in the treatment recommendations for traumatic dental injuries (TDIs) from the previous 2012 iteration of these Guidelines. This evidence-based narrative review aims to provide a detailed appraisal of five specific changes incorporated in the 2020 IADT Guidelines, based on the available literature evidence that may have prompted these changes. The paper discusses three excellent additions/changes to the new Guidelines: (i) inclusion of a core outcome set for reporting TDIs; (ii) more conservative management of primary dentition TDIs including the changed recommendations for radiation exposure and managing primary dentition luxation injuries; and (iii) the changes in the treatment recommendations for permanent dentition avulsion injuries. The paper further debates whether two other changes made in the current IADT Guidelines for-(i) intrusion injuries in immature teeth; and (ii) complicated crown-root fractures in mature teeth-have sufficient evidence to support the changed recommendations.
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Affiliation(s)
- Nebu Philip
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hani Nazzal
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
- Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
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4
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Abbott PV. Indications for root canal treatment following traumatic dental injuries to permanent teeth. Aust Dent J 2023; 68 Suppl 1:S123-S140. [PMID: 37908151 DOI: 10.1111/adj.12989] [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] [Accepted: 10/04/2023] [Indexed: 11/02/2023]
Abstract
The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management-(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown-root fractures, (C) supra-crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system.
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Affiliation(s)
- P V Abbott
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
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5
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Firmiano TC, de Morais GRS, Oliveira AA, Arruda KEM, Silva MAGS, Veríssimo C. The effect of pulp volume and impact direction on the stress and strain distribution during an impact. Dent Traumatol 2023; 39:214-222. [PMID: 36688517 DOI: 10.1111/edt.12818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND/AIM Dentoalveolar trauma has a high incidence in different age groups, including the extremes, children, and older people. Mouth aging leads to some changes, one of them being the pulp volume reduction. The aim of this study was to evaluate the influence of different pulp cavity volumes and the impact direction on the stress and strain distribution of a maxillary central incisor. MATERIAL AND METHODS Twenty cone beam computed tomography sets of images were selected and the pulp cavity volume was measured by ITK-SNAP software. The mean pulp cavity volume for age group of 10- to 12-year-olds was calculated to obtain the largest one. Subsequent reductions (25%, 50%, 75% and 100%) in the pulp volume values were made to simulate the aging process. The maxilla anterior segment was modeled in the Rhinoceros 5.0 software. The three-dimensional volumetric mesh was generated using the Patran software (MSC. Software), with isoparametrics, 4-noded tetrahedral elements, and exported to Marc/Mentat (MSC. Software) as element number 134. A non-linear dynamic impact analysis was performed in which a steel ball reached the central incisor at a speed of 5 m/s in the horizontal or vertical direction. The stresses were evaluated by modified von Mises stresses. The strains and the total displacement were also recorded. RESULTS The pulp volume mean value for the age group of 10- to 12-year-olds was 65.05 mm3 . Stress concentrations were slightly different for the different pulp volumes. Impact directions resulted in different stress distribution. Higher stress values were present with the horizontal impact (range between 25.18 MPa and 24.08 MPa for enamel and 38.89 MPa and 37.03 for dentin) when compared to vertical impact (range between 15.30 MPa and 14.58 for enamel and 24.77 to 22.03 MPa for dentin). Total displacement was different for the two impact directions and higher for the horizontal impact. CONCLUSION Pulp volume did not significantly affect the stress, strain, and total displacement during the impact but the impact direction did affect the evaluated parameters during impact.
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Affiliation(s)
| | | | | | | | | | - Crisnicaw Veríssimo
- Department of Oral Rehabilitation, Federal University of Goiás, Goiânia, Brazil
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6
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Nagendrababu V, Vinothkumar TS, Rossi-Fedele G, Doğramacı EJ, Duncan HF, Abbott PV, Levin L, Lin S, Dummer PMH. Dental patient-reported outcomes following traumatic dental injuries and treatment: A narrative review. Dent Traumatol 2023. [PMID: 36744323 DOI: 10.1111/edt.12827] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 02/07/2023]
Abstract
Dental patient-reported outcomes (dPROs) are self-reported descriptions of a patient's oral health status that are not modified or interpreted by a healthcare professional. Dental patient-reported outcome measures (dPROMs) are objective or subjective measurements used to assess dPROs. In oral healthcare settings, the emphasis on assessing treatment outcomes from the patient's perspective has increased and this is particularly important after traumatic dental injuries (TDIs), as this group of injuries represent the fifth most prevalent disease or condition worldwide. The purpose of this review is to summarize the current use of dPROs and dPROMs in the field of dental traumatology. Oral Health-Related Quality of Life, pain, swelling, aesthetics, function, adverse effects, patient satisfaction, number of clinical visits and trauma-related dental anxiety are the key dPROs following TDIs. Clinicians and researchers should consider the well-being of patients as their top priority and conduct routine evaluations of dPROs using measures that are appropriate, accurate and reflect what is important to the patient. After a TDI, dPROs can assist clinicians and patients to choose the best management option(s) for each individual patient and potentially improve the methodology, design and relevance of clinical studies.
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Affiliation(s)
| | - Thilla Sekar Vinothkumar
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | | | - Esma J Doğramacı
- Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Henry F Duncan
- Division of Restorative Dentistry, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia, Perth, Western Australia, Australia
| | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Alberta, Edmonton, Canada
| | - Shaul Lin
- The Israeli National Center for Trauma & Emergency Medicine Research, Gertner Institute, Tel Hashomer, Israel.,Department of Endodontics, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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7
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Marshman Z, Rodd H. Child-Centred Dentistry: Engaging and Protecting Children. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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8
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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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9
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Goh L, Er J, Pham Y, Abbott PV. An evaluation of the repeatability of electric pulp sensibility tests. AUST ENDOD J 2021; 48:20-26. [PMID: 34333842 DOI: 10.1111/aej.12552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
The accuracy, reliability and reproducibility of electric pulp tests (EPT) have been investigated but there is conflicting information about their repeatability. The aim of this study was to investigate whether EPT are repeatable over time. EPT results from 180 healthy teeth in 39 patients with 2-10 readings per tooth (total 692 readings) were analysed. Single measures intraclass correlation coefficients (ICC) ranged from 0.776 to 0.845 in teeth with 2-7 repeated measures (P < 0.001), indicating good repeatability. With eight or more measures per tooth, the ICC was low, indicating poor repeatability over longer follow-up times, but only seven teeth in two subjects were included in this analysis. The Pearson correlation showed no statistically significant correlation for 2-7 readings but when all readings were included, there was a statistically significant negative correlation. Hence, EPT has good repeatability.
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Affiliation(s)
- Leena Goh
- UWA Dental School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Joy Er
- UWA Dental School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ylan Pham
- UWA Dental School, The University of Western Australia, Crawley, Western Australia, Australia
| | - Paul V Abbott
- UWA Dental School, The University of Western Australia, Crawley, Western Australia, Australia
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10
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Eden E, Buldur B, Duruk G, Ezberci S. Web-based dental trauma database using Eden Baysal dental trauma index: a turkish multicenter study. Eur Oral Res 2021; 55:21-27. [PMID: 33937758 PMCID: PMC8055256 DOI: 10.26650/eor.20210077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose To describe the prevalence and pattern of traumatic dental injuries (TDIs) among Turkish children in a web-based and multicenter design using Eden Baysal Dental Trauma Index (EBDTI). Materials and methods The study sample consisted dental trauma patients aging 1-15 years and a webbased form was developed and used to record the information of the patients' clinical and radiographic findings including EBDTI. The obtained data also included patient gender, age at the initial date of trauma, date of trauma, cause of injury and emergency treatment. Data were analyzed using Pearson Chi-square and Fisher's exact tests. Results A total of 280 traumatized teeth in 252 patients were evaluated. Dental trauma was seen more in boys and 7-10 years age group (p<0.05). There were significant differences between permanent and deciduous teeth with regard to uncomplicated and complicated crown fracture rate (p<0.05). The root fractures were mostly located at the apical third of the root in both dentitions. Conclusion TDI was associated with age, gender, and type of dental trauma. EDBTI provided easy and proper recording of multiple dental injuries and maturity of the apex and it was found to be a very useful tool to facilitate online recordings of dental injuries.
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Affiliation(s)
- Ece Eden
- Department of Pediatric Dentistry, Faculty of Dentistry,Ege University, İzmir, Turkey
| | - Burak Buldur
- Department of Pediatric Dentistry, Faculty of Dentistry,Cumhuriyet University, Sivas,Turkey
| | - Gulsum Duruk
- Department of Pediatric Dentistry, Faculty of Dentistry,Inonu University, Malatya,Turkey
| | - Sibel Ezberci
- Department of Pediatric Dentistry, Faculty of Dentistry,Uşak University, Uşak,Turkey
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11
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Wu TT, Li JY, Yang KY, Wang PX, Yuan JX, Guo QY, Liu F. A cross-sectional evaluation of knowledge among Chinese dentists regarding the treatment of traumatic injuries in primary teeth. Dent Traumatol 2020; 37:188-195. [PMID: 33220147 DOI: 10.1111/edt.12633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Injuries to the primary dentition affect children's esthetics, function, and mental health. They may also affect the development of the permanent teeth. The knowledge of dentists about deciduous tooth trauma is rarely evaluated. The aim of this study was to evaluate the knowledge and attitude of dentists in China regarding traumatic dental injuries to primary teeth. MATERIAL AND METHODS A self-administered online questionnaire containing questions on demographic data and knowledge based on a clinical scenario was given to a purposive sample of dentists, recruited by a non-probability convenience sampling method. The chi-square test was used for statistical analysis, with the significance level set at P <.05. RESULTS A total of 394 out of 409 dentists provided valid data. There was no significant difference in demographic data. Questions about the treatment of hard dental tissue injuries in primary teeth presented a correct-response rate of 66.4%, with the highest correct-response rate for enamel fracture (n = 368, 93.4%) and lowest for complicated crown-root fracture with pulp exposure (n = 104, 26.4%). Questions about treatment of luxation injuries in primary teeth presented a correct-response rate of 66.6%, with subluxation presenting the highest correct-response rate (n = 391, 99.2%). Factors associated with higher correct-response rates were specialist disciplines, educational qualifications, workplaces, experience of injured teeth treated, and educational experience about primary tooth trauma. No significant differences were found in the correct-response rates of dentists with different years of work experience. Lack of cooperation from children was considered a major obstacle for treatment. Special lectures and Internet courses were the most preferred methods of obtaining knowledge. CONCLUSION The results suggest that it is necessary to enhance dental trauma education for dentists in China. More attention needs to be paid to trauma in primary dentition to ensure adequate treatment for traumatized primary teeth.
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Affiliation(s)
- Tian-Tian Wu
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China.,Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin-Yi Li
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ke-Yu Yang
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Pan-Xi Wang
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jia-Xue Yuan
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qing-Yu Guo
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fei Liu
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Pediatric Dentistry, Affiliated Stomatology Hospital of Xi'an Jiaotong University, Xi'an, China
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12
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Day PF, Flores MT, O'Connell AC, Abbott PV, Tsilingaridis G, Fouad AF, Cohenca N, Lauridsen E, Bourguignon C, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol 2020; 36:343-359. [DOI: 10.1111/edt.12576] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Peter F. Day
- School of Dentistry University of Leeds and Community Dental Service Bradford District Care NHS Trust Leeds UK
| | - Marie Therese Flores
- Department of Pediatric Dentistry Faculty of Dentistry Universidad de Valparaíso Valparaíso Chile
| | - Anne C. O'Connell
- Paediatric Dentistry Dublin Dental University HospitalTrinity College DublinThe University of Dublin Dublin Ireland
| | - Paul V. Abbott
- UWA Dental School University of Western Australia Nedlands WA Australia
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | - Nestor Cohenca
- Department of Pediatric Dentistry University of Washington and Seattle Children's Hospital Seattle WA USA
| | - Eva Lauridsen
- Resource Center for Rare Oral Diseases Copenhagen University Hospital Copenhagen Denmark
| | | | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery Resource Centre for Rare Oral Diseases University Hospital in Copenhagen (Rigshospitalet) Copenhagen Denmark
| | - Zafer C. Cehreli
- Department of Pediatric Dentistry Faculty of Dentistry Hacettepe University Ankara Turkey
| | - Stephen Harlamb
- Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
| | - Bill Kahler
- School of Dentistry The University of Queensland St Lucia Qld Australia
| | - Adeleke Oginni
- Faculty of Dentistry College of Health Sciences Obafemi Awolowo University Ile‐Ife Nigeria
| | | | - Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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13
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Palmieri B, Vadalà M, Laurino C. Electromedical devices in wound healing management: a narrative review. J Wound Care 2020; 29:408-418. [PMID: 32654604 DOI: 10.12968/jowc.2020.29.7.408] [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] [Indexed: 01/03/2023]
Abstract
Wound healing is the sum of physiological sequential steps, leading to skin restoration. However, in some conditions, such as diabetes, pressure ulcers (PU) and venous legs ulcers (VLU), healing is a major challenge and requires multiple strategies. In this context, some electromedical devices may accelerate and/or support wound healing, modulating the inflammatory, proliferation (granulation) and tissue-remodelling phases. This review describes some helpful electromedical devices including: ultrasonic-assisted wound debridement; electrotherapy; combined ultrasound and electric field stimulation; low-frequency pulsed electromagnetic fields; phototherapy (for example, laser therapy and light-emitting diode (LED) therapy); biophotonic therapies, and pressure therapies (for example, negative pressure wound therapy, and high pressure and intermittent pneumatic compression) The review focuses on the evidence-based medicine and adequate clinical trial design in relation to these devices.
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Affiliation(s)
- Beniamino Palmieri
- Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Via del Pozzo, 71, 41124, Modena, Italy.,Second Opinion Medical Network, Via Ciro Bisi, 125, Modena, Italy
| | - Maria Vadalà
- Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Via del Pozzo, 71, 41124, Modena, Italy.,Second Opinion Medical Network, Via Ciro Bisi, 125, Modena, Italy
| | - Carmen Laurino
- Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Via del Pozzo, 71, 41124, Modena, Italy.,Second Opinion Medical Network, Via Ciro Bisi, 125, Modena, Italy
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Levin L, Day PF, Hicks L, O'Connell A, Fouad AF, Bourguignon C, Abbott PV. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dent Traumatol 2020; 36:309-313. [DOI: 10.1111/edt.12574] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
| | - Peter F. Day
- School of Dentistry at the University of Leeds Community Dental Service Bradford District Care NHS Trust Leeds UK
| | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Anne O'Connell
- Paediatric Dentistry Dublin Dental University Hospital Trinity College Dublin The University of Dublin Dublin Ireland
| | - Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | | | - Paul V. Abbott
- UWA Dental School University of Western Australia Perth WA Australia
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15
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Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, O'Connell A, Flores MT, Day PF, Hicks L, Andreasen JO, Cehreli ZC, Harlamb S, Kahler B, Oginni A, Semper M, Levin L. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 2020; 36:331-342. [DOI: 10.1111/edt.12573] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Ashraf F. Fouad
- Adams School of Dentistry University of North Carolina Chapel Hill NC USA
| | - Paul V. Abbott
- UWA Dental School University of Western Australia Crawley WA Australia
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Nestor Cohenca
- Department of Pediatric Dentistry University of Washington and Seattle Children’s Hospital Seattle WA Australia
| | - Eva Lauridsen
- Resource Center for Rare Oral Diseases Copenhagen University Hospital Copenhagen Denmark
| | | | - Anne O'Connell
- Paediatric Dentistry Dublin Dental University Hospital Trinity College Dublin The University of Dublin Dublin Ireland
| | - Marie Therese Flores
- Department of Pediatric Dentistry Faculty of Dentistry Universidad de Valparaíso Valparaíso Chile
| | - Peter F. Day
- School of Dentistry Community Dental Service Bradford District Care NHS Trust University of Leeds Leeds UK
| | - Lamar Hicks
- Division of Endodontics University of Maryland School of DentistryUMB Baltimore MD USA
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery Resource Centre for Rare Oral Diseases University Hospital in Copenhagen (Rigshospitalet) Copenhagen Denmark
| | - Zafer C. Cehreli
- Department of Pediatric Dentistry Faculty of Dentistry Hacettepe University Ankara Turkey
| | - Stephen Harlamb
- Faculty of Medicine and Health The University of Sydney Sydney NSW Australia
| | - Bill Kahler
- School of Dentistry The University of Queensland St Lucia QLD Australia
| | - Adeleke Oginni
- Faculty of Dentistry College of Health Sciences Obafemi Awolowo University Ile‐Ife Nigeria
| | | | - Liran Levin
- Faculty of Medicine and Dentistry University of Alberta Edmonton AB Canada
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16
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Eden E, Baysal M, Andersson L. Eden Baysal Dental Trauma Index: Face and content validation. Dent Traumatol 2019; 36:117-123. [PMID: 31705735 DOI: 10.1111/edt.12525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIM Recording of traumatic dental injuries in the emergency situation with a simple and easily recordable index that will also enable computer registration is advantageous. The aim of this paper is to present a new index to facilitate recording traumatic dental injuries and assess its face and content validity. MATERIALS AND METHODS The index included information on the type of injury related to the affected structures (enamel, dentin, cement, pulp, periodontal ligament, and alveolar bone) in accordance with Andreasen's classification. In addition, injuries to the alveolar bone and the maturity of the root were included. Fifteen dental trauma experts from 11 different countries rated the codes and content of the "Eden Baysal Dental Trauma Index" using the RAND modified e-Delphi consensus method. A statement was considered valid after reaching 75% consensus among panel members. Two rounds were necessary for reaching consensus on seven statements and the definition. The last version of the index was then presented online to a feedback group that included 10 experts from five countries to determine the external validity by representative cases. RESULTS The wording of the definition showed 92.8% agreement in the first round. Statements 1 and 2 gave information about the structure of the index and both reached 90% agreement in the first round. Definition and statements from 1 to 7 reached agreement as 93.3%, 93.3%, 100%, 93.3%, 80%, 93.3%, 80%, and 93.3%, respectively, in the second round. Most of the experts in the feedback group reported that the index was useful and user-friendly. CONCLUSION After a total of two rounds with the panel members and one round with the feedback group, the "Eden Baysal Dental Trauma Index" was approved for face and content validity and external validity was obtained.
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Affiliation(s)
- Ece Eden
- Department of Pedodontics, School of Dentistry, Ege University, İzmir, Turkey
| | | | - Lars Andersson
- Department Oral and Maxillofacial Surgery and Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
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17
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Feldens CA, Senna RA, Vargas-Ferreira F, Braga VS, Feldens EG, Kramer PF. The effect of enamel fractures on oral health-related quality of life in adolescents. Dent Traumatol 2019; 36:247-252. [PMID: 31715061 DOI: 10.1111/edt.12526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND/AIM Enamel fractures are the most common type of traumatic dental injury (TDI) in children and adolescents. Recognizing the impact of these fractures on oral health-related quality of life (OHRQoL) could contribute to the establishment of treatment protocols. The aim of this study was to assess and quantify the impact of enamel fractures on overall OHRQoL and domain scores in adolescents. MATERIALS AND METHODS A cross-sectional study was conducted with 775 adolescents aged 11 to 14 years in the city of Santo Ângelo in southern Brazil. Sociodemographic variables were collected from parents/caregivers using a structured questionnaire. The adolescents answered the Child Perceptions Questionnaire (CPQ11-14 ). Physical examinations were performed by an examiner who had undergone training and calibration exercises for the investigation of TDI (Andreasen criteria), dental caries (WHO criteria), and malocclusion (Dental Aesthetic Index). Data analysis involved Poisson regression with robust variance. RESULTS The prevalence of TDI was 11.9% and enamel fractures accounted for 79.3% of all injuries. In the multivariate analysis, adolescents with enamel fractures had 29% higher CPQ11-14 scores (worse OHRQoL) than those without TDI, even after adjustment for sociodemographic and clinical variables (mean ratio = 1.29; 95% CI: 1.09-1.53; P = .003). Enamel fractures exerted a negative impact on the functional limitation, emotional well-being, and social well-being domains. CONCLUSIONS Enamel fractures exert a negative impact on the OHRQoL of adolescents, suggesting that subjective measures should be incorporated in the evaluation of patients with this traumatic injury.
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Affiliation(s)
| | - Rita Azevedo Senna
- Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
| | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vanessa Simas Braga
- Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
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18
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Lopez D, Waidyatillake N, Zaror C, Mariño R. Impact of uncomplicated traumatic dental injuries on the quality of life of children and adolescents: a systematic review and meta-analysis. BMC Oral Health 2019; 19:224. [PMID: 31640671 PMCID: PMC6805369 DOI: 10.1186/s12903-019-0916-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 09/20/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Traumatic dental injuries (TDIs) are highly prevalent during childhood and adolescence and have a significant effect on their oral health related quality of life (OHRQoL). Uncomplicated TDIs, dental trauma involving enamel, enamel and dentin and tooth discolorations, account for approximately two-thirds of all diagnosed TDIs in children and adolescents. Hence, it may be important to understand the impact of uncomplicated TDIs on OHRQoL, by synthesizing the available literature. METHODS Medline, Embase, Web of Science and Scopus databases were systematically searched from January 1966 to April 2018. Studies that evaluated the effect of TDIs on the OHRQoL of children and adolescents using validated methods were selected for analysis. A narrative synthesis and a meta-analysis were performed. The studies were pooled according to age groups and OHRQoL questionnaire used. A random-effect model was applied to calculate the pooled odds ratios (OR) and their respective 95% confidence intervals. RESULTS There were 712 identified studies. Of these, 26 articles were selected for the review and included in the narrative synthesis, 20 of these articles concluded that uncomplicated TDIs were not associated with a negative impact in OHRQoL. Seventeen were included in the meta-analysis. The estimates were pooled by age groups: children (OR: 1.01; 95%CI; 0.85-1.19; I2 = 51.9%) and adolescents (OR: 1.07; 95%CI; 0.91, 1.26; I2 = 50.2%).When pooling all estimates the OR was 0.96 (95% CI: 0.85-1.10; I2 = 61.4%). CONCLUSIONS Uncomplicated TDIs do not have a negative impact on the OHRQoL of children and adolescents. Further prospective studies are needed to confirm the results of this review. The majority of the studies included were of cross-sectional design, which may have limited the ability to reach conclusions on the nature of this association. The PROSPERO systematic review registry is CRD42018110471.
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Affiliation(s)
- Diego Lopez
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - Nilakshi Waidyatillake
- Allergy and Lung Health Unit, Melbourne, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Carlos Zaror
- Department of Pediatric Dentistry and Orthodontics, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Rodrigo Mariño
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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19
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Lechner A, Kottner J, Coleman S, Muir D, Bagley H, Beeckman D, Chaboyer W, Cuddigan J, Moore Z, Rutherford C, Schmitt J, Nixon J, Balzer K. Outcomes for Pressure Ulcer Trials (OUTPUTs): protocol for the development of a core domain set for trials evaluating the clinical efficacy or effectiveness of pressure ulcer prevention interventions. Trials 2019; 20:449. [PMID: 31331366 PMCID: PMC6647312 DOI: 10.1186/s13063-019-3543-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/29/2019] [Indexed: 12/20/2022] Open
Abstract
Background Core outcome sets (COS) are being developed in many clinical areas to increase the quality and comparability of clinical trial results as well as to ensure their relevance for patients. A COS represents an agreed standardized set of outcomes that describes the minimum that should be consistently reported in all clinical trials of a defined area. It comprises a core domain set (defining what core outcomes should be measured) and a core measurement set (defining measurement/assessment instruments for each core domain). For pressure ulcer prevention trials a COS is lacking. The great heterogeneity of reported outcomes in this field indicates the need for a COS. Methods/design The first part of this project aims to develop a core domain set by following established methods, which incorporates four steps: (1) definition of the scope, (2) conducting a scoping review, (3) organizing facilitated workshops with service users, (4) performing Delphi surveys and establishing consensus in a face-to-face meeting with different stakeholders. Discussion After achieving consensus on the core domain set, further work will be undertaken to determine a corresponding core measurement set. This will lead to better pressure ulcer prevention research in the future. There are a number of methodological challenges in the field of COS development. To meet these challenges and to ensure a high-quality COS, the OUTPUTS project affiliates to current standards and works in close collaboration with international experts and with existing international service user groups. Trial registration The OUTPUTs project is registered in the COMET database: (http://www.comet-initiative.org/studies/details/283). Registered on 2015.
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Affiliation(s)
- Anna Lechner
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Jan Kottner
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Susanne Coleman
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Delia Muir
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Heather Bagley
- Clinical Trials Research Centre (CTRC), North West Hub for Trials Methodology, University of Liverpool, Liverpool, UK
| | - Dimitri Beeckman
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Nursing and Midwifery, University of Surrey, Guildford, UK.,School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.,School of Health Sciences, Örebro University, Örebro, Sweden
| | - Wendy Chaboyer
- School of Nursing & Midwifery, Menzies Health Institute Queensland, Griffith University and Gold Coast Hospital and Health Service, Southport, Qld, Australia
| | - Janet Cuddigan
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Zena Moore
- Royal College of Surgeons in Ireland, Dublin, Ireland.,Monash University, Melbourne, Australia.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Lida Institute, Shanghai, China.,Cardiff University, Cardiff, Wales
| | - Claudia Rutherford
- Faculty of Science, Quality of Life Office, School of Psychology, University of Sydney, Sydney, Australia.,Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, Australia
| | - Jochen Schmitt
- Centre for Evidence-based Healthcare, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Jane Nixon
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Katrin Balzer
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK.,Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
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20
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Psychosocial Impacts Relating to Dental Injuries in Childhood: The Bigger Picture. Dent J (Basel) 2019; 7:dj7010023. [PMID: 30836645 PMCID: PMC6473822 DOI: 10.3390/dj7010023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/08/2019] [Accepted: 02/11/2019] [Indexed: 12/30/2022] Open
Abstract
Traumatic dental injuries (TDI) in childhood are fairly commonplace, with a reported prevalence of up to 30% worldwide. These injuries can have significant impacts on patients, their families and dental professionals; however, this area is currently underrepresented within paediatric oral health research. The psychosocial impacts of traumatic injury are personal to each patient and should be addressed as part of a holistic treatment plan. A review of the current evidence base shows that children who have suffered a traumatic injury to the dentition report worse oral-health-related quality of life. They are also more likely to suffer decreased self-esteem due to their appearance, especially where the injury is not effectively managed. Society (including other children) often judges poorly those with obvious dental disease or anomaly, and with the rising use of social media, these judgements can be made by even greater audiences. There is currently a paucity of qualitative research in this topic to explore the negative psychosocial impacts of dental trauma in greater detail. Although there is growing evidence for the benefit of treatment in improving children’s wellbeing following a TDI, the field of paediatric dental traumatology still has much to learn about young patients’ perspectives, experiences and values.
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21
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Day PF, Duggal M, Nazzal H. Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted. Cochrane Database Syst Rev 2019; 2:CD006542. [PMID: 30720860 PMCID: PMC6363052 DOI: 10.1002/14651858.cd006542.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Traumatic dental injuries are common. One of the most severe injuries is when a permanent tooth is knocked completely out of the mouth (avulsed). In most circumstances the tooth should be replanted as quickly as possible. There is uncertainty on which interventions will maximise the survival and repair of the replanted tooth. This is an update of a Cochrane Review first published in 2010. OBJECTIVES To compare the effects of a range of interventions for managing traumatised permanent front teeth with avulsion injuries. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 March 2018), Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 2) in the Cochrane Library (searched 8 March 2018), MEDLINE Ovid (1946 to 8 March 2018), and Embase Ovid (1980 to 8 March 2018). The US National Institutes of Health Ongoing Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We considered randomised and quasi-randomised controlled trials that included a minimum follow-up period of 12 months, for interventions for avulsed and replanted permanent front teeth. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data and assessed the risk of bias. Authors were contacted where further information about their study was required. MAIN RESULTS Four studies, involving a total of 183 participants and 257 teeth were identified. Each of the interventions aimed to reduce infection or alter the inflammatory response or both at the time of or shortly after the tooth or teeth were replanted. Each study assessed a different intervention and therefore it was not appropriate or possible to numerically synthesise the data. All evidence was rated as being of very low quality due to problems with risk of bias and imprecision of results. This means that we are very uncertain about all of the results presented in this review.One study at high risk of bias with 69 participants (138 teeth) compared a 20-minute soak with gentamycin sulphate for both groups prior to replantation with the experimental group receiving daily hyperbaric oxygen for 80 minutes for the first 10 days. There was some evidence of a benefit for the hyperbaric oxygen group in respect of periodontal healing, tooth survival, and pulpal healing.One study at unclear risk of bias with 22 participants (27 teeth) compared the use of two root canal medicaments, Ledermix and Ultracal. There was insufficient evidence of a difference for periodontal healing or tooth survival. This was the only study to formally report adverse events with none identified. Study authors reported that Ledermix caused a greater level of patient dissatisfaction with the colour of avulsed and replanted teeth.A third study at high risk of bias with 19 participants compared extra- or intra-oral endodontics for avulsed teeth which were stored dry for longer than 60 minutes before replantation. There was insufficient evidence of a difference in periodontal healing.The fourth study at high risk of bias with 73 participants compared a 10-minute soak in either thymosin alpha 1 or saline before replantation followed by daily gingival injections with these same medicaments for the first 7 days. There was some evidence of a benefit for thymosin alpha 1 with respect to periodontal healing and tooth survival. AUTHORS' CONCLUSIONS Based on the results of the included studies, there is insufficient evidence to support or refute the effectiveness of different interventions for avulsed and replanted permanent front teeth. The overall quality of existing evidence was very low, and therefore great caution should be exercised when generalising the results of the included trials. There is urgent need for further well-designed randomised controlled trials.
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Affiliation(s)
- Peter F Day
- Leeds Dental InstituteDepartment of Paediatric DentistryClarendon WayLeedsUKLS2 9LU
| | - Monty Duggal
- Faculty of Dentistry, National University of SingaporeDepartment of Paediatric Dentistry9 Lower Kent Ridge Road Level 10National University Centre for Oral HealthSingaporeSingapore119085
| | - Hani Nazzal
- Leeds Dental InstituteDepartment of Paediatric DentistryClarendon WayLeedsUKLS2 9LU
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22
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Clark D, Levin L. Prognosis and complications of immature teeth following lateral luxation: A systematic review. Dent Traumatol 2018; 34:215-220. [PMID: 29719935 DOI: 10.1111/edt.12407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2018] [Indexed: 02/28/2024]
Abstract
BACKGROUND/AIMS Lateral luxation injuries are a type of traumatic dental injury in which the tooth becomes displaced in the palatal/lingual or labial direction. This injury is common among children and can result in pulp canal obliteration or pulp necrosis. The objective of this systematic review was to gather existing data on lateral luxation injuries to immature teeth to evaluate their overall prognosis. METHODS A systematic search was conducted using Medline, Pubmed, Scopus, Lilacs, EMBASE and Cochrane databases in October 2017. Reference lists were also hand-searched to identify additional literature. Prospective and retrospective observational studies were included. A total of 502 articles were screened and six articles were included in the study. RESULTS Pulp canal obliteration was the most frequent complication of immature teeth with lateral luxation (31.3%). This was followed by pulp necrosis (17.5%), inflammatory resorption (5.7%), and surface resorption (3.2%). Due to the heterogeneity of the studies, a meta-analysis was not attempted. There was great variation in the reported outcomes among the studies. CONCLUSION Accurate prognosis evaluation of traumatic dental injuries is difficult due to the nature of current studies being retrospective or prospective cohort studies. Lateral luxation is a common traumatic dental injury and has life-long concerns for a patient. It is important for future studies to report on the same outcomes to increase the quality of evidence regarding prognosis and treatment interventions, not only for lateral luxation injuries, but for all traumatic dental injuries.
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Affiliation(s)
- Danielle Clark
- Faculty of Medicine and Dentistry, Division of Periodontology, University of Alberta, Edmonton, AB, Canada
| | - Liran Levin
- Faculty of Medicine and Dentistry, Division of Periodontology, University of Alberta, Edmonton, AB, Canada
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23
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Petti S, Glendor U, Andersson L. World traumatic dental injury prevalence and incidence, a meta-analysis-One billion living people have had traumatic dental injuries. Dent Traumatol 2018; 34:71-86. [PMID: 29455471 DOI: 10.1111/edt.12389] [Citation(s) in RCA: 261] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 12/24/2022]
Abstract
Traumatic dental injuries (TDIs) account for a considerable proportion of bodily injuries. Nevertheless, global TDI frequency is unknown, probably because TDI diagnosis is not standardized. This study estimated world TDI frequency. A literature search (publication years 1996-2016) was aimed at covering as many countries, communities, ethnic groups as possible, thus achieving high generalizability. In particular, non-specific keywords, no language restrictions, and large databanks were used. Observational studies reporting proportions of individuals with at least one TDI (prevalence) and who developed TDI (incidence rate) were considered. Prevalence rates to permanent dentition, primary dentition and in 12-year-olds, incidence rate to any tooth for any age, male-to-female prevalence ratio (PR) in 12-year-olds, with 95% confidence intervals (95 CIs), were extracted/calculated. Study quality, Z-score distribution, funnel plot symmetry analysis, between-study heterogeneity, sensitivity, and subgroup analyses were performed. Selected primary studies were 102 (permanent dentition; 268 755 individuals; median age, 13.8 years), 46 (primary dentition; 59 436 individuals; median age, 3.4 years), 42 (12-year-olds; 33 829 individuals), 11 (incidence rate; 233 480 person-years; median age, 7.8 years), and 31 (PR; 16 003 males, 16 006 females). World TDI frequency resulted as follows: permanent dentition prevalence 15.2% (95 CI, 13.0%-17.4%); primary dentition prevalence 22.7% (95 CI, 17.3%-28.7%); 12-year-olds prevalence 18.1% (95 CI, 15.3%-21.0%); incidence rate, 2.82 (95 CI, 2.28%-3.42%) per 100 person-years; PR, 1.43 (95 CI, 1.34%-1.52%). Differences between WHO Regions were found. This study shows that more than one billion living people have had TDI. TDI is a neglected condition which could rank fifth if it was included in the list of the world's most frequent acute/chronic diseases and injuries.
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Affiliation(s)
- Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Ulf Glendor
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
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24
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Kenny KP, Day PF, Sharif MO, Parashos P, Lauridsen E, Feldens CA, Cohenca N, Skapetis T, Levin L, Kenny DJ, Djemal S, Malmgren O, Chen YJ, Tsukisboshi M, Andersson L. What are the important outcomes in traumatic dental injuries? An international approach to the development of a core outcome set. Dent Traumatol 2017; 34:4-11. [PMID: 28873277 DOI: 10.1111/edt.12367] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS There are numerous treatment options following traumatic dental injury (TDI). Systematic reviews of different treatments are challenging owing to the diversity of outcomes reported between clinical studies. This issue could be addressed through the development and implementation of a agreed and standardized collection of outcomes known as a core outcome set (COS). The aim of this study was to develop a COS for TDI in children and adults. The secondary aim was to establish what, how, when and by whom these outcomes should be measured. MATERIALS AND METHOD The project was registered with Core Outcomes Measures in Effectiveness Trials (COMET). A web-based survey was developed to capture the opinions of dentists globally as to which outcomes should be recorded. A list of outcomes was entered into a Delphi Survey and scored by an Expert Working Group (EWG). The scoring was repeated, followed by conference calls to discuss, refine and finalize the COS. The EWG split into small groups of subject-specific experts to determine how, when and by whom each outcome would be measured. RESULTS The questionnaire was completed by 1476 dentists. The EWG identified 13 core outcomes to be recorded for all TDI's. An additional 10 injury-specific outcomes were identified. A table has been produced for each outcome detailing what, when, and how each outcome should be recorded. CONCLUSIONS A robust consensus process was used to develop an international COS for TDI in children and adults. This includes both generic and injury-specific outcomes across all identified domains.
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Affiliation(s)
- Kate P Kenny
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Peter F Day
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Mohammad O Sharif
- Departments of Orthodontics, Eastman Dental Hospital and Croydon University Hospital, London, UK
| | - Peter Parashos
- Department of Restorative Dentistry, Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - Eva Lauridsen
- Resource Center for Rare Oral Disease, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Carlos Alberto Feldens
- Department of Paediatric Dentistry, School of Dentistry, Universidade Luterna do Brasil, Porto Alegre, Brazil
| | - Nestor Cohenca
- Lakeside Endodontics, University of Washington and Seattle Children's, Seattle, WA, USA
| | - Tony Skapetis
- Faculty of Dentistry, Oral Health, Western Sydney LHD, University of Sydney, Sydney, NSW, Australia
| | - Liran Levin
- Division of Periodontology, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - David J Kenny
- Department of Dentistry, The Hospital for Sick Children and School of Graduate Studies, University of Toronto, Toronto, ON, Canada
| | - Serpil Djemal
- Department of Restorative Dentistry, King's College Dental Hospital, Denmark Hill, London, UK
| | - Olle Malmgren
- Orthodontic Clinic, Tandregleringen, Huddinge, Stockholm, Sweden
| | - Yong-Jin Chen
- State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, The Fourth Military Medical University, Xian, China
| | | | - Lars Andersson
- Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait, Kuwait
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Schwendicke F, Opdam N. Clinical studies in restorative dentistry: Design, conduct, analysis. Dent Mater 2017; 34:29-39. [PMID: 28988780 DOI: 10.1016/j.dental.2017.09.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/28/2017] [Accepted: 09/15/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Clinical studies should be one main aspect underlying dentists' decision-making towards dental materials. Study design, conduct, analysis and reporting impact on the usefulness of studies. We discuss problems with current studies and highlight areas where improvement might be possible. METHODS Based on systematically and non-systematically collected data, we demonstrate where and why current studies in clinical dentistry deliver less-than-optimal results. Lending from general medicine, we suggest ways forward for clinical dental material science. RESULTS Randomized controlled (efficacy) trials remain a major pillar in dental material science, as they reduce selection bias and, if well-designed and conducted, have high internal validity. Given their costs and limited external validity, alternatives like practice-based or pragmatic controlled trials or observational studies can complement the evidence-base. Prior to conduct, researchers should focus on study comparators and setting (answering questions with relevance to clinical dentistry), and pay attention to statistical power, considering the study aim (superiority or non-inferiority trial), the expected event rate, and attrition. Study outcomes should be chosen on the basis of a core outcome set or, if not available, involving patients and other stakeholders. Studies should be registered a priori, and reporting should adhere to standards. Possible clustering should be accounted for during statistical analysis. SIGNIFICANCE Many clinical studies in dental material science are underpowered, and of limited validity and usefulness for daily decision-making. Dental researchers should mirror existing efforts in other medical fields in making clinical studies more valid and applicable, thus contributing to better dental care.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199 Berlin, Germany.
| | - Niek Opdam
- Radboud University Medical Centre, College of Dental Sciences, P.O. Box 9101, NL 6500 HB Nijmegen, The Netherlands.
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26
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Tonini R. An Innovative Method for Fragment Reattachment after Complicated Crown Fracture. J ESTHET RESTOR DENT 2017; 29:172-177. [PMID: 28205326 DOI: 10.1111/jerd.12281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The case of a nineteen-year-old female with atypical fractures to three maxillary incisors (#11 FDI, #8 universal; #21 FDI, #9 universal and #22 FDI, #10 universal) with one showing a complicated crown fracture and pulp exposure is reported. A partial pulpotomy had been carried out immediately after trauma and the patient complained of acute pain on percussion of the left central incisor. Direct restoration with resin-based composite was carried out on the two teeth where fragments were not available (tooth #8 and #10) and root canal treatment with reattachment of fragments and fiber post was carried out on the third (tooth #9). An innovative method was used to reattach the tooth fragments whereby the fiber post was inserted without drilling a hole in the crown thus preserving the integrity of the crown. Follow-up visits confirmed the success of treatment based on clinical and radiographic evaluations. The patient was pain free with no tooth sensitivity and good function and esthetics after four years of follow-up. CLINICAL SIGNIFICANCE Case report with a follow-up of 4 years, provides confirmatory evidence of the long-term efficacy of an innovative method to reattach tooth fragments whereby fiber post is inserted without drilling a hole in the crown thus preserving the integrity of the crown. (J Esthet Restor Dent 29:172-177, 2017).
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Affiliation(s)
- Riccardo Tonini
- Dental school tutor for Endodontics teaching, University of Brescia, Brescia, BS, Italy
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Bergman L, Milardović Ortolan S, Žarković D, Viskić J, Jokić D, Mehulić K. Prevalence of dental trauma and use of mouthguards in professional handball players. Dent Traumatol 2017; 33:199-204. [DOI: 10.1111/edt.12323] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Lana Bergman
- Department of Fixed Prosthodontics; School of Dental Medicine; University of Zagreb; Zagreb Croatia
| | | | | | - Joško Viskić
- Department of Fixed Prosthodontics; School of Dental Medicine; University of Zagreb; Zagreb Croatia
| | - Dražen Jokić
- Department of Orthodontics; School of Dental Medicine; University of Zagreb; Zagreb Croatia
| | - Ketij Mehulić
- Department of Fixed Prosthodontics; School of Dental Medicine; University of Zagreb; Zagreb Croatia
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Borges TS, Vargas-Ferreira F, Kramer PF, Feldens CA. Impact of traumatic dental injuries on oral health-related quality of life of preschool children: A systematic review and meta-analysis. PLoS One 2017; 12:e0172235. [PMID: 28245226 PMCID: PMC5330474 DOI: 10.1371/journal.pone.0172235] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/01/2017] [Indexed: 11/17/2022] Open
Abstract
Background Observational studies have suggested that traumatic dental injuries (TDI) can lead to pain, loss of function and esthetic problems, with physical, emotional and social consequences for children and their families. However, population-based studies that investigate the impact of TDI on oral health-related quality of life (OHRQoL) among preschool children are scarce and offer conflicting results. The aim of the systematic review and meta-analysis was to evaluate the impact of TDI on OHRQoL among preschool children (PROSPERO-CRD42015032513). Methods An electronic search of six databases was performed in PubMed (MEDLINE), ISI Web of Science, Scopus, Science Direct, EMBASE and Google Scholar, with no language or publication date restrictions. The eligibility criteria were TDI as the exposure variable, OHRQoL as the outcome and a population of children up to six years of age. RevMan software was used for data analysis. Results are expressed as odds ratios with 95% confidence intervals for the total score of the Early Childhood Oral Health Impact Scale (ECOHIS) as well as the scores of the Child Impact Section (CIS) and Family Impact Section (FIS). The random effect model was chosen and heterogeneity was evaluated using the I2 test. Results 2,013 articles were initially retrieved; 1,993 articles were excluded based on title and abstracts; 10 articles excluded after full-text analysis. Ten studies comprising a population of 7,461 preschool children were included in the systematic review and nine studies were included in the meta-analysis. TDI caused a negative impact on OHRQoL based on the overall ECOHIS (OR: 1.24; 95% CI: 1.08–1.43) and CIS (OR: 1.23; 95% CI: 1.07–1.41), but not the FIS (OR: 1.09; 95% CI: 0.90–1.32). Conclusions TDI negatively impacted on OHRQoL of preschool children. The present findings indicate the need for TDI prevention and treatment programs in early childhood.
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Are dental researchers asking patient-important questions? A scoping review. J Dent 2016; 49:9-13. [DOI: 10.1016/j.jdent.2016.04.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022] Open
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30
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Feldens CA, Borges TS, Vargas-Ferreira F, Kramer PF. Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence. Dent Traumatol 2016; 32:429-437. [PMID: 27140525 DOI: 10.1111/edt.12281] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 12/16/2022]
Abstract
The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.
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