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Rajab LD, Nasser OA, Al-Bitar ZB. Orthodontic management of traumatized teeth: a survey among orthodontists. BMC Oral Health 2024; 24:1027. [PMID: 39215264 PMCID: PMC11365195 DOI: 10.1186/s12903-024-04748-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Information on previous traumatic dental injuries is important as they can lead to increased complications during orthodontic treatment and impact the treatment planning and outcomes. The aim of this study was to assess the knowledge of Jordanian orthodontists in orthodontic management of traumatized permanent teeth. METHODS Cross-sectional survey among active registered orthodontists using a questionnaire distributed by hand. RESULTS The study included 139 orthodontists. Nearly half of orthodontists treated between one to three patients with a history of traumatic dental injuries in the past 3 months. Only 43.2% of the participant asked routinely about history of trauma. A vast discrepancy in times waited before orthodontic movement and in the orthodontic management approach of traumatized teeth was noted. A statistically significant negative relationship between age and knowledge level was found (p = 0.002). A significantly higher level of knowledge was found among participants who had fellowship or board certification than those having the high diploma degree (P-0.032) and also who had treated patients with history of dental trauma in the last 3 months than those who did not (p = 0.001). CONCLUSIONS The knowledge of the surveyed orthodontists in both the recommended observation period before orthodontic treatment and management approaches of traumatized teeth during orthodontic treatment was insufficient. Years of clinical experience significantly affected knowledge, with older participants having lower levels of knowledge. Orthodontists who treated patients with history of dental trauma in the last 3 months had significantly higher knowledge in orthodontic management of traumatized teeth. Orthodontists needs to be aware of the proper timing and strategies on orthodontic management of traumatized permanent teeth to improve the long term prognosis and to reduce further complications during orthodontic treatment through proper management.
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Affiliation(s)
- Lamis Darwish Rajab
- Department of Pediatric Dentistry, Orthodontics and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan.
| | - Osama Abdullatif Nasser
- Department of Pediatric Dentistry, Orthodontics and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Zaid B Al-Bitar
- Department of Pediatric Dentistry, Orthodontics and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
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Jogezai U, Kalsi A. Long-term complications and management of dental trauma in the adult patient - Part 2: discoloured, displaced and missing teeth. Br Dent J 2024; 237:171-178. [PMID: 39123018 DOI: 10.1038/s41415-024-7672-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 03/23/2024] [Accepted: 04/12/2024] [Indexed: 08/12/2024]
Abstract
The second paper in this two-part review series aims to outline the long-term complications of dental trauma in the adult patient in relation to discoloured, displaced or missing teeth. A brief overview of the cause of discolouration is outlined, followed by assessment and management options. These can include bleaching, veneers, or crown restorations to mask the discolouration. Displacement of teeth from the socket can occur due to luxation injuries. Management can include simple digital manipulation, surgical repositioning, or orthodontic extrusion based on the severity of extrusion and the time from injury. Teeth can be lost early or in the long-term following dental trauma and associated hard and soft tissues deficiencies may also ensue. Replacement options can include a removable partial prosthesis, resin-retained bridge or dental implants. Often, hard and soft tissue augmentation procedures may be required to address any defects and rebuild lost anatomical contours. A thorough assessment followed by the development of a sound management plan which takes patients' general and local factors into account can ensure a predictable and successful treatment outcome. This would end in an aesthetically pleasing and a functionally stable result for the patient.
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Affiliation(s)
- Ursala Jogezai
- Specialty Registrar in Restorative Dentistry, Royal National ENT and Eastman Dental Hospitals, UK.
| | - Amardip Kalsi
- Consultant in Restorative Dentistry, Cambridge University Hospitals, UK
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Moca RT, Moca AE, Juncar RI, Vaida LL, Janosy AM, Juncar M. Prevalence and Patterns of Positional Dental Anomalies in First Permanent Molars: Insights from a Study in Oradea, Romania. Diagnostics (Basel) 2024; 14:1460. [PMID: 39001351 PMCID: PMC11241676 DOI: 10.3390/diagnostics14131460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/05/2024] [Accepted: 07/07/2024] [Indexed: 07/16/2024] Open
Abstract
Tooth position anomalies, influenced by both genetic and environmental factors, can significantly impact oral health and play a critical role in establishing proper occlusion. The aim of this study was to identify the most prevalent tooth position anomalies in first permanent molars among Romanian patients and to evaluate additional variables as well. This retrospective study utilized digital study models to identify all existing tooth position anomalies. The study included patients aged 12 to 40 years with complete permanent dentition. Axial changes (buccal tilting, oral tilting, mesial tilting, and distal tilting) as well as rotational changes (mesio-buccal rotation and disto-buccal rotation) were investigated. After applying the exclusion criteria, 103 patients remained in the study. Our findings revealed a notable prevalence of positional anomalies, with disto-buccal rotations being most common in upper molars (tooth 1.6-22.3%, tooth 2.6-31.1%) and oral tilting predominating in lower molars (tooth 3.6-6.8%, tooth 4.6-14.6%). Interestingly, neither gender nor malocclusion type significantly influenced the occurrence of tooth position anomalies. Symmetrical patterns in positional changes were observed, with patients having tooth position anomalies at 1.6 significantly more frequently associated with anomalies at 2.6. Similarly, anomalies at 3.6 were significantly more frequently associated with anomalies at 4.6. Additionally, for molars 2.6 and 3.6 on the left side, the differences were statistically significant, with patients having anomalies at 2.6 significantly more frequently associated with anomalies at 3.6. This pattern was not observed for the molars situated on the right side of the dental arches. While this study provides insights into positional anomalies in first permanent molars among the Romanian population, its retrospective design and focus on a specific demographic may limit generalizability. In conclusion, the study underscores the significant prevalence of positional anomalies in first permanent molars among adolescents and adults in Oradea, Romania. Early detection and targeted interventions are crucial to address these anomalies and improve orthodontic outcomes. Comprehensive assessment and treatment planning are essential to achieve optimal dental harmony and function. Further research is needed to elucidate the underlying factors contributing to these positional changes and their long-term impact on oral health and occlusal stability.
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Affiliation(s)
- Rahela Tabita Moca
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Raluca Iulia Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
| | - Anna-Maria Janosy
- Private Dental Practice CMI Dr. Janosy Anna-Maria, 23 Corneliu Coposu Street, 410445 Oradea, Romania
| | - Mihai Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania
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Seeballuck C, Dolan S, K Kilgariff J. Getting it right at every stage: Top tips for traumatic dental injury review: Part 1. Br Dent J 2024; 236:82-86. [PMID: 38278886 DOI: 10.1038/s41415-024-6780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Affiliation(s)
- Clement Seeballuck
- Clinical Lecturer in Paediatric Dentistry, Dundee Dental Hospital and Research School, Dundee, DD1 4HR, UK.
| | - Sean Dolan
- Specialty Training Registrar in Restorative Dentistry, Glasgow Dental Hospital and School, Glasgow, G2 3JZ, UK.
| | - Julie K Kilgariff
- Consultant in Endodontics, Dundee Dental Hospital and Research School, Dundee, DD1 4HR, UK.
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Kilgariff JK, Fairless M. Displacement Injuries: Assessment and Management. Prim Dent J 2023; 12:47-56. [PMID: 38018680 DOI: 10.1177/20501684231213770] [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] [Indexed: 11/30/2023]
Abstract
This paper aims to aid clinicians in the assessment and immediate management of dental trauma displacement injuries to permanent teeth. Long term sequelae, the impact of such injuries, and the evidence-base for managing these are discussed.Clinical cases are provided to illustrate management challenges and highlight where further evidence-based guidance is needed. The role of the general dental practitioner in the immediate management and follow-up of traumatic dental injuries is outlined and sequelae, worthy of potential referral, described.
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Affiliation(s)
- Julie K Kilgariff
- Julie K. Kilgariff BDS, MFDS RCS(Ed), MRD(Endo) RCS(Ed), AFHEA Consultant in Endodontics, Dundee Dental Hospital & Research School, Dundee, UK
- Matthew Fairless BSc (Hons), BDS, MFDS RCS(Ed) Dental Core Trainee, Dundee Dental Hospital & Research School, Dundee, UK
| | - Matthew Fairless
- Julie K. Kilgariff BDS, MFDS RCS(Ed), MRD(Endo) RCS(Ed), AFHEA Consultant in Endodontics, Dundee Dental Hospital & Research School, Dundee, UK
- Matthew Fairless BSc (Hons), BDS, MFDS RCS(Ed) Dental Core Trainee, Dundee Dental Hospital & Research School, Dundee, UK
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Némat SM, Kenny KP, Day PF. Special considerations in paediatric dental trauma. Prim Dent J 2023; 12:64-71. [PMID: 38018674 DOI: 10.1177/20501684231211413] [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] [Indexed: 11/30/2023]
Abstract
Traumatic dental injuries (TDIs) in the paediatric population are common and frequently seen in general dental practice. The management of TDIs can be challenging and, in most cases, the General Dental Practitioner is tasked with the initial assessment and emergency treatment. Patients and their families typically attend with elevated levels of distress, which is complicated by the limited dental experience of some children. Behaviour management is essential and helps prepare patients for dental care at both their emergency and follow-up appointments. Early and accurate diagnosis in combination with appropriate treatment contributes to favourable outcomes for traumatised teeth. Early discussions with or referral to paediatric dental teams for management of complex TDIs is encouraged, however shared follow-up care is beneficial over the long-term. In specific cases, initial dental treatment can be delayed by a few days to a subsequent appointment, allowing the dental team to book sufficient time for the treatment and for the patient and their families to prepare. Education of the patients and adults with parental responsibility is essential to manage expectations, explain likely complications and encourage attendance for long-term follow-up visits. This paper discusses the management of paediatric patients to aid the primary care practitioner in providing effective immediate and long-term care.
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Affiliation(s)
- Shimal M Némat
- Shimal M. Némat MChD, BChD, MFDS RCPS(Glasg) Specialty Trainee in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Kate P. Kenny BDentSc, DClinDent, MPaedDent, FHEA, NIHR Doctoral Research Fellow, Specialist and Lecturer in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Peter F. Day PhD, FDS (Paeds) RCS (Eng), FRCD (Canada), PGCLTHE, BDS, MFDS RCS (Eng), M Dent Sci, M Paed Dent RCS (Eng) Professor and Consultant in Paediatric Dentistry, School of Dentistry, University of Leeds, UK and Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Kate P Kenny
- Shimal M. Némat MChD, BChD, MFDS RCPS(Glasg) Specialty Trainee in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Kate P. Kenny BDentSc, DClinDent, MPaedDent, FHEA, NIHR Doctoral Research Fellow, Specialist and Lecturer in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Peter F. Day PhD, FDS (Paeds) RCS (Eng), FRCD (Canada), PGCLTHE, BDS, MFDS RCS (Eng), M Dent Sci, M Paed Dent RCS (Eng) Professor and Consultant in Paediatric Dentistry, School of Dentistry, University of Leeds, UK and Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Peter F Day
- Shimal M. Némat MChD, BChD, MFDS RCPS(Glasg) Specialty Trainee in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Kate P. Kenny BDentSc, DClinDent, MPaedDent, FHEA, NIHR Doctoral Research Fellow, Specialist and Lecturer in Paediatric Dentistry, School of Dentistry, University of Leeds, UK
- Peter F. Day PhD, FDS (Paeds) RCS (Eng), FRCD (Canada), PGCLTHE, BDS, MFDS RCS (Eng), M Dent Sci, M Paed Dent RCS (Eng) Professor and Consultant in Paediatric Dentistry, School of Dentistry, University of Leeds, UK and Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
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7
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Kalsi HK, Burns B. Prevention of Dental trauma. Prim Dent J 2023; 12:83-88. [PMID: 38018671 DOI: 10.1177/20501684231210090] [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] [Indexed: 11/30/2023]
Abstract
Traumatic dental injuries (TDIs) occur commonly in children and young adults with one in three adults having experience of a TDI to their permanent dentition. Although the management of TDIs have evolved vastly, the consequences of TDIs can still be profound and generally carry a high burden for the patient, family, or carer, as well as the clinician and healthcare services. Hence, prevention of TDIs where possible is key. It is important to ensure that all risk factors for dental trauma are fully explored to allow preventative advice to be tailored to each patient. General Dental Practitioners are well placed to establish a rapport with patients owing to the continuity of care that is commonly seen in dentistry, however, it is imperative that the appropriate questions are asked.This article aims to review dental trauma highlighting the significance of identification of clinical and social risk factors and prevention of TDIs. These risk factors are further divided into modifiable and non-modifiable risk factors which can guide the clinician on what further action is required and when other members of the dental or medical team should be involved. The importance of patient education in prevention of TDIs, including use of mouthguards in sport, and mouthguard design will be discussed.
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Affiliation(s)
- Hasneet K Kalsi
- Hasneet K. Kalsi BDS, MFDS RCPS(Glasg) Specialty Registrar in Restorative Dentistry, Department of Restorative Dentistry, Glasgow Dental Hospital, Glasgow, UK
- Beth Burns BDS, MSc (Med Sci), FDS (Rest Dent), RCPS (Glas) Consultant & Clinical Lead in Restorative Dentistry, Department of Restorative Dentistry, Glasgow Dental Hospital, Glasgow, UK; Board Member Dental Trauma UK (DTUK)
| | - Beth Burns
- Hasneet K. Kalsi BDS, MFDS RCPS(Glasg) Specialty Registrar in Restorative Dentistry, Department of Restorative Dentistry, Glasgow Dental Hospital, Glasgow, UK
- Beth Burns BDS, MSc (Med Sci), FDS (Rest Dent), RCPS (Glas) Consultant & Clinical Lead in Restorative Dentistry, Department of Restorative Dentistry, Glasgow Dental Hospital, Glasgow, UK; Board Member Dental Trauma UK (DTUK)
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Stefopoulos S, Kodonas K, Tzanetakis GN. Long-Term Clinical and Radiographic Observation of Previously Regenerated Treated Incisors Subjected to Orthodontic Movement. A Case Series. J Endod 2023; 49:1487-1494. [PMID: 37657730 DOI: 10.1016/j.joen.2023.08.015] [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: 05/28/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/03/2023]
Abstract
INTRODUCTION With an increasing number of anterior traumatized teeth treated with regenerative endodontic procedures (REPs) nowadays, orthodontic movement of such teeth is expected to become a common scenario in everyday clinical practice. However, little is known about the clinical implications and the response capacity of regenerated tissues to orthodontic forces. METHODS The aim of this clinical article was to report on 4 cases of REP-treated immature anterior permanent teeth subjected to orthodontic forces, and to describe the long-term response of the regenerated apical and intracanal tissues. RESULTS Signs of orthodontic-induced external root resorption were observed in 2 of the 4 presented cases without, however, the presence of any associated adverse events. No other complications were observed, either clinically or radiographically, throughout the observation period. In the long-term, all 4 cases responded favorably to orthodontic forces, maintaining healthy apical tissues and structural integrity of both intracanal as well as apically regenerated tissues. CONCLUSIONS The orthodontic movement of REP-treated teeth seems feasible, nevertheless, special care should be implemented. Lightly acting orthodontic forces, short duration of active movement, and close monitoring of the patient seem to be prerequisites to limit complications to a minimum and achieve a favorable healing of REP-treated teeth in the long-term following orthodontic treatment completion.
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Affiliation(s)
| | - Kostas Kodonas
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Giorgos N Tzanetakis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
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Beyene MMR, Bårdsen A, Klock KS, Sulo G, Thelen DS. Orthodontic management of traumatic dental injuries in Norway and orthodontists' perceptions of referral routines: A quality assurance survey. Dent Traumatol 2023; 39:469-477. [PMID: 37254307 DOI: 10.1111/edt.12854] [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: 01/28/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIM Orthodontic treatment of patients with traumatic dental injuries is challenging, with limited evidence of routines and outcomes. The aims of this study were: (i) to describe how orthodontists perceive the information on traumatic dental injuries received by referral from the Public Dental Health Service before orthodontic treatment and (ii) to assess orthodontists' knowledge and working routines in managing traumatic dental injuries. MATERIALS AND METHODS Data were obtained through a survey of all practicing orthodontists registered as members of the Norwegian Association of Orthodontists (n = 203). RESULTS Eighty-three orthodontists were enrolled, most of whom had received their dental degree (73.0%) and specialist orthodontic training (88.5%) in Norway. They reported examining patients with a history of traumatic dental injury at weekly (34.2%) or monthly (38.0%) basis. In 85.5% of cases, they obtained a history of traumatic dental injury from patients. Half of the respondents (51.3%) favoured two-phase early orthodontic treatment for patients with an overjet ≥6 mm. The observation time and treatment strategy showed considerable discrepancies across traumatic dental injury diagnoses. Most (59.1%) orthodontists considered the information on previous traumatic dental injuries provided by the Public Dental Health Services referral 'inadequate', more commonly in cases of mild (83.5%) than severe (57.5%) traumatic dental injuries. CONCLUSIONS Orthodontic management of patients with traumatic dental injuries was characterised by lack of uniformity in both recommended observation time before orthodontic treatment and management strategy. The referral routines by the Public Dental Health Services for patients with traumatic dental injuries were perceived as 'inadequate' in terms of frequency and quality. The results indicate the requirement of standardisation of routines related to orthodontic management of traumatic dental injuries and referral routines by the Public Dental Health Services.
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Affiliation(s)
| | - Asgeir Bårdsen
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Kristin Solveig Klock
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
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Stučinskaitė S, Laugalė P, Grinkevičienė D, Vėberienė R, Smailienė D. Knowledge of Dental Trauma and Orthodontic Management of Traumatized Teeth by a Group of Lithuanian Orthodontists. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1289. [PMID: 37512100 PMCID: PMC10386023 DOI: 10.3390/medicina59071289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives. There is a deficiency of research on orthodontic movements and management strategies for traumatized teeth to avoid further treatment complications. The aim of the study was to evaluate the knowledge of Lithuanian orthodontists about dental trauma and the orthodontic management of traumatized teeth. Materials and Methods. Lithuanian orthodontists and orthodontic residents were introduced to the purpose, objectives and questionnaire of the study. The questionnaire was developed based on demographics, the participants' personal experience, specific questions about dental traumas and orthodontic treatment tactics for patients with a history of dental trauma. Results. A total of 54 participants (42 orthodontists and 12 orthodontic residents) completed the survey. The overall response rate was 42.9%. The results of the survey revealed that the largest share of the study participants-61%-stated that they had treated traumatized teeth just a few times during the whole practice. Briefly, 53.7% of respondents inquired about the dental trauma history only if they saw signs of complications. The results of the survey revealed that the frequency of correct answers to questions about dental trauma was 63.7%, and that about the orthodontic treatment of traumatized teeth was 54.9%. It is worth noting that one-third of physicians pointed out the lack of information about the orthodontic management of traumatized teeth. Conclusion. The knowledge of Lithuanian orthodontists and orthodontic residents about dental injuries and the orthodontic treatment of traumatized teeth is insufficient. Further educational training is recommended.
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Affiliation(s)
- Simona Stučinskaitė
- Department of Orthodontics, Faculty of Odontology, Lithuanian University of Health Sciences, Lukšos-Daumanto 6, LT-50161 Kaunas, Lithuania
| | - Paulina Laugalė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Dominyka Grinkevičienė
- Department of Orthodontics, Faculty of Odontology, Lithuanian University of Health Sciences, Lukšos-Daumanto 6, LT-50161 Kaunas, Lithuania
| | - Rita Vėberienė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania
| | - Dalia Smailienė
- Department of Orthodontics, Faculty of Odontology, Lithuanian University of Health Sciences, Lukšos-Daumanto 6, LT-50161 Kaunas, Lithuania
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Parashos P. Endodontic-orthodontic interactions: a review and treatment recommendations. Aust Dent J 2023; 68 Suppl 1:S66-S81. [PMID: 37961018 DOI: 10.1111/adj.12996] [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] [Accepted: 10/19/2023] [Indexed: 11/15/2023]
Abstract
The literature is replete with articles describing the many and varied interactions between endodontic treatment and orthodontic tooth movement (OTM), often reporting conflicting views and findings, which creates confusion for clinicians. Original research and review articles have described aspects such as apical root resorption and potential pulpal complications of teeth related to OTM. Some interactions are of relatively minor clinical significance, whilst others may have adverse consequences. A history of dental trauma before or during OTM further complicates the interactions. This review re-assesses the historical literature on endodontic-orthodontic interactions in light of more recent research and presents guidelines for managing clinical situations involving both disciplines. © 2023 Australian Dental Association.
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Affiliation(s)
- P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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12
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Alam MK, Awawdeh M, Aljhani AS, Alotaib GS, Abutayyem H, Alswairki HJ, Hajeer MY. Impact of Dental Trauma on Orthodontic Parameters-A Systematic Review and Meta-Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050885. [PMID: 37238433 DOI: 10.3390/children10050885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Investigation into the impact of dental trauma on the results of orthodontic treatment is crucial because it can have a major influence on patient care. However, there has not yet been a thorough review or meta-analysis of the available data, which is inconsistent and scant. Therefore, the goal of this systematic review and meta-analysis is to investigate the impact of dental trauma on orthodontic parameters. Search methods and criterion of selection: Major online databases were searched (beginning from the year 2011) for relevant articles using a properly defined search strategy. Analysis protocol: Risk of bias (RoB) and the Cochrane risk of bias tool were utilized for the purposes of bias evaluation within the individual studies and within the review, respectively. RESULTS Out of the six clinical trials selected, a significant impact of trauma was observed in individuals in all but one paper. Gender predilection varied across studies and could not be conclusively determined. The follow-up period ranged from two months to two years in the trials. The odds ratio (OR) 0.38 [0.19, 0.77] and the risk ratio (RR) 0.52 [0.32, 0.85] indicated that both the odds as well as the relative risk of experiencing dental trauma were lower in the group with negligible impact compared to the group with noticeable impact. Conclusion and further implications: The findings show that dental trauma significantly affects orthodontic parameters, with lower risk and likelihood of suffering dental trauma in the group with negligible impact than in the group with noticeable impact. However, given the substantial heterogeneity among the studies, it is advised to exercise caution when extrapolating the findings to all populations. Registration and protocol: Registration in the PROSPERO database was carried out before initiating the investigation [CRD42023407218].
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Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai 600077, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
| | - Mohammed Awawdeh
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, 11481, Saudi Arabia
- Dental Services, King Abdulaziz Medical City, Ministry of the National GuardHealth Affairs, Riyadh 11426, Saudi Arabia
| | - Ali S Aljhani
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, 11481, Saudi Arabia
- Dental Services, King Abdulaziz Medical City, Ministry of the National GuardHealth Affairs, Riyadh 11426, Saudi Arabia
| | - Ghada Serhan Alotaib
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, 11481, Saudi Arabia
- Dental Services, King Abdulaziz Medical City, Ministry of the National GuardHealth Affairs, Riyadh 11426, Saudi Arabia
| | - Huda Abutayyem
- Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences Research, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | | | - Mohammad Younis Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus P.O. Box 16046, Syria
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Cobourne M. Producing the Journal of Orthodontics is a team effort. J Orthod 2022; 49:377-378. [DOI: 10.1177/14653125221135712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Incisal Interference Correction after Severe Extrusive Luxation Trauma during Orthodontic Treatment. Case Rep Dent 2022; 2022:7181481. [DOI: 10.1155/2022/7181481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
This case report presents the treatment of a 12-year-old boy who suffered serious dental trauma, accompanied with buccal alveolar socket wall fractures, during orthodontic treatment. The maxillary right lateral incisor and canine were severely extruded and laterally luxated to the palatal side, resulting in an anterior crossbite and creating an incisal interference that prevented the jaws from closing in normal occlusion. During emergency treatment, the dentist attempted manual repositioning, but both severely extruded teeth were found to be immobile. One day after trauma, orthodontic repositioning was started using full fixed appliances with light 0.012″ nickel–titanium round wires, and this occlusal interference was corrected within 3 weeks. In the various internationally recognized treatment guidelines, the options for orthodontic repositioning for dental luxation trauma are only marginally described. Internationally accepted dental treatment guidelines may include immediate orthodontic repositioning after trauma as a treatment option in the management of dental extrusive and lateral luxation trauma.
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Bakkari A, Bin Salamah F. Updated Guidelines for the Orthodontic Management of Traumatized and Endodontically Treated Teeth: A Review Study. Cureus 2022; 14:e28943. [PMID: 36237800 PMCID: PMC9547618 DOI: 10.7759/cureus.28943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/05/2022] Open
Abstract
Traumatic dental injuries (TDIs) are injuries affecting the teeth, periodontium, and surrounding soft tissues. A significant percentage of candidates for orthodontic treatment suffer from previous TDIs to their permanent incisors that mostly remained untreated. Orthodontic treatment of such teeth might be associated with an increased risk of further pulpal and periodontal consequences, especially in teeth with a previous onset of root resorption that has occurred following the trauma. Orthodontic treatment planning can also be challenging for previously endodontically treated teeth. Clinicians should be aware of the techniques and the appropriate time to proceed with orthodontic tooth movement of traumatized and endodontically treated teeth, whether it was secondary to deep carious lesions or TDIs, and about the risks involved. This review was done in order to provide an evidence-based approach regarding the orthodontic management of traumatized and endodontically treated teeth and the current recommendations for orthodontic tooth movement of such teeth.
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16
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Affiliation(s)
- Clement Seeballuck
- Clinical Lecturer in Paediatric Dentistry, Dundee Dental School and Hospital, Park Place, DD1 4HR, UK
| | - Sean Dolan
- Post Dental Core Trainee Fellow, Ninewells Hospital, James Arrott Drive, Dundee, DD2 1UB, UK
| | - Julie K Kilgariff
- Consultant in Endodontics, Dundee Dental Hospital and School, Park Place, Dundee, DD1 4HR, UK
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Patel K, Mack G, Djemal S. Management of acute traumatic dental injuries in the orthodontic patient. Br Dent J 2022; 232:695-700. [PMID: 35624257 PMCID: PMC9142363 DOI: 10.1038/s41415-022-4244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
Abstract
Knowledge of managing traumatic dental injuries (TDIs) is imperative for all dental practitioners. With the number of adults undertaking orthodontic treatment increasing, and children and adolescents alike continually being treated for orthodontics under the NHS in the UK, it is imperative that all clinicians - specialists and generalists - are aware of how to manage the orthodontic appliance in a patient presenting with a TDI in their active phase of orthodontics.This guidance will aid practitioners in implementing pragmatic approaches to manage the orthodontic appliance in a patient presenting with a TDI. Key focus will be given on fixed appliance therapy. Case examples and flow diagrams outlining best practice are given to manage the TDI and orthodontic appliance concurrently.
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Affiliation(s)
- Kishan Patel
- Speciality Registrar in Orthodontics, King´s College Dental Institute, London, SE5 9RS, UK.
| | - Gavin Mack
- Consultant in Orthodontics, King´s College Dental Institute, London, SE5 9RS, UK
| | - Serpil Djemal
- Consultant in Restorative Dentistry, King´s College Dental Institute, London, SE5 9RS, UK
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18
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Morris HT, Campbell RE, Kissling AD, Cully JL, Thikkurissy S. Observation periods before tooth movement in orthodontic patients who have experienced mild-to-moderate dental trauma: a scoping review of current evidence. J World Fed Orthod 2022; 11:59-68. [PMID: 35184986 DOI: 10.1016/j.ejwf.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Guidelines for orthodontic patients that have experienced mild-to-moderate dental trauma recommend an observation period before beginning or resuming tooth movement, but they appear to be based on limited evidence. OBJECTIVES This scoping review examines available research on recommended observation periods before beginning or resuming tooth movement for orthodontic patients that have experienced mild-to-moderate dental trauma. The extent of research, methodologies used, outcomes reported, and justification for recommended observation periods were reviewed to identify any gaps in current knowledge. DESIGN Online databases were searched to identify papers published from 1950 to September 2021. Two publications, one from Sweden and one from Israel, reported dental outcomes of tooth movement with versus without observation periods for orthodontic patients that had experienced trauma. The risk of bias was assessed using the Cochrane Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-1) tool. RESULTS One article was published in 1982, and the other in 1991. Both were observational retrospective cross-sectional studies of orthodontic patients with a history of mild-to-moderate trauma to permanent teeth (uncomplicated crown fracture, concussion, subluxation, luxation), ranging in age from 7 to 16 years. The studies listed a variety of outcomes, including clinical exams, electric pulp testing, and analysis of periapical or panoramic radiographs for signs of root resorption. CONCLUSIONS The identified articles lack sufficient evidence to determine an appropriate observation period after mild-to-moderate trauma before beginning or resuming orthodontic treatment. High-quality research is needed to better define appropriate observation periods before beginning or continuing orthodontic treatment for mildly to moderately traumatized teeth.
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Affiliation(s)
- Heather T Morris
- Clinical Instructor, Division of Pediatric Dentistry & Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Richard E Campbell
- Assistant Professor, Department of Pediatrics, College of Medicine, Cincinnati, Ohio, USA; Assistant professor, Division of Pediatric Dentistry & Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Alison D Kissling
- Senior Medical Research Librarian, Edward L. Pratt Research Library, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer L Cully
- Associate Professor, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Associate Professor, Division of Pediatric Dentistry & Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Sarat Thikkurissy
- Professor Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Professor and Robert Creedon chair, Division of Pediatric Dentistry & Orthodontics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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19
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Khan M, Jindal M. Successful treatment of laterally luxated teeth with traumatic occlusion in adolescent patient by single arch fixed orthodontic therapy: A case-report. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_19_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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