Pattern of traumatised anterior teeth among adult Nigerians and complications from late presentation

Treatment priorities and arrival time of traumatic dental injuries-An 8-year retrospective study

BACKGROUND/AIM

Most of the previous studies in the available literature discussed the time of arrival in general to the healthcare system, while a minority studied the relationship between the type of trauma and arrival. The aim of this retrospective study is to assess the arrival time of traumatic dental injuries (TDIs) depending on the urgency of treatment according to Andreasen.

MATERIALS AND METHODS

This 8-year retrospective study was carried out at the Department of Pediatric Dentistry at the University Dental Clinic in Zagreb, Croatia. Andreasen's classification was used to define the kind of TDI as well as to divide them by the need for urgent treatment or treatment priorities in three groups: acute, subacute, and delayed.

RESULTS

The sample consisted of 1040 children (59% male and 41% female) with a median age of 7. Each year, the age group most affected by TDIs was 6-12 years old. While there is a general increase in the prevalence of TDIs overall, there is a decline in TDIs among children aged 6-12 and an increase among preschoolers and adolescents (below 6 and above 12 years old). Throughout the years, 52.73% red/acute and 41.16% yellow/subacute TDIs were not treated on time due to delayed arrival. More patients from Zagreb come in the first 24 h, while more patients from outside Zagreb come to the clinic a month or more after their injuries. Patients which suffered TDI accompanied with soft-tissue injury arrived sooner.

CONCLUSIONS

It is necessary to introduce monitoring and education of patients under the age of 6 and over 12, as well as their parents/caregivers. New programs should be implemented and new referent centers that specialize in treating TDIs outside of Zagreb should be established.

Evaluation of Clinical and Radiographic Findings among Patients with Traumatic Dental Injuries Seeking Delayed Treatment

Background

Time elapsed between trauma and treatment greatly influences the prognosis of traumatic dental injuries (TDIs). The aim of this study was to analyze clinical and radiographic findings related to complications of TDIs among patients seeking delayed treatment of such injuries.

Materials and Methods

123 permanent teeth with a history of previous TDIs were included in the study. Clinical findings analyzed were the type of fracture, type and number of injured teeth, crown discoloration, and pulpal status of the injured tooth (pulpal diagnosis). The radiographic findings analyzed included pulp canal obliteration (PCO), root resorption (RR), and periapical radiolucency (PR). Statistical analysis included descriptive analysis.

Results

Tooth discoloration was the most common presenting complaint (53.65%), while fall (48.78%) was the most frequent cause of trauma. The range of time duration between trauma and presentation for treatment was 5 months to 30 years (average time 12.82 years). Pulp necrosis (PN) was the most common complication (90.24%). Almost half of the teeth with PN had fracture injury and discoloration along with a high frequency of PR (78.37%). Even teeth with a normal appearance were found to have a high incidence of PN (76.92%) and PR (53.84%). The crown discoloration was the second most frequent finding (48.78%). Many teeth (41.66%) with vital pulp were also discolored. Most of the teeth (79.31%) with yellowish discoloration and all teeth with brownish discoloration were nonvital. A high frequency of PN (90%) and PR (78.33%) was found in teeth with discoloration. PR was the most common radiographic finding (69.10%), while PCO and RR were observed in 17.88% and 21.13% of teeth, respectively.

Conclusion

The findings of this study support the fact that delayed treatment of TDIs leads to increased complications. PN was the most common complication followed by tooth discoloration, RR, and PCO among patients seeking delayed treatment after TDIs.

Evaluation of dental trauma in inmates of the most highly populated Brazilian prison complex

BACKGROUND/AIM

Due to the increase in incarceration rates, the prison community has attracted much concern in the recent past. Although people in prison are often socially disadvantaged and vulnerable to a range of health problems, there is a lack of information on the oral health conditions of prisoners. Thus, the aim of this study was to survey the oral problems of a sample of the male incarcerated population of Brazil, focusing on dental trauma.

MATERIAL AND METHODS

The research was undertaken over a three-month period in 2017. It was a cross-sectional study of 756 prisoners of the Curado Prison Complex, located in Recife, PE. Using a previously calibrated examiner, dental trauma was measured with the Andreasen index. Etiology of dental trauma and socio-demographic data were collected with questions developed for this survey. Standard descriptive statistics were used to report frequency estimates. The chi-square test, Fisher's exact test, and Mann-Whitney U-test were used to compare groups. In addition, a binary logistic regression was performed to identify whether the studied variables could predict the occurrence of dental trauma.

RESULTS

The prevalence of dental trauma in the sample was 10.8% and most of the cases (42.7%) occurred due to violent events. A higher frequency of violent etiology was observed in cases that occurred during imprisonment (p = 0.037). Individuals that suffered dental trauma during incarceration were more likely to have been incarcerated for longer periods of time (p = 0.043). The main type of injury found was enamel and dentin fracture without pulp exposure (68%). The most affected tooth was the upper right central incisor (40%).

CONCLUSION

These results underline the high prevalence of dental trauma experienced by men in prison.

Causes of dental trauma: Results of findings among patients in a secondary oral healthcare center, Jos, Nigeria

Background:

Dental trauma is a major type of traumatic dental injury (TDI) and a common presentation in many oral health facilities in Nigeria. Despite the high prevalence of TDIs, causes of dental trauma are yet to be fully investigated among Nigerians.

Aim:

The aim of this study is to determine the types of dental trauma, aetiology, and the causes of dental trauma as it relates with sociodemographic characteristics among dental patients.

Materials and Methods:

This was a cross-sectional study among patients attending a secondary oral healthcare facility in the North Central city of Jos between January 2019 and December 2020. The sociodemographic features of the patients include patients’ complaints, clinical and social history, result of simple clinical oral examinations, and diagnoses of dental trauma. The classification of Ellis and Davey (1970) was used to classify dental trauma for this study.

Results:

One hundred and seventy-six (6.7%) patients presented with dental trauma involving 281 teeth. The mean age was 37.54 ± 2.16 years. The most common cause of dental trauma in 48 (27.3%) patients was bone cracking, followed by falls in 33 (18.8%), road traffic accidents (RTAs) in 26 (14.8%), and bottle opening with teeth in 26 (14.8%). Bone cracking was the major cause of dental trauma in 18 (31.0%) educated and 2 (28.6%) non-educated patients. Among the patients, 118 (67.1%) presented with single traumatized tooth. Permanent anterior teeth 151 (53.74%) were more involved, and class 2 trauma involving enamel and dentinal structure was the most common presentation.

Conclusion:

Oral health awareness campaign on the damaging effect of bone cracking and use of tooth for opening metal caps of bottled drinks among adult population will reduce the prevalence of dental trauma among many adult Nigerians.

Emergency management of dental trauma: a survey of public knowledge, awareness, and attitudes in Al-Madinah Al-Munawwarah

Background

Dental trauma is one of the most commonly encountered dental emergencies. The prognosis is determined by the appropriate intervention and immediate management of the traumatized teeth. Thus, public awareness is a leading determinant of treatment success. The purpose of this study was to assess the knowledge, attitudes, and awareness of Al-Madinah Al-Munawwarah residents regarding the management of dental trauma.

Methods

This cross-sectional observational study was conducted between December 2016 and January 2018. A two-part self-administered questionnaire comprising 13 closed-ended questions was used. Part one contained questions to elicit demographic data that included information related to the participants' sources of dental trauma. Part two assessed their knowledge and attitudes regarding the most common types of dental trauma. The data were analyzed with IBM SPSS Statistics for Windows, Version 22.0 software.

Results

A total of 598 participants were included in this study. The results indicated that 64% of the participants knew where to go to receive treatment for dental trauma, and 74% were aware of the differences in the management of the primary and permanent teeth after trauma. A majority (83%) did not have any information about these issues; however, 83% were interested in learning about the appropriate management of dental trauma.

Conclusion

The study participants were found to have low levels of knowledge. A majority had never received information about the management of dental trauma or avulsed teeth. Education programs are necessary for promoting positive attitudes by increasing the knowledge about dental trauma management.

Combined orthodontic, surgical, and restorative approach to treat a complicated crown-root fracture in a maxillary central incisor

This case report shows the treatment of a severe traumatic tooth injury. For the maxillary right central incisor, the trauma was considered a complicated crown-root fracture. The level of the fracture line, the length of the remaining root segment, and the presence and condition of the tooth fragment determined the type of therapy. Traumatized teeth with fractures below the alveolar crest are often considered hopeless. As this report shows, the treatment of a complicated crown-root fracture in the esthetic region can be challenging. Orthodontic extrusion and crown-length surgery were performed to bring the fracture line above the alveolar bone crest. A multidisciplinary approach was required for complete rehabilitation of the traumatized maxillary incisor. Suggestions are made to improve treatment planning of complicated crown-root fractures.