A 3-year Retrospective Analysis of Dento-Alveolar Injuries at the University Children's Hospital Zurich (2018-2020)

Children and adolescents are vulnerable to dental trauma due to their active lifestyles, lack of coordination, and inexperience in recognizing potentially dangerous situations. Early recognition and proper management of dental trauma is crucial in order to minimize the risk of complications and ensure optimal outcomes. The aim of this study was to perform a retrospective analysis of all dento-alveolar injuries in children and adolescents who were treated at the University Children's Hospital Zurich from 2018-2020 by the resident physicians of the Centre of Dental Medicine of the University of Zurich. All information concerning age and sex distribution, seasonal and weekly variations, as well as aetiology, types of trauma and co-affected structures in the head and neck area from 389 patients was analysed. For data extraction, a parameterised Excel list was created, enabling a continuous data collection. In the study, 65% of the patients were male and 35% female. The average patient age was 7 years and 4 months. The highest frequency of trauma occurred in mixed dentition (49%), followed by deciduous dentition (36%) and permanent dentition (15%). Most of the accidents occurred in the second quarter of the year, especially in the month of May slightly more injuries were reported. The most common injuries were increased tooth mobility (40%) and tooth fractures without pulp exposure (34%). Less frequent were tooth fractures with pulp exposure (12%), lateral dislocations (29%), avulsions (21%), intrusions (8%), extrusions (6%) and root fractures (4%). As in many studies the upper central incisors were most often affected. Main causes of dental trauma were falls, especially by bike (18%) or scooter (14%). Soft tissue injuries or fractures, in the area of the head and neck occurred in 59% and 10% of the cases simultaneously accompanied by dento-alveolar trauma.

Working Dog Dentistry

Working dogs serve different functions based on their trained purpose. Due to the nature of their work, they are prone to traumatic dentoalveolar injuries (TDIs). TDIs include tooth wear, fracture, discoloration, and displacement. Undiagnosed or untreated TDIs result in pain, which could lead to poor performance. Veterinarians should educate handlers on potential injuries and perform a thorough oral examination and appropriate diagnostics to identify any oral abnormalities and initiate treatment. The primary goal of treatment is to return dogs to normal function so that they can continue to perform their assigned duty at maximum performance.

Prognosis and complications of mature teeth after lateral luxation: A systematic review

BACKGROUND

Dental trauma injuries are frequent in children and adolescents and can result in a sequela of future complications. Lateral luxation injuries are diagnosed when a tooth becomes displaced in a position other than axial and is often associated with alveolar bone fracture. Although the tooth is not immediately lost, pulp canal obliteration or pulpal necrosis can occur. The objective of this systematic review was to gather existing data on lateral luxation injuries to mature teeth to evaluate their overall prognosis and reported complications.

TYPES OF STUDIES REVIEWED

The authors conducted a systematic search of the literature using MEDLINE, PubMed, Embase, and Cochrane databases in February 2019. They hand searched reference lists to identify additional literature. The authors included prospective and retrospective observational studies in the search. They screened a total of 291 articles, downloaded 28 articles, and included 4 articles in the study.

RESULTS

The most frequent complication reported for mature teeth with lateral luxation was pulpal necrosis (44.2%). Less frequent findings included surface resorption (14.0%), inflammatory resorption (8.5%), pulp canal obliteration (8.1%), and replacement resorption (0.9%). The included studies were cohort studies, which resulted in great heterogeneity, and the authors could not attempt a meta-analysis.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

A large number of permanent teeth that experience lateral luxation are at risk of developing pulpal necrosis and other complications. Careful follow-up is required for these patients to treat complications as early as possible. Furthermore, the authors of this systematic review emphasize the importance of consistent reporting of dental trauma outcomes.

The face of conflict: Significant sharp force trauma to the mid-facial skeleton in an individual of probable 16th-17th century date excavated from Byczyna, Poland

A variety of injuries have always been associated with violence, consequences of which people had to deal with. In this paper we present a complex of craniofacial and dental injuries resulted from sharp force trauma. The basis of our study was historical skeletal material excavated from archeological site in Byczyna (11th-17th century), Poland. An individual whose skeleton was exhumed from the grave No. 610 exhibited healed, oblique trauma of the left maxilla, damage to the crowns of right central and lateral incisors and concomitant luxation of the right maxillary central incisor. We describe the mechanism of this trauma and complications that resulted from damage to the masticatory apparatus.

Post-traumatic complications of severe luxations and replanted teeth

AIM

The aim of this study was to evaluate the main post-traumatic complications of severe luxation and replanted teeth using clinical and radiographic analyses.

MATERIALS AND METHODS

Eighty-three patients aged between 7 and 55 years old presenting 180 traumatized teeth that suffered extrusive luxation (n=67), lateral luxation (n=69), intrusive luxation (n=10) and tooth avulsion (n=34) followed by replantation were evaluated. The follow-up period was 24 months. The complications examined were: pulp canal obliteration, pulp necrosis and root resorption (infammatory and replacement). Furthermore, the relationship between time elapsed before receiving dental attendance and development of infammatory resorption was observed.

RESULTS

Pulp necrosis was the main complication, occurring in 147 teeth (82.7%). All of the teeth that suffered intrusive luxation and tooth avulsion were diagnosed with pulp necrosis, with significant difference in comparison with another traumas (p<0.001/Fisher's exact test). Infammatory root resorption was observed in 20.5% of the cases and replacement resorption was more related to tooth replantation (94.1%), showing significant prevalence among tooth luxations (p<0.001/Fisher's exact test). In addition, it was noted that patients who seek treatment 9 weeks after the trauma episode presented 10 times more chance of developing infammatory resorption when compared with patients who seek treatment soon after dental trauma (Odds ratio test).

CONCLUSION

It may be concluded that pulp necrosis was the main post-traumatic complication observed in traumatized teeth and that delay in seeking treatment may damage the prognosis of severe luxation and replanted teeth.

CLINICAL SIGNIFICANCE

Clinical studies describing the main complications that may affect traumatized teeth present great relevance to make the population aware of the importance of seeking immediate treatment and to alert the professional to the need for follow-up. When traumatic injuries are diagnosed and treated early, post-traumatic complications may be controlled, allowing conservation of the tooth in oral cavity.

Dental traumas during the military service

BACKGROUND

Dental traumas are most frequent during the first three decades of life and more frequent among males than females. Approximately 80% (n = 28 000) of the male age cohort performs military service annually in Finland. As little is known of dental, head, and neck traumas during the military service, our aim was to study the etiology, number and occurrence of traumas of the Finnish conscripts during one calendar year. Our hypothesis was that above-mentioned traumas comprise a remarkable proportion of military accidents.

MATERIALS AND METHODS

The data comprised of all the Finnish conscripts' trauma cases in the year 2009 (mean age 20.1 years, SD 1.1). The frequency, mechanism, and time of the incidences were analyzed.

RESULTS

Of the total 1432 trauma cases, 303 (23%) involved head, neck, or dentition. The occurrence rate of dental traumas was 6.5 cases/1000 persons/year. Dental traumas comprised 14.3% of all traumas. The most common mechanism for dental traumas was a blow-type force. First 4 months of the service and winter time were periods of increased risk of dental traumas. Two-thirds of the dental traumas, one-third of the body traumas and a quarter of the head and neck traumas occurred during military field exercises. Most dental traumas required a visit to a military dental clinic and also needed follow-up care.

DISCUSSION AND CONCLUSION

Head, neck, and dental injuries are common during the military service in Finland. Prevention of dental traumas and need for first aid dental skills of the personnel should be emphasized.