Tooth injuries: Knowledge of parents of public school students from the city of Alfenas, Minas Gerais, Brazil.

BACKGROUND/AIMS: The prognosis of traumatized teeth can be optimized if appropriate procedures are following at the time of the accident. The aim of this study was to evaluate the level of knowledge of students' parents from a group of Brazilian schools regarding fracture and tooth avulsion in permanent teeth. METHODS: Parents of 802 students were interviewed using a pre-tested questionnaire designed to explore how they would manage their child's dental avulsion or fracture. RESULTS: Among the parents, 8.6% reported their child had already suffered tooth injuries. Concerning dental fracture, 49.5% considered the possibility of bonding the tooth fragment and, for dental avulsion, 65.5% considered tooth replantation. Approximately 33.5% of parents would take the child to the dental office in case of fracture or dental avulsion, and of those, 66.2% would do so immediately. Further, 69.5% (for fracture) and 70.4% (for avulsion) would do so regardless of symptoms; only 24.2% and 21.3%, respectively, would seek care only if there was pain. In case of avulsion, 22.3% of those interviewed would store the tooth in liquid, such as saline solution (17.8%), water (16.4%) and fresh milk (12.2%). CONCLUSION: Parents had partial and insufficient knowledge as to the proper approach to be adopted in cases of fracture and dental avulsion. Previous experience of dental trauma was not related to more appropriate behavior regarding these injuries.

Histological evaluation of the repair process of replanted rat teeth after storage in resveratrol dissolved in dimethyl sulphoxide.

BACKGROUND/AIM: The storage media is directly related to the prognosis of avulsed teeth, with resveratrol drawing attention due to its antioxidant and anti-inflammatory proprieties. The aim of this study was to evaluate the repair process in rat teeth following delayed replantation after storage in resveratrol (R) dissolved in dimethyl sulphoxide (DMSO). MATERIALS AND METHODS: The upper right central incisors of 36 rats were divided into 4 groups. In group I, the teeth were extracted and immediately replanted. Group II teeth were stored in 50 mL R+DMSO (0.0512 g/mL), whereas group III teeth were stored in 50 mL pure DMSO, both for a period of 60 minutes. The teeth of group IV were stored dry for 60 minutes. The teeth of groups II, III and IV were then replanted, and the animals were euthanized after 60 days. Longitudinal histological cuts were HE stained for histomorphometric analysis of the periodontal ligament, alveolar bone, cementum and dentin. RESULTS: The analysis of HE stained histological sections showed the following statistical differences: the acute inflammatory process in the epithelial insertion was less prominent in group II than in group III; the organization of the periodontal ligament was better in group I, while the intensity and extension of acute inflammation in the periodontal ligament were better in group I, and worse in group III; the chronic inflammatory infiltrate was less in groups I and IV, and the depth and extent of resorption, as well as the repair of root resorption, were better in group I. CONCLUSIONS: Storage in R+DMSO solution did not inhibit root resorption after delayed replantation in rat teeth. It is concluded that pure DMSO is not a suitable transport medium for avulsed teeth.

Tooth fragment reattachment techniques-A systematic review.

BACKGROUND/AIM: Several strategies have been developed for tooth fragment reattachment following fracture. Although many techniques have been reported, there is no consensus on which one has the best results in terms of the bond strength between the fragment and the dentin over time. The aim of this study was to assess the currently reported tooth fragment reattachment techniques for fractured crowns of anterior teeth. MATERIALS AND METHODS: The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were cross-checked to identify additional studies; gray literature and ongoing trials were investigated. Two authors assessed studies to determine inclusion and undertook data extraction. Case reports/series of three or more cases, cross-sectional studies, cohort studies, and in vivo clinical trials in all languages were included. RESULTS: Five articles remained after screening. These studies predominantly reported on fragment reattachment with composite resin and resin cement. There was little consistency among the studies in regard to the technique used for tooth fragment reattachment and length of the follow-up period. CONCLUSIONS: According to the evidence found in the studies included in this review, simple tooth fragment reattachment was the preferred reattachment technique. An increase in the bond strength between tooth fragment and dentin was observed when an intermediate material was used. Further investigation is needed, using standard follow-up periods and larger samples.

Histomorphometric analysis of the healing process after the replantation of rat teeth maintained in bovine milk whey and whole milk.

BACKGROUND/AIM: In cases of tooth avulsion, a minimal extra-alveolar dry storage period or the use of a suitable storage medium is crucial to maintaining the vitality of the periodontal ligament. Whey has similar properties to milk and has therefore been investigated as a storage medium for avulsed teeth. The aim of this study was to evaluate the repair process after replantation of rat teeth kept in whey and whole milk. MATERIALS AND METHODS: Thirty-six male rats were divided into four groups of nine animals. The upper right incisor was extracted under general anesthesia. In Group I, the teeth were immediately replanted without treatment (positive control). In Group II, the teeth were stored in 50 mL of sweet whey. In Group III, the teeth were kept in 50 mL of long-shelf-life whole milk (UHT, Parmalat® ). In Group IV, the teeth were kept dry (negative control). After 60 minutes, the teeth in Groups II, III, and IV were replanted into their sockets. The animals were subjected to euthanasia 60 days after replantation. The specimens were stained with hematoxylin and eosin for histomorphometric analysis. RESULTS: The organization of the periodontal ligament in Group II (whey) was similar to that in Groups I (immediate replantation) and III (whole milk) (P > .05). However, some specimens in this group exhibited periodontal fibers inserted into the bone and cementum throughout the entire length of the periodontal ligament. This occurred in the group submitted to immediate replantation, whereas this histological aspect was not seen in whole milk group. Group IV (late replantation) had a higher rate of root resorption. Regarding the root repair process, it was expected that Group I (immediate) would demonstrate more favorable repair than the other groups. However, Group III (whole milk) had better results when compared to Groups II (whey) and IV (late) (P < .05). CONCLUSION: Whey and whole milk achieved similar results and were adequate storage media for avulsed teeth.

Treatment of Extrusive Luxation in Permanent Teeth: Literature Review with Systematic Criteria.

INTRODUCTION: Extrusive luxation is a traumatic dental injury caused by the action of oblique forces, characterized by partial displacement of the tooth out of its socket. The ideal treatment for this type of trauma involves repositioning the tooth in its socket. However, in cases where the tooth cannot be repositioned, different options may be considered, such as intentional reattachment and orthodontic intrusion. The aim is to review the literature on the extrusive luxation of permanent teeth while assessing the risks of complications for two methods of delayed treatment for extrusive luxation. MATERIALS AND METHODS: An electronic search from August 2005 to August 2014 was performed by two reviewers independently, and conflicts were resolved by a third reviewer. The databases used were PubMed and Scopus; the reviewers performed a manual search of the following journals: Dental Traumatology, American Journal of Orthodontics, and Clinical Oral Investigation. RESULTS: After removing the duplicate studies, 328 articles were found. Out of these, 321 were rejected as not addressing the proposed research topic. In addition, five articles were excluded because apical repositioning was used for treatment. Therefore, four articles formed the basis of the study. CONCLUSION: Factors, such as root formation, the degree of tooth mobility, and the presence of tooth vitality were decisive for the choice of treatment. However, both treatments were effective and showed favorable results, i.e., without periodontal and root damage. CLINICAL SIGNIFICANCE: Knowledge of the risks of complications among two methods of delayed treatment for extrusive luxation, as well as other important factors to take into consideration when choosing a treatment assists dentists in improving the prognostic.

Peripheral ossifying fibroma.

The peripheral ossifying fibroma (POF) is a common gingival growth usually arising from the interdental papilla. The anterior maxilla is the most common location of involvement. The etiology and pathogenesis of POF remains unknown. Some investigators consider it a neoplastic process, whereas others argue that it is a reactive process; in either case, the lesion is thought to arise from cells in the periodontal ligament. Trauma or local irritants, such as dental plaque, calculus, microorganisms, masticatory force, ill-fitting dentures, and poor quality restorations, have been implicated in the etiology of POF. The recommended treatment is the excisional biopsy; however, it can leave a defect if the procedure is not followed by a subepithelial connective tissue graft. The main objective of this article was to present a clinical case of excisional biopsy of a POF followed by a subepithelial connective tissue graft to correct the defect caused by the biopsy. The biopsy defect was satisfactorily repaired, and the lesion has not recurred after 6 years of follow-up.