Accuracy of a dynamic navigation system for dental implantation with two different workflows and intraoral markers compared to static-guided implant surgery: An in-vitro study.

PURPOSE: To investigate the accuracy of a miniaturized dynamic navigation system with intraoral markers and two different workflows for dental implantation and to compare with static computer-assisted implant surgery (sCAIS) surgery. MATERIALS AND METHODS: Two operators performed a total of 270 implant insertions in polyurethane mandibular models under simulated clinical conditions. Implants were placed after CBCT-based virtual planning in three different groups: two workflows utilizing dynamic computer-assisted implant surgery (dCAIS; DG1: marker in CBCT; DG2: 3D-printed marker) and the others with sCAIS (TG: template guided). Postoperative surface scans were matched to the planning data and allowed an evaluation of the angular and spatial deviation between the planned and the actually achieved implant position. Descriptive statistics were followed by a Mixed Model Analysis to determine the influence of the operator, the method, and operating area on different accuracy parameters and the random effect of the model number. RESULTS: The mean angular deviation ranged from 2.26° (DG1) to 2.96° (TG). The mean 3D deviation at the implant's tip ranged from 1.08 mm (TG) to 1.51 mm (DG2) and at the implant's base from 0.69 mm (TG) to 1.49 mm (DG2). The operator showed no significant influence on the accuracy. The method showed significant influence on singular parameters and the operating area on all spatial accuracy parameters. CONCLUSIONS: Dynamic navigation systems with intraoral markers enable accurate implant positioning, which is comparable to the static-guided implant surgery. 3D-printed markers provide less accurate results compared to prefabricated markers, attached before CBCT scan.

Endodontic and restorative management of an adult with avulsion of multiple teeth: A case report with 5 years and 9 months of follow-up.

Simultaneous avulsion of four or more teeth is a rare event. This case report examines the dental care given to an adult who, during a bicycle accident, experienced the avulsion of a mandibular incisor as well as all of his maxillary incisors. In the immediate aftermath of the accident, four out of the five incisors were located, promptly collected, and stored in a tooth rescue box, all within a 20-min window. Replantation and splinting were performed on the day of the accident. Endodontic treatment involved sequential intracanal dressing with an antibiotic-corticosteroid paste followed by calcium hydroxide prior to root canal obturation. 3 months post-accident, signs of external replacement resorption (ERR) began to appear in all the replanted teeth. The gap created by the missing maxillary central incisor was managed with a three-unit fixed dental prosthesis, despite the onset of ERR in the incisors used as abutment teeth. Regular follow-ups showed a relatively slow ERR progression rate over a span of nearly 6 years. The patient expressed satisfaction with both the esthetic and functional outcomes. This case, marked by multiple avulsions, underscores the importance of immediate and appropriate intervention alongside the imperative for carefully considered long-term management strategies. Given the decelerated bone remodeling rate in adults, ERR generally progresses at a slower pace than in children. Accordingly, this case demonstrates the viability of retaining replanted teeth over the long term, even when these teeth have been subjected to nonphysiological storage for extended durations, a factor known to impede periodontal healing.

Head and dental injuries among farriers and hoof care practitioners: A nationwide survey in Switzerland.

BACKGROUND/AIM: There is a paucity of evidence on injuries sustained by farriers and hoof care practitioners, two professions exposed to unique occupational hazards. The aim of this study was to collect and examine data on occupational head/face and dental injuries among farriers and hoof care practitioners in a nationwide survey in Switzerland. MATERIALS AND METHODS: Data on occupational head/face and dental injuries were gathered in a questionnaire-based, voluntary survey, which was mailed to all farriers and hoof care practitioners in Switzerland. The statistical analysis comprised multiple regressions with a nested design (α = 0.05). RESULTS: The survey included 278 respondents (response rate of 78.1%). Head/face injuries were more frequently reported by farriers than hoof care practitioners (60.6% and 20.7%, respectively). Among full-time workers, farriers had a higher chance of an occupational head/face injury compared with hoof care practitioners (p = .007). The rate of dental injuries, mainly related to a horse kick, was 11.1% and 1.9% among farriers and hoof care practitioners, respectively. Negligence in wearing mandatory eye protection was reported by 37.5% of respondents. CONCLUSIONS: Farriery and hoof care management entail a significant risk of occupational head/face and dental injuries. Preventive safety measures-eye protection in particular-and knowledge in dental first aid should be promoted among farriers and hoof care practitioners to decrease the frequency and severity of work-related injuries.

General and dental injuries sustained at concerts: A questionnaire-based study.

BACKGROUND/AIM: Evidence on the risk of injury at concerts is scant. The aim of this study was to collect data on general and dental injuries incurred by concertgoers in Switzerland and to investigate whether the frequency of accidents was related to music genre, gender and consumption of alcohol. MATERIALS AND METHODS: A questionnaire-based, cross-sectional study comprising 451 concertgoers in Switzerland was conducted on the timeframe January 2019 to February 2021. The survey gathered data on general and dental injuries, alcohol consumption and drug use. The statistical analysis included Fisher's exact tests, chi-squared tests, rank sum tests and logistic regressions (α = .05). RESULTS: There were 28.8% of respondents who reported an injury incurred at a concert. Contusion was the most prevalent injury, accounting for 33.8% of all injuries. Legs were the most commonly injured body part (34.6%). Injuries to their mouth/lips/teeth were reported by 17.7% of respondents. Dental injuries, accounting for 4.6% of all reported injuries, comprised four tooth fractures, one lateral luxation and one avulsion. The risk of injury while attending punk rock concerts was 8.6 times higher than for pop concerts (p < .001). In comparison with pop concerts, metal and rock concerts had an increased risk of injury by factors of 5.1 and 2.3, respectively (p ≤ .029). Neither gender nor drug use had a significant effect on the injury risk (p ≥ .3). Heavy alcohol consumption (>5 standard glasses) increased the risk of injury by a factor of 2.3 (p = .028). CONCLUSIONS: This study suggests that concert attendees at rock, metal and punk concerts face an increased risk of injury, which is likely due to the frequency of aggressive dance styles such as moshing. Heavy alcohol consumption leads to a greater risk of injury at concerts.

Evaluation of five methods to identify composite restorations in human teeth on a forensic purpose-an ex vivo comparative study.

The use of tooth-colored composite resin materials in dentistry is increasing. As composite restorations appear similar to the natural tooth structure, their detection is becoming more challenging. The aim of this study was to compare five diagnostic methods for detection of dental restorations and to create reliable postmortem dental records for forensic purposes. A conventional examination method without a direct light source (CONV), with a dental loupe light (DL), Galilean loupes with a direct light source (GDL), a fluorescence-inducing device (FIT), and intraoral radiographs (RX) were compared. Dentists specializing in conservative dentistry or oral surgery and dentistry students participated. Regarding sensitivity, specificity, positive predictive value, and negative predictive value, FIT and RX showed significantly higher results than CONV, DL, and GDL. RX and FIT showed comparable results in identifying composite restorations but depending on their location. The combination of both methods may lead to even better results. In conclusion fluorescence-inducing devices show good results in identifying composite restorations and therefore should be considered as a standard tool in forensic examinations. Another advantage is their small size, low cost, and mobility. Good illumination and magnification devices are recommended to enhance performance during conventional examinations. Involving dentists specialized in conservative dentistry could contribute to dental identification.

Cytokines in saliva as biomarkers of oral and systemic oncological or infectious diseases: A systematic review.

Recent evidence suggests that salivary cytokines provide information about both oral conditions and systemic diseases. This review summarizes evidence for the use of salivary cytokines as biomarkers for oral and systemic diseases. We included studies in adults and children with a focus on the latter, due to the importance of non-invasive diagnostic methods in the paediatric age group. A systematic review was performed using Medline and Web of Science covering the period of January 1996 to December 2019 according to the preferred reporting items for systematic reviews. Thirty-four studies were included in the final analysis, for a total of 2407 patients and healthy controls. Pro-inflammatory cytokines including interleukin (IL)-1ß, IL-2, IL-6 and tumor necrosis factor (TNF)-α were associated with the severity of oral mucosal tissue damage in patients with cancer, and IL-1ß may be an early marker of graft-versus-host disease. Salivary interferon-γ levels were correlated with oral complications and the presence of the underlying disease in HIV-infected individuals, and salivary cytokine patterns may be useful for diagnosing tuberculosis. In summary, current data illustrate that salivary cytokines are associated with oral inflammation, making them potential biomarkers for disease diagnosis and treatment efficacy. Because of the simplicity of saliva collection, this method may be useful in pediatric studies and in resource-limited settings.

Impact of the COVID-19 pandemic on urgent dental care delivery in a Swiss university center for dental medicine.

OBJECTIVES: This study aimed to assess whether the emergency service of a major Swiss dental institution faced different demands (patient volume, treatment needs, dental care characteristics) during a lockdown, issued to mitigate the COVID-19 pandemic, compared with the weeks before and after. MATERIALS AND METHODS: Data of patients receiving urgent care at a university center for dental medicine (Basel, Switzerland) during the 6-week lockdown, pre-lockdown, and post-lockdown periods were retrospectively evaluated. Statistical analysis involved tests for equal proportions and logistic regression models. The level of significance was set at α=0.05. RESULTS: The study comprised 3109 dental emergency visits in the period from February 2 to June 5, 2020. Daily caseloads increased during lockdown. Abscesses, orthodontic emergencies, and surgical follow-ups were more common during lockdown, whereas the number of dento-alveolar injuries declined (≤0.048). Urgent dental care provision involved intraoral radiographs more frequently in the pre-lockdown period compared with the following weeks (p<0.001). Among all treatments, aerosol-generating procedures dropped from 56.1% (pre-lockdown) to 21.3% during lockdown (p<0.001), while teledentistry follow-ups became more frequent (p<0.001). Patients with comorbidities sought urgent dental care less frequently during the post-lockdown period (p=0.004). CONCLUSIONS: The lockdown significantly impacted the dental emergency service in terms of patients' diagnoses, treatment needs, and the characteristics of the urgent care that was delivered. CLINICAL RELEVANCE: Access to essential dental care must be monitored and safeguarded throughout the COVID-19 pandemic and beyond as deferred care entails risks for serious sequelae and persons with comorbidities may change their dental care-seeking behavior.

Dental trauma and tongue injuries in professional alpine ski racing-A worldwide survey.

BACKGROUND/AIM: Skiing is a sport with a medium risk of injuries, and injuries are increasingly common among professional alpine skiers. Examples of other medium-risk sports are for example handball, basketball, and karate. The aim of this study was to assess the frequency of dental trauma in professional alpine skiing and to determine whether the frequency of dental injuries is associated with a skier's performance level, alpine skiing discipline, and/or years of skiing experience. MATERIAL AND METHODS: A questionnaire consisting of 17 questions was distributed to professional male ski racers to gather information about their skiing discipline (category), performance level, and injuries, particularly dental trauma. RESULTS: A total of 161 out of 190 skiers returned the survey, with a response rate of 84.2%. Of these, 134 (83.2%) had suffered alpine ski racing-related injuries during their career and 38 (23.6%) reported skiing-related dental trauma-most commonly crown fractures (65.8%, n = 25), which mainly involved the maxillary or mandibular incisors (76.0%, n = 28). Ski racers with higher performance levels were more likely to experience dental injuries, but the difference in the frequency of dental trauma between participants in the speed versus technical category was not significant. Likewise, the number of years of ski racing experience did not impact the frequency of dental injuries. The participants rarely wore custom-made mouthguards (6.8%, n = 11). None of those who reported dental injuries were wearing a custom-made mouthguard when the injury occured. They preferred to wear chin guards, over-the-counter mouthguards, or no mouthguards. CONCLUSION: Professional alpine ski racing has a medium risk of dental trauma, which further increases with skier performance level. The participating skiers rarely wore custom-made mouthguards.

Photographic assessment of simulated dental luxation injuries.

BACKGROUND/AIM: Dental photographs are a valid means for documentation of dental luxation injuries. The aim of the study was to evaluate the utility of two photographs from different perspectives in the assessment of dental luxation injuries compared to one perspective only. MATERIALS AND METHODS: Photographs of simulated dental luxation injuries were shown to experts in dental traumatology and other dentists who had to estimate the displacement in the vertical and horizontal dimensions. The overall error of estimation as a result of both vertical displacement and horizontal displacement was calculated and statistically analyzed. RESULTS: The mean overall error of estimation was 0.43 mm and 0.75 mm for experts and dentists, respectively. If two (frontal and occlusal) perspectives were available, the overall error was lower than when only one perspective was available (p < .001). Experts had a lower overall error compared to dentists (p < .015). CONCLUSION: Two photographs from two perspectives allowed better interpretation of dental luxation injuries.

Stability of screw-retention in two-piece zirconia implants: An in vitro study.

OBJECTIVES: To compare the stability of a screw-retained connection in a novel two-piece zirconia implant to a conventional titanium-based connection in an in vitro chewing simulation including artificial ageing. MATERIAL AND METHODS: Incisor (I) and molar (M) shaped monolithic zirconia crowns were screw-retained on either two-piece zirconia (test) or two-piece titanium (control) implants resulting in 4 groups of 8 samples (titanium implants with incisor-shaped crowns (T-I), titanium implants with molar-shaped crowns (T-M), zirconia implants with incisor-shaped crowns (Z-I) and zirconia implants with molar-shaped crowns (Z-M). These were subjected to artificial ageing by thermal cycling (TC: 2 × 3000 × 5°C/55°C cycles of 2 min) and mechanical loading (ML: 1.2 × 106 cycles of 50 N, f = 1 Hz). Surviving samples additionally underwent a fracture force test. Kaplan-Meier plots were drawn, and two-way ANOVA was calculated taking anatomical localisation and material variables as factors. RESULTS: The mean corresponding survival times were lower for T-M (0.86 × 106  ± 0.31 × 106 cycles) and Z-I (0.84 × 106  ± 0.21 × 106 cycles) compared to T-I (1.14 × 106  ± 0.10 × 106 cycles) and Z-M (1.20 × 106  ± 0.10 × 106 cycles). In one-way ANOVAs for survival time dependent on either location or material, no statistically significant differences could be found (location: p = .31; material: p = .62) in one-way ANOVAs. The interaction of location and material showed significant differences (F = 21.3, p < .001). CONCLUSION: The connection of the tested screw-retained zirconia crowns in two-piece zirconia implants is comparable to standard titanium implants in the specific in vitro testing.

The prevalence of orofacial injuries in judo: A cross-sectional study.

BACKGROUND/AIMS: Judo is a popular martial art with a high risk of injury. Notwithstanding this risk, mouthguards were not allowed until June 2018. The aim of this study was to measure the prevalence of traumatic injuries in judo with a particular focus on dental and lip injuries. A further aim was to assess the influences of increased overjet and wearing fixed orthodontic appliances. MATERIAL AND METHODS: Judokas (n = 382) from two judo clubs in Bern, Switzerland, were interviewed with a standardized questionnaire. RESULTS: About two thirds had suffered at least one traumatic injury with a high number of limb injuries (n = 1054), followed by face injuries (n = 855) and spine, torso, occiput or neck injuries (n = 84). Among the face injuries, 562 lip injuries were recorded. A significantly higher number of lip injuries were found for judokas who wore fixed orthodontic appliances compared to judokas who never wore such appliances. Forty-seven dental trauma incidents during judo were recorded. During both judo and leisure time, 161 dental trauma incidents were recorded. Individuals with lip incompetence and increased overjet showed the highest number of dental injuries ( x ¯ = 0.815; SD = 0.622), which differed in statistically significant ways from the number of dental injuries in individuals with lip incompetence and normal or reduced overjet ( x ¯ = 0.278; SD = 0.461). For individuals with no lip incompetence, no difference between the sub-group with an increased overjet and the sub-group with a normal or reduced overjet could be found. Nobody in the study population was wearing a mouthguard, and the acceptance of mouthguards was low (9.7%). CONCLUSION: It is important to increase the awareness of the recent authorization of mouthguards and to promote their acceptance among judokas. The combination of increased overjet and lip incompetence was more relevant for the dental trauma risk than an increased overjet alone.

Comparison of heat generation between guided and conventional implant surgery for single and sequential drilling protocols-An in vitro study.

OBJECTIVES: The aim of this in vitro study was to compare the heat generation during guided osteotomy preparation (GOP) with that of a conventional approach (CA) for a single and sequential drilling protocol. METHODS: Temperature measurements were performed during standardized osteotomy preparations in polyurethane foam blocks with an infrared camera. The four groups included single and sequential drilling with and without the use of a surgical guide. In the first group (single CA) and the second group (single GOP), only the final drills diameters were applied once. In the third group (sequential CA) and the fourth group (sequential GOP), two to four drills with increasing diameters were applied. Guided and conventional as well as single and sequential drilling were compared using a one-way ANOVA with Tukey post hoc test. The level of statistical significance was set at α = 0.05. RESULTS: Guided osteotomy preparation showed statistically significant higher temperatures than CA for the 2.2 mm, the 3.5 mm, and the 4.2 mm drill (p = 0.032, p = 0.005 and p < 0.001, respectively). Sequential drilling led to higher heat generation and longer duration of latent heat than single drilling. For all drilling procedures, the duration of heat exposure over critical temperature was less than 1 min, except for the sequential GOP drilling protocol with the 4.2 mm drill (76 s). CONCLUSIONS: Guided drilling requires specific attention to heat development. When guided implant surgery is performed, a single drilling procedure could alleviate heat production compared to a sequential procedure.

Streptococcus spp. and Fusobacterium nucleatum in tongue dorsum biofilm from halitosis patients: a fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM) study.

The present study involved a qualitative and quantitative evaluation of tongue dorsum biofilms sampled from halitosis patients and healthy volunteers. The aim of the study was to quantify the distribution of Streptococcus spp. and Fusobacterium nucleatum within the oral halitosis biofilm in order to highlight the role of these bacterial members in halitosis. Tongue plaque samples from four halitosis-diagnosed patients and four healthy volunteers were analyzed and compared. The visualization and quantification of the tongue dorsum biofilm was performed combining fluorescence in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM). Eubacteria, Streptococcus spp. and Fusobacterium nucleatum were stained using specific fluorescent probes. For a comparison of the two tested biofilm groups the Wilcoxon rank-sum test was used. Morphological analysis by CLSM illustrated the distribution of the species which were tracked. Streptococcus spp. appeared to be enclosed within the samples and always associated to F. nucleatum. Furthermore, compared to the control group the biofilm within the halitosis group contained significantly higher proportions of F. nucleatum and Streptococcus spp., as revealed by the FISH and CLSM-analysis. The total microbial load and relative proportions of F. nucleatum and Streptococcus spp. can be considered as causative factors of halitosis and thus, as potential treatment targets.

Evaluation of a Fluorescence-aided Identification Technique (FIT) for removal of composite bonded trauma splints.

BACKGROUND/AIM: Accurate removal of composite bonded titanium trauma splints (TTS) can be challenging. The aim of this study was to evaluate a Fluorescence-aided Identification Technique (FIT) compared with a conventional light source (CT) for removal of trauma splints regarding loss of tooth substance, residual composite, and time taken. MATERIALS AND METHODS: Twenty maxillary models with six bovine teeth (13 - 23) were fabricated. An optical three-dimensional impression was taken and a TTS was applied from 12 to 22 with two bonding sites on every tooth under standardized conditions using an etch-and-rinse adhesive and resin composite. Two operators removed 10 splints each (5x FIT and 5x CT). For FIT, a 405 nm light-emitting headlamp was used. Time was recorded. A post-operative scan was superimposed on the pre-operative scan using OraCheck software. A qualitative and quantitative analysis of tooth defects and composite remnants was performed by two operators and statistically analyzed. RESULTS: Compared with the CT, FIT led to significantly fewer and smaller enamel defects (mean volume: -0.04 mm3 vs -0.33 mm3 ) (P < 0.001), significantly less composite remained (mean volume: 0.02 mm3 vs 0.28 mm3 ) (P < 0.001), and the removal procedure with FIT was significantly quicker (mean: 162 seconds vs 268 seconds) (P < 0.001), CONCLUSIONS: FIT facilitated the removal of composite used to bond trauma splints leading to less time-consuming as well as less invasive treatment. It left fewer composite residues on enamel surfaces.

Lip and tooth injuries at public swimming pools in Austria.

BACKGROUND/AIMS: There is an increased risk of orofacial injuries in swimming pool facilities. Nevertheless, only a few studies have addressed this issue. The aim of this study was to identify the frequency of lip and tooth injuries at public swimming pools in Austria. A further aim was to examine which gender and age groups were affected, where and why these injuries occurred, and whether pool attendants had sufficient knowledge of dental first-aid measures. MATERIAL AND METHODS: A total of 764 pool attendants in Austria were contacted by telephone and 689 participated in the study (90.2%). The attendants were interviewed retrospectively about accident occurrences in 2014 by a standardized questionnaire. Responses to the provision of first aid and choice of storage medium for avulsed teeth were subsequently evaluated. RESULTS: The frequency of lip injuries was 19.0%, and tooth injuries were 11.3%. Male bathers (P < .05) and children under 12 years (P < .001) most frequently suffered injuries. The waterslide was the most common accident site. The most common cause of lip injuries was slipping on wet surfaces (39.0%), and for tooth injuries it was collisions with other persons or objects (each 28.1%). The pool attendants' responses were predominantly good or sufficient on first aid, with the exception of what storage medium to choose. Tooth rescue boxes were available in only 8.6% of all pool facilities. CONCLUSION: Orofacial injuries are a frequently occurring problem in swimming pool facilities. The pool attendants' knowledge on first-aid care of tooth injuries could still be improved.

Life-threatening hemorrhage associated with dental implant surgery: a review of the literature.

OBJECTIVES: Life-threatening bleeding may occur during implant placement. PURPOSE: The present review was conducted to evaluate the localization, the symptoms, and therapies of life-threatening bleedings associated with implant placement. MATERIAL AND METHODS: A literature review including 590 articles was performed in PubMed, Medline, and Cochrane database. Any article reporting on life-threatening bleeding was included which additionally reported on the site of implant surgery. RESULTS: Twenty-seven cases were extracted. In the majority of the cases, bleeding occurred in the anterior interforaminal region. Aside local management stopping the bleedings, most cases required intubation or tracheotomy. CONCLUSIONS: Surgeons must be aware of the risk of severe bleedings during implant surgery and should immediately refer patients to a specialized clinic in suspicious or proved cases.

Detection of peri-implant bone defects with different radiographic techniques - a human cadaver study.

OBJECTIVES: Two- and three-dimensional radiographic techniques are available to determine peri-implantitis-related bone loss around dental implants. PURPOSE: To compare the performance of detecting different peri-implant bone defects in intraoral radiography (IR), panoramic radiography (PR), Cone Beam Computer Tomography (CBCT) and Computer Tomography (CT). MATERIAL AND METHODS: Six implants were inserted under ideal conditions into the lower jaw of an edentulous human cadaver. IR, PR, CBCT and CT were performed. Two-wall, three-wall and four-wall defects with 1 mm depth were artificially created around two of the implants (one anterior and one posterior), and radiographies were repeated. The identical set-up was used for 3-mm-deep bone defects. All images were presented to seven observers. Sensitivity (SN) and specificity (SP) were determined for each modality, defect type and depths, and likelihood ratios were calculated. RESULTS: The highest sensitivity was found with IR and CBCT for 1 mm (0.67; 0.68) and 3-mm defects (0.81; 0.79). The highest specificity was found with IR for both defect depths (0.51). The best classification of defect type revealed PR for both 1-mm and 3-mm-deep defects. Both likelihood ratios (LR+ and LR-) were best for IR with 1-mm (1.37 and 0.65) and with 3-mm defects (1.65 and 0.37). CONCLUSIONS: IR should still be recommended as favourable method evaluating bone loss around dental implants, while CT demonstrated the lowest performance in detecting peri-implant bone defects.

Dental trauma in showjumping - A trinational study between Switzerland, France and Germany.

AIM: Showjumping is one of the sporting activities with a high injury risk. Unpredictable behaviour of the horse, considerable speed and the height of the rider in the saddle make this sport to one of the most dangerous, with the highest risk of injury and the highest mortality rate per competitor. The aim of this study was to determine the frequency of dental trauma, the wearing of protective gear such as helmet, back protector and mouthguard as well as the knowledge of primary care after dental trauma. MATERIAL AND METHODS: Within the framework of this study, 608 female and male showjumpers from Switzerland, France and Germany were questioned in a personal interview consisting of 14 questions about general injuries, dental injuries and the usage of protective gear. The competitors were subdivided into different categories according to amateur or professional level, gender and age. RESULTS: Of the 608 competitors, 189 (31.1%) had witnessed an accident involving tooth injury and 91 (15.0%) had suffered one themselves. The prevalence of dental trauma rose with increasing age and more riding experience. A total of 436 (71.1%) of the competitors were familiar with mouthguards, of which only three owned one. The main reasons for not wearing a mouthguard were both doubtful necessity (22.5%) and a generally low acceptance among the riders (26.3%). Less than half of the competitors (44.4%) knew that an avulsed tooth can be replanted and only 4.1% had knowledge about the existence of a tooth rescue box. CONCLUSION: The results of this study show that in equestrian sports still little is known about dental trauma and protective measures.

Dental and jaw injuries sustained by hooligans.

AIM: The study deals with fighting-related dental injuries sustained by hooligans and the influence of wearing a mouthguard on fighting-related dental trauma. MATERIAL AND METHODS: From 2012 to 2013, standardized multiple-choice questionnaires were distributed via contacts in the hooligan scene in Switzerland. The survey was conducted with the guarantee of complete anonymity and investigated injury patterns in hooligans from different age groups, of different nationalities as well as educational and income levels. RESULTS: Of the 95 hooligans surveyed, 82 had sustained a dental injury: 29 were minor and 53 were severe dental injuries. During violent confrontations, 37 of the 95 hooligans wore a mouthguard. The most commonly used mouthguards were custom-made (19/37) or boil-and-bite (10/37). The use of ready-made mouthguards without an individualized fit (6/37) was less frequent. Hooligans who wore a boil-and-bite or a custom-made mouthguard lost fewer teeth during fights than participants wearing a mouthguard without an individualized fit (P = 0.056). CONCLUSION: The risk of trauma during violent confrontations between hooligans is very high, as expected. The injuries range from dental trauma to bruising, lacerations and even serious bone fractures of the face and the extremities. During violent clashes over a third of the hooligans wear a mouthguard that has usually been custom-made or at least individually fitted; this is a far higher frequency than for most contact sports.

Management of avulsions in Switzerland 2007-2010.

INTRODUCTION: More than 50% of all European children suffer a dental injury (DI), for which the emergency treatment is usually carried out by a general dentist. The aim of this survey was to assess the management of avulsions in Switzerland as the common treatment procedures used by Swiss dentists in such cases. As yet there are no published data on the treatment of DI in Switzerland. MATERIALS AND METHODS: A 15-item questionnaire was distributed to all members of the Swiss Dental Society containing questions about the dentists' profile, the distribution of dental injuries they had encountered affecting permanent teeth, especially avulsions, the number of treated avulsions and questions about how the dentists had treated an avulsion in the past 3 years. RESULTS: The response rate was 41% (n = 1350). On average, two avulsions per practitioner had been seen in the past 3 years. The dental practitioners who encountered cases of tooth avulsion treated an average of 2.8 avulsions in that time frame. Most dentists applied conventional intraoral root canal treatment, which was performed on average 9 days after replantation. As the intracanal dressing, calcium hydroxide was used by 69.8% and Ledermix® by 49.3%, while Asphaline® was used by only 1.8% (multiple answers were possible). Seventy-eight percent (78.1%) of the respondents had received postgraduate dental trauma education. Dentists with such an education used Ledermix® significantly more often (P = 0.002), and the time until pulp extirpation was significantly shorter (P < 0.001). The favorite splint after replantation was the Titanium Trauma Splint®, followed by the wire composite splint and the bracket splint, while the aligner was used very rarely. The average splinting time was 11.2 days. Eighty-one percent (81.1%) of the respondents had a tooth rescue box in their office, 41.1% had Emdogain®, 25.9% had tetracycline for local application, and 14.7% had steroids for local application available. CONCLUSION: Although only a few patients with avulsions had presented in Swiss dental offices in the past 3 years, their treatment was closely aligned to current guidelines.