Traumatic dental injuries over an 8-year period at a German dental center: a retrospective overview and cross-sectional analysis.

BACKGROUND/AIM: The aim of this study was to analyze a population of patients who had suffered from traumatic dental injuries (TDIs) by using different patient-, trauma- and treatment-related parameters. MATERIAL AND METHODS: All dental records of patients ≥ 3 years old who had presented at the dental emergency service between Jan 1, 2009 and Dec 31, 2016 for the treatment of dental trauma were analyzed. A total of 2758 patients were invited for a recall examination at the Department for Dental Surgery and Implantology, ZZMK Carolinum, Goethe University Frankfurt, Germany; of these, 269 patients attended their recall appointments. RESULTS: The enrolled patient population consisted of 1718 males and 1040 females, with a mean age of 19.63 years (median 12.00 ± 17.354 years). A total of 4909 injured teeth were assessed, with a mean of 1.78 injured teeth per patient (median 2.00 ± 1.279). Males were found to be more frequently affected by TDIs compared to females (1.65:1). The majority of these injuries occurred in the first two decades of life (66.1%; n = 1824). The majority of the patients presented for initial treatment within 24 h of their accident (95.7%). The most frequent TDIs were isolated luxation injuries 49.4% (n = 2426) and isolated crown fractures 30% (n = 1472). Combination injuries were diagnosed in 20.6% of the cases (n = 1011). CONCLUSIONS: Based on the findings of the present analysis, it can be concluded that males were more frequently affected by TDIs than females. Most patients had suffered from TDI before they had turned 10 years of age. Overall, the enamel-dentin fracture was found to be the most frequent injury, followed by concussions and lateral luxations.

Prevalence of and Factors Associated With Vertical Root Fracture in a Japanese Population: An Observational Study on Teeth With Isolated Periodontal Probing Depth.

INTRODUCTION: Previous studies on the prevalence of vertical root fractures (VRFs) were based on extracted teeth, or teeth referred for apical surgery. This study examined teeth with an isolated periodontal probing depth (PD) as an indicator of VRF. The primary aim of this study was to investigate the prevalence of vertical root fracture (VRF) and non-VRF among teeth with an isolated probing depth (PD) ≥ 5 mm. The secondary aim was to assess factors associated with VRF by comparing the teeth with and without VRF in the Japanese population. METHODS: A total of 288 teeth with an isolated PD ≥ 5 mm were grouped pathologically into 8 groups comprising VRF and non-VRF conditions. A descriptive analysis for age, sex, tooth type, endodontically treated teeth (ETT) versus non-ETT, proximal contacts, PD (depth), PD (broadness and location), restoration type, and presence of a post was performed. Moreover, the associations between these factors and VRFs were investigated using the Chi-square test. RESULTS: The prevalence of VRF was 32%. Lower first molars were the most common tooth type in both VRF (31.5%) and non-VRF groups (29.7%), while premolars were exclusively frequent in VRF (30.2%) and not frequent in non-VRF (7.8%). Narrow buccolingual PD was common in VRF (78.1%) whereas wide PD was frequent in non-VRF (67.1%). ETT, narrow buccolingual PD, tooth type (premolars), restoration type (crown), and the presence of a post showed significant associations with VRF (P ≤ .001). CONCLUSIONS: VRFs may be more prevalent in ETT among the Japanese. Careful assessment is necessary to differentiate VRFs from other conditions when the lower first molars show an isolated PD ≥ 5 mm. When an endodontically treated premolar with a post shows a narrow buccolingual PD, the probability of a VRF may be greater than in other tooth types.

Dental and Dentoalveolar Injuries in the Pediatric Patient.

Dental and dentoalveolar injuries are common in the pediatric population. Management is predicated on the type of tooth injured (primary or permanent), extent of injury, the dental and behavioral age of the patient, and ability of the patient to tolerate treatment. Although many dental injuries occur in isolation, a systematic evaluation of the patient is mandatory to confirm the absence of basal bone fractures of the maxilla or mandible, traumatic brain injury, cervical spine injury, and/or facial soft tissue injury. Long-term follow-up is paramount to achieving a functional occlusion and optimal dental health following injury.

Incidence and contributing factors of non-root canal treated teeth with chronic fatigue root fracture: A cross-sectional study.

BACKGROUND/PURPOSE: Chronic fatigue root fracture describes a root fracture in a non-root canal treated (non-RCT) tooth. This study aimed to report the incidence and contributing factors of non-RCT teeth with chronic fatigue root fracture in a Taiwanese population. METHODS: This cross-sectional study included teeth extracted at Taipei Veterans General Hospital in Taiwan between 2018 and 2019. The reasons for extractions were recorded and included vertical and horizontal root fractures (VRF and HRF). Comparisons of clinical factors between teeth with fatigue VRF and teeth with fatigue HRF were performed by chi-square or Fisher exact test, where appropriate. RESULTS: Of the 4207 extracted teeth examined, 263 (6.25%) had tooth fracture. Thirty-two non-RCT teeth had chronic fatigue root fracture, including 16 with VRF and 16 with HRF. The incidence was 0.76% (32/4207). The occurrence of chronic fatigue root fracture was higher in males (83.9%). The mean age of the 31 patients with chronic fatigue root fracture was 71.7 ± 13.1 years. More than half of these teeth had intact crowns with severe attrition. The fatigue VRF occurred more frequently in molars (P = 0.003), in roots with a long oval cross-section (P = 0.037), and in terminal teeth (P = 0.013) than the fatigue HRF. CONCLUSION: The incidence of chronic fatigue root fracture is 0.76%. Both VRF and HRF occur mainly in aged males, in posterior teeth with attrition, and in teeth without restoration. Tooth position, cross-section root morphology, and terminal tooth are contributing factors related to chronic fatigue root fracture.

Incidencia de fracturas dentales verticales reportadas en la Ciudad de Chihuahua y su relación con la evolución de la pandemia por COVID-19 / Incidence of vertical dental fractures reported in Chihuahua City and its relationship with the evolution of the COVID-19 pandemic

Durante la pandemia por COVID-19, la presencia de un incremento de fracturas y/o fisuras verticales ha sido reportada por Cirujanos Dentistas en diferentes países y foros, Objetivo: Determinar por medio de un análisis si existe una relación con este aumento de casos y la evolu- ción de la pandemia. Material y método: Se recopilaron los casos de fracturas verticales no restaurables durante el periodo de mayor índice de casos de contagio y defunciones por COVID-19 en la Ciudad de Chihuahua, México. Resultados: Durante el primer pico de casos y defunciones causadas por la pandemia, se incrementó el número de casos de fracturas verticales no tratables. Conclusiones: Existió una relación entre la evolución de la pandemia con la aparición de casos de fracturas dentales verticales no restaurables (AU)

During the COVID-19 pandemic, the presence of an increase in fractures and/or vertical fissures has been reported by Dental Surgeons in different countries and forums. Objective: To determine through an analysis, if there is a relationship with this increase in cases and the evolution of the pandemic. Material and methods: The cases of non-restorable vertical fractures were collected during the period of highest rate of cases of contagion and deaths due to COVID-19 in the City of Chihuahua, Mexico. Results: during the 1st peak of cases and deaths caused by the pandemic, the number of cases of untreatable vertical fractures increased. Conclusions: There was a relationship between the evolution of the pandemic and the appearance of cases of non-restorable vertical dental fractures (AU)

Incidencia de fracturas dentales reportadas en la Ciudad de Chihuahua durante la pandemia por COVID-19 / Incidence of dental fractures reported in Chihuahua city during COVID-19 pandemic

Se presentan los casos de fracturas verticales sintomáticos que ameritaron la extracción de las órganos dentales afectados en un periodo de cinco meses durante la pandemia por COVID-19 en la ciudad de Chihuahua, México. Material y métodos: Se recolectaron 26 muestras para el estudio, proporcionadas por los cirujanos dentistas integrantes del Grupo de Egresados de la Facultad de Odontología de la Universidad Autónoma de Chihuahua. Resultados: Los resultados muestran diferencias a lo reportado previamente respecto al tipo de diente involucrado, sexo de los pacientes, restauraciones coronales y tratamientos endodóncicos previos. Conclusiones: Se puede suponer que las modificaciones en el estilo de vida de la población, sumadas a la angustia permanente, pueden ser factores que contribuyen a las fracturas dentales (AU)

There are cases of symptomatic vertical fractures that warranted the extraction of affected teeth are presented, over a period of five months during the COVID-19 pandemic in Chihuahua City, Mexico. Material and methods: 26 samples were collected for the study, provided by the dentist who were members of the Graduate Group of the Faculty of Dentistry of the Autonomous University of Chihuahua. Results: The results show differences from what was previously reported regarding the type of tooth involved, sex of patients, coronal restorations and previous endodontic treatments. Conclusions: It can be assumed that changes in the lifestyle of the population, added to permanent distress, may be factors to preserve dental fractures (AU)

Occurrence of Vertical Root Fractures after Apical Surgery: A Retrospective Analysis.

INTRODUCTION: Vertical root fractures (VRFs) are among the most frequent causes of tooth loss, mainly of endodontically treated teeth. However, very few data is available about the occurrence of VRFs following apical surgery. METHODS: Patient charts from 864 patients with 1058 teeth treated with apical surgery (September 1999 to December 2018) were retrospectively evaluated, if a VRF had occurred after surgery. The following, possibly influencing factors were analyzed: sex and age, type of treated tooth, primary versus resurgery, technique of root-end preparation, and timepoint of VRF diagnosis. Endpoints were either tooth extraction or the last follow-up. RESULTS: The study cohort (55% women, 45% men) had a mean age of 52.00 ± 13.97 years (range 9-93 years). The overall rate of VRFs after apical surgery was 4% (42 of 1058 teeth). Among these 42 teeth, 33.3% were mandibular first molars and 26.2% were maxillary second premolars. The most frequently affected root was the mesial root of mandibular first molars (28.6%). With regard to the study parameters, significant differences of VRF rates were observed only for the type of tooth treated. CONCLUSIONS: A low VRF rate of 4% was observed in this study. VRFs commonly occurred in maxillary premolars and mandibular molars, with the mesial root of mandibular first molars affected most frequently. This is in line with previous reports about VRFs in endodontically treated teeth without additional apical surgery.

The perception of caregivers of poor oral health of their children and its related clinical conditions / Percepção de cuidadores sobre a má saúde bucal das crianças e sua relação com condições clínicas

ABSTRACT Objective: To determine the association between the perception of caregivers regarding the oral health of their children and socio-demographic characteristics, report of dental pain, and clinical oral conditions. Methods: A cross-sectional study was conducted with 570 children aged two to five years old, enrolled at public preschools, and with their caregivers. Data regarding perceptions of oral health status in children, socio-demographic characteristics, and dental pain were collected from a questionnaire. Three examiners (Kappa>0.7) evaluated children's oral health status using the dmft index, pufa index, and the Andreasen classification for traumatic dental injury (TDI). The occurrence of open bite and overjet was also investigated. Descriptive analyses, and unadjusted and adjusted logistic regression were used, considering a 5% significance level. Results: A total of 24.7% of children had poor oral health status, which increased 4.92-fold (95% confidence interval [95%CI] 3.05-7.93) when children had dental caries, and 3.78-fold (95%CI 1.63-8.76) when there were consequences from dental caries. The perception of poor oral health was also associated to open bite (Odds Ratio [OR] 1.98; 95%CI 1.16-3.38) and TDI (OR 1.68; 95%CI 1.06-2.68). No associations were found between the perception of caregivers and socio-demographic variables or overjet. Conclusions: The perception of caregivers of poor oral health in their children was associated to dental caries, its consequences, TDI, and open bite.

RESUMO Objetivo: Determinar a associação entre a percepção dos cuidadores sobre a saúde bucal das crianças e características sociodemográficas, relato de dor dentária e condições clínicas bucais. Métodos: Foi realizado um estudo transversal com 570 crianças de dois a cinco anos matriculadas em pré-escolas públicas e seus cuidadores. Os dados referentes à percepção do estado de saúde bucal nas crianças, características sociodemográficas e dor dentária foram coletados por meio de um questionário. Três examinadores (Kappa>0,7) avaliaram o estado de saúde bucal das crianças usando o índice ceo-d, o índice PUFA e a classificação de Andreasen para traumatismo dentário (TD). A ocorrência de mordida aberta e overjet também foi investigada. Análise descritiva e regressão logística não ajustada e ajustada foram realizadas, considerando um nível de significância de 5%. Resultados: A percepção da má condição de saúde bucal nas crianças foi de 24,7%, a qual aumentou 4,92 vezes (IC95% ­3,05-7,93) quando as crianças apresentaram cárie dentária e 3,78 vezes (intervalo de confiança de 95% [IC95%] 1,63-8,76) quando houve consequências de cárie dentária. A percepção de saúde bucal ruim também foi associada a mordida aberta (Odds Ratio [OR] 1,98; IC95% 1,16-3,38) e TD (OR 1,68; IC95% 1,06-2,68). Não foram encontradas associações entre as percepções dos cuidadores e variáveis sociodemográficas ou overjet. Conclusões: As percepções dos cuidadores sobre a má condição de saúde bucal das crianças foram associadas à cárie dentária, suas consequências, TD e mordida aberta.

Complex Dentoalveolar Fractures: Main Clinical Variables Description and Analysis.

AIMS AND OBJECTIVES: To analyze and evaluate clinical features that define complex dentoalveolar trauma. MATERIALS AND METHODS: Forty-five patients, with a mean age of 36.1 years, were included in the study; most patients were male (82.2%). The main clinical features defining dentoalveolar fractures were evaluated, including the status of the tooth, alveolar socket and adjacent soft tissues and their relationships with tooth loss. The relationship between splinting and tooth loss was also studied. The data were analyzed using descriptive and statistical methods. RESULTS: A significant relationship was observed between the different clinical variables and tooth loss, in particular the status of the alveolar socket as the most relevant clinical factor; there was also a significant relationship between splinting and tooth loss, as this was the main protective factor. CONCLUSIONS: Tooth loss prognosis following complex dentoalveolar trauma is related to the clinical features of the fracture, particularly the status of the alveolar socket and the possibility of using splinting as treatment.

How does orofacial trauma in children affect the developing dentition? Long-term treatment and associated complications.

Each year, millions of children are injured and live with the consequences of those injuries. Through infancy and childhood, orofacial trauma caused by falls or being struck by or against objects occurs in children. The long-term implications on the developing permanent teeth are little known, even when the oral region is the second most frequently injured body area in children under 6 years of age. During this period, the developing permanent teeth may be directly involved after trauma, causing mild to severe hypoplasia, displacement, damage to the tooth germ, or an extended range of morphofunctional disturbances. In some cases, the effects of oral and dental injuries caused by trauma appear later with the eruption of the permanent incisors when ectopic eruption, malalignments, and other developmental disturbances become visible. Therefore, long-term follow up of the patient in order to diagnose and treat associated complications becomes essential. Critical points for facing the consequences of orofacial trauma on the developing dentition are to recognize the impact of orofacial trauma in young children and the dentist's role in providing anticipatory guidance to parents and health care professionals, differentiate between mild and severe disturbances affecting the developing permanent teeth after oral injuries in early childhood, recognize the importance of follow-up controls, and recognize the importance of early referral to a pediatric dentist and orthodontist for diagnosis and treatment planning.

The association between clinical diagnostic factors and the prevalence of vertical root fracture in endodontic surgery.

BACKGROUND/PURPOSE: Diagnosis of vertical root fractures (VRFs) can often be challenging due to the similarity of signs and symptoms with other common dental infectious diseases. This study was aimed at evaluating the potential relationship between VRFs and commonly used clinical diagnostic factors. METHODS: 330 root-filled teeth with endodontic failures were subjected to endodontic microsurgery over a six-year period. VRFs were identified in 61 teeth. A randomly age- and sex-matched retrospective case-control study was conducted on a subset of 59 root-filled teeth with VRFs (cases) and 177 root-filled teeth without VRFs (controls). The strength of association between preoperative signs and radiographic findings and VRFs was evaluated using logistic regression model. RESULTS: Sinus tract, periodontal pocket depth ≥5 mm, periodontal swelling or abscess, and radiological image of J-shaped or "halo" radiolucency were significantly more frequent in cases than in controls (p < 0.05). With regard to logistic regression analysis, J-shaped or "halo" radiolucency demonstrated the greatest association with VRF, followed by periodontal pocket depth ≥5 mm, sinus tract, and periodontal swelling or abscess. Approximately 70% of cases manifested themselves as combinations of at least two of these factors. Teeth having two and three or four of these factors had 3.14 times and 11.64 times higher risks for the presentations of VRFs, respectively (p < 0.001). CONCLUSION: The major risk for VRFs was represented by those presenting radiological image of J-shaped or "halo" radiolucency, periodontal pocket depth ≥5 mm, sinus tract, and periodontal swelling or abscess simultaneously.

Dental Pathology of the Iberian Lynx ( Lynx pardinus), Part I: Congenital, Developmental, and Traumatic Abnormalities.

The Iberian lynx is an endangered felid that has been subject to an intensive ongoing conservation program in an attempt to save it from extinction. Identification of dental pathologies could play an important role in the survival of this endangered species. The objective of this study is to evaluate the dental pathologies (congenital, developmental, and traumatic abnormalities) of this species of felid. Skulls of 88 adult specimens of the Iberian lynx ( Lynx pardinus) from the Doñana Biological Station [Estación Biológica de Doñana-Consejo Superior de Investigaciones Científicas] (EBD-CSIC), Seville, Spain, were examined macroscopically, and full-mouth dental radiographs of all specimens were performed. Presence, absence, form of teeth, number of roots, supernumerary teeth, and persistent deciduous teeth were evaluated. The presence of attrition/abrasion, tooth fractures, enamel hypoplasia/hypomineralization, endodontic disease, intrinsically stained teeth, and other traumatic findings were also evaluated. Abnormal grooves and dilacerations were the most common abnormalities seen in the roots of teeth. Two hundred and fifteen fractured teeth (11.3% of evaluated teeth) were detected, and mainly complicated fractures were noted in maxillary canine teeth (24.2% of fractured teeth) and mandibular canine teeth (16.7% of fractured teeth). Endodontic disease was present in 3.9% of the teeth examined. Intrinsic tooth staining was assessed in 8.5% of evaluated teeth. Of all teeth examined, 831 teeth (43.7% of evaluated teeth) exhibited some type of attrition/abrasion. Our study concluded that there is a high prevalence of dental fractures and attrition/abrasion with associated endodontic disease that could lead to impaired hunting ability as well as a threat to overall health and subsequent survival of this endangered species.

Prevalence of vertical root fractures in teeth planned for apical surgery. A retrospective cohort study.

AIM: To evaluate retrospectively the prevalence of vertical root fractures (VRFs) in a cohort of patients during apical surgery and the factors possibly associated with VRF. METHODOLOGY: The sample consisted of 944 root filled teeth belonging to 768 patients (49.3% males and 50.7% females; mean age 43.5 ± 11.2 years, range 22-68 years), consecutively referred for endodontic surgery over a six-year period. All patients underwent a clinical assessment of their signs and symptoms. Periapical radiographs of teeth that were candidates for endodontic surgery were taken. Sixty-eight teeth with VRF were identified. Vertical root fractures were identified in pre-surgical screenings in 32 cases (47.1%), and these did not undergo surgery. Another 36 cases of VRF were noted during the intervention for root-end resection. The influence of posts, post type, tooth type, periodontal probing defects, spontaneous pain, sinus tract and follow-up duration was assessed using a logistic regression analysis. RESULTS: Vertical root fractures occurred significantly more frequently (P < 0.001) when a post was present (61 VRF out of 377 teeth with post, prevalence 16.2%) than in teeth without a post (1.2%). Threaded posts and cast posts were significantly more involved in VRF than fibre, silica or carbide posts (P < 0.001). Most fractures (80.9%) occurred 1-5 years after root canal treatment. Sinus tracts, probing defects and spontaneous pain were significantly more associated with VRF cases than with nonfractured teeth. CONCLUSIONS: In the present group of teeth, the major risk for VRF was represented by posts retained by actively engaging the canal via mechanical design (thread) or by frictional fit (cast).

Prevalence of and factors associated with enamel fracture and other traumas in Brazilian children 8-10 years old

Abstract The aim of this study was to assess the prevalence and discriminate the associated factors between enamel fractures and other trauma/trauma sequelae in 8 to 10-year-old Brazilian schoolchildren. A representative sample of 1,201 children from public and private schools were enrolled in this cross-sectional study. Questionnaires about sociodemographic characteristics were answered by parents. The outcome variable (traumatic dental injury, TDI) was multi-categorized. Independent individual variables were sex, age, number of residents in household, parents/caregivers' level of education, family income, dental caries, and overjet. Type of school was considered an independent contextual variable. Multilevel analysis, bivariate, and multivariate multinomial logistic regression models were performed. The prevalence of TDI was 14.0% (2.8% with other trauma/trauma sequelae). The multilevel analysis revealed no significant difference between the type of school and TDI. The multinomial logistic regression showed that boys (OR = 2.3; 95%CI: 1.1-4.8), older children (OR = 1.8; 95%CI: 1.1-3.0) and individuals with an overjet > 3 mm (OR = 2.5; 95%CI: 1.0-6.2) were more likely to present other trauma/trauma sequelae. Enamel fracture was not significantly associated with any variables. The prevalence of TDI in 8 to 10-year-old schoolchildren was 14% but only 2.8% of other trauma/trauma sequelae. Differences regarding the associated factors of TDI involving enamel fracture or other trauma/trauma sequelae were detected, suggesting that the different TDI classification cannot be evaluated as a single category.

Diagnoses and Treatment of Dental Disorders in a Research Colony of Macaca fascicularis: A Case Series.

During daily routine oral examinations in a research colony of nonhuman primates (NHPs, Macaca fascicularis), a variety of oral-dental lesions were identified. A dental care program was established based on these findings. Based on the presence of dental clinical signs and their severity, 31 animals were triaged to be examined and treated by a veterinarian. Clinical examination consisted of visual inspection using a periodontal probe/explorer and full or partial mouth dental radiographs. Treatment was performed during the same procedure. Some animals had a follow-up examination including radiographs months later. Four common dental diseases were diagnosed: periodontal disease, caries, tooth fracture, and tooth attrition. Less frequent were dental abscess, enamel hypomineralization, gingival hyperplasia, hypercementosis, tooth luxation, tooth dysplasia, root resorption, abrasion. Less severe periodontal disease was treated conservatively. If severely affected, teeth were extracted. Well-circumscribed caries without endodontic involvement were treated by composite restoration. Teeth with extensive caries and pulp involvement were extracted. Teeth with exposed pulp were treated via extraction or orthograde root canal treatment. In this case series, 27 (87%) of 31 NHPs exhibited at least 1 moderate to severe dental lesion that required treatment. The presumable improvement in welfare and weight of oral/dental lesions for the overall health status in research NHPs encourages us to continue this program prospectively.

Complicaciones intra y postquirúrgicas de exodoncias en un programa de atención comunitaria de la FOUBA en Junín de los Andes / Intra and postsurgical tooth extraction complications at a FOUBA community dentistry program in Junin de los Andes

El objetivo de este estudio fue analizar la incidencia de complicaciones intra y postquirúrgicas de extracciones simples en 5 días de atención comunitaria en Junín de los Andes, provincia de Neuquén, Argentina. Se realizaron 109 extracciones dentales en 74 de los pacientes que concurrieron al centro único de atención, entre el 27 y 31 de octubre de 2014, presentando piezas dentarias con indicación de extracción. Las complicaciones más frecuentemente encontradas fueron la fractura de la tabla ósea vestibular, la fractura de la corona de la pieza dentaria y el dolor posoperatorio. Complicaciones de frecuencia intermedia fueron el trismus, la alveolitis, la laceración de los tejidos blandos y la fractura de la raíz de la pieza dentaria. Se registró un caso de hemorragia primaria y una inyección accidental dentro de un vaso sanguíneo. Cuando se comparó estadísticamente la presencia de complicaciones pre y posquirúrgicas entre cirugías que duraron menos de 30 minutos y 30 minutos más, se encontró una asociación significativa; para ambas complicaciones, el porcentaje fue mayor en el segundo grupo. La práctica de extracciones simples ocasionalmente conlleva tener que manejar complicaciones. Es importante que el odontólogo general sea capaz de prevenirlas, diagnosticarlas y tratarlas. Reducir los tiempos operatorios parecería ser una medida clave para disminuir las probabilidades de aparición de complicaciones intra y posquirúrgicas.

The objective of this study was to analyze the incidence of intra and postoperative complications of simple extractions in 5 days of community care in Junín de los Andes, province of Neuquén, Argentina. A total of 109 dental extractions were performed in 74 patients who attended the single care center between October 27 and 31, 2014, presenting teeth with indication of extraction. The most frequent complications were the fracture of the buccal bone table, the fracture of the crown of the tooth and the postoperative pain. Complications of intermediate frequency were trismus, alveolitis, laceration of the soft tissues and fracture of the root of the tooth. There was a case of primary haemorrhage and an accidental injection into a blood vessel. When statistically comparing the presence of pre and postsurgical complications between surgeries that lasted less than 30 minutes and 30 minutes more, a significant association was found; for both complications, the percentage was higher in the second group. The practice of simple extractions occasionally entails having to handle complications. It is important that the general dentist be able to prevent, diagnose and treat them. Reducing operative times seems to be a key measure to decrease the chances of intraoperative and postoperative complications.

Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users.

The aim of the current study was to identify and compare the characteristics of maxillofacial trauma in alcohol and drug users with those of nonusers. A retrospective study was conducted using the medical records of patients treated for facial trauma between April 1999 and March 2012 at the Maxillofacial Surgery Division of the Piracicaba Dental School. The data were analyzed by descriptive analysis, binary logistic regression, and correlational analysis using SPSS 18.0 software. The results were considered relevant at P < 0.05. Medical records of 3724 patients with facial trauma were analyzed, of which 173 were illicit drug users and 19.36% reported alcohol intake. The use of illicit drugs was reported by 4.64%. The prevalent etiological factor among drug and alcohol users was interpersonal violence. The mandible was the face part most affected by fractures. Male patients exhibited increased odds of experiencing fractures (OR = 1.43), as did users of illicit drugs (OR = 1.62), when compared with nonusers. When faced with maxillofacial trauma, male drug users exhibited an increased chance of experiencing fractures. This knowledge should be used as a baseline to implement more efficient prevention strategies for this population.

Classification and Epidemiology of Traumatic Dentoalveolar Injuries in Dogs and Cats: 959 Injuries in 660 Patient Visits (2004-2012).

The objective of this study was to determine the epidemiology of traumatic dentoalveolar injuries (TDI) in dogs and cats and to evaluate the applicability of a human classification system for TDI in dogs and cats. All patients diagnosed with a TDI were identified from the University of Wisconsin-Madison School of Veterinary Medicine Dentistry and Oral Surgery Service case log and the hospital patient processing software. The study population consisted of 621 dogs and cats, in a total of 660 patient visits from 2004 to 2012, admitted for oral treatment and subsequently diagnosed with at least one TDI Medical records including diagnostic imaging studies were reviewed to group the injury according to a classification system used in humans for TDI. Patient signalment, tooth injured, and number of injuries per patient were recorded and tabulated. The overall prevalence of TDI was 26.2%. The mean +/- SD number of TDI per patient was 1.45 +/- 0.85. All 14 classes of TDI recognized by the classification system utilized in humans were identified, and all (100%) TDI identified in this study were classifiable using this system. Enamel-dentin-pulp fracture was the most common TDI (49.6%). The most commonly injured teeth were the mandibular or maxillary canine teeth (35.5%). The most common age for dogs and cats with TDI were 3-6 years (33.0%) and 7-10 years (31.3%). With a frequency of 1 in 4 animals, TDI are common and represent a significant pet health concern. Most TDI are considered severe and require timely, and sometimes immediate, treatment. The adoption and utilization of a complete classification system, such as the one used in this study, is recommended in order to improve future epidemiological study of TDI in animals.

ATYPICAL DISLOCATION OF IMPACTED PERMANENT TEETH IN CHILDREN. OWN EXPERIENCE.

INTRODUCTION: Disturbances in forming of the hard tissue of teeth and bones can be a cause of their malformation and translocation. The impact of permanent teeth is one of them. It can occur with translocation of the tooth germ. The aim of the study was to present an atypical translocation of impacted permanent teeth in children. MATERIAL AND METHODS: 3.5 year clinical observation was carried out in 14 children (5 girls and 9 boys), aged between 9 and 12 years old. Patients were referred to our Department by orthodontists, paedodontists and General Dental Practitioners, due to impacted permanent teeth. According to the interview, in 8 cases children suffered from a trauma of a facial part of the skull, caused by a fall. On admitance patients were generally healthy. Basing on the clinical and radiological examination, translocation of the impacted permanent teeth has been diagnosed. In 9 cases it concerned medial maxillary incisors, whereas in remaining children--maxillary premolars. The extraction of such teeth has been performed as a part of the one day surgery procedures. CONCLUSION: In the cases where basing on the radiogram, the position of the tooth allows to predict the latter translocation, the germ has to be extracted.

Traumatismo dentário em crianças de 8 a 10 anos de idade: fatores associados e impacto na qualidade de vida / Traumatic dental injury in children 8-10 years of age: associated factors and impact on quality of life

O traumatismo dentário (TD) pode impactar negativamente a qualidade de vida relacionada à saúde bucal (QVRSB) das crianças. Foi realizado um estudo transversal com o objetivo de avaliar a prevalência do TD, os fatores associados e seu impacto na QVRSB das crianças. Este estudo será apresentado no formato de dois artigos científicos. Uma amostra representativa de 1201 crianças de 8 a 10 anos de idade, matriculadas em escolas públicas e privadas da cidade de Belo Horizonte, Minas Gerais, foi examinada nas escolas, de acordo com os critérios de Andreasenet al. (2007), por duas examinadoras previamente calibradas (Kappa intra-examinador= 0,91 e 0,89 e Kappa inter-examinador= 0,85). Para análise da QVRSB foi aplicado o CPQ8-10 às crianças, sendo os seus escores dicotomizados pela técnica de "two-step cluster" em baixo e alto imapcto...