Is there a relationship between the presence of external root resorption in second molars adjacent to impacted mandibular third molars with awake bruxism and masticatory muscle activity?

OBJECTIVES: This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. MATERIALS AND METHODS: Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n = 30), and control group (n = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. RESULTS: The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC (p = 0.027) and EMA (p = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols (p < 0.05). CONCLUSIONS: Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. CLINICAL RELEVANCE: The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.

Brightness and contrast adjustments influence the radiographic detection of soft tissue calcification.

OBJECTIVE: To assess the influence of subjective enhancement of brightness and contrast of digital panoramic radiographs on the detection of soft tissue calcifications. MATERIALS AND METHODS: In this observational study, 500 digital panoramic radiographs were evaluated by two examiners in consensus, who scored the images for the presence of calcifications for each right and left side of the image. After 30 days, all images were revaluated under subjective manipulation of digital brightness and contrast. Calcifications were classified based on the diagnostic hypothesis: sialolith, tonsillolith, calcified atheroma, phlebolith, rhinolith, maxillary sinus antrolith, synovial chondromatosis, lymph node calcification, stylohyoid ligament, triticeous cartilage, or/and upper horn of thyroid cartilage calcification. For intra-examiner agreement, 20% of the sample was reevaluated. The Kappa test and McNemar test were used (α = 0.05). RESULTS: In original images, calcifications were observed in 44.2% of the patients, and in enhanced images, this number was 70.8%. Many calcifications were detected only in enhanced images, mainly in the diagnostic hypotheses of calcified atheroma and stylohyoid ligament. Intra-examiner agreement was excellent for the detection of soft tissue calcifications (0.82) and for the classification (0.81). CONCLUSION: Subjective enhancement of brightness and contrast alters the detection of soft tissue calcifications in digital panoramic radiograph.

Is Surgical Treatment Based on a 1-Step or 2-Step Protocol Effective in Managing the Odontogenic Keratocyst?

PURPOSE: The literature does not present any consensus on a uniform treatment plan for odontogenic keratocysts (OKCs) and does not provide adequate evidence for determining which modality is most effective in lowering morbidity or preventing recurrence. The purpose of this study was to compare the effectiveness of surgical treatment based on a 1- versus 2-step protocol. MATERIALS AND METHODS: The authors designed and implemented a retrospective cohort study and enrolled a sample of patients diagnosed with OKC from 1991 through 2018. The medical records of all cases were retrieved from files of the Oral and Maxillofacial Surgery Division of the Piracicaba Dental School (Piracicaba, Brazil). The predictor variable was treatment group (1- vs 2-step protocol). Statistical analysis was performed using Kaplan-Meier analysis, Mantel-Cox log-rank test, and proportional hazard regression analysis. RESULTS: The sample was composed of 72 patients (38 male) with a mean age of 40.72 years. Thirteen patients received 1-step treatment and 59 received 2-step treatment. The complex composed of the body, angle, and mandibular ramus was the site most frequently affected. In the individual Kaplan-Meier analysis for each presented variable only involved tooth was significant (P = .0128 by log-rank test), with the risk of relapse 4.23 times higher for the involved tooth than for the non-involved tooth. CONCLUSION: The 1- and 2-step protocols for treatment of OKCs are safe and appropriate as the first treatment option, offering a conservative and effective option with low morbidity. Treatment protocols associated with systematic monitoring promote a better quality of life for patients with low potential for complications.

Complications in Orthognathic Surgery.

The aim of this study was to analyze the presence of complications related to orthognathic surgery performed by surgeons in train. A retrospective study was conducted between 2005 and 2014, analyzing the clinical records of patients treated in the authors' Department. Patients who underwent orthognathic surgery were included, under a bidimensional analysis and with the conventional orthosurgical sequence; intraoperative complications were identified, such as the occurrence of a bad split, bleeding, tissue injury, among others and postoperative variables such as impaired sensation, infection, and alterations in the osteosynthesis systems. A statistical analysis was done using χ and Student t tests, considering a statistical significance when P < 0.05. Two hundred fifty patients were included with an average follow-up of 13 months; 62.8% were women and 37.2% were men; 18.8% of the subjects presented some type of intraoperative or postoperative complication; excluding relapse and complications due to loss of bonding of the orthodontic device, a 12.4% complication rate was observed; intraoperative complications were 8% and postoperative complications 10.4%. Only the sensorineural alterations were associated with the mandibular surgery (P < 0.05). Finally, orthognathic surgery is relatively safe and produces a low number of complications when it is performed by surgeons in train.

Evaluation of Failed Implants by Metallographic and Energy Dispersive X-ray Analysis.

OBJECTIVE: To evaluate the microscopic structure and chemical composition of titanium dental implants removed from patients with implant failure. MATERIALS AND METHODS: Thirty-eight dental implants removed from 29 patients between January 2012 and September 2014 were studied by metallographic analysis, and 7 of these implants were also studied by energy-dispersive x-ray (EDX) analysis. Medical records of these patients were examined. RESULTS: Dental implants were removed in a median of 54.6 ± 88.1 weeks after insertion. The lack of osseointegration without symptomatology or signs of infection was the main reason for implant failure (55.17%). Seventeen patients presented implant failure in the maxilla and 12 patients in the mandible. Metallographic analysis revealed that all the dental implants were manufactured from commercially pure titanium, presenting microscopic uniform appearance, with no "alpha case". The implants studied by EDX analysis presented between 99.85% and 99.87% of titanium and 0.13% and 0.15% of iron by mass. All the implants evaluated were within the ASTM specifications in both analyses. CONCLUSION: There was no relationship between dental implant failure and the microscopic structure and chemical composition of these devices.

A Rare Case of Malignant Fibrous Histiocytoma (Undifferentiated High-Grade Pleomorphic Sarcoma) of Malar Region.

Malignant fibrous histiocytoma is a sarcoma with rare occurrence in the oral and maxillofacial region; surgery is the most reliable treatment. Inadequate resection of the sarcoma on the oral and maxillofacial region is associated with a high incidence of local recurrence and a poor prognosis. Only few patients of malignant fibrous histiocytoma of the malar region have been previously reported in the literature. The authors report a new patient of malignant fibrous histiocytoma on the right malar region that treated a complete tumor surgical excision without lymph node dissection. Examination of the resected specimen revealed that the tumor was completely removed.

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.

Maxillary sinus floor augmentation using blood without graft material. Preliminary results in 10 patients.

PURPOSE: The maxillary sinus lift is recognized and stable, and there have been different innovations to optimize the technique. The aim of this study was to investigate the maxillary sinus lift technique with the use of a blood clot and without the use of a bone graft. MATERIALS AND METHODS: Ten patients were recruited for a unilateral sinus lift; patients without sinus pathology or other contraindication were selected. The maxillary sinus was accessed conventionally under local anesthesia followed by an osteotomy and a 1-cm(2) bony window access. The sinus membrane was detached and the window was repositioned above and stabilized with a 12- or 14-mm osteosynthesis screw introduced through the alveolar ridge. Dental implants were installed in the second surgical stage. Standardized panoramic radiographic checks were performed at every stage. RESULTS: Seven completely edentulous patients and 3 partially dentate patients were treated surgically. From the first to the second surgery, a bone gain of 2.37 mm was obtained, although loss of bone height was observed in 1 completely edentulous patient. In 7 patients, it was not possible to install the implants owing to insufficient bone height or inadequate bone quality. CONCLUSION: The protocol used in this investigation failed in the bone increase required for implant installation.

Clinical outcomes of the discopexy using suture anchors for repositioning disc displacement in temporomandibular joints: Systematic review and meta-analysis.

The present study evaluated the literature regarding the clinical outcomes after discopexy using suture bone anchors for repositioning disc displacement. A systematic review was conducted according to the PRISMA statement and applied for the PROSPERO platform. The database searches were performed in the PubMed, Scopus, Web of Science, EMBASE, The Cochrane Library, and LILACS for full articles published from no restrictions of the initial period time to April 2022. Selection criteria included clinical studies in humans comparing maximal inter-incisal opening (MIO), pain by visual analogue scale (VAS), and protrusive and lateral excursions before and after discopexy. The screening process was performed by two independent reviewers, and if they did not agree with each other, a third reviewer was consulted before proceeding. The meta-analysis was carried out by Comprehensive Meta-Analysis software. Eleven studies met the inclusion criteria. A total of 327 patients were diagnosed with disc displacement, and 142 patients were refractory to conservative and minimally surgical therapies. Preauricular and endaural approaches were performed to place suture bone anchors on the posterior area of the condyle. A significant difference was found in MIO, which ranged from 15.5 mm pre-opeatively to 41.6 mm post-operatively (p = 0.001). Pain scores using the VAS ranged from 7.42 to 0.28 indicating improvement post-operatively (p = 0.001). Mandibular excursions were underestimated. The available results have shown that discopexy using suture anchors seemed to decrease pain and improve mouth opening. Clinical studies are required in a larger sample and lower variability of follow-up time to predict actual benefits.

A comparison of motorcycle and bicycle accidents in oral and maxillofacial trauma.

PURPOSE: The aim of this study was to present a large series of motorcycle- and bicycle-related traumas to the face in an attempt to identify the injury pattern in motorcyclists and bicyclists. PATIENTS AND METHODS: Data were collected from patients during a 10-year period (1999 through 2009), which included demographic data, diagnosis of facial fractures, use of protective devices, dentoalveolar trauma, and facial soft tissue injuries. RESULTS: There were 556 patients with bicycle accidents and 367 with motorcycle accidents. Men were involved in 79% (436) of bicycles accidents and 82% (299) of motorcycle accidents. Young male patients were more frequent in bicycle and motorcycle accidents. Two hundred fifty bicyclists showed 311 maxillofacial fractures. Two hundred twenty-one motorcyclists showed 338 maxillofacial fractures. Motorcycle accidents caused multiple fractures in more patients. Seventy-six percent of motorcyclists were using helmets at the time of the accidents, whereas 6% of cyclists were using helmets. Motorcyclists showed a larger number of lacerations, whereas bicyclists showed a larger number of abrasions. Avulsion was the most common dentoalveolar injury for these accident types. Hospital stays were 3.8 days for motorcyclists and 1.3 days for bicyclists. CONCLUSIONS: The high-impact collisions typically observed in motorcycle accidents is directly related to larger percentages of soft tissue lacerations and facial fractures. The low-impact trauma that is observed in bicycle accidents is more commonly associated with soft tissue abrasion, hematoma, and dentoalveolar fractures. This stresses the need for compulsory legislation for helmet use with face-guards for cyclists and motorcyclists. It is important to take measures to alert the public regarding the severity of injuries likely to occur in bicycle- and motorcycle-related accidents and ways to prevent them.

Comparison of CBCT and panoramic radiography for the assessment of bone loss and root resorption on the second molar associated with third molar impaction: a systematic review.

OBJECTIVE: To investigate whether the use of cone beam CT (CBCT) changes the diagnosis of external root resorption (ERR) or marginal bone loss (MBL) involving a second molar adjacent to an impacted third molar. METHODS: A systematic search was applied in PubMed, EMBASE, Scopus, Web of Science, LILACS, Google Scholar, OpenGrey, and ProQuest. Studies assessing the detection of ERR or MBL in a second molar adjacent to an impacted third molar through CBCT and panoramic radiography (PAN) were included. Prevalence and agreement between PAN and CBCT on the detection of ERR and MBL were collected. The risk of bias was assessed using the MAStARI. RESULTS: A total of 593 papers were identified, and after a 2-phase selection, 5 studies were included in the narrative synthesis. Regarding ERR, its prevalence in PAN was reported from 5.31 to 19.5% and from 22.8 to 62.0% in CBCT. The percentage of agreement varied from 28.5 to 74.0%. The prevalence of MBL varied from 21.9 to 62.9% in PAN, while those values varied from 21.6 to 80% in CBCT images. The percentage of agreement between PAN and CBCT for the detection of MBL ranged from 66.0 to 85.0%. Four studies presented low risk of bias and one had moderate risk. CONCLUSIONS: More ERR and MBL are assessed in CBCT compared to PAN. There is a considerable agreement between PAN and CBCT assessment of ERR and MBL, however, mostly related to the absence of the pathology rather its presence.

Photoelastic analysis of stress distribution of surgically assisted rapid maxillary expansion with and without separation of the pterygomaxillary suture.

PURPOSE: The aim of this study was to evaluate in vitro the mechanical effect over teeth and bone structures of surgically assisted rapid maxillary expansion (SARME) in photoelastic analogs by observing stress produced during Hyrax-type and Haas-type appliances activation. MATERIALS AND METHODS: Two photoelastic analogs were fabricated by use of birefringent materials to simulate an adult skull that contained teeth, bone, and maxillary sinus. Hyrax-type and Haas-type appliances were applied to the anchor teeth and incrementally activated. SARME was simulated by subsequent cuts of the lateral maxillary wall and midpalatine suture and separation of the pterygomaxillary junction. After each osteotomy, the appliances were activated. Resulting stress patterns were recorded photographically in the field of a plane polariscope. RESULTS: Before any osteotomy, the activation of the appliances distributed stress through the anchoring teeth to the zygomaticomaxillary walls, concentrating at the zygomaticomaxillary and zygomaticofrontal sutures and at the midline of the maxilla. After midpalatal and maxillary wall osteotomies, a marked reduction of the stress at the zygomaticomaxillary walls was observed. With successive activations, the stresses increased in intensity at the molars, maxillary tuberosity, and pterygoid plates. After pterygomaxillary separation, the stress intensity at the molar area, maxillary tuberosity, and pterygoid plates decreased considerably. With successive activations, stress increased in intensity around the molars and maxillary tuberosity. There were no differences between stresses produced by the 2 appliances. CONCLUSIONS: In this biomechanical model, sectioning of all maxillary articulations, including separation of the pterygomaxillary junction, caused a decrease in stress over anchorage teeth. These data cannot be completely extrapolated to the clinical situation but indicate that electing to perform the SARME technique should be based on periodontal health and amount of expansion necessary for each case.

A retrospective analysis of submental intubation in maxillofacial trauma patients.

PURPOSE: The aim of this study was to retrospectively evaluate the frequency, indications, and outcomes of airway management by submental intubation in maxillofacial trauma patients. PATIENTS AND METHODS: Data were collected from patients during a 10-year period (1999-2009) from clinical notes and surgical records from each patient using a standardized data collection form that was specifically developed to investigate the epidemiological features of maxillofacial trauma. Data about anesthetic management were assessed. RESULTS: During the study period, 3,149 patients, victims of facial trauma, were evaluated: 2,090 patients presented facial fractures; 674 were submitted to surgery under general anesthesia. There were 449 nasal intubations, 204 oral intubations, 6 tracheotomies, and 15 submental intubations. Submental intubation permitted reduction and fixation of all the fractures without the interference of the tube during surgical procedure in all of the patients. There were no intra- or postoperative complications. CONCLUSIONS: Submental intubation is a simple, safe, with low morbidity technique for operative airway management in maxillofacial trauma patients when there are fractures involving the nasal region and concomitant dental occlusion disturbances.

Comparative study between 2 methods of mounting models in semiadjustable articulator for orthognathic surgery.

PURPOSE: Compare the traditional method of mounting dental casts on a semiadjustable articulator and the new method suggested by Wolford and Galiano, 1 analyzing the inclination of maxillary occlusal plane in relation to FHP. MATERIALS AND METHODS: Two casts of 10 patients were obtained. One of them was used for mounting of models on a traditional articulator, by using a face bow transfer system and the other one was used to mounting models at Occlusal Plane Indicator platform (OPI), using the SAM articulator. After that, na analysis of the accuracy of mounting models was performed. The angle made by de occlusal plane and FHP on the cephalogram should be equal the angle between the occlusal plane and the upper member of the articulator. RESULTS: The measures were tabulated in Microsoft Excell(®) and calculated using a 1-way analysis variance. Statistically, the results did not reveal significant differences among the measures. CONCLUSION: OPI and face bow presents similar results but more studies are needed to verify its accuracy relative to the maxillary cant in OPI or develop new techniques able to solve the disadvantages of each technique.

Surgical complications of mandibular condylar fractures.

The purpose of this study was to retrospectively evaluate the complications of 58 patients who underwent surgery for mandibular condylar process fractures. Data were collected from patients during a 10-year period (1999-2009). The data recorded included demographic data, etiology, diagnosis, type of condylar fracture, surgical approaches, and postoperative complications. A total of 58 underwent surgery for reduction of the condylar fractures. There were 22 patients with bilateral condyle fractures and 36 patients with unilateral condyle fractures, accounting for 65 surgeries. In 8 fractures, a preauricular approach was performed to access the fractures condyle, whereas the retromandibular approach was performed in 57 fractures. There were 2 temporary facial palsies, 1 permanent facial palsy, and 1 sialocele. There were no cases of hypertrophic scar, Frey syndrome, or salivary fistula. In conclusion, permanent deformities after surgical complications were unusual, and the results are acceptably safe.

Pattern and treatment of facial trauma in pediatric and adolescent patients.

Pediatric maxillofacial trauma is a challenge for surgeons. There are no completely defined protocols, and sometimes, the initial management could be complex. The aim of this research was to perform a retrospective study to analyze the pattern and treatment of maxillofacial fractures in pediatric and adolescent patients. We reviewed the clinical records of 2986 patients treated at the Oral and Maxillofacial Surgery Division of Piracicaba Dental School between 1999 and 2008. Seven hundred fifty-seven patients were younger than 18 years and were divided into 3 groups according to age; the age and sex of the patients, etiology, fractures and associated injury, treatment, and complications were evaluated. Five hundred thirty boys (70.01%) and 227 girls (29.99%) were treated for injuries with major prevalence in adolescents. The most common injury causes were bicycle accidents (29.06%) and falls (28.40%). The mandible was the most fractured bone (44.8%); associated injuries were lacerations of the soft tissue and dental trauma. Surgical treatment was performed in 75 cases (30%) with minor complications (10% of surgical patients). We conclude that maxillofacial trauma in child is associated to fall and bicycle accidents; the mandible is more affected than other maxillofacial structures, and frequently, nonsurgical treatment is performed.

Comparative biomechanical and photoelastic evaluation of different fixation techniques of sagittal split ramus osteotomy in mandibular advancement.

PURPOSE: The aim of the present study was to comparatively evaluate the resistance and tension areas created after load incidence in different varieties of sagittal split ramus osteotomy fixation techniques. MATERIALS AND METHODS: Fifty synthetic polyurethane hemimandible replicas were subjected to linear loading tests to evaluate 4 fixation techniques of the sagittal split ramus osteotomy using 2-mm system plates and screws. The hemimandibles were fixed with three 90 degrees linear screws, three 60 degrees linear screws, 3 screws in a reversed L arrangement, and one titanium miniplate. Each group was subjected to linear loading using an Instron 4411 servohydraulic mechanical testing unit. The load peak value and peak displacement were measured. Another 4 hemimandible replicas were made of photoelastic resin and subjected to photoelastic analysis after linear loading with a 3-mm displacement. RESULTS: The results of the mechanical tests showed statistically significant differences between the fixation groups. The linear 90 degrees fixation and the reversed L arrangement presented with greater loading resistance, followed by the linear 60 degrees fixation and miniplates. In relation to the stress distribution in the photoelastic analysis, the fringes were concentrated near the osteotomy and to the lower part of the mandible in the linear 90 degrees -screw system and reversed L arrangement. In the case of the linear 60 degrees screws, most fringes were located around and between the screws. In the case of the miniplates, the fringes were concentrated around the screws near the osteotomy and more distally. CONCLUSION: Under the conditions tested, the linear 90 degrees and reversed L arrangements provided the most favorable behavior.

Incidence and patterns of mandibular condyle fractures.

PURPOSE: The aim of the present study was to retrospectively evaluate the epidemiologic characteristics of the prevalence, type, and treatment modalities of condylar fractures of the mandible. PATIENTS AND METHODS: Data were collected from patients during an 8-year period (1999 to 2007). The data recorded included demographic data, etiology, diagnosis, type, dislocation, use of protective devices, state of the dentition, associated facial and general trauma, soft tissue lesions, treatment methods, and the interval between trauma and treatment. Data analysis included a descriptive analysis, chi(2) test, Fisher's exact test, t test, and Kruskal-Wallis test. RESULTS: During the 8-year period, 209 unilateral fractures and 54 bilateral fractures were treated, with a male/female ratio of 3.05:1 and a mean age of 28.4 years, for a total of 317 condylar fractures. Male gender was significantly associated with the presence of a condylar fracture (P < .05). The most common cause of condylar fractures was road traffic accidents (57.8%). Of the 317 fractures, 300 were classified as simple fractures, and 249 fractures were not displaced. Protective devices significantly decreased the number of condylar fractures occurring from road traffic accidents (P < .05). Symphysis fractures were significantly associated with both unilateral and bilateral fractures of the mandibular condyle (P < .05). Subcondylar displaced fractures were significantly associated with surgical treatment (P < .05). CONCLUSIONS: Young adults were involved in most of the accidents. Road traffic accidents were the main cause of condylar fractures. The mandatory use of safety helmets and seatbelts and education of those using the road are essential to decrease the number of facial fractures.

A 9-year retrospective study of dental trauma in Piracicaba and neighboring regions in the State of São Paulo, Brazil.

PURPOSE: The purpose of this study was to evaluate the occurrence of dentoalveolar trauma during a 9-year period in the Oral and Maxillofacial Surgery Division at Piracicaba Dental School, State University of Campinas in patients from the Piracicaba municipality and neighborhood regions in São Paulo, Brazil. PATIENTS AND METHODS: This retrospective epidemiologic study from January 1999 to December 2007 evaluated all patients who presented at the Oral and Maxillofacial Surgery Division at Piracicaba Dental School with sustained oral and maxillofacial traumatic injuries associated with dentoalveolar trauma. Information regarding age, gender, etiology, use of protective devices such seatbelts, crash helmets, and presence of facial fractures and general trauma, oral condition, stage of dentition, date of trauma, drug abuse, type, teeth affected, and classification of the trauma were gathered from the medical files. Descriptive analysis was conducted. RESULTS: In total, 2,785 patients were analyzed and 542 (19.46%) were included in this study. The male to female ratio was 2.81:1. Most patients presented with oral hygiene as regular (51.85%). Friday, Saturday, and Sunday were the most prevalent days. Smoking was the most common harmful habit analyzed (16.05%) followed by alcohol use (15.87%). Bicycle accidents (26.94%) were the most common cause, followed by falls (22.69%). With regard to protective devices, 31.51% of drivers were wearing seatbelts during the accidents and helmets were used by 84.38% of motorcycle drivers at the moment of injury. One hundred thirty-five facial fractures were associated with dental and dentoalveolar traumas, and the mandible was the facial bone most associated with dentoalveolar trauma. Upper and lower limbs were most frequently associated with general trauma, accounting for 140 (38.78%) and 111 (30.75%), respectively. CONCLUSION: This study shows that dentoalveolar trauma rates and patterns in the Piracicaba municipality and neighborhood regions in São Paulo are similar to other populations. The weekend is the period with the major incidence of dentoalveolar trauma. Alcohol consumption was linked with this type of trauma. Dentoalveolar trauma is involved in and closely related to severe maxillofacial trauma. The use of a helmet is as important as that of a seatbelt. More studies are necessary for a better knowledge and understanding when considering protocols and organization charts in emergency rooms.