Treatment priorities and arrival time of traumatic dental injuries-An 8-year retrospective study.

BACKGROUND/AIM: Most of the previous studies in the available literature discussed the time of arrival in general to the healthcare system, while a minority studied the relationship between the type of trauma and arrival. The aim of this retrospective study is to assess the arrival time of traumatic dental injuries (TDIs) depending on the urgency of treatment according to Andreasen. MATERIALS AND METHODS: This 8-year retrospective study was carried out at the Department of Pediatric Dentistry at the University Dental Clinic in Zagreb, Croatia. Andreasen's classification was used to define the kind of TDI as well as to divide them by the need for urgent treatment or treatment priorities in three groups: acute, subacute, and delayed. RESULTS: The sample consisted of 1040 children (59% male and 41% female) with a median age of 7. Each year, the age group most affected by TDIs was 6-12 years old. While there is a general increase in the prevalence of TDIs overall, there is a decline in TDIs among children aged 6-12 and an increase among preschoolers and adolescents (below 6 and above 12 years old). Throughout the years, 52.73% red/acute and 41.16% yellow/subacute TDIs were not treated on time due to delayed arrival. More patients from Zagreb come in the first 24 h, while more patients from outside Zagreb come to the clinic a month or more after their injuries. Patients which suffered TDI accompanied with soft-tissue injury arrived sooner. CONCLUSIONS: It is necessary to introduce monitoring and education of patients under the age of 6 and over 12, as well as their parents/caregivers. New programs should be implemented and new referent centers that specialize in treating TDIs outside of Zagreb should be established.

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.

Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste, Italy.

BACKGROUND/AIMS: The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period. METHODS: From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated. RESULTS: From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth. CONCLUSIONS: There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.

Cross-sectional study of posterior tooth root fractures in 2015 and 2019 in a Chinese population.

OBJECTIVES: This study aimed to compare posterior tooth root fractures in endodontically treated teeth versus nonendodontically treated teeth in the Chinese population. MATERIALS AND METHODS: We investigated 500 root fractured posterior teeth in 461 Chinese patients. The clinical information (age, sex of patients, tooth type) were recorded. The fractured teeth were divided into endodontically treated root fractured (ETRF) teeth and nonendodontically treated root fractured (NETRF) teeth. The morphology of the fractured root (circular, oval, other), the orientation of fracture lines (vertical and non-vertical), the restorations performed (crown, filling, non-filling), and the position of the teeth in the dental arch (normal, misaligned) were evaluated based on cone-beam computed tomography images. These data were compared between 2015 and 2019. ETRF% was calculated as ETRF/ETRF + NETRF. Vertical% was calculated as vertical/vertical + non-vertical. RESULTS: There were 177 ETRF teeth and 323 NETRF teeth in this population. The total ETRF% was 29.3% in 2015 and 37.6% in 2019 (P = 0.087). The proportion of vertical root fracture in the ETRF group increased significantly in 2019 compared with that in 2015 (46.2% vs. 80.2%, P = 0.000). The ETRF% in female patients increased by 16.8%, but increased by only 1.2% in male patients in 2019 compared with that in 2015. The ETRF% of mandibular and maxillary premolars increased by 48.5% and 29.3%, respectively. The proportion of crown restoration increased by 2.4% in 2019 compared with that in 2015 in the ETRF group. CONCLUSIONS: The proportion of NETRF teeth and non-vertical root fractures in posterior teeth is high in this Chinese population. The number of vertical root fractures in endodontically treated teeth increased significantly from 2015 to 2019. CLINICAL RELEVANCE: More attention should be paid to endodontic treatment factors in the occurrence of root fractures, especially as female patients and premolars are more susceptible.

Traumatic dental injuries and their sequelae in visually impaired adolescents.

BACKGROUND/AIM: Traumatic dental injuries are a public health problem. Visual impairment can be considered a risk factor for traumatic dental injury given the difficulties imposed upon visually impaired patients by limited physical perception. The aim of this study was to evaluate the frequency of traumatic dental injuries and their sequelae in adolescents with visual impairment. MATERIAL AND METHODS: Adolescents (12-18 years) with visual impairment (blind or low vision) and no other special needs were included in the study. Data were collected after a clinical and radiographic examination. Data regarding gender, age, type of visual impairment, site of traumatic dental injury, tooth type, and affected tissues, care, and sequelae were obtained. The data were analyzed descriptively and with the chi-square test (p < .05). RESULTS: Among 96 adolescents (65% blind; 55% female), 20.8% (n = 20) reported they had previously experienced a traumatic dental injury of 33 teeth (78.8% maxillary central incisors). Combined injuries (30.3%; n = 10) were the most common traumatic dental injuries, followed by concussion (27.3%, n = 9) and enamel-dentine fractures (21.2%, n = 7). Sequelae were observed in 27.3% (n = 9) of the teeth affected by a traumatic dental injury, and apical periodontitis (77.8%, n = 7) was the most common. CONCLUSION: The frequency of traumatic dental injuries among visually impaired adolescents can be considered high, and the observed sequelae could have been minimized if adequate clinical and radiographic follow up had been carried out. These results suggest the importance of enhanced educational efforts to reduce traumatic dental injuries.

Tooth chipping prevalence and patterns in extant primates.

OBJECTIVES: A tooth chip occurs when a hard object forcefully contacts the surface of the tooth, typically removing enamel from the occlusal edge. In this study, chipping patterns in extant primates were compared, and hard-object-feeding assessed alongside other factors (e.g., grit mastication and dental properties), to elucidate dietary and behavioral inferences in archeological and paleontological samples. MATERIALS AND METHODS: Thirteen species of extant primates were studied, including eight species within the Cercopithecidae, two within the Ceboidea, and three within the Hominoidea. Four additional species were also incorporated from the literature for some of the analyses. The severity (Grade 1-3), position (buccal, lingual, mesial, and distal) and number of tooth fractures were recorded for each specimen. RESULTS: Species considered hard-object-feeding specialists presented higher rates of chipping, with sakis, mandrills, sooty mangabeys and Raffles' banded langurs having high chipping rates (28.3%, 36.7%, 48.4%, and 34.7% of teeth, respectively). Species that seasonally eat harder foods had intermediate chipping frequencies (e.g., brown woolly monkeys: 18.5%), and those that less commonly consume hard food items had the lowest chipping frequencies (e.g., Kloss gibbon: 7.3%; chimpanzees: 4.4%). DISCUSSION: The results suggest hard food mastication influences differences in chipping prevalence among the species studied. Although Homo fossil samples show high rates of chipping comparable to hard-object-feeding extant primates, they display a different pattern of chipping, supporting the hypothesis that these fractures are mostly non-food related (e.g., grit mastication in Homo naledi; non-masticatory tooth use in Neanderthals).

Prevalence and Etiological Factors of Dental Trauma among 12- and 15-Year-Old Schoolchildren of Lebanon: A National Study.

BACKGROUND: Traumatic dental injuries represent nearly 5% of children and adolescents' injuries leading to serious medical and psychological issues. This current study aims to evaluate the prevalence of dental trauma and its potential association with different predisposing factors among 12-and 15-year-old schoolchildren in Lebanon. MATERIALS AND METHODS: 7902 schoolchildren, 3806 male and 4096 female aged 12 years (n = 3985) and 15 years (n = 3917), were recruited by a stratified multistaged randomized cluster sampling method from public and private schools and were clinically examined in a national cross-sectional study. WHO criteria were used to assess anterior permanent teeth; the nature of trauma, the tooth involved, the size of the incisal overjet, and the type of the lip coverage were furthermore assessed. Data regarding age, sex, and causes of TDI were recorded through a structured questionnaire. RESULTS: The prevalence of dental trauma to anterior teeth was 10.9%. Maxillary central incisors (83.7%) were commonly affected. The most common type of injury was enamel fracture (68.3%), falls being the main reason (52.5%). Increased overjet (OR = 2.32, p = 0.034), deficient lip coverage (OR = 5.73, p = 0.019), and gender (OR = 5.36, p ≤ 0.001) were significant predisposing factors for dental trauma. CONCLUSION: This research highlighted many predisposing factors for dental trauma that affect commonly the anterior teeth. Based on these results, the implementation of strategic preventive measurements targeting especially the identified risk groups remains crucial.

Profiles of traumatic dental injuries among children aged 0-15 years in Cappadocia, Turkey: A retrospective cohort study.

BACKGROUND/AIM: Traumatic dental injuries are among the most serious dental public health problems in children. The aim of this retrospective study was to evaluate the dental trauma profile of primary and permanent teeth among children aged 0-15 years who presented to a university hospital. MATERIAL AND METHODS: The study included 650 patients (1,000 primary and permanent teeth) who presented with a history of dental trauma to the Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University between 2016 and 2019. Traumatized teeth were assessed according to the Andreasen classification. The following information was recorded: age, gender, teeth affected by trauma, etiologies of trauma, place and season of trauma, type of trauma, type of treatment, and time between the trauma and treatment. RESULTS: In total, 650 patients (240 females, 410 males) and 1,000 incisors (212 primary teeth, 788 permanent teeth) were evaluated. The average age of the patients was 8.89 ± 3.41 years, and dental injuries were more frequent between 8 and 10 years of age. The maxillary central incisors, both primary (40.1%) and permanent (42.8%), were the most frequently affected teeth. The main cause of traumatic dental injuries was falls. Most accidents occurred at school and home. The most common type of dental injuries recorded was luxation injuries in the primary teeth (21.5%) and enamel-dentin fractures (35.9%) in the permanent teeth. Only 48 teeth were treated during the first hour after injury. CONCLUSIONS: The most common type of traumatic injury affecting permanent teeth was enamel-dentin fractures, and primary teeth were luxation injury. Only 4.8% of teeth were treated within the first hour after trauma.

[Clinical analysis of children and adolescents emergency dental trauma cases].

OBJECTIVE: To analyze the etiological and clinical characteristics of oral emergency patients under 18 years with dental trauma, and to provide guidance on the prevention and treatment in children and adolescents. METHODS: A retrospective study on the intact data of the dental trauma patients under 18 years from January 2016 to December 2018 in the Department of Oral Emergency in Peking University School of Stomatology was conducted, and the distribution of the patients' gender, age and visiting time, as well as the number and position of traumatic teeth, diagnostic classification, and multiple injury with dental trauma were analyzed. RESULTS: During the period, 54.2% of the first visit dental trauma patients (10 164) were children or adolescents (5 506). The two peak ages were 3-4 and 7-9 years. The incidence of the male was higher than the female in every age group (Wilcoxon test, P < 0.001). From May to June and September to November, there were more cases of dental trauma. The peak time of daily dental trauma cases was from 19:00 to 20:00 (Jonckheere-Terpstra test, P < 0.001). The positions of traumatic teeth in both sides were approximate symmetrical, and maxillary central incisors were the most affected. 52.3% of the patients suffered multiple teeth injuries. Among the permanent teeth trauma, enamel and dentin fracture was the most common (24.7%), followed by concussion (20.5%), sub-luxation (17.9%) and complicated crown fracture (14.4%). And among the primary teeth trauma, subluxation was the most common (31.1%), followed by concussion (14.5%) and lateral luxation (9.5%). 19.7% of the children and adolescent dental trauma patients were also suffered maxillofacial soft or hard tissue injury. CONCLUSION: The incidence of dental trauma in children and adolescents is higher than that in adults. There were two age peaks among the children and adolescents patients. Primary teeth and young permanent teeth were usually suffered. Clinical treatment should be considered along with the characteristics of child tooth growth. In order to prevent the occurrence of dental trauma, early orthodontic intervention should be carried out in children with severe overjet. Families, schools and nursery institutions should strengthen the protection against dental trauma.

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.

The Incidence of Dental Fracturing in Electroconvulsive Therapy in Sweden.

OBJECTIVES: One adverse effect of electroconvulsive therapy (ECT) is dental fracture; thus, a bite guard and muscle relaxants are used to prevent it. Earlier research reported varying rates of dental fracture, but there is no large-scale study on the incidence of dental fracture during ECT. This study aimed to examine the incidence of dental fracture during ECT and to investigate whether the incidence differs between different sexes, age groups, diagnosis groups, electrode placements, or number of treatment sessions. METHODS: This register-based study used data from the Swedish national quality register for ECT. All hospitals offering ECT report to this register, and the coverage ratio is about 90%. All registered patients who started an ECT series between January 2012 and January 2019 were included in this study, with the data representing 16,681 individuals, 38,862 series, and 254,906 sessions. RESULTS: Forty-six dental fractures were identified, giving an incidence of dental fracture of 0.2% per series, 0.02% per session, and 0.3% per individual. We did not find any significant associations between dental fracture rates and male or female populations, age, or different diagnosis groups, nor was there any significant difference between dental fracture rates and electrode placement. The mean number of treatments was significantly higher in the dental fracture group than in patients without dental fracture. CONCLUSIONS: There is a minimal risk of dental fracture during ECT. Our findings, together with those of other studies, provide further motivation for the use of a bite guard and muscle relaxant.

Retrospective analysis of traumatic dental injuries in the western black sea region of Turkey.

BACKGROUND: The incidence of traumatic dental injuries is affected by social, environmental, and socioeconomic variables. For this reason, epidemiological studies are an important tool for increasing social consciousness and guiding the necessary precautions about trauma. OBJECTIVES: The study aims to analyze the epidemiological and clinical data of traumatic dental injuries in patients attending Department of Pediatric Dentistry, Faculty of Dentistry, Bulent Ecevit University, from around Zonguldak, over a period of 3 years (between January 2014 and January 2017). MATERIALS AND METHODS: Data obtained from trauma charts were analyzed for age, sex, the time elapsed between injury and referral to the clinic, cause of trauma, number, and type of the teeth, type of the trauma, treatment, and seasonal distribution. RESULTS: In all, 188 patients, including 120 boys and 68 girls with a total of 316 traumatized teeth were evaluated. Most (61.7%) of the patients were 7-12 years old (the remaining 38.3% were 1-6 years old). The main cause of injury in both genders was falling. The most common types of trauma were subluxation in primary teeth and enamel dentin fracture in permanent teeth. In the primary dentition, examination and follow-up were the most applied treatments, whereas in permanent dentition, restorative treatments were the most applied treatments. CONCLUSION: Early intervention is important for the prognosis of the injured tooth. However, except for severe injuries, the rate of referral to the clinic after trauma was low. Therefore, the level of social awareness and knowledge of trauma should be increased.

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.

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.

Traumatic Dental Injuries among Adolescents In Republic of Moldova.

Objectives: The aim of this investigation was to evaluate the epidemiological data on dental injuries in permanent teeth among seventh and tenth grade schoolchildren in the Republic of Moldova. Study design: The pathfinder study model was chosen to evaluate the prevalence of Traumatic Dental Injuries (TDI). Schoolchildren ages 12 and 15 years old were examined: In the capital city (four schools), in two other major cities-(two schools each city), and in four villages (one per each village) in accordance with the WHO's recommendations. Results: A total of 720 seventh and tenth grade schoolchildren were examined. The overall prevalence of TDI was found to be 16.4% (total of 118 children). The prevalence of TDI was greater in the older age cohort (p<0.05). Children from rural areas presented with greater prevalence of TDI compared to children who live in urban region (p<0.03). The maxillary central incisors were found to be the most common teeth affected by trauma constituting 57.1% of the evaluated TDI cases. Enamel fracture was the main type of TDI (83%). Conclusions: The TDI mainly involved enamel fractures. Urban schoolchildren show lower rates of TDI compared to rural schoolchildren.

Tooth fractures in the Krapina Neandertals.

Dental fractures can be produced during life or post-mortem. Ante-mortem chipping may be indicative of different uses of the dentition in masticatory and non-masticatory activities related to variable diets and behaviors. The Krapina collection (Croatia, 130,000 years BP), thanks to the large number of teeth (293 teeth and tooth fragments) within it, offers an excellent sample to investigate dental fractures systematically. Recorded were the distribution, position and severity of the ante-mortem fractures according to standardized methods. High frequencies of teeth with chipping in both Krapina adults and subadults suggest that the permanent and deciduous dentition were heavily subjected to mechanical stress. This is particularly evident when the frequencies of chipping are compared with those in modern humans (Upper Paleolithic and historic samples) that we analysed using the same methods. The distribution of chipping in the Krapina sample (anterior teeth are more affected) and its position (labial) suggest a systematic use of the anterior teeth for non-masticatory tasks.

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).

Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study.

OBJECTIVE: This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors. METHODS: The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors. RESULTS: The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05). CONCLUSION: Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

The impact of crown fracture in the permanent dentition on children's quality of life.

BACKGROUND/AIM: Among the diseases related to oral health, traumatic dental injuries (TDI) can lead to pain, loss of function and aesthetic problems, with physical, emotional and social consequences for children and their families. The aim of this study was to investigate the relationship between enamel fracture and enamel-dentin fracture with oral health-related quality of life (OHRQoL). MATERIAL AND METHODS: This cross-sectional study had a representative sample of 1589 children between 8-10 years of age from public schools. The OHRQoL was obtained through the Child Perceptions Questionnaire (CPQ8-10 ), which is a questionnaire validated for Brazilian children. Clinical data were collected by 4 calibrated examiners (Kappa > 0.7) using the Decay, Missing, Filled Teeth (DMFT) Index, Dental Aesthetic Index (DAI) and TDI. A socio-economic questionnaire was sent to the caregivers to be answered at home. Descriptive statistics and Poisson regression with prevalence ratio (PR) and 95% confidence interval (CI) were used for statistical analysis. RESULTS: The prevalence of TDI was 10.6%, and among these 10.3% who had an impact on the OHRQoL, it was due to enamel-dentin fracture. Children with enamel-dentin fracture had (PR 1.35; 95% CI 1.07-1.70) higher prevalence of impact on the OHRQoL. Children with enamel fracture had no impact on the OHRQoL (P = .254). CONCLUSION: Enamel fracture had no significant impact on children's quality of life, while enamel-dentin fracture did have an impact on quality of life.

Prevalence and Reasons for Extraction of Endodontically Treated Teeth in Adult Nigerians.

AIM: Teeth extraction is an important problem in elder patients. Although some of these teeth have been endodontically treated, many of them may be subjected to extraction. The reasons for extraction are important for prevention planning in further patients. The aim of this study was to assess the prevalence and important reasons for extraction of endodontically treated teeth in adult Nigerians. MATERIALS AND METHODS: This study involved a retrospective examination of 2,000 case files in the archives of the University of Nigeria Teaching Hospital. Out of the 2,000 case files, 650 concerned endodontically treated teeth. RESULTS: The prevalence of extractions in the population was 21.5%. This was more often in the mandible (67.9%) than in the maxilla (32.1%). In both jaws, more molars were extracted (57.1%), followed by premolars (27.1%) and anterior teeth (15.7%). Extractions occurred 57.1% of times in females. However, the rate of extraction decreased with age but peaked in the 51-60 year age band. CONCLUSION: The association between age and extraction was proven. Caries, vertical root fracture and endodontic reasons accounted for the commonest cause of extraction in the mandible; while in the maxilla, endodontic reasons and cusp fracture caused extractions most often. CLINICAL SIGNIFICANCE: The reasons for extraction of endodontically treated teeth are different between maxilla and mandible.