Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review.

Osteoporosis is a common systemic bone disorder in the elderly, characterized by low bone mineral density and deterioration of bone structure. Apical periodontitis is an inflammatory response to the microbial infection of root canals, typically characterized by apical bone destruction surrounding the tooth's apex. This systematic review aimed to determine if osteoporosis affects the prevalence of apical periodontitis in adults. PRISMA guidelines have been followed. It included randomized clinical trials, cross-sectional, cohort, and case-control studies, and excluded non-relevant investigations and various secondary sources. A comprehensive search was performed in PubMed, Scopus, and Web of Science, until 13 March 2024. The Newcastle-Ottawa Scale was used to assess the quality of the three selected studies: two cross-sectional studies and one case-control study. One investigation only included post-menopausal women recruited at a dental university clinic, the other integrated data from the total hospital patients' population, and the third selected patients referred to the university dental clinic from the university hospital. The findings varied: one study noted a marginal association between low bone mineral density and apical periodontitis, another found a significant association, and the third, with the lowest risk of bias, reported no link. The main limitations were the scarcity of eligible studies and their overall quality. The review was registered in the PROSPERO database (CRD42024523705), applied strict inclusion criteria and thorough searches by experienced and independent reviewers. There is no strong evidence that adult individuals with osteoporosis have a higher probability of developing apical periodontitis. However, clinicians should remain cautious of osteoporosis's potential impact on apical periodontitis development.

Temporomandibular joint trauma and disability assessment - A longitudinal exploratory study.

BACKGROUND: Orofacial trauma can encompass, isolated or not, several anatomical regions, namely facial, dental and temporomandibular joint (TMJ), one of the most complex joints in the human body. Evidence-based knowledge in the field of TMJ trauma and in temporomandibular joint disorders (TMD) diagnosis and treatment, provides the necessary data for medico-legal assessment. OBJECTIVE: The aim of this study is to bring up epidemiological data referring to TMJ injuries and sequelae, in order to present a medico-legal approach of TMJ disability. METHODS: An observational longitudinal exploratory study was performed in the database of the National Institute of Legal Medicine and Forensic Sciences, Portugal, between 2000 and 2017, regarding inclusion and exclusion criteria.Statistical significance was set as P<0.05, Fisher's exact test, Binomial test and Goodman and Kruskal's test were used. RESULTS: Post-traumatic orofacial reports (n = 2622) included 234 TMJ-injury and 149 TMJ-sequelae.Epidemiological data was presented regarding age,gender, professional status and etiology. There was a statistically significant association between TMJ injury and TMJ sequela, despite a weak relation (ƛ = 0.170). No statistically significant association was identified between TMJ-injury/TMJ-sequelae and the professional status, etiology. CONCLUSION: The TMJ sequela group is smaller than the TMJ-injury, reflecting that 2/3 of the injuries have been cured without a monetary compensation value and without Health costs. The association between TMJ injury and TMJ sequelae reinforces the necessity of preventive measures in TMJ trauma, namely in physical violence context and in medico-legal impairment.

COVID-19 Management in Clinical Dental Care Part II: Personal Protective Equipment for the Dental Care Professional.

BACKGROUND: Facing the coronavirus disease 2019 (COVID-19) challenge on a global level, dental care professionals are encouraged to optimize universal precautions and adopt measures that ensure protection against infection by contaminated aerosols and droplets. Although aerosol transmission is possible, direct contact through large droplets is probably responsible for the vast majority of transmissions. METHODS: This paper is the second of a series of 3 on the management of COVID-19 in clinical dental care settings and aims to describe the selection and use of personal protection equipment (PPE) by dental care professionals (DCP), with consideration of the level of risk associated with the planned procedures. PPE selection depends directly on the local epidemiological setting, the patient's characteristics, and the level of risk of the planned procedures. The procedures performed in the office environment are classified as low-, moderate-, or high-risk. Moderate risk includes 2 further sublevels associated with the cleaning, disinfection, and sterilization of materials for clinical procedures that do not generate aerosols. The training of DCP on how to properly don (put on) and doff (remove) PPE is as important as choosing the appropriate PPE because it can be associated with a risk of infection. DISCUSSION: When there is limited availability of PPE, measures should be adjusted to the risk associated with the intervention. Assuming that an effective COVID-19 vaccine will be developed, once it becomes widely available for DCP, PPE requirements will likely be different. CONCLUSION: The proper use of PPE, together with the adoption of other operational procedures, can provide effective protection against microorganisms being transmitted via body fluids or in the air.

Prevalence of, and disability approaches to, temporomandibular joint trauma: A 17-year cross-sectional study.

BACKGROUND/AIM: Sociodemographic, cultural and environmental factors play significant roles in orofacial trauma. The main aim of the present work was to study the epidemiological data regarding temporomandibular trauma, in the orofacial trauma context. Secondly, follow-up data between injury and sequelae were assessed, in the medico-legal approach for this disability. MATERIAL AND METHODS: An observational, cross-sectional study, from 2000 to 2017, was performed, using the clinical reports of the National Institute of Legal Medicine and Forensic Sciences Institute of Portugal-Coimbra Central Branch. A descriptive analysis was performed. RESULTS: The injury group, 8.9% of the analysed population (2622 reports), included a majority of men (60.7%) with a mean age of 33.9 years. They were mainly students or retired (38.9%) and reported physical violence as the main external cause (56.4%) and temporomandibular joint (TMJ) trauma occurred with dental and facial trauma (84.2%). The sequela group, 2.9% of the analysed population, included a majority of men (65.6%) with a mean age of 40.1 years, focusing on a professional active population. They reported physical violence as the main external cause (46.3%) and TMJ (13.2%), soft tissues and teeth (12.8%) sequelae. CONCLUSIONS: Not all TMJ injuries corresponded to sequelae (63.4%). The sequela resulting from TMJ trauma encompass soft and hard tissues and TMJ sequelae, isolated or not. Physical violence was the primary external cause of TMJ injuries in both groups. Conversely, road accidents were the major external cause of isolated TMJ sequelae, highlighting the need to reinforce safety measures.

Mini implants osseointegration, molar intrusion and root resorption in Sinclair minipigs.

AIM: The use of mini implants to create a passive intraoral anchorage point has been mainly tested in clinical trials. In this study, an experimental integrated approach evaluated mini implant loading protocols (immediate vs. delayed loading) on bone remodelling and mini implant stability and the consequent degree of dental intrusion and apical root resorption. METHODS: A total of 40 Absoanchor® mini implants with 1.2mm diameter and 8mm length were placed in a total of 5 minipigs, 8 per animal, 2 in each hemiarch. Each implant was attached through a lingual button to the vestibular side of the second and fourth premolars with a nitinol coil spring of 150g force. The analysis of morphological aspects included the degree of dental movement, mini implant stability, and new bone formation over the mini implant heads. Bone mini-implant interface and modifications of dental root in response to intrusion were studied by light and electron microscopy. RESULTS: The rate of mini implant success was>98%, mainly in those subjected to immediate loading. This loading protocol promoted a high degree of osseointegration along with a high degree of intrusive dental movement, particularly of the second premolars. However, the radiological and histological studies showed a low degree of root resorption. Associated with the high intrusive movement, the penetration of the root apexes produced an inner cortical surface deformation of the maxillary sinus floor by remodeling and bone growth. CONCLUSION: In minipigs immediate loading of smooth mini implants promoted a high degree of intrusive movement particularly of the second premolars, stimulated bone growth and osseointegration, but extensive root resorption was not observed.

Novel cellulose/hydroxyapatite scaffolds for bone tissue regeneration: In vitro and in vivo study.

Cellulose scaffolds containing nano- or micro-hydroxyapatite (nHA or µHA) were prepared by the regeneration of cellulose from its acetylated derivative and the mechanical immobilization of inorganic particles, followed by freeze-drying. Microtomographic (micro-computed tomography) evaluation revealed that both scaffolds presented a highly interconnected porous structure, with a mean pore diameter of 490 ± 94 and 540 ± 132 µm for cellulose/nHA and cellulose/µHA, respectively. In vitro and in vivo characterizations of the developed scaffolds were investigated. Commercially available bone allograft was used as a control material. For the in vitro characterization, osteoblastic cell cultures were used and characterized over time to evaluate cell adhesion, metabolic activity, and functional output (alkaline phosphatase activity and osteoblastic gene expression). The results revealed greater spreading cell distribution alongside an increased number of filopodia, higher MTT values, and significantly increased expression of osteoblastic genes (Runx-2, alkaline phosphatase, and BMP-2) for cellulose/nHA, compared with cellulose/µHA and the control. The in vivo biocompatibility was evaluated in a rabbit calvarial defect model. The investigated scaffolds were implanted in circular rabbit calvaria defects. Four- and 12-week bone biopsies were investigated using micro-computed tomography and histological analysis. Although both cellulose/HA scaffolds outperformed the assayed control, a significantly higher amount of newly formed mineralized tissue was found within the defects loaded with cellulose/nHA. Within the limitations of this study, the developed cellulose/HA scaffolds showed promising results for bone regeneration applications. The biological response to the scaffold seems to be greatly dependent on the HA particles' characteristics, with cellulose scaffolds loaded with nHA eliciting an enhanced bone response.

Application of Bonelike® as synthetic bone graft in orthopaedic and oral surgery in veterinary clinical cases.

Autologous bone remains the gold standard grafting substrate for bone fusions used for small gaps and critical defects. However, significant morbidity is associated with the harvesting of autologous bone grafts and, for that reason, alternative bone graft substitutes have been developed. In the present case series, a glass-reinforced hydroxyapatite synthetic bone substitute, with osteoinductive and osteoconductive proprieties, was applied. This synthetic bone substitute comprises the incorporation of P2O5-CaO glass-based system within a hydroxyapatite matrix, moulded into spherical pellets with 250-500 µm of diameter. A total of 14 veterinary clinical cases of appendicular bone defects and maxillary / mandibular bone defects are described. In all clinical cases, the synthetic bone substitute was used to fill bone defects, enhancing bone regeneration and complementing the recommended surgical techniques. Results demonstrated that it is an appropriate synthetic bone graft available to be used in veterinary patients. It functioned as a space filler in association with standard orthopaedic and odontological procedures of stabilization, promoting a faster bone fusion without any local or systemic adverse reactions. This procedure improves the animals' quality of life, decreasing pain and post-operative recovery period, as well as increasing bone stability improving positive clinical outcomes.

Chronology of mineralization of the permanent mandibular second molar teeth and forensic age estimation.

Forensic age estimation frequently relies upon the chronology of mineralization of the third molar teeth. However, even when present, third molar teeth cannot always be used for estimating age in people who are classified as minors. Seconds molars develop earlier and in a more predictable way, and therefore are often more reliable for age estimation in this age group. This study aims to contribute to forensic age estimation using an age threshold of 14-years, studying the stages of development of permanent mandibular second molar teeth mineralization. 367 orthopantograms of a Portuguese population group, aged between 3 and 19 years, were studied. The stages of mineralization of mandibular permanent second molar teeth were studied following the classification stages proposed by Demirjian et al. Stage descriptive analysis was performed, and associations between age and stage were studied. A logistic regression to determine age over 14 years, using maturation stages and sex as a predictive variables, was made. A second sample was used for testing the model. The significance level was set at 5%. The model correctly classified 92.0% of cases overall. The equation was tested in the second sample, and the results showed that there were no statistical significant differences between the binary real age (i.e. age < 14 and age ≥ 14 years) and the estimated age (p = 0.109). The developed model is useful for age estimation using 14-years as a threshold. However, stage maturation analyses showed that stage F, in males, and stages G and H, in both sexes, lead to an estimated age with significant statistical differences from chronological age.

The in vivo performance of an alkali-free bioactive glass for bone grafting, FastOs® BG, assessed with an ovine model.

Although bioactive glasses are successfully used as bone substitutes, recent studies have revealed that the high alkali content in these glasses leads to fast in vivo degradation rates that may not match the rate of new bone ingrowth. This prompted us to design and develop novel bioactive glasses that are devoid of alkali but still demonstrate high bioactivity in vitro. This article describes the in vivo performance of an alkali-free bioactive glass with the following composition (Wt %): 13.03 MgO-33.98 CaO-13.37 P2 O5 -38.84 SiO2 -0.77 CaF2 (labelled as FastOs® BG). An animal model was used to assess the in vivo performance of FastOs® BG, using 45S5 Bioglass® as control. The evaluation was performed through implantation of FastOs® BG and 45S5 Bioglass® , during one month, in femoral bone defects in sheep. Subcutaneous implantation of both glasses was also performed in order to assess tissue response through a standardized method. Histological and scanning electron microscopy assessment of retrieved subcutaneous and bone samples demonstrated that FastOs® BG is biocompatible, osteoconductive, that it can be osteointegrated, and that it is more slowly resorbed than 45S5 Bioglass® . These features suggest that FastOs® BG is a potential candidate for bone grafting. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 30-38, 2017.

Is Demirjian's original method really useful for age estimation in a forensic context?

PURPOSE: The suitability of Demirjian's method for forensic age estimation has been systematically questioned. The aim of this study is to further assess the reliability of Demirjian's original method in forensic age estimation using a sample of Portuguese children. METHODS: 564 panoramic radiographs of Portuguese boys and girls between 6 and 16 years of age were evaluated using Demirjian's method. Dental age (DA) was determined using the 50th percentile for the maturity score obtained for each age group. The mean difference between chronological age (CA) and dental age (DA) and the mean absolute difference between CA and DA were calculated for each age group. Paired t tests were used to test the statistical significance of mean differences between CA and DA. For each individual, a 94% confidence interval was calculated for estimated DA, using the 3rd and 97th percentiles in Demirjian's conversion tables. RESULTS: Chronological age was overestimated in boys, in every age group; mean differences between CA and DA were statistically significant, expect for age 7. In girls, chronological age was overestimated in the 10-15 year-old age group. The difference between CA and DA was highest in the 12 years olds for both sexes. The 94% confidence intervals did not include the true chronological age in all 6, 13, and 15 year-old girls, and all 14 and 15 year-old boys. Only a small portion of the individuals in the remaining age groups had their true chronological age falling within the probable age interval. CONCLUSIONS: Results show a systematic bias and consistent inaccuracy in estimating age from dental development using Demirjian's original method, making this methodology unsuitable for age estimation in the study sample. These results add to published evidence which suggests that Demirjian's method is not suitable and should be abandoned altogether for forensic age estimation purposes.

Human identification using dental techniques: A case report.

Dental identification of skeletal remains frequently relies on data comparison. Comparative dental identification is used to establish with a high degree of certainty that the remains of a corpse and a person represented by ante-mortem dental records are the same individual. There is no minimum number of concordant points necessary to perform a positive identification; rather, each case is unique and should be treated as such. In this paper, we present a report of a case in which positive identification was made by a paramolar tubercle in both upper first deciduous molars.

Age estimation using the radiographic visibility of the periodontal ligament in lower third molars in a Portuguese population.

OBJECTIVES: The mineralization of third molars has been used repeatedly as a method of forensic age estimation. However, this procedure is of little use beyond age 18, especially to determinate if an individual is older than 21 years of age; thus, the development of new approaches is essential. The visibility of the periodontal ligament has been suggested for this purpose. The aim of this work was to determine the usefulness of this methodology in a Portuguese population. STUDY DESIGN: Periodontal ligament visibility was assessed in the lower third molars, using a sample of 487 orthopantomograms, 228 of which belonging to females and 259 to males, from a Portuguese population aged 17 to 31 years. A classification of four stages based on the visual phenomenon of disappearance of the periodontal ligament of fully mineralized third molars was used. For each stage, median, variance, minimal and maximal age were assessed. RESULTS: The relationship between age and stage of periodontal ligament had a statistical significance for both sexes. In this population, stage 3 can be used to state that a male person is over 21 years-old; for females, another marker should be used. CONCLUSIONS: This technique can be useful for determining age over 21, particularly in males. Differences between studies are evident, suggesting that specific population standards should be used when applying this technique. Key words:Forensic sciences, forensic odontology, age estimation, third molar, periodontal ligament.

Orohanditest: A new method for orofacial damage assessment.

BACKGROUND: Currently, orofacial sequelae are recognized as very influential on the quality-of-life for a victim of orofacial damage. Therefore, correct forensic assessment for indenisation purposes is mandatory. However, orofacial damage is frequently reduced to organic components, which results in a forensic assessment process, which are inadequate. This study aims to improve the orofacial damage assessment through the development of an auxiliary tool, the orohanditest. MATERIALS AND METHODS: A preliminary inventory was constructed, using relevant bibliographic elements and retrospective study of forensic examinations reports concerning orofacial trauma. This inventory was then utilized in the assessment of 265 orofacial trauma victims for validation. Validity was studied by analyzing the internal construct validity (exploring factorial validity and assessing internal consistency) and the external construct validity (assessing convergent validity and discriminant validity). The level of significance was defined as P < 0.05. RESULTS: The final inventory (orohanditest) was comprised of the three components of body (8 items), functions (10 items) and situations (24 items), which were found to be statistically reliable and valid for assessment. The final score (orofacial damage coefficient) reflects the orofacial damage severity. CONCLUSION: Orohanditest provides a reliable, precise, and complete orofacial damage description and quantification. Therefore, this method can be useful as an auxiliary tool in the orofacial damage assessment process.

Oral injuries in victims involving intimate partner violence.

INTRODUCTION: Current literature states that dental medicine can have an important role in diagnosing situations of domestic violence, namely cases of intimate partner violence, since many of the injuries that occur in this context concern the head and neck areas. The aim of this study was to characterize oral injuries in these cases in a Portuguese population, and to determine the kind of permanent consequences that they might represent. MATERIAL AND METHODS: 332 forensic reports of domestic violence survivors were analysed. The reports concerned examinations performed in the North Branch of the National Institute of Legal Medicine of Portugal in 2007. Reports were assessed in order to obtain data regarding victim and offender demographic characteristics, and to characterize the nature and number of sustained injuries and their permanent consequences. MAIN RESULTS: Most victims were females with a mean age of 33.7 years; the most frequent offender was the spouse; the majority of oral injuries affected soft tissues; permanent body consequences were found mainly in the teeth and periodontal tissues; permanent functional consequences were described as chewing difficulties, feeling pain or soft tissue mobility changes; permanent consequences for life activities referred mostly to social life aspects. CONCLUSIONS: Oral injuries and their consequences were observed in 13.4% of intimate partner violence cases, and though being suggestive of this kind of violence, oral injuries alone are insufficient to identify this kind of abuse, and additional diagnostic criteria and evidence should be used.

Surface properties and osteoblastic cytocompatibility of two blasted and Acid-etched titanium implant systems with distinct microtopography.

OBJECTIVES: The aim of this study is to compare two commercially available screw-type sandblasted and acid-etched (SLA) Ti implant systems from Eckermann Laboratorium S.L., with similar geometry and distinct microtopography, regarding surface properties and osteoblastic cytocompatibility. MATERIAL AND METHODS: Implant I (referred as a conventional SLA system) and Implant II (a system patented as Eckcyte(®)) were characterized for macro and microtopograpphy, surface roughness and chemical composition. For the cytocompatibility studies, human bone marrow osteoblastic cells were seeded over the implants' surface, and the cell response was assessed for cell adhesion and proliferation, alkaline phosphatase (ALP) activity and matrix mineralization. RESULTS: Implant I presented a rough surface with irregularly shaped and sized cavities among flatter-appearing areas, whereas Implant II exhibited a homogeneous rough microporous surface. Compared to Implant I, Implant II presented higher Ra values (0.8 [SD 0.008] µm and 1.21 [SD 0.15] µm, respectively, P < 0.05) and also increased values of Rz, Rt and Rsm, a more negative value of Rsk, and similar RKu values. XPS showed the expected presence of Ti, O, C and N; Al, Si, F, P and Ca were detected in low concentrations. Implant II exhibited significantly lower Al levels. Both implants supported the adhesion, proliferation and differentiation of osteoblastic cells. Implant II showed a thicker fibrilar cell layer and an earlier onset and more abundant matrix mineralization. CONCLUSIONS: The homogeneous rough and microporous surface of Implant II is most probably a main contributor for its improved cell response.

Chronological course of third molar eruption in a Portuguese population.

Forensic age determination has become increasingly important over the past few years. Dental age estimation is frequently used as a part of this process due to the technique simplicity and reliability. This process is done taking into account pre-established values that, often, concern the population of the undocumented person. In this manner, population parameters are needed. In this paper, the authors present data concerning the third molar eruption in a Portuguese population: The minimum age for alveolar emergence of third molars ranged from 6.6 to 11.3 in females and 7.4 to 8.3 in males, for gingival emergence was 11.1 to 15.1 for females and 8.3 to 14.4 in males and for complete emergence was 15.9 to 19.4 in females and 13.4 for males. Complete emergence was found to be a useful marker for diagnosing age inferior 16 years, both in males and females, with 99.2% and 99.3% of correct predictions, respectively. These findings point out that it is possible to estimate the age of investigated persons based on alveolar, gingival and complete emergence of the third molars in the occlusal plane.

Chronological age estimation based on third molar development in a Portuguese population.

Third molar development was assessed using a sample of 1,131 orthopantomograms from a Portuguese population. The methodology applied was the eight stages (A-H) method described by Demirjian et al. The final sample was made of 739 orthopantomograms, 387 (52.5%) of which belonging to females; age ranged between 6.1 and 22.5 years old (mean age = 14.49, S.D. = 4.37). For each developmental stage, mean age, standard deviation, and minimal and maximal age was assessed; evaluation of the rate formation of each tooth, according to sex, was calculated and data distribution expressed in percentiles for each stage; the probability of an individual being 16 was also evaluated. The relationship between tooth development and chronological age had a statistical significance for all teeth and both sexes (p < 0.0001). The data described may provide reference for forensic application and agree with the thesis that each population need specific data.

Evaluation of implant osseointegration with different regeneration techniques in the treatment of bone defects around implants: an experimental study in a rabbit model.

AIM: The aim of this study was to evaluate the osseointegration of implants placed in areas with artificially created bone defects, using three bone regeneration techniques. MATERIAL AND METHODS: The experimental model was the rabbit femur (16), where bone defects were created and implants were placed. The peri-implant bone defects were filled with a deproteinized bovine bone mineral, NuOss™ (N), NuOss™ combined with plasma rich in growth factors (PRGF) (N+PRGF), NuOss™ covered by an RCM(6) membrane (N+M), or remained unfilled (control group [C]). After 4 and 8 weeks, the animals were euthanized and bone tissue blocks with the implants and the surrounding bone tissue were removed and processed according to a histological protocol for hard tissues on non-decalcified ground sections. The samples were studied by light and electron scanning microscopy, histometric analysis was performed to assess the percentage of bone in direct contact with the implant surface and a statistical analysis of the results was performed. RESULTS: In the samples analyzed 4 weeks after implantation, the percentage of bone tissue in direct contact with the implant surface for the four groups were 57.66±24.39% (N), 58.62±20.37% (N+PRGF), 70.82±20.34 % (N+M) and 33.07±5.49% (C). In the samples with 8 weeks of implantation time, the percentage of bone in direct contact was 63.35±27.69% (N), 58.42±24.77% (N+PRGF), 78.02±15.13% (N+M) and 40.28±27.32% (C). In terms of the percentage of bone contact, groups N and N+M presented statistically significant differences from group C in the 4-week trial test (P<0.05; ANOVA). For the 8-week results, only group N+M showed statistically significant differences when compared with group C (P<0.05; ANOVA). CONCLUSION: In conclusion, the NuOss™ granules/RCM(6) membrane combination presented a percentage of bone contact with the implant surface statistically greater than in the other groups.

The consequences of orofacial trauma resulting from violence: a study in Porto.

Orofacial injuries resulting from violence are a fairly common event. In Portugal, however, the impact of these injuries remains to be elucidated. This study aims to analyze the injuries and permanent consequences of orofacial trauma (in a three-dimensional perspective: organic, functional and situational), resulting from violence. To do so, a retrospective analysis of all violence-related forensic reports performed in the North Branch of the National Institute of Legal Medicine, during 2007, was carried out (n = 513). It was found that most victims were men with a mean age of 35.4 (SD = 15.1). Most aggressions were due to punches and/or kicks. The most frequent orofacial injuries were lip injuries (57.7%), followed by extra-oral soft tissue injuries (35.9%), gingival and oral mucosa injuries (29.2%), and teeth and/or periodontal injuries (17.5%). The most frequent long-term consequences concerned the teeth and periodontal area (14.0%), followed by the lip area (7.4%), and gingival and oral mucosa tissues (3.9%). In terms of the effect on functions and life situations, it was found that chewing and embarrassment in social life events were the most prevalent (43.6% and 83.6%, respectively). These results showed that orofacial trauma from violence-related events can damage a person's quality of life, especially those concerning the teeth area, as a result of their implications in normal function and in life situations.

Orofacial damage resulting from road accidents.

The objective of this paper was to study the epidemiological characteristics of orofacial damage resulting from road accidents among victims assessed in the Oporto delegation of the Legal Medicine Institute, in Portugal. It was also our goal to analyze in which way orofacial sequelae was reflected in the victims' complete social reintegration.