The relationship of previous dental trauma with new cases of dental trauma. A systematic review and meta-analysis.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are a public health concern with high prevalence and recurrence rate. The aim of this study was to perform a systematic review and meta-analysis to determine whether previous dental trauma is a predictive factor for new episodes of TDI (recurrence or first episodes). MATERIALS AND METHODS: Electronic searches were performed with no language or date restrictions. According to the PECOS strategy, cohort studies that investigated subjects with and without previous TDI, and its association with new TDI episodes, as primary or secondary outcomes, were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies into deciduous and permanent dentition, and the risk ratio (RR) was also calculated (P ≤ 0.05). The evidence was quality-tested using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: After titles and abstracts were examined, and full texts were read, five studies were included in this systematic review. Four studies had high methodological quality, and one presented a risk of bias on confounding factors. No association and a positive association were determined between previous history of TDI and new episodes of TDI in the primary (RR 1.26 [0.99, 1.62], P = 0.06) and in the permanent dentitions (RR 2.68 [1.20, 4.19], I2  = 37%, P < 0.00001), respectively. The pooled results demonstrated a positive association (P < 0.00001) between previous dental trauma and new episodes of TDI (RR 2.17 [1.20, 3.90], P = 0.01, I2  = 83%) with moderate evidence quality level. CONCLUSIONS: Individuals that have suffered previous TDI present a greater risk of suffering new episodes of TDI.

Suppuration-associated bacteria in patients with chronic and aggressive periodontitis.

BACKGROUND: Suppuration (SUP) on probing may be an indication of active periodontal breakdown. The aim of the present study is to analyze which subgingival species are associated with SUP in patients with chronic (CP) and aggressive (AgP) periodontitis. METHODS: A total of 156 patients with CP and 66 with AgP were submitted to full-mouth periodontal examination and subgingival biofilm sampling (14 sites/patient). The counts of 44 bacterial species were determined by checkerboard. Comparisons between groups and sites were analyzed by the Mann-Whitney and Wilcoxon tests, respectively. Associations between frequency of SUP and bacterial species were analyzed by the Spearman correlation coefficient. RESULTS: The prevalence of SUP in patients with CP was 24.4%, and in patients with AgP it was 30.3%, and the percentage of SUP sites in the groups was 5.72% ± 1.06% and 6.96% ± 1.70%, respectively (P >0.05). SUP sites from patients with CP had significantly higher counts of Veillonella parvula, Dialister pneumosintes, Tannerella forsythia, and Prevotella nigrescens than SUP sites from patients with AgP (P <0.005). Significant positive correlations between high frequency of SUP and high levels of Actinomyces spp, Streptococcus spp., members of the orange complex, Acinetobacter baumannii, and Pseudomonas aeruginosa were observed in patients with CP (P <0.05). In patients with AgP, Actinomyces oris, Propionibacterium acnes, P. aeruginosa, Staphylococcus aureus, and Streptococcus sanguinis were positively associated with SUP, whereas Prevotella intermedia presented a negative association with SUP (P <0.05). CONCLUSIONS: SUP sites from patients with CP harbored significantly higher counts of several periodontal species than SUP sites from patients with AgP. Actinomyces spp., Streptococcus spp., members of the orange complex, T. forsythia, and certain non-oral pathogens were associated with a high number of sites with SUP.