Occlusal Radiographs in a Turkish Pediatric Subpopulation.

Objectives: Dental radiographs are a useful diagnostic aid in the oral health care and dental treatment of children. The most commonly used radiographs are periapical and panoramic radiographs. Occlusal radiographs are preferred in more specific cases. The aim of this study was to retrospectively evaluate the reasons for obtaining occlusal radiographs in pediatric patients. Material and methods: Occlusal radiographs of patients aged 1-13 years who attended the Pediatric Dentistry Clinic of Ondokuz Mayis University Faculty of Dentistry between 01 August 2015 and 01 August 2020 were retrospectively evaluated. Patients with syndromes and diseases that could cause cleft lip and palate and dental anomalies were not included in the study. The medical history of the 354 patients who were included in the study was provided by the automated system. Results: A total of 359 occlusal radiographs from these patients were analysed. The number of male patients included in the study was 208 and the number of female patients was 146. Occlusal radiographs of the maxilla of 312 patients were taken, of the mandible of 37 patients, and both the upper and lower jaws of 5 patients. It was found that occlusal radiographs were taken mostly for dental trauma in the permanent dentition (156), injuries in the primary dentition (68) and for the diagnosis of dental anomalies (57). Conclusions: Occlusal radiographs are taken for specific situations in pediatric dentistry and are particularly useful in the detection and diagnosis of primary and permanent tooth injuries.

Awareness about emergency management of avulsed tooth among intern dentists-a cross-sectional observational study.

Tooth avulsion is a frequently encountered dental emergency. Children are commonly reported group due to frequent sports activities, trauma, accidents and falls. Prompt emergency management is vital for long term success and to avoid morbidity. The study was aimed to assess the understanding of intern dentists about the emergency handling of avulsed teeth cases as mostly they are first responders among health care personnel. In this study a fourteen-item questionnaire with predefined responses was shared as online Google survey form with intern dentists of 5 different dental teaching hospitals of Islamabad, Pakistan. The duration of the study was 6 months (01 March 2022 to 31 August 2022). The questions were intended to collect personal information and to check level of knowledge and awareness about the management of avulsed tooth among the dental interns. The data was analyzed by statistical methods and is presented through tables and descriptive methods. In total, 152 participants completed the shared questionnaire. The vast majority (71%) of them were aware of the initial management of avulsed teeth, 49% were aware of the ideal transport medium for an avulsed tooth, (43%) were aware of the critical time for successful replantation, while (62%) had knowledge of the multiple factors responsible for the outcome of the tooth replantation. For majority of the statements, female participants had better knowledge as compared to their male counterparts. Statistically significant difference was noted for the statement "If you found the knocked-out tooth and it is dirty what will be your initial approach?" with female participants having better knowledge as compared to the male (p value = 0.005). Based on our study results, generally dental interns are well-informed but still lack expected level of awareness regarding the proper management protocol for avulsed tooth. Hence, improvement is needed regarding the effective handling of avulsed teeth cases.

Prevalence of orofacial injuries resulting from trauma in individuals with cerebral palsy: A systematic review and meta-analysis.

Individuals with cerebral palsy (CP) may have cognitive, sensitive, behavioral, communicative, and convulsive disorders. Because defensive reflexes are reduced by CP, the risk of orofacial trauma is greater in these individuals. This study aimed to evaluate the prevalence of orofacial injuries resulting from trauma in patients with CP. This review was reported according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO-CRD42022293570). The search was performed for articles published until January 2023 in Embase, Latin American and Caribbean Literature on Health Sciences (LILACS), PubMed/Medline, Scopus, and Web of Science databases. Gray literature was also consulted through Google Scholar, OpenGrey, ProQuest Dissertations, and Theses. Studies in which orofacial injuries due to trauma were prevalent in individuals with CP were included. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Additionally, a random-effects meta-analysis was conducted. Twelve studies were included in the synthesis, of which nine presented a low risk of bias and three presented a moderate risk. When considering the general prevalence of orofacial injuries in patients with CP, a prevalence of 34% [95% CI = 18%-52%; I2 = 98%] was observed, with enamel and dentin fractures being the most common orofacial injuries. Approximately one in three patients with CP showed at least one type of orofacial injury involving dental trauma. There is a lack of literature assessing the prevalence of these traumas in soft tissues and the evidence for this outcome remains uncertain.

Knowledge of Brazilian Dentists about Dentoalveolar Trauma Care and their Experiences during the COVID-19 Pandemic

ABSTRACT Objective: To assess dentists' knowledge from Minas Gerais, Brazil, about dentoalveolar trauma (DT) and their experiences during the COVID-19 pandemic. Material and Methods: An online questionnaire with 34 questions was applied to collect personal data, professional training, self-assessment of experience/knowledge about DT, experience in care provided during the social distancing, and knowledge/conduct. The specific responses were evaluated based on the guidelines of the International Association of Dental Traumatology (IADT). Descriptive analysis and Pearson's chi-square test were performed. The level of significance was set at p≤0.05. Results: Most professionals (97.7%) had received information on DT, and only 4.6% of the participants considered their knowledge poor or very poor. However, 92.7% felt the need for more information on the subject. Regarding experiences during the pandemic, 55.7% provided trauma care during that period. Forty percent of the consultations were performed in person, and 33.3% of the professionals noted an increase in cases during the pandemic; 56.6% reported that the frequency did not change. The overall mean number of correct answers about DT was 5.29±2.11, indicating an acceptable level of knowledge. The mean percentage of hits for the specific questions was 44.1%. Conclusion: Although the level of knowledge of the dentists evaluated was acceptable, some aspects were deficient, with the need for more information about the IADT guidelines.

Evaluation of dental trauma associated with cycling accidents in a city in the south of Brazil: an observational study / Avaliação de traumatismos dentários associados a acidentes com bicicletas em uma cidade do sul do Brasil: um estudo observacional

Aim: to evaluate the cyclists' profile and the frequency of dental trauma associated with cycling in a southern city in Brazil. Materials and Methods: a questionnaire was applied to 234 cyclists with at least 18 years old. The variables of interests were: sociodemographic data, data related to the profile of users, and data on the occurrence of all traumas and dental traumas. Descriptive and inferential statistical analyses were carried out (α=5%). Results: The mean age of participants was 31.38 ± 11.6 years, ranging from 14 to 67 years. The majority of the participants were male (62.8%), had attended higher education (45.7%), and had incomes equivalent to 1 to 3 times the minimum wage (39.3%). The main reason given for riding a bicycle was leisure (35.9%). Users of their own bicycles had fewer items of mandatory safety equipment fitted to their bicycles than users of rented bicycles (Student's t test, P<0.0001). However, study participants riding their own bicycles wore personal protective equipment more frequently than renters (Student's t test, P<0.0001). Moreover, 33.7% of the respondents reported having suffered an accident, and 25% had traumatized some part of the body. Among those who reported traumas, 20% (4/20) had suffered traumas to hard dental tissues and supporting structures. Discussion: Dental trauma was not frequent in a population predominantly from an urban area that uses bicycles, especially for leisure, despite the prevalence of accidents involving bicycle use. Conclusion: Health education campaigns should emphasize the importance of personal protective equipment for cyclists and of safety items fitted to bicycles, whether cyclists' own or rented.

Objetivo: avaliar o perfil dos ciclistas e a frequência de traumatismo dentário associado ao ciclismo em uma cidade do sul do Brasil. Materiais e Métodos: aplicou-se um questionário a 234 ciclistas com idade mínima de 18 anos. As variáveis ​​de interesse foram: dados sociodemográficos, dados relacionados ao perfil dos usuários e dados sobre a ocorrência de todos os traumatismos e traumas dentários. Foram realizadas análises estatísticas descritivas e inferenciais (α=5%). Resultados: A idade média dos participantes era de 31,38 ±11,6 anos, variando de 14 a 67 anos. A maioria dos participantes era do sexo masculino (62,8%), tinha curso superior (45,7%) e renda equivalente a 1 a 3 salários mínimos (39,3%). O principal motivo para andar de bicicleta foi lazer (35,9%). Usuários de suas próprias bicicletas tinham menos itens de equipamentos de segurança obrigatórios instalados do que os usuários de bicicletas alugadas (teste t de Student, P<0,0001). Porém, participantes do estudo que andavam em sua própria bicicleta usavam equipamentos de proteção individual mais frequentemente do que os locatários (teste t de Student, P<0,0001). Ainda, 33,7% dos entrevistados relataram ter sofrido algum acidente e 25% traumatizado alguma parte do corpo. Entre os que relataram traumatismos, 20% (4/20) sofreram traumas em tecidos duros dentais e estruturas de suporte. Discussão: O traumatismo dentário não foi frequente em uma população predominantemente de área urbana que utiliza bicicletas, principalmente para lazer, apesar da prevalência de acidentes envolvendo o uso de bicicletas. Conclusão: As campanhas de educação em saúde devem enfatizar a importância dos equipamentos de proteção individual dos ciclistas e dos itens de segurança instalados nas bicicletas, sejam elas próprias ou alugadas.

Dental trauma trends in emergency care:a comparative analysis before, during, and after COVID-19.

Objectives: This analysis details the characteristics of dental trauma in South Korea during the coronavirus disease 2019 (COVID-19) (DC) pandemic and compares them in patients before and after COVID-19 (BC and AC, respectively). Materials and Methods: Data were collected from medical records of patients who visited Seoul National University Bundang Hospital's Emergency Dental Care Center during three 12-month periods: BC, DC, and AC (BC from March 1, 2019 to February 29, 2020; DC from March 1, 2020 to February 28, 2021; AC from March 1, 2022 to February 28, 2023). A retrospective review was conducted to investigate patient age, sex, time of visit, cause, and diagnosis. The study included 1,544 patients: 660 BC, 374 DC, and 510 AC. Results: Significant difference in age and sex was not observed among the three periods; 1-9 years of age was the largest group (38.3% in BC, 29.6% in DC, and 27.8% in AC), and the percentage of male patients was greater than of female patients (male proportion as 63.5% in BC, 67.4% in DC, and 64.9% in AC). The number of patients generally peaked at a Saturday night in spring (for BC: May, Saturday, 18:00-19:59; for DC: March, Saturday, 18:00-19:59; for AC: April as the second most (October as the most peaked), Saturday, 20:00-21:59). The primary etiology of the dental trauma was identical in the three periods: falls, followed by sports. The most frequent diagnosis was laceration, followed by tooth avulsion and jaw fracture. Conclusion: Significant differences were not found between the characteristics and patterns of dental trauma in the BC, DC, and AC periods. However, due to the pandemic and social distancing, activities decreased and associated dental trauma-related incidents declined.

Medico-legal liability of injuries arising from laryngoscopy.

OBJECTIVE: Dental and mucosal injuries from laryngoscopy in the peri-operative period are common medico-legal complaints. This study investigated lawsuits arising from laryngoscopy. METHODS: Westlaw, a legal database containing trial records from across the USA, was retrospectively reviewed. Plaintiff and/or defendant characteristics, claimed injuries, legal outcomes and awards were extracted. RESULTS: Of all laryngoscopy-related dental or mucosal injuries brought before a state or federal court, none (0 per cent) resulted in a defence verdict against the provider or monetary gain for the patient. Rulings in the patient's favour were observed only when laryngoscopy was found to be the proximate cause of multiple compounding complications that culminated in severe medical outcomes such as exsanguination, septic shock or cardiopulmonary arrest. CONCLUSION: Proper laryngoscopy technique and a robust informed-consent process that accurately sets patients' expectations reduces litigation risk. Future litigation pursuits should consider the low likelihood of malpractice allegation success at trial.

Endodontic and restorative management of an adult with avulsion of multiple teeth: A case report with 5 years and 9 months of follow-up.

Simultaneous avulsion of four or more teeth is a rare event. This case report examines the dental care given to an adult who, during a bicycle accident, experienced the avulsion of a mandibular incisor as well as all of his maxillary incisors. In the immediate aftermath of the accident, four out of the five incisors were located, promptly collected, and stored in a tooth rescue box, all within a 20-min window. Replantation and splinting were performed on the day of the accident. Endodontic treatment involved sequential intracanal dressing with an antibiotic-corticosteroid paste followed by calcium hydroxide prior to root canal obturation. 3 months post-accident, signs of external replacement resorption (ERR) began to appear in all the replanted teeth. The gap created by the missing maxillary central incisor was managed with a three-unit fixed dental prosthesis, despite the onset of ERR in the incisors used as abutment teeth. Regular follow-ups showed a relatively slow ERR progression rate over a span of nearly 6 years. The patient expressed satisfaction with both the esthetic and functional outcomes. This case, marked by multiple avulsions, underscores the importance of immediate and appropriate intervention alongside the imperative for carefully considered long-term management strategies. Given the decelerated bone remodeling rate in adults, ERR generally progresses at a slower pace than in children. Accordingly, this case demonstrates the viability of retaining replanted teeth over the long term, even when these teeth have been subjected to nonphysiological storage for extended durations, a factor known to impede periodontal healing.

Development and psychometric properties of a questionnaire about knowledge of lay people about traumatic dental injury.

BACKGROUND/AIMS: The level of knowledge about traumatic dental injuries (TDI) of lay people from a national point of view has never been studied and there is currently a lack of validated research instruments on this issue. The present study aims to develop and validate a questionnaire (TDI-Q) to assess the knowledge of lay people about TDI, including participants from the five regions of Brazil. MATERIAL AND METHODS: TDI-Q was drafted, in Brazilian Portuguese, based on the recommendations of the International Association of Dental Traumatology (IADT). Before its application, TDI-Q was evaluated by dentists, lay people, linguists, and psychometrists. The questionnaire was applied to measure temporal stability at two distinct times, with an interval of 15-20 days between the two applications: test (n = 110) and retest (n = 50). The presence of floor and ceiling effects were investigated by analyzing the frequency of responses of the questionnaire; convergent construct validity was tested through Spearman's correlation; the Mann-Whitney test was applied to discriminant construct validity. Temporal stability and internal consistency were evaluated through intraclass correlation coefficient and Cronbach's alpha, respectively. RESULTS: The floor and ceiling effects were not observed (0.9% and 2.7%, respectively); convergent validity analysis indicated a positive and strong correlation (r = 0.50; p < .001). Significant discriminant construct validity (p < .05) was observed. Satisfactory internal consistency (α = 0.7) and temporal stability (ICC = 0.82, p < .001) were also achieved. CONCLUSION: TDI-Q proved to have good psychometric properties and to be a reliable tool for evaluating the knowledge of lay people regarding TDI in the Brazilian population.

Middle superior and anterior superior alveolar nerve injury following trauma to the maxillary sinus: a prospective clinico-radiographic evaluation.

Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

Validation of an educational comic book to guide conducts in situations of dental trauma.

BACKGROUND/AIM: Childhood dental trauma poses a prevalent concern, and the limited knowledge of lay caregivers toward the needed immediate actions can adversely affect a child's well-being. This study aimed to create and validate an educational comic book for lay individuals, designed to guide immediate actions in dental trauma cases, and assess its effects toward enhancing reader knowledge. METHODOLOGY: The four-stage study involved: (1) Literature review and script development; (2) Version 1 of the comic book creation (including illustrations, layout, and design) and Flesch Readability Index (FI) calculation; (3) Version 1 validation by expert judges, assessed by the Content Validity Index (CVI); (4) Version 1 refinement based on the judges' feedback, recalculation of FI, and a pilot test (CVI) involving lay individuals who validated the final material (Version 2). The validation process involved 67 participants, including 13 specialist judges and 54 elementary school teachers. RESULTS: The CVI for Version 1 was calculated at 0.89 (89%), indicating a favorable level of agreement on the evaluated criteria. The FI was determined as 91.1%, indicating a high level of readability. The FI for Version 2 was 92.1% (indicating a very easy level of comprehension). The CVI calculated for the target audience after the pilot test was 0.99 (99%), denoting a substantial agreement among the participants. In assessing the level of knowledge, a significant increase was observed in the rate of correct answers after the comic book was read by lay individuals (p < 0.05), inasmuch as the percentage rose from 50.5% before to 81.2% after reading it. CONCLUSION: The educational comic book proved valid in terms of readability, appearance, and content. Furthermore, it had a positive impact on gaining the knowledge needed to take the appropriate actions, thus making it a valuable tool for guiding the lay population in cases of dental trauma.

Reducing the risk of tooth injury in anterior maxillary interdental osteotomy for cleft lip and palate patients using a surgical navigation technique.

The aim of this study was to investigate the clinical feasibility of preventing tooth injury from anterior maxillary interdental osteotomy by using a surgical navigation technique. A retrospective review was conducted on cleft lip and palate patients treated with anterior maxillary osteotomy followed by distraction osteogenesis between August 2019 and May 2022. Patients operated on through image guidance were enrolled in the navigation group, while those who were operated on freehand were enrolled in the freehand group. Tooth injuries were identified on postoperative images. Linear and angular deviations of the osteotomy line were measured. Twelve patients were enrolled in the study, seven in the navigation group and five in the freehand group. Altogether, 24 osteotomy lines and 53 adjacent teeth were evaluated. The dental injury rate was 3% in the navigation group and 27% in the freehand group (P = 0.016). The average linear deviations (mean ± standard deviation) were 0.67 ± 0.30 mm and 2.05 ± 1.33 mm, respectively (P < 0.001), while the average angular deviations were 1.67 ± 0.68° and 11.41 ± 7.46°, respectively (P < 0.001). The results suggest that navigation was able to reduce the tooth injury risk compared with freehand interdental osteotomies in crowded dental arches.

The Top 100 Most-Cited Articles on Permanent Teeth Avulsion: A Bibliometric Analysis.

INTRODUCTION: Knowledge of bibliometric indices on the avulsion of permanent teeth can help researchers to identify gaps in the literature. The aim of this study was to analyze the bibliometric characteristics of the 100 most-cited articles on the avulsion of permanent teeth. MATERIALS AND METHODS: Two researchers conducted an unfiltered search in the Core Collection section of the Web of Science (WoS-CC) database. The following data were extracted: position in the citation list, total number and density of citations, title, authors, institution, country, year of publication, journal, keywords, study design, tooth storage medium, and other topics of interest. Bibliometric networks were generated and analyzed using the VOSviewer software. Descriptive analysis and a Poisson regression analysis were performed (P < .05). RESULTS: The number of citations per article varied between 31 and 407. The average was 70.05, and 13 articles received more than 100 citations. J.O. Andreasen (n = 13) and M. Trope (n = 15) were the authors who contributed most often to publications. The United States was the country with the highest number of articles (n = 31). Authors associated with the University of Copenhagen, Denmark (n = 9) and University of North Carolina, USA (n = 10) showed higher productivity. In vitro/animal model studies were the most frequent study designs (n = 50), and the most-discussed topic of interest was prognosis (n = 47). There was strong clustering among 13 research groups. CONCLUSION: Observational studies, published by authors from Europe and about prognosis or treatment presented more citation ratio in WoS-CC. Clinical studies on permanent tooth avulsion are needed to increase the quality of scientific evidence and provide insights for health professionals and public policy makers.

Conhecimento de acadêmicos de Odontologia acerca da avulsão dentária / Knowledge of dental students about tooth avulsion

Objetivo: verificar o conhecimento de acadêmicos de Odontologia de uma instituição de ensino superior da Paraíba acerca da avulsão dentária. Métodos: foi realizado um estudo transversal, no qual 64 acadêmicos responderam um formulário com perguntas objetivas relativas a dados sociodemográficos, período de formação do curso e conhecimento e condutas em casos de avulsão dentária. Foi realizada análise descritiva de frequência absoluta e relativa dos dados (SPSS, v. 20.0). Resultados: a maioria dos acadêmicos recebeu informações sobre avulsão dentária em aulas ministradas no curso (86%) e indicaria a irrigação com soro fisiológico seguida de reimplante quando da ocorrência do trauma há menos de uma hora (64,1%) e há mais de uma hora (43,8%). O tratamento endodôntico foi indicado, independentemente do tempo do dente fora do alvéolo, por 34,4% da amostra. A contenção rígida foi a mais indicada para o dente reimplantado (48,4%) e seu tempo mínimo de proservação radiográfica respondido pela maioria dos pesquisados foi de 6 meses (48,4%). Conclusões: apesar de a maioria dos acadêmicos ter recebido informações acerca da temática, o conhecimento foi considerado insuficiente em relação a condutas referentes ao reimplante dentário, indicação do tratamento endodôntico, tipo de contenção e tempo de proservação.

Objective: to verify the knowledge of dental students from a Higher Education Institution of Paraíba about dental avulsion. Methods: a cross-sectional study was carried out, in which 64 students answered a form with objective questions regarding sociodemographic data, course period, knowledge and conduct in cases of tooth avulsion. Descriptive analysis of absolute and relative frequency of data was performed (SPSS, v. 20.0). Results: most students received information about dental avulsion during the graduation classes (86%) and would indicate irrigation with saline solution followed by reimplantation when the trauma occurred less than one hour (64.1%) and more than one hour (43.8%). Endodontic treatment was indicated, regardless of the time the tooth was out of the dental socket, according 34.4% of the sample. Rigid retention was the most indicated for the reimplanted tooth (48.4%) and six months was the minimum radiographic follow-up time answered by most students (48.4%). Conclusions: although most students have received information about the topic, the knowledge was considered insufficient in relation to some aspects of the protocols recommended for emergency care for dental avulsion, with emphasis on behaviors related to dental reimplantation, indication of endodontic treatment, type of containment and follow-up.

Orthodontic treatment in traumatized permanent teeth: a systematic review / Tratamento ortodôntico em dentes permanentes traumatizados: uma revisão sistemática

Objective: to analyze, through literature review, the available literature on orthodontic treatment in traumatized permanent teeth. Methods: A literature search was performed in electronic databases (PubMed and SciELO) using the descriptors [tooth injuries] OR [injuries, teeth] OR [injury, teeth] OR [teeth injury] OR [injuries, tooth] OR [injury, tooth] OR [tooth injury] OR [teeth injuries] AND [orthodontics]. Observational studies and clinical trials were included, narrative reviews, laboratory and in vitro studies, case reports and series as well as articles that presented abstracts written in languages other than Portuguese, English and Spanish were excluded from the study. Two reviewers considered the eligibility, the risk of bias of the analyzed data and the qualitative synthesis of the studies included. A total of 1,322 references were found and 4 articles met all inclusion criteria and were included in the qualitative analysis. Some consequences like pulp necrosis and root resorption have been highlighted and trauma severity should be considered when orthodontically intervening in previously traumatized teeth. Final considerations: The traumatized teeth can be orthodontically treated as long as the time of tissue reorganization is respected, and the pull and periodontal conditions are followed up.(AU)

Objetivos: analisar, por meio de revisão de literatura, a respeito do tratamento ortodôntico em dentes permanentes traumatizados. Metodologia: Uma pesquisa bibliográfica foi realizada em bancos de dados eletrônicos (PubMed e SciELO) usando os descritores [tooth injuries] ou [injuries, teeth] ou [injury, teeth] ou [teeth injury] ou [injuries, tooth] ou [injury, tooth] ou [tooth injury] ou [teeth injuries] e [orthodontics]. Foram incluídos estudos observacionais e ensaios clínicos, revisões narrativas, estudos laboratoriais e in vitro, relatos de casos e séries, bem como artigos que apresentassem resumos redigidos em idiomas diferentes do português, inglês e espanhol foram excluídos do estudo. Dois revisores consideraram a elegibilidade, o risco de viés dos dados analisados e a síntese qualitativa dos estudos incluídos. Foram encontradas 1.322 referências e 4 artigos atenderam a todos os critérios de inclusão e foram incluídos na análise qualitativa. Algumas consequências como necrose pulpar e reabsorção radicular têm sido destacadas e a gravidade do trauma deve ser considerada na intervenção ortodôntica em dentes previamente traumatizados. Considerações finais: Os estudos incluídos nesta revisão sugerem que dentes traumatizados podem ser tratados ortodônticamente desde que respeitado o tempo de reorganização tecidual e acompanhadas as condições pulpares e periodontais.(AU)

Long Term Outcome of Avulsed Immature Mandibular Incisor with Progressive External Root Resorption: 9 Years Follow-Up.

Background: Avulsion of permanent teeth is the most common in young permanent dentition. Replantation of immature teeth after avulsion represents a major challenge in terms of treatment management and long-term prognosis. This case report describes 9 years of follow-up for an avulsed and replanted immature mandibular lateral incisor with progressive external root resorption. Methods: A 7-year-old patient following an accident in which his mandibular left central incisor was avulsed and replanted within one hour after being stored in a physiological storage medium. However, radiographic examination conducted six weeks after the dental injury revealed inflammatory root resorption of the replanted tooth #31. To address root resorption, endodontic treatment was performed involving the use of calcium hydroxide as an intracanal medication for a short period of time, followed by root canal obturation with mineral trioxide aggregate placed below the crestal bone margin. Results: Three months later the root resorption had progressed. Consequently, a decision was made to perform periodontal surgery. While the long-term follow-up revealed that the inflammatory root resorption had damaged half of the root, the tooth remained functional and aesthetically favourable. Conclusions: Despite the challenges associated with replantation of an immature tooth following avulsion, this case demonstrated favourable outcomes. The tooth maintained its functionality, exhibited favourable aesthetic, and the dimensions of the alveolar ridge were preserved, allowing for the physiological expansion of the dental arch.

Do orthodontic movements of traumatized teeth induce dental pulp necrosis? A systematic review.

INTRODUCTION: Usually, orthodontic movements encompass children and young adult patients, which are more susceptible to the occurrence of traumatic dental injuries. It is necessary to understand whether the effects of orthodontic movements on traumatized teeth could induce pulp necrosis. The aim of this study was to answer the following question: "Do orthodontic movements of traumatized teeth induce dental pulp necrosis?". MATERIAL AND METHODS: Searches were performed for studies published up to May 11, 2023, in the MEDLINE/PubMed, Cochrane Library, Scopus, SciELO Citation Index, Web of Science, EMBASE, and Grey Literature Report databases, without restriction for language or year of publication. The revised Cochrane risk of bias tools for nonrandomized interventions (ROBINS-I) was used to assess the quality of the included studies. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS: Of 2671 potentially relevant studies, five were included. Four were classified as having a moderate risk of bias and one as a serious risk of bias. It was reported a higher susceptibility to pulp necrosis in teeth subjected to orthodontic movements with history of trauma involving periodontal tissues. Additionally, orthodontic movements of traumatized teeth with total pulp obliteration had an increased risk of pulp necrosis. GRADE analysis presented a moderate certainty of evidence. CONCLUSIONS: An increased risk for pulp necrosis when traumatized teeth are subjected to orthodontic movements was verified. However, this is based on evaluations performed with subjective tests. Further well-designed studies are necessary to confirm this trend. CLINICAL RELEVANCE: Clinicians must be aware of the possibility of pulp necrosis. However, endodontic treatment is recommended when verified signs and symptoms of pulp necrosis.

Retrospective Study of Oral and Maxillofacial Trauma in Portuguese Population.

Objective: The increasing significance of medicolegal evaluation following maxillofacial traumatic events constitutes a complex issue. This clinical research aimed to assess the current etiology of oral and maxillofacial injuries in Portuguese population. Material and methods: An epidemiological clinical observational study was conducted in Centro Hospitalar Lisboa Norte on a sample of 384 subjects diagnosed with oral and maxillofacial trauma, between 2018 and 2020. Data were collected through clinical reports and analyzed using SPSS version 27. Results: Women and men were nearly identical in the number and distribution, with 49.5% females and 50.5% males. In 2020, there was a decrease in the number of traumatic incidents compared to other years. Falls or accidental descents were found to be the most common cause of injury, accounting for 44.3%, followed by assaults accounting for 24.7%. A total of 84 subjects exhibited soft tissue injuries related to periodontal region. The upper central incisors (174) were the most frequently affected teeth with uncomplicated fractures, and the predominant form of treatment was the administration of pain medication. Conclusion: A correlation between falls or accidental descents, female subjects, and advancing age, as well as between assaults, male subjects, and adults, has been established. Falls or accidental descents and assault were the predominant etiologies, and the year 2020 exhibited a decrease in the incidents of traumatic events.

Traumatismos dentários na rede social Instagram: um estudo exploratório / Dental trauma on Instagram: an exploratory study / Traumatismos dentoalveolares en Instagram: un estudio exploratorio

Estudo exploratório realizado entre 14/02/2021 e 06/03/2021, visando mapear e caracterizar os perfis sobre traumatismos dentários no Instagram, analisar as publicações quanto ao teor e à qualidade do conteúdo, como também examinar a interação e a prática comunicativa. Foram incluídos 25 perfis que apresentavam baixa audiência e pequena atividade, considerando-se o número de seguidores, a frequência de atualização e o número de publicações. Dezoito perfis eram brasileiros e estavam vinculados a projetos de extensão de Instituições de Ensino Superior (IES). Realizou-se a análise de 13 posts dos três perfis ativos, e verificou-se que eles estavam em conformidade com os protocolos da Associação Internacional de Traumatologia Dentária. As práticas comunicativas eram informacionais não se configurando como espaços de aprendizagem colaborativa. Redes sociais on-line constituem-se atualmente em estratégias importantes para a divulgação científica e a participação cidadã, mas os limites e os desafios do seu uso devem ser levados em conta no planejamento das ações de comunicação institucional em saúde pública

Exploratory study made from 14/02/2021 to 06/03/2021, aiming to map and characterize the profiles about dental trauma on Instagram, besides analyzing the posts according to its content and quality, interac-tions and communicative practice. Twenty-five profiles were included and presented low audience and low activity, considering the number of followers, updating frequency and number of posts. Eighteen of these profiles were Brazilian and had links with Universities Extension Projects. Thirteen posts were analyzed on the three active profiles, and it was verified that they were in conformity to the International Association of Dental Traumatology (IADT). The communicative practices were international, not being configured as collaborative learning spaces. Social media are important strategies to scientific communication and citizen participation, but limits and challenges of its use must be considered on the planning of institutional public health communication

Estudio exploratorio realizado entre el 14/02/2021 y el 06/03/2021, con el objetivo de mapear y caracteri-zar perfiles sobre trauma dental en Instagram, además de analizar publicaciones sobre contenido y calidad del contenido, interaciones y la práctica comunicativa. Se incluyeron 25 perfiles que tenían baja audiencia y poca actividad, considerando el número de seguidores, frecuencia de actualización y número de publica-ciones. Dieciocho perfiles eran brasileños y estaban vinculados a proyectos de extensión de Instituciones de Educación Superior. Se realizó un análisis de 13 publicaciones de los tres perfiles activos y se verificó que cumplían con los protocolos de la Asociación Internacional de Traumatología Dental. Las prácticas comunicativas fueron informacionales, no configuradas como espacios de aprendizaje colaborativo. Las redes sociales constituyen estrategias importantes para la divulgación científica y la participación ciuda-dana, pero los límites y desafíos de su uso deben ser tomados en cuenta a la hora de planificar acciones de comunicación institucional en salud pública

Epidemiology and severity of traumatic dental injuries in permanent teeth: A 20-year retrospective study

Abstract This study aimed to assess the traumatic dental injuries (TDIs) in permanent dentition among patients who attended at the outpatient clinic of a Brazilian dental school, during the last 20 years, and to investigate factors associated with the severity of these injuries. Clinical records of patients who attended a specialized center for dental trauma care in Brazil presenting at least one TDI in a permanent tooth, between the years 2000 and 2019, were reviewed. The data recorded were sex, age, affected arch, etiology, number, and type of the teeth affected, and classification and severity of the TDIs. The diagnosis and classification of the TDIs were based on the guidelines of the International Association of Dental Traumatology (IADT). The severity of each patient's injuries was defined as mild, moderate, or severe. Descriptive statistics, chi-square and multinomial regression analyses were used to evaluate the results. The significance level was set at 5%. A total of 837 clinical records were included, totaling 2357 teeth. Males were more prevalent than females. The patients' age ranged from 5 to 71 years. The most common traumas were avulsion (n=512) and uncomplicated enamel-dentin fracture (n=488). Univariate analyses showed that there was a statistically significant association between age group (p=0.004), etiology (p=0.000) and number of teeth affected (p=0.000) with severity of dental trauma. In conclusion, TDIs that occurred in Piracicaba and region are epidemiologically similar to those found worldwide, and that more severe injuries are related to age range, etiology and number of teeth affected.

Resumo Esse estudo objetivou avaliar as injúrias dentárias traumáticas (IDTs) na dentição permanente entre os pacientes que compareceram ao ambulatório de uma faculdade de odontologia brasileira, durante os últimos 20 anos, e investigar fatores associados à severidade dessas lesões. Os registros clínicos dos pacientes que compareceram a um centro especializado de atendimento em traumatismo dentário no Brasil apresentando pelo menos uma IDT em dente permanente, entre os anos de 2000 e 2019, foram revisados. Os dados registrados foram sexo, idade, arco dental afetado, etiologia, número e tipo dos dentes afetados, e classificação e severidade das IDTs. O diagnóstico e a classificação das IDTs foram baseados nas diretrizes da Associação Internacional de Traumatologia Dentária (AITD). A gravidade das lesões de cada paciente foi definida como leve, moderada ou severa. Estatísticas descritivas, teste qui-quadrado e análises de regressão multinomial foram usadas para avaliar os resultados. O nível de significância foi fixado em 5%. Um total de 837 registros clínicos foi incluído, totalizando 2357 dentes. O sexo masculino foi mais prevalente que o feminino. A idade dos pacientes variou de 5 a 71 anos. Os traumas mais comuns foram avulsão (n=512) e fratura não-complicada do esmalte-dentina (n=488). As análises univariadas mostraram que houve associação estatisticamente significativa entre a faixa etária (p=0,004), etiologia (p=0,000) e número de dentes afetados (p=0,000) com a gravidade do traumatismo dentário. Em conclusão, as IDTs que ocorreram em Piracicaba e região são epidemiologicamente semelhantes aos encontrados em todo o mundo, e que lesões mais graves estão relacionadas à faixa etária, etiologia e número de dentes afetados.