Traumatic dental injury.

BACKGROUND: The aim of this study was to retrospectively evaluate the incidence of traumatic dental injury and consequential dental impairment following road traffic accidents and to examine the factors that can affect the monetary value of compensation for bodily injury payable pursuant to current insurance regulations. METHODS: From 2004 to 2014, 7233 persons involved in road traffic accidents in the province of Messina, eastern Sicily, were examined by insurance physicians to assess bodily injury damage. Data were collected from cases of traumatic dental injury causing malocclusion and temporomandibular joint dysfunction, either alone or concomitant with injuries to other parts of the body. Injury characteristics and consequential bodily injury damage were classified and the incidence calculated using Microsoft Excel software. RESULTS: The incidence of traumatic dental injuries was 3% of the total population (195 subjects - 127 males and 68 females); the majority of cases (56%) involved riders of two-wheeled vehicles. A high percentage of riders received injury to one or more teeth, i.e. fractures and dislocations, more frequently to the anterior teeth (68%) than the posterior teeth because of their position in the dental arch. Temporomandibular joint injuries were far fewer (8%) and resulted from either direct or indirect trauma associated with severe head and/or neck injury. The incidence of permanent bodily damage consequential to these injuries was fairly low. CONCLUSIONS: Although the incidence of dental trauma following road traffic accidents is low, the monetary compensation for consequential dental impairment based on current insurance regulatory law is far from negligible.

Incisor trauma and early treatment for Class II Division 1 malocclusion.

This study investigated incisor trauma in children with overjets greater than or equal to 7 mm who were enrolled in a clinical trial of 2-phase early orthodontic treatment for Class II malocclusion. In phase 1, children were randomly assigned to treatment in the mixed dentition with either modified bionator or combination headgear or to a group in which treatment was delayed until the permanent dentition. All children received comprehensive treatment during phase 2 if necessary. At the start of the trial, 29.1% of the patients had already had some incisor trauma. This was not significantly related to dental developmental age. During the trial, there was an increase in trauma in all 3 groups, but the magnitude of this increase was not significantly greater in the group for which treatment was delayed until the permanent dentition. This might suggest that orthodontic intervention aimed at reducing trauma should begin very soon after the eruption of the maxillary incisors. However, the injuries tended to be minor, and the expected cost of treatment related to incisor trauma was small compared with the expected additional cost of a 2-phase orthodontic intervention.

Treatment of traumatic dental injuries. Shift in strategy.

A more conservative approach to the treatment of traumatic dental injuries has been made possible by knowledge concerning the pathogenesis of external root resorption, increased knowledge about wound healing processes in the pulp and periodontium, as well as by advances in restorative dentistry (reattachment of crown fragments with a dentin bonding system, the use of adhesive bridges, and advances in autotransplantation and implantation). However, a rethinking by the public, clinicians, and third-party payers is necessary for these procedures to gain wider acceptance. The present article describes the state of the art of treating dental trauma in the hope that these advances can become an accepted part of the dental trauma armamentarium and not merely scientific curiosities.

Maxillofacial and dental ice hockey injuries.

Maxillofacial and dental ice hockey injuries in Finland were studied during 1979 to 1985. A total of 6,885 accidents occurred to registered players between 1979 and 1982, and 791 (11.5%) of them affected the maxillofacial and dental regions. There were 1,401 separate injuries during the same period, 1,184 of which (84.5%) affected the teeth. The most common cause of accidents (in 54.1% of cases) was a blow received from a stick. Maxillofacial and dental injuries accounted for 38.0% of the total cost of all ice hockey injuries. The mean cost of maxillofacial and dental injuries was over 3 times as high as that for ice hockey injuries as a whole. The use of a mandatory full-cage face mask greatly reduced the number of maxillofacial and dental injuries and hence the cost of treatment.

[A plea for better compensation for dental lesions in adults under common law]. / Plaidoyer pour une meilleure indemnisation du dommage dentaire de l'adulte en droit commun.

Compensation for dental damage in the adult (common law) must follow the physiological deficit and its consequences as closely as possible. Any dental loss must be compensated, but also any relative loss when dental trauma requires therapeutic mortification. Loss of the canines, of functional dental groups, unilateral posterior prostheses with prolongation, temporomandibular dysfunction and prosthetic difficulties must be taken into account in order to ensure just compensation for damage sustained. Prostheses and their replacement must be compensated separately from injury compensation. Accessory consequences linked to dental damage must not be neglected.