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.

Union between deciduous and permanent as intrusive luxation sequelae: A case report.

Traumatic dental injuries (TDI) are common in children due learning to walk and lack of balance that leads to falls. Luxation is the trauma that occurs most frequently in the deciduous, being that the intrusive and the avulsive are the ones that cause more damage to the permanent successors. The potential to cause disturbances to the developing permanent germ is high due to anatomical proximity and depends on age, direction of intrusion, severity and treatment. The consequences to the permanent range from hypocalcifications of enamel to retention of the permanent germ. In this case, the developmental disturbance of the tooth 21 presenting with acute dentoalveolar abscess was a result of a three-degree intrusive luxation of the deciduous predecessor. The tooth 61 was misdiagnosed initially as avulsion, but it was a total intrusion as uncovered after a radiographic examination that showed an image suggestive of the presence of the deciduous tooth. The deciduous was extracted along with his permanent successor through outpatient procedure under antibiotic coverage and local anesthesia. The macro and microscopic analysis of the piece evidenced the presence of elements 21 and 61 closely united, as well as alterations provoked in both. There was remission of the infectious process and after 7 days it was verified the correct healing of the surgical wound. The radical outcome of this case emphasizes the relevance of appropriate clinical support as soon as possible in all TDI.

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.

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.

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.

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.

The relationship between traumatic dental injuries and adolescents' non-suicidal self-injury behaviour: A cross-sectional analysis of an East London cohort.

BACKGROUND/AIM: Recent reviews of case reports have pointed out a potential connection between non-suicidal self-injury (NSSI) and traumatic dental injuries (TDIs). The aim of this study was to investigate the association of a history of NSSI with TDIs in 15- to 16-year-old adolescents. METHODS: This study analysed cross-sectional data from the Research with East London Adolescents Community Health Survey, a prospective population survey of adolescents attending state schools in East London, England. The history of NSSI was obtained using two items from the Lifestyle and Coping questionnaire (whether they have ever engaged with self-harm and the last time they engaged in such behaviours). The presence of TDIs, increased overjet and inadequate lip coverage were determined through clinical assessments by two trained dentists. Survey logistic regression was fitted to test the association of NSSI with TDIs. Odds ratios (ORs) were adjusted for socio-demographic and clinical characteristics as potential confounders. RESULTS: The lifetime and last-year prevalence of NSSI were 11.9% and 6.7%, respectively, whereas the prevalence of TDIs was 16.5%. Neither the lifetime prevalence of NSSI (OR: 1.02, 95% confidence interval: 0.56-1.85) nor the last-year prevalence of NSSI (OR: 0.76, 95% CI: 0.36-1.61) were associated with TDIs in regression models adjusted for confounders. CONCLUSION: This study did not support an association between history of NSSI and TDIs among adolescents aged 15-16 years old in East London.

Conservative management of a horizontal root fracture in a primary maxillary central incisor: Case report.

Dental trauma occurs frequently in toddlers and the treatment protocols vary depending on each case. Thus, clinicians must not only plan the treatment but also consider any possible sequelae and characteristics related to the child and the family. The aim of this paper was to report a case of a three-year-old boy who had a horizontal root fracture in the middle third of the primary maxillary right incisor root (tooth 51) and crown discoloration of the primary maxillary left incisor (tooth 61) which were successfully treated with conservative management. The management was established in agreement with the family and was based on active surveillance. The clinical and radiographic follow-ups showed no changes besides pulp canal calcification of the left incisor throughout the eight years of follow-up. The pulps remained normal with no pathological signs throughout their life cycle and the permanent successors erupted normally, presenting an excellent result of the non-invasive approach adopted.

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.

Mothers' knowledge and self-reported performance regarding the management of traumatic dental injuries and associated factors: a cross-sectional study.

BACKGROUND: Dental trauma is common among children. It has negative effects on a child's quality of life. Parental knowledge, especially among mothers is an important factor for the long-term success of this emergency. This study aimed to investigate mothers' knowledge and self-reported performance regarding the management of traumatic dental injuries and associated socio-demographic factors. METHODS: In this cross-sectional study, 277 mothers of children (8-12 years) attending the pediatrics department of Alborz dental school were studied by convenience sampling. The participants completed a valid reliable questionnaire about the management of traumatic dental injuries. The predictor variables were the child's gender, maternal education and employment status, economic status, and accommodation status. The outcome variables were the mothers' knowledge about the management of traumatic dental injuries (Eight statements with 10 scores) and self-reported performance including four case scenarios of traumatic dental injury (Five questions with 7 scores). Data were analyzed by T-test or One-way ANOVA to test the within-group changes, Pearson's correlation coefficient and Linear multiple regression to examine the effect of predictor variables on maternal knowledge and self-reported performance. RESULTS: The mean score of mothers' knowledge was 3.43; SD = 1.58 (total score ranged from 0 to 10). The mean score of mothers' performance was 3.38; SD = 1.2 (total score ranged from 0 to 7). Mothers who work (p < 0.001) and mothers with high qualifications (p < 0.001) had higher knowledge. Furthermore, mothers who work (p = 0.011), mothers with high qualifications (p < 0.001), and those who have had previous experience with traumatic dental injuries (p < 0.001) had higher self-reported performance. The results of multiple linear regression analysis demonstrated the association between mothers' knowledge with mothers' education (ß = 0.22, p = 0.001) and mothers' employment status (ß = 0.15, p = 0.017), while there is a relationship between mothers' self-reported performance and mothers' education (ß = 0.27, p < 0.001). CONCLUSION: Since the means of mothers' knowledge and performance scores regarding dental trauma management, were less than half of the obtainable scores as well as mothers have a crucial role in the children's oral health, it is important to increase the mothers' knowledge and improve their performance in this context. Therefore, running educational programs is necessary for this respect.

Present status and future directions: Endodontic management of traumatic injuries to permanent teeth.

The prognosis of traumatized teeth depends largely on the fate of the pulp and its treatment. This review aims to update the present status on the endodontic management of traumatic injuries to permanent teeth and to identify relevant research areas that could contribute to an improvement in diagnosis and treatment of traumatized permanent teeth. Future research should pay greater attention to (1) diagnostic methods to assess the perfusion of the pulp and enhance detection of tooth cracks and initial signs of root resorption; (2) improved materials for vital pulp treatment; (3) studies focusing on type and duration of splinting after root fractures; (4) antiresorptive intracanal medication in case of posttraumatic pulp necrosis and infection-related resorption and (5) long-term data on the apical barrier technique compared to revitalization.

Evolution of root length throughout orthodontic treatment in maxillary incisors with previous history of dental trauma: a longitudinal controlled trial.

OBJECTIVES: To compare changes in root length of maxillary incisors with and without dental trauma throughout orthodontic treatment. MATERIALS AND METHOD: Patients younger than 18 years, with trauma on at least one maxillary incisor, undergoing orthodontic treatment between 2017 and 2021 were included, using the contralateral side as control without trauma when available. Periapical radiographs were taken pre-treatment and at 6 months intervals, and root/crown ratio was calculated. Linear mixed models were used to describe the evolution of root length at the different time points and to compare trauma and control values. Differences between central and lateral incisors and between treatment modalities were additionally explored. RESULTS: A total of 1768 measurements were performed on 499 teeth (201 with trauma) in 135 patients. Incisor root length significantly decreased during orthodontic treatment in teeth with and without trauma. Lateral incisors with trauma were more susceptible to root resorption than those without trauma and central incisors. No significant decrease in root length was observed with removable appliances, which never exceeded 15 months of treatment. Treatment with fixed appliances led to gradually increasing, significant root length shortening in teeth with and without trauma. CONCLUSION: Treatment duration directly correlated with root length shortening both in teeth with and without trauma history. Teeth with trauma showed significantly more root resorption after treatment with fixed appliances while removable appliances had no significant influence on root length. CLINICAL RELEVANCE: Previous history of dental trauma is no absolute contra-indication to start orthodontic treatment, as long as treatment duration is kept as short as possible.

Anatomical distribution of mandibular fractures from severe bicycling accidents: A 12-year experience from a Norwegian level 1 trauma center.

BACKGROUND/AIM: The mandible makes up a substantial part of the lower face, and is susceptible to injury. Even in helmeted cyclists, accidents may lead to fractures of the mandible because conventional helmets provide little protection to the lower part of the face. In addition, some studies indicate that helmets may lead to an increased risk of mandibular fractures. Thus, the aim of this study was to examine the anatomic distribution of mandibular fractures in injured cyclists and to assess if helmet use influenced the fracture locations. MATERIAL AND METHODS: Data from a Norwegian Level 1 trauma center were collected in the Oslo University Hospital Trauma Registry over a 12-year period. Of 1543 injured cyclists, the electronic patient charts of 62 cyclists with fractures of the mandible were retrospectively evaluated in detail. Demographic data, helmet use, and fracture type were assessed. RESULTS: Sixty-two patients (4%) had fractures of the mandible, and women had an increased risk (OR 2.49, 95% CI 1.49-4.16, p < .001). The most common fracture site was the mandibular body, followed by the condyle. Isolated mandibular fractures occurred in 45% of the patients and 55% had other concomitant facial fractures. There were 42% of the patients with fractures in multiple sites of the mandible, and 42% had a concomitant dentoalveolar injury. Half of the cyclists were wearing a helmet at the time of the accident and 39% were not. There was no significant difference in fracture distribution between the helmeted and non-helmeted groups. CONCLUSIONS: Fracture of the mandibular body was the most prevalent mandibular fracture type following bicycle accidents. Women had an increased risk of mandibular fractures compared with men, whereas helmet wearing did not affect the anatomical fracture site.

Effectiveness of the ToothSOS App as a training tool for the emergency management of traumatic dental injuries among non-dentists.

BACKGROUND/AIM: Traumatic dental injuries (TDIs) are a major and urgent problem in oral health. Therefore, non-dentists need to be conscious of the emergency management of TDIs. The aim of this study was to assess the effectiveness of the ToothSOS App on the level of knowledge about emergency management of TDIs among people who are not dental professionals. MATERIALS METHODS: One hundred and five non-dentists, aged 22-57 years, participated in this study and were given training on TDIs. The ToothSOS App launched by the IADT was used as a training tool. A 25-question survey was conducted three times; before the ToothSOS App was downloaded and reviewed (T0 ), immediately after (T1 ), and one month later (T2 ). RESULTS: There was a statistically significant difference among the three time periods (p < .001) in terms of the knowledge about the management of TDIs, and the knowledge increased significantly (p < .001) at both T1 and T2 after reviewing the ToothSOS App. On a scale from 0 to 10, the mean correct scores increased from 2.85 ± 2.15 (median [min-max]: 2[0-10]) to 8.23 ± 2.21 (median [min-max]: 9 [1-10]) (effect size: 2.5) at T1 and to 7.40 ± 2.34 (median [min-max]: 8 [1-10]) (effect size: 2.1) at T2 . CONCLUSION: The ToothSOS App as a training tool was effective to increase the knowledge level of individuals about the emergency management of TDIs.

Troublesome behaviour and traumatic dental injuries during adolescence.

BACKGROUND/AIM: Troublesome behaviour can lead to bodily injuries among young people, although a link with traumatic dental injuries (TDIs) remains unclear. The aim of this study was to evaluate the longitudinal association between troublesome behaviour and TDIs during adolescence. METHODS: This study analysed data from phases 2 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal study of public secondary schools in East London. Troublesome behaviour in the past 12 months was measured with 8 items (told lies to get things from others, started fight, bullied or threatened people, stayed late outside, stole valuable things, ran away from home, played truant from school and intentionally destroyed someone else's property) from the Development and Well-Being Assessment (DAWBA), when participants were 13-14 years old (Phase 2). Adolescents were dentally examined for TDIs when they were 15-16 years old (Phase 3). The association between troublesome behaviour and TDIs was tested in logistic regression models adjusting for socio-demographic characteristics and oral clinical factors. RESULTS: Forty-three per cent of adolescents reported one or more troublesome behaviours at age 13-14 years, and 16% had evidence of TDIs by age 15-16 years. Adolescents who answered 'perhaps' and 'definitely' to any troublesome behaviour item had, respectively, 1.37 (95% CI: 0.62-3.00) and 1.50 (95% CI: 0.69-3.30) greater odds of having TDIs than those who answered 'no' after adjustment for confounders. Of the 8 behaviours assessed, having run away from home, bullied or threatened people, often told lies, and stolen valuable things were associated with having TDIs. CONCLUSION: This study among adolescents shows that reporting troublesome behaviour was associated with TDIs two years later. Given the wide confidence intervals for these associations, the present findings require confirmation from further longitudinal studies.

Prevalence of sequelae after traumatic dental injuries to anterior primary teeth: A systematic review and meta-analysis.

BACKGROUND/AIM: Clinical and radiographic sequelae are common following traumatic dental injuries to primary teeth. The aim of this systematic review was to assess the prevalence of such sequelae. MATERIALS AND METHODS: Searches were conducted in the PubMed, Scopus, Embase, Web of Science, and BBO/LILACS databases as well as the gray literature. The outcome of interest was the prevalence of the most common sequelae following traumatic dental injuries to anterior primary teeth. Observational studies that evaluated such sequelae were included. Data were extracted, and methodological quality was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The number of sequelae per tooth and the total number of teeth evaluated in each study were considered to calculate pooled prevalence rates with 95% confidence intervals (CI). The quality of the evidence was determined using the GRADE approach. RESULTS: Twenty-five articles were included in this systematic review and meta-analysis. The prevalence of each complication in descending order was as follows: 39.7% crown discoloration (95% CI: 29.52-50.32), 24.3% pulp necrosis with infection (95% CI: 17.34-32.06), 16.2% periapical radiolucency (95% CI: 8.88-25.49), 15.9% premature tooth loss (95% CI: 9.93-23.15), 14.8% pulp canal obliteration (95% CI: 8.46-22.73), 11.9% pathological root resorption (95% CI: 7.68-16.98), 7.1% abscess/fistula (95% CI: 4.4-10.6), and 1.8% ankylosis (95% CI: 0.82-3.17). The certainty of the evidence was very low. CONCLUSIONS: Crown discoloration was the most common sequela in injured primary teeth, but this should be interpreted with caution due to the very low certainty of the evidence. Considerable variation was found in the prevalence of each sequela.

Intrusive luxation of permanent upper central incisor into the nasal cavity: A case report.

This case report outlines a rare complete intrusion of a permanent, maxillary central incisor (tooth 11) into the nasal cavity, with a late diagnosis and treatment. An eight-year-old boy was referred to an oral and maxillofacial surgery service with absence of tooth 11 after an episode of a fall from his own height. Approximately 50 days after the trauma, the patient presented with a complaint of obstruction of the right nostril. The clinical examination and tomographic evaluation showed that the tooth had been intruded into the nasal cavity on the right side. The tooth in question was removed under general anesthesia by direct approach through the right nostril. The patient was followed up for approximately one year without complications. This case demonstrates the importance of a detailed evaluation during the first examination after intrusive luxation, so the correct diagnosis is made and the correct treatment is performed to avoid greater morbidity and complications for the patient.

Trends and seasonality in public interest in dental trauma: Insights from Google Trends.

AIM: To assess trends and seasonal variation of dental trauma by using the Google Trends data. DESIGN: Google Trends was used to obtain relative search volume (RSV) of search terms such as dental trauma, broken tooth, chipped tooth, knocked-out tooth, avulsed tooth, and gum trauma. The search strategy was set to the time period (January 2004 to December 2019), region (worldwide, the United States, the UK, Australia, Canada, New Zealand, Ireland, and Turkey), Web search, and all categories. Seasonal variation was evaluated using the cosinor analysis. RESULTS: The worldwide RSV values of broken tooth, chipped tooth, knocked-out tooth, and avulsed tooth have shown a general increase in recent years with an upward forecast line. The RSV values of dental trauma have shown a general increase in recent years with a plateau forecast line, and gum trauma has shown a stable trend with a plateau forecast line. Seasonal variation of chipped tooth, broken tooth, dental trauma, knocked-out tooth, avulsed tooth, and gum trauma was not found statistically significant in any of the countries (p > .025). The top related queries of chipped tooth and broken tooth were about pain, fix/repair, and cost. The top related topics for avulsed tooth and knocked-out tooth are about infant, child, toddler, and primary tooth. CONCLUSIONS: People's interest on dental trauma, broken tooth, chipped tooth, knocked-out tooth, and avulsed tooth has shown a general increase in recent years without showing a seasonal pattern. Healthcare professionals should pay more attention to people's concerns and informational needs.

Mobile application as a learning tool for improving dental students' knowledge regarding dental trauma.

INTRODUCTION: Current evidence suggests an important knowledge gain of health sciences' students and professionals with mobile devices (m-learning). This study aimed to verify whether different strategies of teaching (traditional lecture classroom, m-learning and association of both methods) would present greater efficacy in knowledge improvement regarding dental trauma in primary dentition. MATERIALS AND METHODS: An action research study using a participatory approach was conducted with 36 undergraduate Brazilian dental students. A structured questionnaire composed of six clinical cases of traumatic injuries was initially applied to all students (pre-test). Participants were then randomly distributed into three experimental groups: TC-students who had access exclusively to traditional lecture classroom; APP-access exclusively to the mobile application; and TC-APP-access to both approaches. The traditional and technological methods had evidence-based content and visual resources of the subject. After interventions, all students responded to the same previous questionnaire (post-test). Wilcoxon and Kruskal-Wallis tests were performed for statistical analysis. RESULTS: All tested groups obtained statistically significant improvement between their pre-test and post-test scores, for both diagnosis and treatment of dental trauma (p < .005). Nonetheless, no intergroup differences were observed amongst the scores of pre- and post-test for diagnosis (p = .159) and treatment (p = .206). CONCLUSION: All teaching approaches applied obtained similar knowledge improvement of undergraduate dental students regarding traumatic injuries in primary teeth.

European Society of Endodontology position statement: endodontic management of traumatized permanent teeth.

This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the endodontic management of traumatized permanent teeth. A recent comprehensive review with detailed background information provides the basis for this position statement (Krastl et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13508). The statement is based on current scientific evidence as well as the expertise of the committee. Complementing the recently revised guidelines of the International Association of Dental Traumatology, this position statement aims to provide clinical guidance for the choice of the appropriate endodontic approach for traumatized permanent teeth. Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.