Avulsed Teeth Research Articles

Effect of icariin surface treatment on the resorption of denuded roots after replantation in rat.

Limiting the incidence of resorption associated with delayed replantation of avulsed teeth is critical for long-term tooth survival. In this study, we assessed whether icariin, a natural product with anti-osteoclastic properties, could reduce root resorption in a rat model of tooth replantation. Cytocompatibility of icariin (10, 20, 40 and 80 μM) was evaluated by CCK-8 proliferation assay in vitro, and an osteoclastogenesis assay was performed to evaluate the effect of icariin on the differentiation of rat bone marrow macrophages and human peripheral blood monocytes into tartrate-resistant acid phosphatase-stained (TRAP+ ) multinucleated giant cells (MNGCs). Differentiation of human periodontal ligament stem cells (hPDLSCs) treated with icariin (10 μM) was also evaluated at 5, 10 and 21 days of osteogenic induction. The first maxillary molars of five-week-old male Sprague-Dawley rats were extracted, denuded of PDL, then treated either with neutralized collagen solution (Carrier control) or icariin in collagen (3 μg/μL) before replantation into their sockets. The animals were euthanized 2 weeks post-surgery for micro-computed tomography (micro-CT) imaging and histological analyses. Icariin was cytocompatible and significantly reduced the differentiation of TRAP+ MNGCs in a dose-dependent manner compared to the control. Moreover, icariin enhanced alkaline phosphatase activity, expression of osteogenic marker genes and proteins, and calcium deposition in hPDLSCs. Micro-CT imaging of the replanted samples demonstrated a significantly higher volume of remaining roots in the icariin-treated group than in the control group. Histological analysis revealed a marked number of resorptive lacunae with TRAP activity in the control group, whereas icariin-treated samples showed signs of functional healing and reduced osteoclastic activity. Icariin was biocompatible and demonstrated potent anti-osteoclastic and pro-osteogenic properties that reduced resorption and promoted functional healing of denuded roots in a rat maxillary first molar model of replantation. These findings indicate that root surface treatment with icariin may be a clinically relevant and practical method for improving the retention and survival of teeth with compromised PDL after delayed replantation following traumatic avulsion.

Assessing Knowledge, Perception, and Management Toward Traumatic Tooth Avulsion Among Dentists in Jeddah, Saudi Arabia: A Cross-Sectional Study.

The long-term prognosis of teeth that have experienced traumatic avulsion is highly dependent on appropriate and prompt emergency management taken immediately after the avulsion. The main goal in the treatment of traumatic permanent tooth avulsion is to replant as soon as possible in its correct anatomical position to maintain the viability of the periodontal ligament and neurovascular supply while restoring aesthetic and preserving the functional integrity of the tooth. General dentists can deal properly with emergency cases, such as tooth avulsion, and also should be aware of appropriate management to take care of avulsions and to determine the prognosis especially since such incidents often occur at times when dental professionals are least prepared to address them. The primary aim of this study was to evaluate the knowledge of dentists who are working in various hospitals, clinics, and dental schools in Jeddah, Saudi Arabia, with respect to traumatic permanent tooth avulsion and the appropriate methods for its management. The study design is a cross-sectional study with dentists working in various clinical settings in Jeddah, Saudi Arabia.The questionnaire used in the study consists of a total of 19 items: nine items about demographic data, including training background, and 10 multiple-choice questions regarding dental trauma and its management. Higher dental education and post-graduate training gave the dentists better judgment in dealing with dental emergencies compared to general dentists. Thus, the recommendation of this study is to include the comprehensive treatment of avulsion emergencies in the dental school curriculums and increase the exposure of dental students to such cases.

THREE YEARS FOLLOW UP REPLANTATION IN HEAVY SMOKER PATIENT: CASE REPORT

Tooth avulsion is different from all other dental injuries due to the extracorporeal situation with varying duration and degree of contamination of the teeth and the patient's systemic conditions. In a heavy-smoker patient, wound healing could be interrupted. Extra-alveolar handling, good replantation, and educating the patient could be the key to successful treatment of tooth avulsion, especially in a heavy smoker. The aim of this study is to discuss an avulsed tooth case that has been successfully treated by replantation in a heavy smoker. A 39-year-old female patient was refered to Siloam Hospital due to a dental trauma injury. The patient was in good general health, but she was a heavy smoker. Intraoral examination revealed that the maxillary left permanent central incisor was avulsed after the patient fell off in her bathroom. Replantation is a treatment of choice in this case. The avulsed tooth was stored in a saline solution. On one visit, root canal treatment was done on the avulsed tooth extra orally soon after the patient was refered to the AE department at Siloam Hospital. The avulsed tooth was replanted and fixed using an Erich arch bar to the previous position by finger pressure. Fix the Erich bar as far as possible to the distal and mesial of the avulsed tooth using circumferential wire in every single tooth. We decided to put the Erich bar from 15 to 25. The following oral hygiene cleaning, dietary instructions, and education to reduce or stop smoking during the healing process were given. Extra-alveolar handling, good replantation, good fixation, and adequate oral hygiene education are the keys to treating a tooth avulsion, even in a heavy smoker.

Assessment of Elementary School Teachers’ Knowledge of and Attitude toward the Management of Traumatic Dental Injuries in Makkah

Background: Traumatic dental injuries (TDI) to primary and permanent teeth are not uncommon in children. Almost half of TDI in children occur at schools and the prognosis is time dependent. Hence, the teacher’s knowledge towards management of TDI is important. The aim of this study is to assess the knowledge and attitude of female elementary school teachers in Makkah, regarding the management of TDI. Methods: This is a descriptive cross-sectional questionnaire-based study, designed using Google forms to collect information from 350 female elementary school teachers from randomly selected schools in Makkah. The questionnaire collected data on participants’ demographic characteristics, knowledge, and attitude towards management of TDI. Results: 265 teachers participated in this study. 66.8% of the participants had positive attitude towards moral responsibility regarding the management of TDI. 63.4% of the participants lacked the proper knowledge regarding the management of TDI and 74.6% did not know the best storage media for an avulsed tooth. 60.7% of the participants were not satisfied with their knowledge, yet 94% had a positive attitude towards improving their knowledge. Conclusions: Female elementary school teachers in Makkah, showed insufficient knowledge but a positive attitude and willingness towards improving their level of knowledge regarding management of TDI. Hence, strategies to improve teachers’ knowledge about TDI must be planned and implemented.

Parents' knowledge of emergency management of avulsed permanent teeth in children and adolescents in the State of Qatar: a questionnaire cross-sectional study.

To elucidate the level of parental knowledge in Qatar regarding the management of avulsed teeth. A self-administered questionnaire was completed by 400 parents attending their children's routine dental appointments. The questionnaire comprised of items on sociodemographics, parents' prior knowledge on management of avulsion, parents' willingness to replantavulsed teeth at the site of injury, and parents' opinion as to the best format for future parental education on the management of dental trauma. Univariate and multivariate logistic regressions were employed to assess the association between sociodemographic status and knowledge in the management of avulsion. The overall mean score of parents' knowledge was (23%). Only 23.3% (n = 93) of parents thought that it was possible to reinsert an avulsed permanent tooth. Out of those, only 12.9% (n = 12) indicated willingness to reinsert the tooth back into its socket, while 48.4% (n = 49) indicated that an avulsed tooth should be stored using physiological media. Less than one third (27.8%) indicated that they would seek professional help within 30min. Males were less likely to give favourable answers when compared to females (OR = 0.43, 95% CI = 0.22-0.84). Age groups "31-40" years and "41-50" years were more likely to give favourable answers when compared to 20-30years age group (OR = 2.8, 95% CI = 1.05-8.0and OR = 3.8, 95% CI = 1.3-11.48; respectively). This study highlights critical deficiencies in parental knowledge on the management of tooth avulsion and the need to improve parents' knowledge by developing easily accessible onsite emergency management tools.

Effect of Polydeoxyribonucleotide on Human Periodontal Ligament Cells as a Storage Medium for Avulsed Tooth

Objective: This study aimed to evaluate the suitability of polydeoxyribonucleotides (PDRN) as a storage medium for avulsed teeth.Materials and Methods: The viability of human periodontal ligament (PDL) cells stored in Hank’s balanced salt solution and PDRN solutions (concentrations, 10, 25, 50, and 100 μg/mL) and tap water was measured using the Cell Counting Kit-8 and Live/Dead assays. In addition, Nitric oxide detection and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to evaluate the anti-inflammatory effect of PDRN.Results: The viability of PDL cells stored in a 100 μg/mL PDRN solution was significantly higher than that of cells stored in the other solutions (<i>p</i> < 0.01). Furthermore, cells stored in 100 μg/mL PDRN solution demonstrated a significantly reduced NO production (<i>p</i> < 0.0001), and cells stored in 50 and 100 μg/mL PDRN solutions expressed significantly lower levels of tumor necrosis factor α, interleukin (IL) -4, IL-6, and IL-10 (<i>p</i> < 0.01) compared to cells stored in HBSS.Conclusion: The PDRN solution exhibited cell-preserving and anti-inflammatory effects on the PDL cells. The findings of this study can serve as a basis for further experiments directed at the development of an effective storage medium for avulsed teeth.

YouTube™ as a source of tooth avulsion information: A video analysis study.

Evaluate the informative content in tooth avulsion videos intended for dentists available on YouTube™ and analyse their compliance with the International Association of Dental Traumatology (IADT) guidelines 2020. Google Trends was used to identify the most searched term for tooth avulsion. Tooth avulsion-related videos in Brazilian Portuguese intended for dentists were searched on YouTube™ with a 12-month filter. Two raters reviewed these videos to extract their features and evaluate and qualify them with two 9-point checklists based on the IADT 2020 guidelines. The emergency steps for tooth avulsion at the accident site were assessed before, during and after clinical management; each step received 1 point if present and 0 points if absent. The final score ranged from 0 to 9 points on each checklist (18 points total), and the total score was used to classify the videos as having poor, moderate or rich content. Reliability and video quality were evaluated by an adapted version of the DISCERN tool and global quality scale (GQS), respectively. The data were analysed with the Mann-Whitney U-test, Pearson chi-square test, and the Kappa statistic (p < .05). Of 60 videos, 8 were included. All were uploaded by dental professionals or undergraduate students; the average duration was 11 min (range: 0.40-65 min), and the average number of views was 56.75. Half the videos (50%) had maximum completeness scores for questions about emergency dentist referral before clinical management, and more than half (75%) had maximum completeness regarding the steps required during and after treatment. Rich videos had higher GQS scores (p = .049) without significant correlation. Although most videos in Brazilian Portuguese were considered high-quality according to the IADT checklist, half of them presented partial absence of information regarding orientations at the accident site.

A retrospective comparative study of maxillofacial injury patterns caused by electric scooters and bicycles.

The emergence of shared stand-up electric scooters has led to an increase in their usage and, subsequently, an increase in the incidence of maxillofacial trauma. This study aimed to investigate the trauma pattern associated with the use of stand-up electric scooters compared with that related to the use of bicycles, which was a popular mode of personal mobility before the emergence of stand-up electric scooters. This study investigated the medical records of patients who visited Wonju Christian Hospital for maxillofacial trauma due to the use of stand-up electric scooter and bicycles between November 1, 2017 and October 31, 2022. Maxillofacial trauma was analyzed based on medical records, including those in the evaluation results of teeth, maxillofacial bones, and soft tissues. Crown fractures and tooth avulsions were observed more frequently with the use of stand-up electric scooters than with the use of bicycles. In contrast, crown-root fractures, tooth subluxation, and extrusive luxation were more commonly observed in bicycle riders. Additionally, the proportion of root fractures was similar between the two groups. However, no vertical root fractures were observed in patients who rode bicycles. The maxillofacial bone fracture rates between the two groups were similar, although the fracture patterns were different. The number of patients using stand-up electric scooters is increasing, and they are likely to have a worse prognosis compared with those using existing personal mobility devices.

The Comparative Analysis of the Effectiveness of Four Different Storage Media (Placentrex, Propolis 10%, Pomegranate Juice 5%, and Hank's Balanced Salt Solution) in Preserving the Viability of Periodontal Ligament Cells: An In Vitro Study.

Out of all traumas, dentoalveolar trauma occurs quite frequently and is commonly linked to avulsion injuries. Of all severe lesions to the permanent dentition, tooth avulsion accounts for 1%-16% of cases. The extraoral dry time and the storage medium in which the tooth is stored and its capacity to promote cell viability are two important variables influencing the prognosis of an avulsed tooth following replantation. The aim of this paper is to assess and contrast the effectiveness of placentrex, propolis 10%, pomegranate juice 5%, and Hank's balanced salt solution (HBSS) as a storage medium in preserving the periodontal ligament (PDL) cells' viability. Sixty freshly extracted premolars were put in four various media for 45 minutes each, including HBSS, placentrex, propolis 10%, and pomegranate juice 5%, and placed in an incubator for 30 minutes in 15 mL falcon tubes with 2.5 mL solutions of collagenase 0.2 mg/mL and dispase 2.4 mg/mL in phosphate-buffered saline. Bovine serum was added after incubation, and the mixture was centrifuged for four minutes. Trypan blue 0.4% wasused to identify the cells. Under a light microscope, a hemocytometerwasutilized to quantify the number of periodontal ligament cells that were still alive. Propolis, pomegranate, and placentrex are all significantly inferior to HBSS in the context of the sustainability of the cells. It was discovered that HBSS with placentrex and pomegranate juice 5% was statistically insignificant. The difference in periodontal ligament cell viability between propolis 10%, HBSS, placentrex, and pomegranate juice 5% was shown to be statistically significant. When compared to other media such as propolis 10% and pomegranate juice 5%, placentrex is a better alternative storage medium for avulsed teeth.

Penyuluhan dan Pelatihan Kegawatdaruratan Dental Serta Penanganannya Kepada Guru-guru SDI Assalam Joglo Jakarta Barat

Dental emergencies are potentially life-threatening conditions and immediate treatment is needed to stop ongoing bleeding, reduce pain and also uncontrolled bleeding, cellulitis or bacterial tissue infection causing swelling in the mouth or mouth area and trauma to the bones in the facial area . Delay in treatment of trauma to the teeth can lead to treatment failure. Delay in emergency dental treatment after trauma will increase the risk of complications, non-vital teeth and an unpredictable prognosis.Dental emergencies often occur at the elementary school level and the most common cases are loose or avulsed teeth due to falls and impacts. Teachers in schools not only have a central role as educators, but teachers also act as first aid agents in dealing with health problems in schools. In addition, teachers also play a role and assist health workers in collecting data and also as the first emergency referral before being handled by health workers.SDI Assalaam has a staff of 46 teachers and 250 students. Having students who are actively moving has a risk of accidents such as falling and so on which can cause injury, especially the oral cavity, while knowledge of dental emergencies and their management according to the Principal of SDI Assalaam has never been received by the teachers who teach at SDI Assalaam , so that if there is a dental emergency the teachers don't know what action to take.To overcome the lack of knowledge about dental emergencies and their management. So the teachers of SDI Assalam are given counseling and training about dental emergencies and their handling so that the importance of dental emergencies is socialized so that teachers at SDI Assalaam can increase their knowledge about dental emergencies and their management.Based on the evaluation results of community service activities. There was a significant increase in the level of knowledge of SDI Assalaam teachers regarding dental emergencies and their treatment.

Comparative Evaluation of Maintenance of Cell Viability of an Experimental Transport Media "Ringer's Lactate" with Dextrose Normal Saline ORS Egg White and Infant Milk Formula for Transportation of an Avulsed Tooth.

The viability of the periodontal ligament (PDL) cells on the root surface of the avulsed tooth determines the prognosis of the replanted tooth, which in turn is determined by a suitable transport medium in which the tooth was stored. The aim of the present study is to evaluate and compare the effectiveness of Ringer's lactate (RL) as a storage medium for an avulsed tooth in maintaining the PDL cell viability with dextrose normal saline (DNS), oral rehydration salt (ORS), egg white (EW), and infant milk formula (IMF). A total of 85 freshly extracted human teeth were divided into five experimental groups and two control groups. The positive and negative controls corresponded to 0-minute and 8-hour dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of five experimental media (RL, DNS, ORS, EW, and IMF) for 45 minutes. The teeth were then treated with collagenase type III and trypsin for 10 minutes. The number of viable PDL cells was counted with a hemocytometer and analyzed. Statistical analysis showed that IMF, RL, and EW had no statistically significant differences among them in maintaining the viability of the PDL cells but were significantly better than DNS. No statistically significant difference between RL, EW, and ORS in the number of viable PDL cells. Infant milk formula (IMF), RL, and EW showed similar results within the parameters of the study; they can be used as alternative storage media for avulsed teeth. DNS showed poor results, and ORS could serve as short-term storage media if the other solutions are not readily available. The search for an appropriate storage media with favorable pH and osmolality along with easy availability is the basic thought behind this study. Kumar P, Kotumachagi SS, Fabi AJ, et al. Comparative Evaluation of Maintenance of Cell Viability of an Experimental Transport Media "Ringer's Lactate" with Dextrose Normal Saline ORS Egg White and Infant Milk Formula for Transportation of an Avulsed Tooth. Int J Clin Pediatr Dent 2023;16(3):453-458.

Knowledge, Attitudes, and Practices of School Teachers Regarding Dental Trauma and its Emergency Management in Madinah, Saudi Arabia: A Questionnaire-Based Online Cross-Sectional Survey.

Traumatic dental injuries (TDIs) are a common occurrence in the general population, and they are one of the most severe dental public health issues among children. This cross-sectional study aims to assess the knowledge, attitude, and practices of school teachers in Madinah, Saudi Arabia, regarding dental trauma and its emergency management. This cross-sectional study included teachers of elementary and middle schools both male and female in Madinah. Each teacher received a study questionnaire and was briefed about the procedure of filling it. The questionnaire contained 17 questions which are related to the knowledge, attitude, and practices relating to TDIs. A total of 294 teachers participated in the present study, which includes 163 males (55.4%) and 131 females (44.6%). When we asked the respondents if an avulsed tooth may be replanted, 49.7% answered in the positive and men show more awareness compared to women. When questioned regarding the storage media, 31.3% of participants said they will store the tooth in a cloth or tissue which was the wrong answer and 60.9% of males and 39.1% of females were unaware of appropriate storage media. A percentage of 68.4 of the teachers were not willing to replant a knocked-out tooth (tooth avulsion), 59.7% of these were males, and 40.3% were females. A percentage of 59.2 of participants consider that the dental trauma is an emergency situation, while 25.9% did not consider it as an emergency situation and 15% were not aware of the same. The majority of the participants were not aware of dental trauma and its emergency management. Children indulge in contact sports and play at schools posing the risk for a significant amount of dental trauma. Affirmative action from teachers is critical for successful treatment outcomes.

Knowledge about Emergency Management of Orofacial Injuries among School Teachers at Alkharj Saudi Arabia.

Children suffer from orofacial injuries during sport activities in schools. School teacher's knowledge about managing emergency during orofacial injuries will help in treatment prognosis. To assess and compare school teacher's knowledge about management of orofacial injuries at alkharj Saudi Arabia. Cross-sectional study was planned among school teacher working in various schools at alkharj. Questionnaire consisted of Demographic details such as age and year of experience and knowledge-related questions about management of orofacial injuries. Questionnaire was distributed and collected on the same day. All participants were aware that sport activities results in injuries to head, orofacial structures, or teeth. 15.6% participants have undergone training. 84.4% of study participants have told they don't know to manage avulsed tooth. 92.8% of study participants are interested to get training on orofacial injury management. Knowledge of school teachers about management of orofacial injury is insufficient. Teachers are primary level of contact in schools during sports injuries, measures should be taken to improve their knowledge about orofacial injuries.

TEETH AVULSION SECONDARY TO ORO-TRACHEAL INTUBATION IN A TERTIARY HEALTHCARE FACILITY. A CASE SERIES

General anaesthesia using endo-tracheal intubation carried out to provide pain free surgical and medical procedures sometimes results in Traumatic Dental Injuries [TDIs]. Among the rarely reported TDI complication is Tooth avulsion. We present 2 cases of such complications, factors which can be responsible, management of such cases and the need to educate medical and paramedical personnel of what to do if such complication arises before definitive management can be carried out by the Dentist. Such awareness will go a long way in preventing unnecessary litigations which might likely occur from such routine procedures.&#x0D;

Development and validation of a novel index to assess the perceived impact of sports-related oro-dental trauma among adolescents: findings from Sri Lanka

BackgroundSports-related oro- dental trauma, such as tooth fracture, displacement, mobility, and avulsion, cause significant concern among adolescent players due to detrimental impacts. The current study aims to develop, validate and assess the reliability of a simple index as a questionnaire to assess the impact of sports-related oro-dental trauma both untreated and treated, among adolescent school children in Sri Lanka.MethodsAODTII, an adolescent oro-dental trauma impact index, was developed and validated using a mixed-method approach. Items for the index were generated by quantitative as well as qualitative analysis of the results from Oral Health-Related Quality of Life Questionnaires, personnel interviews with experts and focus group discussions with adolescents. Principal component analysis and Exploratory factor analysis were used to create the index. The index was validated in the Sinhala language, and the reliability of the index was assessed using a separate sample in the school context in the Colombo district.ResultsThe initial list of 28 items was reduced to 12 by the Principal Component Analysis. Exploratory Factor Analysis categorised the variables into four latent constructs; physical impact, psychosocial effect influenced by peer pressure, the impact of oral health care and the impact caused due to unmet dental trauma treatment need. The cut-off values of the AODTII were based on PCA. The index achieved the Content Validity Ratio of 88.33. The construct validity was assessed with confirmatory factor analysis by developing a structural equation model. It obtained good model fit indices of RMSEA value of 0.067, SRMR of 0.076, CFI of 0.911 and the Goodness of Fit index of 0.95. The homogeneity was ensured with convergent and discriminant validity. The Cronbach's alpha value was 0.768, ensuring reliability. The index assesses the level of impact due to oro- dental trauma and identifies whether the adolescents perceive it significantly or not.ConclusionTwelve-item AODTII emerged as a reliable and valid tool to assess the perceived impact of untreated and treated sports-related oro- dental trauma on Sri Lankan adolescents with implications for its use in other populations. Further research is required to improve the translational value of AODTII. Moreover, the tool is potential as a patient-centred communication tool, clinical adjunct, advocacy tool and a useful OHRQoL index. However, it is needed to be supported end-users’ feedback.

Optimal storage media for avulsed teeth: an in vitro study

Background: Tooth avulsion can be replanted to the alveolar bone if appropriate preserved. This study aimed to evaluate the viability of periodontal ligament cells in several storage media at different time after the tooth leaves the alveolar bone. Method: 46 teeth premolars and third molars were divided into 4 storage media (DMEM, milk, physiologic saline, sports drink) and randomly for 4 period (30 minutes, 1 hour, 2 hours, 24 hours). The root surface was scraped to collect periodontal ligament cells. Cells were stained with 0.4% Trypan blue solution and observed by a Neubauer chamber under inverted microscope. Comparison of the percentage of cells viability between the study groups using the Kruskal-Wallis test, complemented by the Scheffé test (α = 5%). Results: At 30 min, all 4 media gave high cell survival rate (over 95%) (p &gt; 0.05). At 1 hour, the cell survival rate in DMEM, milk, and sports drink was higher than physiologic saline (p &lt; 0.05) while at 2 hours and 24 hours, DMEM and milk have a higher percentage of viable cells (p &lt; 0.05). Conclusion: Milk is a favorable storage medium for the viability of periodontal ligament cells, sports drink shows that it can completely replace milk when the tooth storage time is not more than 1 hour. Key words: periodontal ligament, storage media, tooth avulsion

Cognition about emergency management of avulsed incisor in children among dentists in Guangdong province.

This study aimed to evaluate and analyze the current situation of dentists in Guangdong pro-vince regarding the management of avulsed incisors, thereby providing a reference for making treatment strategies for avulsed incisors in the future. A total of 712 dentists with different educational backgrounds and working conditions in Guangdong province were randomly selected to conduct an online questionnaire survey on the cognition of children with avulsed incisors from April 2022 to May 2022. The data were recorded by Excel software and statistics were analyzed on Stata/SE 15.1. A total of 712 dentists were investigated and 701 questionnaires were collected (98.46%). In addition, 65.9% of investigators came from the Department of Stomatology in a First-class Hospital or Stomatological Hospital. The results showed that the average number of avulsed teeth consulted by dentists was less than 20 per year. Although 99.7% of respondents considered normal saline as a suitable storage medium, 3.1% and 23.8% of them had a misunderstanding that the tap/alcohol could be used for root cleaning. Moreover, 93.4% was the correct selection rate of the treatment plan for processing on root surfaces before replanting by investigators. The correct selection rate of the duration using elastic fixation was only 10.7%. Meanwhile, 42.9% of investigators refused to inoculate tetanus immunoglobulin after teeth replanting. Emergency management of dental avulsion (EM) and clinical management of dental avulsion (CM) answered correctly with average scores of 14.60±11.85 and 14.48±2.67, respectively. Multivariate linear regression analysis revealed that working years were negatively correlated with EM and CM scores (P<0.05). There was a positive correlation between CM and EM scores with the number of avulsion cases treated by physicians each year (P<0.05). In terms of the EM score of dentists' learning attitude, investigators who had received enough knowledge were higher than those who had not and insufficient knowledge reserved, and the difference was statistically significant (P<0.05). The scores of investigators who thought they had a certain degree of knowledge about dental trauma were higher than those who thought they "did not understand", and the difference was statistically significant (P<0.05). In terms of CM scores, investigators who thought the knowledge of dental trauma was "very helpful" had higher scores than those who thought it was "not helpful", and the difference was statistically significant (P<0.05). The scores of the investigators who thought they had "relatively sufficient knowledge" of dental trauma were higher than those who thought they had "no knowledge" or "insufficient know-ledge", and the difference was statistically significant (P<0.05). The overall accuracy of the management of avulsed incisors among dentists was low in Guangdong province. Dentists were more likely to have a higher rate of accuracy choice in treatment options for luxation injury and avulsion to enhance the prognosis of replanted teeth.

Knowledge about tooth avulsion and replantation among students from public schools

Research on knowledge regarding tooth avulsion and replantation among children and adolescents is still scarce. Objective: This cross-sectional study aimed to evaluate the knowledge about tooth avulsion and replantation and their association with independent variables among 7th-grade students in public schools. Material and methods: Data collection on the knowledge regarding tooth avulsion and replantation (nine questions) and sociodemographic profile was performed through semi-structured and self-administered questionnaires. The presence of trauma in permanent incisors of students (n=251) was obtained in a clinical examination performed by a calibrated examiner in Sertaozinho, Sao Paulo, Brazil. After a descriptive data analysis, association and multiple logistic regression tests were applied at a significance level of 5%. Results: Most of the students were female (61.4%), were residents in suburban areas (89.6%) and did not present dental trauma (87.7%). Students answered correct 42.2% of the questions. The variable “last visit to the dentist” was the only one that showed a statistically significant association with knowledge about tooth avulsion and replantation in the bivariate analysis (p = 0.007) and the logistic regression (p = 0.031). Conclusion: The level of knowledge was low, and the students whose last visit to the dentist was two years or longer showed a greater chance of having less knowledge about tooth avulsion and replantation. Clinical Significance: During routine dental visits, the dental team should educate patients about the procedures to manage different situations of dental trauma.

Global status of knowledge of parents for emergency management of traumatic dental injuries: a systematic review and meta-analysis.

The protocol was developed as per the recommendations of the Cochrane-handbook and PRISMA and was registered in PROSPERO. Search was performed by using MeSH-Terms and keywords in PubMed, Scopus, Embase, Web of Sciences, Lilacs, and Cochrane databases and gray literature sources 15th July 2022. There were no limits regarding the year of publication and language. Hand-searching of included articles was also performed. Titles and abstracts and later full texts were screened as per strict inclusion and exclusion criteria. Self-designed pilot-tested form was used. Risk of bias was analyzed through Joanna-Brigg's-Institute's-critical appraisal checklist. The evidence analysis was done by using the GRADE approach. Qualitative synthesis was performed for describing the study characteristics, details of sampling, and results of various questionnaires. It was discussed by the expert group and presented using KAP heat map. Meta-analysis was done by using Random Effects Model. The risk of bias was found to be low in seven and moderate in one study. It was observed that >50% of parents knew about the urgency to seek professional advice after TDI. Only <50% of parents were confident of their ability to identify the injured tooth, clean the soiled avulsed tooth, and perform the replantation. Appropriate responses regarding immediate action after tooth avulsion were given by 54.5% (95% CI: 50.2-58.8, p = 0.042) of parents. The knowledge of the parents regarding the emergency management of TDI was found to be inadequate. The majority of them were interested in obtaining information about dental trauma first aid.

Comparative evaluation of the viability of periodontal ligaments cells in green tea and turmeric as storage media – An ex vivo study

BACKGROUND: Tooth avulsion clinically presents as complete displacement of a tooth from the alveolar socket and it is one of the most severe forms of dental trauma leading to compromised neurovascular supply, loss of periodontal ligament and pulp necrosis. Storing of avulsed tooth in appropriate storage medium to preserve the periodontal cell viability is of prime importance and research to find the appropriate storage media is still on. AIM: The aim of this study was to investigate the effects of green tea and turmeric as a storage media on periodontal cell viability. MATERIALS AND METHODS: This was a prospective, randomized study conducted using sixty single rooted human premolars freshly extracted for orthodontic purpose. Selected subjects were divided into three groups of 20 each. Randomization was done by performing simple random sampling; Group A consisted of teeth to be stored in HBSS, Group B included teeth to be stored in Green tea and Group C included teeth to be store in Turmeric. Periodontal cell viability was assessed by using a Neubauer’s chamber under the light microscope after two hours interval. RESULTS: HBSS preserved significantly higher number of viable PDL cells than any other storage solutions. Green tea extract showed better cell viability in comparison with turmeric. CONCLUSION: The present study indicates that HBSS and green tea effectively maintains the viability of PDL for two hours. Turmeric is less effective in preserving the PDL cell viability within the study time interval.