Dental Trauma Cases Research Articles

Evaluation of Late Dental Trauma Cases In Pediatric Patients

Evaluation of Late Dental Trauma Cases In Pediatric Patients

Experience and level of confidence in the management of dental trauma among dental students and fresh graduate dentists

ABSTRACT Background: Dental trauma is one of the most serious and frequent oral problems in active children as well as adolescents worldwide. Anyone can be a victim. Hence, the level of competence in the management cannot be undermined. Aim: This study aims to evaluate the experience and confidence in the management of dental trauma among dental students and fresh graduate dentists in Benin City, Nigeria. Methodology: This questionnaire-based, analytical, and cross-sectional study utilized a self-administered questionnaire containing 15 closed- and open-ended questions to garner data from respondents. Data from 95 respondents were analyzed using the Statistical Package for the Social Studies software version 26.0 (IBM Corporation, Chicago, Illinois, USA.), and both univariate and bivariate analyses were used in this study. Results: A substantial proportion of respondents 73 (76.8%) had never managed any case of dental trauma. A relatively higher proportion of respondents were more confident in managing cases of enamel fracture 18 (18.9%), enamel infraction 17 (17.9%), and enamel-dentine fracture 12 (12.6%) as compared to other more complicated fractures. Conclusion: The experience and level of confidence in the management of dental trauma among dental students and fresh graduate dentists were found to be poor, and they were more confident in managing less complicated cases of dental trauma.

Enhancing elementary school teachers' knowledge in managing traumatic dental injuries: The effectiveness of educational sessions.

This study aims to evaluate the short- and long-term effects of educational intervention on elementary school teachers' knowledge of traumatic dental injuries (TDI). The study included all of the elementary schools (29) in the emirate of Ras Al Khaimah, United Arab Emirates. Of the initial 538 participants, 497 teachers completed the full-length study. The first assessment (T0) was performed prior to intervention using a four-part validated questionnaire that evaluated demographics, knowledge, attitudes, and self-assessment in relation to TDIs. The questionnaire was followed by a 30-min lecture presentation featuring various dental trauma scenarios. Each teacher's knowledge was reassessed immediately after the intervention (T1) and 3 months after the intervention (T2). The data were analyzed using the Cochran test, Wilcoxon signed-rank test, and chi-squared test. Half of the participants had witnessed dental trauma at least once; however, 96.6% of the participants had not attended any training related to dental trauma prior to the educational intervention. Knowledge regarding first aid management of broken teeth and avulsions was disappointing pre-intervention but was significantly higher post-intervention (p < .001). Following the workshop, participant self-assessments indicated improvement in the ability to appropriately respond to cases of dental trauma as necessary (p < .001). Inadequate knowledge of emergency management of TDI was demonstrated initially. There was a remarkable improvement in the overall knowledge of TDI after the educational sessions. Raising the awareness in dental trauma field by conducting educational sessions is crucial for achieving a better outcome.

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

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. 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. 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. 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.

A computational model to assess the effectiveness of adhesive materials in restoration of crown-root fractures

Fragment reattachment for crown root fractures has become a routinely employed treatment modality with the advancements in adhesive dentistry. Among the majority of documented dental trauma cases, this specific fracture type is one of the most prevalent and difficult fracture kinds. Due to its complexity, these fracture kinds are often not computationally modelled. Moreover, there is a lack of literature to understand the effect of different adhesive materials, used to re-attach this particular fracture, on traumatic injuries. In our work, 3D models of the permanent maxillary central incisor tooth were developed using cone beam computed tomography image of a patient. This model was systematically modified to represent a prominent crown root fracture and subsequently re-attached computationally using three different adhesives. A biting force and a traumatic load were applied, and the induced stresses were studied across the healthy and treated tooth models and compared for three different adhesives used for re-attachment of fractured fragments. Tooth reattached with resin adhesive performed better in all the loading conditions that were considered in the study as compared to flowable composite and resin cement.

Is use of CBCT without proper training justified in paediatric dental traumatology? An exploratory study

BackgroundProper skills in radiographic diagnosis are essential for optimal management of dental trauma.AimTo assess diagnostic accuracy obtained by paediatric dentists using Cone Beam Computed Tomography (CBCT) without specific training and to compare this with their performance using intraoral radiographs.MethodsIntraoral and CBCT images of 89 teeth, spread over twenty dental trauma cases were presented in random order to nine paediatric dentists. Diagnostic findings were compared with those of a benchmark reference. Sensitivity and specificity were calculated and compared using paired t-tests.ResultsOverall, observers’ diagnostic performance was rather poor with significantly higher sensitivity when using 2D images (P = 0.017). Performance differed considerably according to the type of pathology. Using either imaging modality, sensitivity for diagnosing apical pathology and root fractures was high while the opposite was seen for inflammatory root resorption, root cracks and subluxations. Statistically significant differences between imaging modalities were seen for root fractures (P = 0.013) and apical pathology (P = 0.001), in favor of 3D, and for crown fractures (P = 0.009) in favor of 2D.ConclusionOverall poor performance of paediatric dentists indicates that additional training in radiographic diagnosis is required. In order to justify the use of CBCT to increase diagnostic performance, proper training of the paediatric dentist is mandatory.

Preparing to Manage Dental Trauma Cases

Preparing to Manage Dental Trauma Cases

Assessment of the validity and reliability of a novel dental trauma index.

Traumatic dental injuries (TDI) are one of the most commonly encountered dental health complications. In order to standardize the evaluations and compare the findings of TDI, a carefully defined dental trauma index may serve as a good tool for the correct recording of dental trauma. A new dental trauma index, the Modified Eden & Baysal dental trauma index (MEBTI), has been introduced. It is an expanded index to record soft tissue injuries in addition to dental injuries. The aim of this study was to assess the validity and reliability of the MEBDTI. The archival data of 20 patients with different traumatic injuries were selected. A web-based form including the radiographs and photographs of selected cases was created. Following a training session, 12 dentists with a minimum of 10 years of clinical experience were asked to score the cases using the MEBDTI on an online form. The Kolmogorov-Smirnov test was used to test the normality. The Kruskal-Wallis Test was used for intergroup comparisons. Inter-observer agreement was investigated by reliability analysis. The intraclass correlation coefficient (ICC) was used to evaluate the agreement among observers. The Chi-Square test of independence was used to determine if there is a significant relationship between two nominal variables (p< .05). The rate of correctly assessing the alveolar bone fracture was 96.9% followed by apex maturity (92.7%), root fracture (85.4%), luxation injury (76.5%), crown fracture (76.2%), and soft tissue injury (50%). Considering all parameters, the soft tissue injuries were statistically different in terms of the answers given by the 12 dentists (p< .05). The accuracy of the scores of participants was high and in accordance with each other except for the identification of soft tissue injuries. In favor of this novel index, the data on dental trauma cases could be recorded practically and reliably.

Penyuluhan Penanganan Kedaruratan Trauma Gigi Di Masa Pandemik Covid-19 Pada Ibu-Ibu PKK Cideng - Jakarta Pusat

Dental trauma is an injury involving the teeth and/or involving the supporting structures of the teeth. Dental trauma can cause tooth fracture, tooth displacement, tooth loss (avulsion), or damage to supporting tissues (gums and bones). During the Covid-19 Pandemic Period, mothers have more dominant time with their children, so they are expected to provide quick and effective action in dental trauma cases. This community Service Counseling aims to increase knowledge and skills in dealing with dental trauma problems. Counseling was carried out by the Trisakti University Faculty of Dentistry Team to PKK organization in Cideng, Gambir, Central Jakarta on January 5, 2022. Counseling includes the knowledge on handling emergency dental trauma using webinar methode with power point and animated videos. There is a significant difference in the mean percentage of correct answers between the pre-test (54,23 + 16,47) and post-test (68.58 + 11.45) with a significance level of p = 0.013. Thus, it can be concluded that after the Counseling activity, there is an increase in the level of knowledge regarding the handling of emergency dental trauma. Training is needed to improve skills so that trauma emergencies can be handled better

Traumatic Dental Injuries among 12-Year-Old Schoolchildren in the United Arab Emirates.

Aims: This study aimed to evaluate the prevalence of the factors related to traumatic injuries to the permanent incisors of 12-year-old children in the Emirate of Ajman, United Arab Emirates. Methods: A sample of 1008 12-year-old children (510 boys and 498 girls) participated in this study. A multi-stage randomized sampling technique was used to select children from public schools for their inclusion in the sample population. An oral examination was completed by a calibrated examiner after receiving training for traumatic dental injury (TDI) to permanent incisor teeth utilizing a modified version of Ellis’s classification. Data that were related to sociodemographic factors, TDI causes, and where the TDI took place were recorded using a structured questionnaire. Results: Of all of the children that were examined, 9.8% of them had experienced dental trauma. The difference in TDI prevalence between boys (15.9%) and girls (3.9%) was statistically significant (p < 0.05). The children whose mothers had low levels of education experienced a higher prevalence of TDI (p = 0.001). The children with incisal overjets that were greater than 5 mm or with inadequate lip coverage tended to have experienced dental injuries (p < 0.01). The main causes of injury to permanent incisors were collision against an object or person (53.5%) and falling (42.4%). Most of the accidents happened at home (58.6%) and school (25.3%). The most prevalent injuries were enamel fractures (58.7%) and enamel-dentine fractures (34.3%). Conclusions: This research highlighted many predisposing factors for traumatic dental injuries among children. There is an urgent need to initiate detailed public health policies to decrease the prevalence of dental trauma cases, especially in the identified risk group.

The Impact of Cone-beam Computed Tomography on Diagnostic Thinking, Treatment Option, and Confidence in Dental Trauma Cases: A Before and After Study

IntroductionThe aim of this study was to identify whether cone-beam computed tomographic (CBCT) imaging affects endodontists' diagnostic thinking, treatment option, and confidence in dental trauma cases. MethodsTwelve endodontists reviewed 15 dental trauma cases with clinical histories and periapical radiography (PR) and answered questions regarding their diagnostic thinking and treatment decisions and their confidence in both. One month later, the same participants reviewed the same cases and answered similar questionnaires with the aid of CBCT imaging. A statistical analysis of their responses was conducted. ResultsDifferences were observed in diagnostic thinking when using PR or CBCT imaging (P < .05), and the use of PR was associated with a higher number of “unsure” answers to questions about diagnoses. After reviewing periapical radiographic images, the approach most frequently endorsed was “don’t start conventional endodontic treatment and order CBCT,” whereas the most common decision made after analyzing the CBCT images was “start conventional endodontic treatment.” Clinical interventions were proposed more often when participants evaluated the clinical case using CBCT imaging than when using PR (P < .05). The participants' degree of confidence in their diagnostic thinking was not different after analysis using PR or CBCT imaging (P > .05). However, there was a difference between PR and CBCT imaging in participants' confidence in their treatment decisions (P < .05). Participants who initially indicated a lack of confidence in their diagnosis or treatment option gained confidence when CBCT images were available. However, the inverse behavior was also observed for participants who were initially confident on the basis of PR (P < .05). Participants who decided to start treatment after CBCT analysis were less confident than when using PR (P < .05). ConclusionsIn dental trauma cases, CBCT imaging influenced participants' diagnostic thinking and choice of treatment modality and affected their confidence in the decision-making process.

The Influence of Dental Trauma Education on Undergraduate Students at Ajman University, United Arab Emirates: An Interventional Study.

Background and ObjectivesThe main objective of this study was to assess the impact of a lecture on dental trauma on the knowledge of undergraduate dental students at Ajman University in the United Arab Emirates (UAE).MethodsFourth-year dental students were asked to attend a lecture on dental trauma and then respond to an online questionnaire containing 10 close-ended questions related to their approach to managing dental trauma cases and tooth avulsion before (T0) and directly after (T1) the lecture. They were given 5 min for filling the questionnaire either time. McNemars test was used to compare the accuracy of their answers based on the correct or incorrect response for each question. The level of significance was set at p < 0.05.ResultsThe questionnaire was sent to 164 students, out of which 157 responded, giving a response rate of 95.7%. After receiving the educational intervention, the students showed a significant improvement in their knowledge on managing permanent tooth avulsion, especially regarding the handling of an avulsed tooth before replantation, extra-alveolar time, and media used for the storage and transportation of avulsed teeth (< 0.001).ConclusionThe study reveals that the lecture on dental trauma had an excellent outcome on the knowledge of the students. Therefore, it is essential to emphasize the importance of this information among undergraduate dental students in order to save teeth exposed to trauma and to reduce the social burden of such cases. This study contributes to better understanding of the effect of dental trauma education on undergraduate dental students’ knowledge of the subject.

Assessment of the knowledge and attitudes about the management of dental trauma among ear, nose and throat physicians.

Ear, nose and throat physicians (ENTp) encounter dental trauma (DT) when patients refer to the emergency department, as well as during operations such as tonsillectomy and suspension laryngoscopy. This study aimed to investigate the attitudes and knowledge of ENTp about managing DT, and motivation for further education. This study was a cross-sectional observational survey on a sample of ENTp from 15 different private/public hospitals. A questionnaire of 22 questions was divided into three parts: the level of professional experience and the frequency of encountering DT; specific questions on the management of DT; self-assessment of educational approach and level of knowledge regarding DT. A total of 128 surveys were accomplished and included in the evaluation. A larger percentage (96.9%) of the participants have experienced at least one case in the practice, and one-third (31.3%) have encountered more than ten DT cases. Although the duration of experience significantly affected the total number of correct responses to knowledge and attitudes regarding DT questions (p:0.028), more than half of the participants (44.38%) responded incorrectly to the questions. The majority of participants (97.7%) stated that they had no education on DT, and 90.6% were willing to receive DT training. The results of this study emphasize the deficiency of ENTp' knowledge level about the management of DT. In addition, results demonstrated the enthusiasm of ENTp for further training, which can contribute to the requirement of education for providing appropriate management of DT cases.

School Teachers' Knowledge and Attitudes about the Emergency Management of Traumatic Dental Injuries in Turkey.

The emergency management of traumatized teeth is critical to their long-term outcomes. In school-aged children, most traumatic dental injuries (TDI) occur at school and teachers are often required to manage dental trauma (DT) emergencies. Therefore, the aim of this study was to determine teachers' knowledge and attitudes about TDI. Survey in 147 randomly selected schools in 53 cities in Turkey. A questionnaire enquiring about demographic data, knowledge of DT, and knowledge of first aid related to DT was distributed to primary school teachers. 1,634 completed questionnaires were returned (65% response rate). 92.5% of the teachers were not satisfied with their DT knowledge, and almost all (97.8%) had never received DT training, although 28.1% had witnessed at least one case of DT. In the case of tooth avulsion, 26.4% believed that an avulsed tooth would be permanently lost, whereas 28.9% knew that a permanent tooth could be replanted. Knowledge of emergency management of TDI among schoolteachers in Turkey is inadequate, and training on their emergency management should be provided.

Paediatric dentist's ability to detect and diagnose dental trauma using 2D versus 3D imaging.

Visualisation of the third dimension has been reported to increase effectiveness of correctly diagnosing traumatic dental injuries. To assess the ability of paediatric dentists to detect and diagnose Traumatic Dental Injuries (TDI) using two different imaging modalities, intraoral radiographs (2D) and CBCT scans (3D). In addition, observer's confidence regarding the obtained diagnosis, using either technique, was assessed. Both 2D and 3D images of 20 dental trauma cases in children were presented in random order to a panel of thirteen paediatric dentists. Observers received instructions for the screening of the images for radiographic findings related to dental trauma, using structured scoring sheets for 2D and 3D images. Observed data were compared to those recorded by two experienced benchmark observers. A ten-point scale was used for assessing observer's confidence regarding their final diagnosis using 2D versus 3D images. Performance of individual observers showed wide variation. Statistical significance was reached for correctly detected and correctly diagnosed findings (p = 0.02), in favor of 3D. Most of the observers reported comparable confidence using 2D and 3D, two observers were more confident using 3D and one observer was more confident using 2D. Paediatric dentist's ability to detect and diagnose findings in patients with TDI was higher on 3D images. Most observers showed a similar confidence score of their diagnostic performance both on 2D and on 3D.

TRAUMATISMO DENTÁRIO: QUAL O CONHECIMENTO DO CIRURGIÃO DENTISTA?

The aims of this study were to evaluate the knowledge of dentists on the diagnosis and treatment of clinical situations of dental trauma and the impact of an orientation activity in the form of a lecture on the training process of professionals. The assessment instrument was a questionnaire that contained professional information and different clinical cases of dental trauma for dentists to answer. Data were collected in two stages, before and after the lecture. For statistical analysis, the G test was used, with a 5% significance level. Most professionals were general practitioners (71.4%), and most of them had experience with dental trauma (75.5%). However, when the statistical analysis was carried out, only the conduct before a tooth with pulp exposure &gt; 2mm with incomplete rhizogenesis and management after immediate re-implantation of avulsed tooth with complete rhizogenesis, demonstrated positive results with statistically significant differences. In view of this, we concluded that the professionals had satisfactory knowledge, with reservations for more complex cases.However, orientation activity did not contribute to the improvement in clinical decisions.

Orthodontic Approach in Dental Trauma Cases

Orthodontic Approach in Dental Trauma Cases

Crown Fracture Case and Complications

When the treatment of dental trauma cases is late, success decreases and complicated approaches are needed. This case report aims to present the problems encountered in the late intervention of the uncomplicated crown fracture, treatments applications and results of 1-year follow-up. In the intraoral examination of an eight-year-old male patient who applied to our clinic there was an uncomplicated crown fracture in the permanent left upper incisor. Radiological examination showed that the root development of the tooth is incomplete and there was a lesion in the apical region. Root canal treatment was started immediately and calcium hydroxide was placed in the root canal. 2 weeks later a triple antibiotic paste was placed for 2 weeks for disinfection of the root canal. At the next appointment, it was taken a culture sample after placing a drain in the root canal due to recurrent infection and drainage. Following the discontinuation drainage, the drain was removed, calcium hydroxide was placed for 2 more weeks, and the permanent filling was completed by Mineral Trioxide Aggregate. In the dental volumetric tomography taken due to the mobility of the relevant tooth, severe hard tissue loss was observed and then apical resection procedure was applied by applying splint. No pathological condition was observed in the follow-up periods of 3, 6 and 12 months, and hard tissue formation was observed on the received radiography. It is very important to inform patients and their families about post-traumatic treatment approaches.

Dental trauma learning facilitators for medical doctors: A viewpoint.

It is important for medical doctors to be equipped with the requisite knowledge and skills to manage dental trauma cases when patients present to them in an emergency. The aim of this paper is to identify facilitators (factors that enhance learning) that may impact on the ability and competency of medical doctors, who are expected to treat traumatic dental injuries (TDI), to appropriately treat and manage such cases. A change in medical curricula that is more inclusive of dental education and TDI management is imperative to promote effective teaching and learning of the treatment and management of dental trauma cases.

Multidisciplinary conservative management of dental fracture in young patient: case report

Introduction: The management of fractured permanent teeth due to dental trauma in young patients is a challenge that requires an efficient approach. Objective: Describe a conservative and multidisciplinary treatment of a case of dental trauma in a 13 years-old boy. Case report: At clinical examination was verified enamel and dentin fracture in the left upper central incisor and a fracture with pulp exposure in the right upper lateral incisor, with subgingival extension of its margin at lingual surface, and no swelling or tooth displacement was observed. At radiographic evaluation, no pulp or periradicular disturbances were verified. It was proposed the surgical lengthening of the clinical crown of the right upper lateral incisor for later performing endodontic treatment. It was decided to make direct composite resin restorations in both fractured teeth, instead of doing a prosthetic treatment in the affected lateral incisor, such as the placement of a full ceramic crown, in an attempt to perform a less invasive treatment, mainly due to the age of the patient. At a two years follow-up visit was observed the maintenance of the health of periapical tissues and the absence of clinical alterations. Conclusion: The restorations were kept in good conditions and aesthetics was considered satisfactory by professionals, patient and parents.