Dental Trauma Research Articles

Achieving excellence with interdisciplinary approaches in complex orthodontic adult patients

Over the last decades the percentage of adult orthodontic patients has substantially increased. Undeniably, an important motif for seeking orthodontic care at an older age is smile improvement, but this is not all. Frequently, impaired dentofacial aesthetics are combined with several other issues: severe dentoskeletal malocclusions; multiple tooth loss due to caries or endodontic failure; dental agenesis or trauma; periodontal breakdown; or functional problems, such as temporomandibular disorders or obstructive sleep apnoea. Therefore, comprehensive adult treatment mostly requires close collaboration of a team of equally well-trained dental specialists to select and execute the most suitable treatment option for the individual patient from day one. With joint planning, intensive communication with the patient and the involved specialists, and continuous monitoring of the treatment process, true patient-centred care can be delivered. In order to serve the individual patient best, the treating orthodontist does not only need thorough speciality training and continuing education, but furthermore, should be well-equipped with sufficient knowledge of the other dental fields of expertise. In combination with digital technology as an important tool for enhancing communication and efficient exchange of information between all involved team members, excellent joint clinical skills will take comprehensive interdisciplinary treatment to the next level.

Oral Cavity Cancer Secondary to Dental Trauma: A Scoping Review.

(1) Background: Oral cavity cancer represents the most common site of origin of head and neck mucosal malignancies. A few limited studies have suggested that chronic irritation, particularly in non-healing ulcers, and fibrotic tissue from poor dentition or ill-fitting dentures had a role in developing mouth cancer. This scoping review aims to evaluate the existing evidence concerning Oral Cavicty Cancer (OCC) in non-smokers/non-drinkers and the relationship with dental trauma. (2) Methods: A scoping review of the PubMed, Embase, and Web of Science databases was completed in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. (3) Results: Of the 33 articles that met inclusion, in 6 of them authors discussed the role of topography in dental trauma, in 11 articles authors discussed the carcinogenesis mechanism involved in chronic mucosal trauma, in 17 articles data on ill-fitting dentures was included, 4 studies dealt with the effect of broken/sharp teeth on mucosal damage, and in 7 studies the role of oral hygiene was covered. Less frequently discussed topics included gender, risk of neck nodes, and the role of potentially malignant oral disorders. (4) Conclusions: The available literature suggests a potential connection between chronic dental trauma and the development of OCC. Studies have highlighted factors such as denture use and ill-fitting dental appliances as contributors to an increased risk of oral cancer. Interestingly, we still miss data to support the hypothesis that women, particularly those without toxic habits like smoking or alcohol consumption, appear to be disproportionately affected by oral cancer related to chronic dental trauma.

Replantation After Dental Avulsion: A Scoping Review and Proposal of a Flow Chart.

Dental avulsion, the complete displacement of a tooth from its socket, is a severe dental trauma with a prevalence of 0.5% to 16% of all dental injuries. Replantation of avulsed teeth is common, yet recent studies show high failure rates and unpredictable long-term outcomes. This review examines clinical variables influencing intentional dental replantation decisions and proposes a treatment flow chart. A comprehensive literature search was conducted in PubMed-Medline, Scopus, WoS, and Cochrane databases using the keywords "tooth avulsion," "tooth replantation," and "tooth ankylosis." Inclusion criteria encompassed studies from January 2018 to February 2024. From 752 identified articles, 9 systematic reviews including 3 meta-analyses were selected for this scoping review. Immediate replantation is the gold standard for avulsed teeth, yet delayed replantation is more common in practice, impacting survival rates. Adherence to guidelines from the International Association on Dental Traumatology improves outcomes, especially in paediatric patients. Factors such as multiple caries, severe periodontal disease, advanced age, psychological conditions, immunodeficiency, and lack of cooperation are contraindications for replantation. Despite the high failure rate, replantation remains recommended in literature due to its potential advantages over prosthetic implants. This review highlights the complexities in decision-making for dental replantation, emphasising the need for a comprehensive approach considering individual clinical cases. A proposed treatment flow chart aims to support clinicians in predicting prognosis and making informed decisions. The review also underscores the link between dental trauma, poor oral health, and potential neglect in children, highlighting the importance of preventive measures and parental awareness.

Traumatic Dental Injuries among Adolescents and Young Adults in Iași, Romania: Legal and Medical Perspectives.

This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence. Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241). Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups.

Initial screening for dental abnormalities identified by labial and buccal photographs in dogs and cats.

To evaluate the dental abnormalities by visually assessing the labial and buccal photographs in dogs and cats and analyze their prevalence based on age and breed. 1,096 client-owned dogs and 775 client-owned cats. Data were collected from patients who visited 26 private veterinary clinics from January to December 2022. Each animal was evaluated through dental photographs taken from the labial and buccal sides. Correlations between the prevalence of the identified dental abnormalities and age, craniofacial type, and breed, were analyzed. Calculus, discoloration, epulis, fractured teeth, gingival recession, gingivitis, malocclusion, missing teeth, and persistent deciduous teeth could be identified by analyzing the dental photographs in both dogs and cats. Enamel defects in dogs and tooth resorption in cats could be identified. Brachycephalic dogs had a significantly higher prevalence of malocclusion (OR, 1.93; 95% CI, 1.36 to 2.75) and missing teeth (OR, 3.63; 95% CI, 2.71 to 4.91) compared to nonbrachycephalic dogs. Brachycephalic cats had a significantly higher prevalence of fractured teeth (OR, 1.95; 95% CI, 1.24 to 3.04) and a lower prevalence of gingival recession (OR, 0.30; 95% CI, 0.15 to 0.55) compared to nonbrachycephalic cats. Calculus, persistent deciduous teeth, and possibly gingivitis could be identified in dogs and cats by analyzing labial and buccal photographs. The assessment of some dental abnormalities such as fractured teeth, missing teeth, and tooth resorption can be limited without a complete dental examination under anesthesia. Although the assessment of dental conditions may be underestimated, the data on the prevalence of the dental abnormalities evaluated through the photographs could be utilized for screening dental diseases.

Fragment Reattachment of Maxillary Anterior Tooth- A Case Report

Dental trauma often results in fracture of the tooth. Reattaching the fractured fragment is one among the treatment modalities in the management of fractured tooth. The procedure is simple and relatively inexpensive. However, understanding the limitations of the procedure is essential. Also, patient cooperation is essential for long term success of the treatment. The case report highlights the management of fractured maxillary anterior tooth in a elderly patient.

Management of Complicated Crown Root Fracture Using Chamfer Reattachment Technique

Abstract The reattachment of the tooth fragment is one of the viable treatment options if the original intact tooth fragment is available following dental trauma. The reattachment of the remaining fractured tooth can provide better aesthetics, improved function and generate a positive psychological response amongst patients. This case report consists of three cases of crown root fracture that was successfully treated using tooth fragment reattachment technique.

Demographic and Clinical Characters of the Patient of Condylar Fracture Treated under the Department of Oral and Maxillofacial Surgery in a Tertiary Level Hospital

Introduction: Mandible is the only mobile bone of the facial skeleton which plays an important role in mastication, speech and deglutition. Being a prominent bone of the facial skeleton, it is one of the most common facial bone to be fractured. Fracture in the mandible causes severe loss of function and disfigurement. Objective: The aim of this paper was to investigate the demographic and clinical characteristics of the patients of condyle fracture treated under the oral and maxillofacial department of a tertiary level hospital of Bangladesh. Methods: This retrospective cross-sectional descriptive type of study was conducted at the Department of Oral and Maxillofacial Surgery in Dhaka Dental College and Hospital, Dhaka, Bangladesh during June, 20 23 to December, 2023. A consecutive sampling technique was used and a series of 120 cases of condyle fracture aged 17-65 years of both sex were retrospectively enrolled in this study. The data were analyzed using Statistical Package for Social Sciences (SPSS), version-23.0. Results: A series of 120 cases of condyle fracture patients were enrolled in this study. Among the patients, the most frequent age group was 30-39 years which includes 62(51.25%) patients. The mean age of the patients was 41.10±10.21 years. A significant gender disparity was observed, with 87(72.5%) of the patients being male. Most of the patients were service holder 63(52.5%). The major cause of injury of the patients was road traffic accident 75(62.5%).Among the study patients, 111(92.5%) had third molar teeth present. Of them, the most frequent 75(67.56%) patients had erupted third molar condition and 36(32.43%) patients had impacted third molar condition. According to distribution of type of impacted teeth, 21(50%) cases, had oriented vertically and followed by mesioangular 11(25%), disto-angular 4(10.7%), and horizontal 6(14.3%). According to distribution of condylar fracture, the most frequent 73 (6.25%) patients had non-displaced injuries. followed by displaced 36(30%) and dislocated 11(8.75%). Conclusion: This study investigated that road accident is the principal factor of condylar fracture and third molar teeth and its position has a significant impact on condylar fracture and at the same time the male are the more prone to condylar fracture than the female in Bangladesh

The technical consultancy office in the evaluation of dental trauma from a road accident

The technical consultancy office in the evaluation of dental trauma from a road accident

Dental trauma related to orotracheal intubation: Prospective study of 43 cases

Dental trauma related to orotracheal intubation: Prospective study of 43 cases

Endodontic Access Cavity Design and Fracture Resistance: A Systematic Review and Meta-Analysis of Conventional vs. Newer Access Cavity.

The era of minimally invasive dentistry has led to the development of new access cavity designs. The impact of various access cavity designs on the fracture resistance of teeth has been extensively studied. The primary aim of this systematic review and meta-analysis is to evaluate and compare the effects of recent modifications in endodontic access cavity design- specifically, conventional, conservative, and truss designs on tooth fracture resistance. Three independent reviewers searched studies across six different databases (PubMed, Scopus, EBSCOhost, BVS, Wiley, and Google Scholar) from January 2000 to July 2024, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were then screened using strict inclusion and exclusion criteria. A quality assessment was performed using a modified version of the quality assessment of in-vitro studies according to the QUIN (Quality Assessment Tool For In Vitro Studies) tool, categorizing the selected articles into low, moderate, and high risk of bias. Quantitative data synthesis was conducted to combine equivalent results using STATA. Forest plots were created with the level of significance set at 0.05 (p = 0.05). Out of 243 articles, 14 met the strict inclusion criteria. Among the selected articles, 11 showed a low risk of bias and three showed a moderate risk. The meta-analysis revealed that fracture resistance of conservative and truss access designs is significantly higher than that of conventional endodontic access, with a standardized mean difference (SMD) of 2.61 (95% 1.47 to 3.74; p-values <0.001) and SMD = -1.26 (95% confidence interval (CI): -1.81 to 0-0.71; p<0.001). The heterogeneity (I²) values for these comparisons were 92% and 65.6%, respectively. The extent of the access cavity has a substantial impact on tooth fracture resistance. Newer conservative and truss endodontic access designs offer better fracture resistance compared to conventional endodontic access.

Clinical application of Er:YAG laser and traditional dental turbine in caries removal in children.

This study compares the clinical efficacy of erbium-doped:yttrium-aluminium-garnet (Er:YAG) laser and traditional dental turbine in caries removal in children. The study cohort comprised 78 children aged 5 to 10 years with caries in two symmetrical maxillary molars. Different carious sides of the same child were randomly divided into control and observed sides. For each child, the caries on the control side were treated with a traditional dental turbine, while the observed side was treated with an Er:YAG laser. The study evaluated the use of anesthetics, pain levels, tooth hypersensitivity and the occurrence and severity of tooth fractures during caries removal with different methods. Additionally, the clinical anxiety and cooperative behavior of the children were observed. The time required for caries removal and cavity preparation by both methods was recorded, and the success rate of treatment was assessed after one year of follow-up. The results indicated a significant reduction in the use of anesthetics, pain and the incidence and severity of tooth hypersensitivity with the use of Er:YAG laser (p < 0.05). No significant difference was found in the occurrence of tooth fractures between the two groups (p > 0.05). The children treated with Er:YAG laser demonstrated better clinical anxiety levels and cooperative behavior. However, the time required for cavity preparation was longer with the use of Er:YAG laser (p < 0.05). After a 12-month follow-up, there was no significant difference in the success rate of treatment between the two groups (p > 0.05). In conclusion, compared to the traditional dental turbine, the use of Er:YAG laser improves treatment comfort and cooperation in children with caries and reduces the need for intraoperative anesthetics.

Management of complicated crown fracture in maxillary incisor using fragment reattachment - 5-year follow-up

Complicated crown-root fractures of maxillary incisors are a relatively common occurrence in cases of trauma to the facial region. Patients with such fractures are in acute pain and usually require emergency care on their first clinical visit. Pain management and restoration of function, esthetics, and phonetics should be the prime objective in handling such patients. The reattachment of fractured tooth fragments is a relatively simple procedure that provides natural esthetics and conservation of tooth structure. This case report describes such a reattachment procedure in a complicated crown-root fracture and its success at 5 years of follow-up.

Prosthetic Maintenance Assessment for Two Implant- Retained Overdentures Reinforced with PEKK Versus Co-Cr Framework: A Randomized Controlled Clinical Trial.

The primary challenge associated with implant overdentures lies in the occurrence of denture fractures around the attachments. Hence, it is recommended to enhance flexural strength through reinforcement frameworks. This study aimed to assess and compare the prosthetic maintenance of mandibular implant overdentures reinforced with Co-Cr and PEKK frameworks. Twenty-four participants with completely edentulous ridges were selected, and two implants were placed at the mandibular canine areas. After osseointegration period, ball attachments were installed. Participants were randomly assigned into two groups: Group I received a mandibular implant overdenture reinforced with a Co-Cr framework, while Group II received a mandibular implant overdenture reinforced with a PEKK framework. Prosthetic maintenance evaluations were conducted in both groups twelve months post-denture insertion. Categorical data were analyzed, and results were presented as frequency and percentage values. Group II exhibited a significantly higher percentage of cases with screw looseness, denture relining, and tooth separation compared to Group I. Although Group II cases showed a non-significant increase in the percentage of insert wear and retention loss. Within the limitations of this study, the findings suggest that Co-Cr, in contrast to PEKK frameworks, offers a more reliable reinforcement of the implant-retained overdentures.

Management of Ellis Class II Fracture in Young Permanent Maxillary Central Incisor

Background: Tooth fracture is a condition of missing or lost fragments of a complete tooth. Tooth fracture usually occurs simultaneously with another oral injury. Objective: This case report discussed the management of Ellis class II fractures on an immature permanent central incisor of a patient who reported to Jenderal Achmad Yani University (Unjani) Dental Hospital. Case: An 11-year-old girl revealed a broken upper left tooth, sensitive to cold drinks that interfered with her appearance one year ago. The patient had a good general condition, no abnormalities during an extraoral examination, and a history of pain on the lower back tooth since a year ago. Case Management: Management of Ellis class II fracture in young permanent central incisor was conducted by using a class IV composite resin restoration. Conclusion: The management of Ellis class II fracture should be conducted holistically and systematically with subjective, intraoral, extraoral, and adjunctive examinations which should be performed correctly and considering the child’s psychology.

Multiple cranial pathologies in spotted hyaenas, Crocuta crocuta

Spotted hyaenas are generally considered to have resilience against injuries and pathogens, and the incidence of pathologies is scarcely reported. However, it is important for ecological studies and conservation efforts to have a clear overview of the physical threats that can occur in the life of a species. The present paper describes and interprets several osteopathologies in the crania of the spotted hyaena, Crocuta crocuta, in the collections of the Royal Museum for Central Africa (RMCA) in Tervuren, Belgium. Of the fifty-two specimens from central Africa examined, twenty-three (i.e., 44 %) of them showed evidence of pathologies, including injuries, congenital pathologies, and disease. Selected specimens were scanned using Computed Tomography and their internal cranial structures were studied. Here we describe and discuss the different types of pathologies evident in the crania of these hyaenas: craniosynostosis, microtia, osteomyelitis and periodontitis, as well as a trauma indicated by cranial fractures, dental fractures, and bite puncture marks. Some pathologies reported herein are novel for hyaenas, and there are some instances of multiple pathologies in the same individual. Implications of these pathologies, including the social interactions of hyenas, conservational threats, as well as biased data sampling, are highlighted. This study improves our knowledge of disease and trauma experienced by hyaenids, and provides a better understanding of their biology, and the potential threats faced by these iconic animals. This case study offers a comparative base for similar studies in other carnivorans, to clarify the pathological background of apex predators.

Orthodontic management of traumatized teeth: a survey among orthodontists

BackgroundInformation on previous traumatic dental injuries is important as they can lead to increased complications during orthodontic treatment and impact the treatment planning and outcomes. The aim of this study was to assess the knowledge of Jordanian orthodontists in orthodontic management of traumatized permanent teeth.MethodsCross-sectional survey among active registered orthodontists using a questionnaire distributed by hand.ResultsThe study included 139 orthodontists. Nearly half of orthodontists treated between one to three patients with a history of traumatic dental injuries in the past 3 months. Only 43.2% of the participant asked routinely about history of trauma. A vast discrepancy in times waited before orthodontic movement and in the orthodontic management approach of traumatized teeth was noted. A statistically significant negative relationship between age and knowledge level was found (p = 0.002). A significantly higher level of knowledge was found among participants who had fellowship or board certification than those having the high diploma degree (P-0.032) and also who had treated patients with history of dental trauma in the last 3 months than those who did not (p = 0.001).ConclusionsThe knowledge of the surveyed orthodontists in both the recommended observation period before orthodontic treatment and management approaches of traumatized teeth during orthodontic treatment was insufficient. Years of clinical experience significantly affected knowledge, with older participants having lower levels of knowledge. Orthodontists who treated patients with history of dental trauma in the last 3 months had significantly higher knowledge in orthodontic management of traumatized teeth. Orthodontists needs to be aware of the proper timing and strategies on orthodontic management of traumatized permanent teeth to improve the long term prognosis and to reduce further complications during orthodontic treatment through proper management.

Pulp Cavity Calcification in SLE Patient Associated with Long-term Use of Glucocorticoids: A Case Study with Endodontic Approaches

Background Calcification in the tooth pulp cavity occurs in response to various factors, including dental trauma and chronic irritation. Systemic lupus erythematosus (SLE) is the most common type of lupus, causing widespread inflammation and tissue damage in the affected organs. The SLE condition is generally managed by long-term use of drugs, including glucocorticoids (GCs). Objective This study aimed to assess the association of pulp cavity calcification in SLE patients with long-term use of GCs and to present endodontic perspectives on the issue. Case Presentation A female SLE patient with a history of long-term use of GCs visited our hospital for an oral surgery examination due to an accident. The crown of tooth 11 was visibly fractured. The tooth was sensitive to cold stimulus, while tooth 21 was mobile. Various examinations (including electric pulp test and panoramic radiography) pointed to the diagnosis of chronic pulpitis in the affected teeth (11 and 21), and cone beam computed tomography (CBCT) revealed that the pulp cavities in all teeth were almost completely calcified. Thus, the root canal treatment (RCT) was attempted and followed by crown restoration for the affected teeth. The involvement of GCs in the pulp cavity calcification was assessed. Conclusion According to this case and a series of related studies, long-term use of glucocorticoids is associated with the incidence of pulp cavity obliteration (PCO). More frequent dental examinations and appropriate adjustments in medication use (dose and duration) should be considered and implemented.

Clinical Evaluation of Metal Dental Prostheses in Captive Wild Felids.

Captive felids are prone to dental fractures, and the recommended treatment involves endodontics (root canal treatment), prosthodontics (coronal restoration), or tooth extraction. A single-unit dental prosthesis can restore the crown of a tooth whose structure has been partially or completely lost. Nine animals out of 35 captive wild felids kept under human care in 7 different Brazilian institutions were selected for the study. The animals selected included the little spotted cat (Leopardus tigrinus), ocelot (L. pardalis), margay cat (L. wiedii), pampas cat (L. colocolo), jaguarundi cat (Puma yagouaroundi), puma (P. concolor), jaguar (Panthera onca), lion (P. leo), and tiger (P. tigris). Nineteen canine prosthodontic crowns (18 full and one 3/4) were cemented using dual-cure resin cement and their feasibility was evaluated for 30 months. Fourteen (73%) remained fixed to the tooth and 5 (27%) were lost after the evaluation period. This study aimed to assess the longevity of prosthodontic crowns in the canine teeth of wild felids. Furthermore, it aimed to determine the functionality and longevity of teeth which had received prosthodontic crowns.

PENATALAKSANAAN TRAUMA GIGI PADA ANAK USIA TUMBUH KEMBANG

Dental trauma is often found in children of growing age due to poor psychomotor coordination, making them prone to falls. This can cause damage to the teeth and their supporting tissues, which can interfere with mastication, speech, aesthetics and the eruption of permanent teeth. The management of dental trauma in children is still poorly understood by parents and teachers, therefore an approach is needed regarding the first treatment of trauma to primary teeth. The choice of Community Service target at Kepodang preschool was due to a request from the school principal as the community leader. Education and training activities were carried out on Monday, March 4th 2024 for a total of 22 teachers and parents. The aim of this activity is to increase knowledge, motivate changes in attitudes and behavior in maintaining oral health, and provide learning about first care for trauma in primary teeth. An initial assessment of knowledge and attitudes regarding first care for trauma in primary teeth was carried out through administering a pre-test with multiple choice questions. The material given includes dental and oral health problems, prevention methods, as well as first treatment for trauma in primary teeth by using the power point text, discussion, and a simulation of how to brush teeth with songs. Evaluation was carried out through a post test with multiple choice questions. Evaluation of the post test results shows that there was an increase in test score. The results of this activity recommend continuing this training activity in kindergartens or other elementary schools, especially for teachers and parents