Traumatic Dental Injuries Research Articles

Traumatic dental injuries and molar incisor hypomineralization: a cross-sectional study of schoolchildren from southern Brazil.

To describe the prevalence and the variables associated with TDIs in schoolchildren aged 8 to 14years in Estância Velha city in southern Brazil, placing emphasis on molar incisor hypomineralization. Students enrolled in public schools of a medium-sized city in the southern Brazil were selected using cluster random sampling. Clinical examinations assessed molar incisor hypomineralization-MIH (European Academy of Pediatric Dentistry criteria), dental caries (DMFT index), and TDIs (O'Brien's criteria). Socioeconomic and demographic variables were assessed using a standardized questionnaire. Prevalence ratios were estimated using Poisson regression (p < 0.05). 513 students (54.8% female), with a mean age of 11.6 (± 1.9) years, participated in the study. The prevalence of TDIs was 11.3%, with enamel fracture representing 90.4%. The high prevalence of traumatic dental injuries was associated with MIH (PR: 2.22 CI: 1.27; 3.87; p < 0.01) and overjet > 3mm (PR: 2.03 CI 1.19; 3.45; p < 0.01). The sample of schoolchildren from southern Brazil had a low prevalence of traumatic dental injuries. Molar incisor hypomineralization and increased overjet were associated with the higher prevalence of traumatic dental injuries.

Visual Behaviour During the Interpretation of Cone-Beam Computed Tomography Images of Traumatic Dental Injuries: An Eye-Tracking Study.

This cross-sectional observational study aimed to investigate the visual attention patterns of postgraduate endodontic residents during the interpretation of cone-beam computed tomography (CBCT) scans for traumatic dental injuries (TDIs) using eye-tracking technology. A cohort of 10 residents who were recruited from King Abdulaziz University Dental Hospital (KAUDH) underwent interpretation of seven CBCT images of TDIs. Eye-tracking metrics, including dwell time, entry time, end time, and the number of revisits, were recorded and analyzed using nonparametric statistical tests. Eye-tracking data revealed that patients with lateral luxation and extrusive luxation pathologies had the longest mean dwell times (1.82 seconds and 1.50 seconds, respectively). These findings were statistically significant compared to other pathologies (p<0.001). Conversely, horizontal root fractures and periapical radiolucency were identified more quickly by the participants (mean entry times of 6.60 seconds and 8.84 seconds, respectively). The findings indicate variability in visual attention metrics depending on the type of TDI, suggesting that certain injuries may require more focused attention for accurate diagnosis. Specifically, lateral and extrusive luxation injuries attracted longer dwell times, possibly due to their unique diagnostic challenges. This research provides a basis for future studies aiming to optimize education and training related to CBCT interpretation of traumatic dental injuries.

Apexification treatment on tooth with a history of trauma: A case report

Background: Traumatic dental injuries to the teeth may result in pulpal and periapical disease. Most dental traumas occur in the 7 -10-year-old age group with incomplete apical root development. Apexification is the procedure to close the apex using bioactive material to create an apical plug. MTA can be used as a material of choice to treat open apex. Purpose: To perform an apexification of open apex with MTA apical plug. Case: A 30-year-old female patient with a chief complaint to fix her missing anterior filling and blackened tooth. The tooth had a history of trauma when the patient was 7 years old. One year ago, the tooth had intermittent pain so the tooth was treated and filled by another dentist. Case Management: Access opening is performed and apical gauging is determined. Then, working length was established. Debridement was done with H-file #80. Irrigation sequence with NaOCl 1,5% - Aquadest – EDTA 17% -aquadest. Ca(OH)2 dressing was given and temporary restoration was placed. On the second visit, temporary restoration was removed, followed by a root canal filled with MTA 3 mm from the apex using MAP carrier then confirmed with a radiograph. Conclusion: Trauma that occurs during tooth formation may cause an open apex that is treatable using an MTA plug.

Regenerative endodontic treatment and traumatic dental injuries.

Pulp necrosis is the most common complication following dental trauma and is often associated with apical periodontitis. The management of these teeth is challenging in terms of large root canals, open apices, thin dentinal walls, and short roots. Over decades the conventional treatment for these teeth was calcium hydroxide apexification, a time-consuming procedure despite high success rates. Subsequently after the introduction of mineral trioxide aggregate and hydraulic calcium silicate materials single visit apical plug procedures became increasingly practiced with comparable success rates to the conventional apexification. The search continued afterward for a clinical procedure that may stimulate further root development and apical closure to avoid the long-term complication of root fracture after apexification. Regenerative procedures using stem cells derived from the apical papilla and blood clots as scaffolds were then introduced for the management of immature teeth, with variable protocols and success rates. This review will cover the evidence available and current position of regenerative endodontic procedures in traumatized immature teeth with apical periodontitis, in terms of clinical protocols, outcome, and potential prognostic factors.

Knowledge and attitude of traumatic dental injuries in Mongolian schoolteachers

BackgroundTraumatic dental injury (TDI) is a growing public health concern worldwide, and children and adolescents are commonly affected. Because TDI often occurs at school, the response of teachers to these injuries is crucial. However, teachers in various countries have been shown to lack knowledge of effective TDI first-aid response and need an intervention to improve their knowledge. The aim of the study presented here was to ascertain and analyze teachers’ knowledge of and attitude about TDI in Mongolia.Materials and methodsA cross-sectional study of full-time teachers in Mongolia was performed using an online questionnaire (compiled from relevant studies) from September 2022 to December 2022. The questionnaire consists of 47 items and among them 14 were used to assess the teacher’s knowledge, and 5 were for attitude towards TDI. The maximum possible score was 14 points and grouped as follows good, moderate, and poor. T-test, ANOVA test (post-hoc) and linear regression analysis were performed.ResultsThe online survey provided quantitative data from 2821 participants: 28% were elementary school teachers, 29% middle school teachers, and 42% high school teachers. Their mean age was 36.7 ± 9 years, and 2433 (86%) were female. The mean score of the TDI knowledge of the teachers was 5.3 ± 2.1 out of 14. The ANOVA test showed that older (p < 0.01) and more experienced teachers (p < 0.01) had higher scores. Teachers in the eastern (5.46 ± 2.2) and southern (5.49 ± 2.2) provinces had higher mean scores than in the other provinces (p < 0.02). Teachers majored in natural sciences (5.4 ± 2.2) had a higher score than those in the social sciences (5.2 ± 2.1) and difference were significant (p < 0.02). The multiple regression model statistically significantly predicted a one-year increase in experience, the TDI score increased 0.034 (95% CI 0.026, 0.043) unit.ConclusionsThe knowledge regarding TDI and effective first-aid response to such injury is low in teachers in Mongolia. However, the teachers’ attitude about TDI was positive and they wanted to learn and improve their knowledge. Therefore, further education and training programs are advised.

A phenomenological exploration of experience of Syrian dentists with online Course “Traumatic dental injuries”

BackgroundSeveral learning modalities have been implemented to improve learning about Traumatic Dental Injuries (TDIs) worldwide. Free online courses about TDIs might be an effective and convenient approach for equipping Syrian dentists with essential competencies during the Syrian crisis. Therefore, this qualitative study with a descriptive phenomenological method was undertaken to explore the lived experience of Syrian dentists enrolled in an online course about TDIs and investigate areas requiring improvement. MethodsEthical approval was obtained from the Faculty of Dentistry, Damascus University, and the University of Dundee. Educational contents of the TDI course were developed. About 10 dentists who completed the TDI course, were interviewed. The interviews were recorded, transcribed, and analyzed to identify emerging themes. Inductive thematic analysis was performed to extract all data. ResultsAbout 10 clustered categories were first developed and this has led to the emergence of 3 themes that represent the lived experience including usefulness, challenges, and recommendations. Participants were so motivated and keen to take advantage of the course despite the personal, technical problems, and crisis-related challenges. TDIs course was effective for general and specialists despite the challenges they experienced. Factors that lead to effective TDIs courses as reported by participants were flexibility in time and location, interactivity with colleagues, other commitments, quantity and quality of content, easiness, and variety of virtual environment tools. Conversely, negative attitudes were linked to factors like lack of interest, unfamiliarity with the learning environment and tools, late participation, lack of confidence, anxiety about independent learning and insufficient interactivity and engagement tools. ConclusionSyrian dentists can benefit from online courses if constraints and various learning needs are addressed during the design and delivery of online courses. Future work is still required to identify other effective instructional modalities that equip Syrian dentists to overcome challenges and enhance their learning.

Assessment of oral health status and treatment needs among visually impaired children in Vadodara city: An observational study

ABSTRACT Background: Maintaining optimal oral health is crucial for all children, but it holds particular significance for visually impaired children (VIC). Neglecting oral health can lead to a myriad of issues such as dental caries, gum disease, traumatic dental injuries (TDI), and even systemic health problems. Therefore, tailored interventions are essential to ensure their well-being and life quality. Aim: The current research aimed to assess the oral health status and treatment needs among VIC. Materials and Methods: The cross-sectional survey was conducted on 300 VIC in Vadodara city between September 2022 and December 2022. The oral examination was done in the respected school in the daylight with a normal sitting chair. Oral health status was checked according to the World Health Organization criteria (2013). Malocclusion was checked according to Angle’s classification of malocclusion. Descriptive statistical analysis was used. Results: The prevalence of dental caries was found to be 65%. 70% of children showed periodontal condition. TDIs among VICs were 40%. There is a high prevalence (91%) of Class I malocclusion. Most of the children require prompt treatment. Conclusion: The study reveals alarming dental health issues among VIC in Vadodara. With 65% experiencing dental caries, 70% displaying periodontal conditions, and 40% suffering from TDI, the oral health challenges are significant. Furthermore, a striking 91% exhibit Class I malocclusion. These findings underscore an urgent need for comprehensive dental care and tailored interventions to address the substantial oral health disparities in this vulnerable population. Immediate attention and specialized treatment plans are crucial to improving their overall well-being and quality of life.

Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone-Acquired Photographs: A Multicenter Diagnostic Accuracy Study.

Background: Mobile health (mHealth) has an emerging potential for remote assessment of traumatic dental injuries (TDI) and support of emergency care. This study aimed to determine the diagnostic accuracy of TDI detection from smartphone-acquired photographs. Methods: The upper and lower anterior teeth of 153 individuals aged ≥ 6 years were photographed using a smartphone camera app. The photos of 148 eligible participants were reviewed independently by a dental specialist, two general dentists, and two dental therapists, using predetermined TDI classification and criteria. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and inter-rater reliability were estimated to evaluate the diagnostic performance of the photographic method relative to the reference standard established by the dental specialist. Results: Of the 1,870 teeth screened, one-third showed TDI; and one-seventh of the participants had primary or mixed dentitions. Compared between the specialist's reference standard and four dental professionals' reviews, the diagnostic sensitivity and specificity for TDI versus non-TDI were 59-95% and 47-93%, respectively, with better performance for urgent types of TDI (78-89% and 99-100%, separately). The diagnostic consistency was also better for the primary/mixed dentitions than the permanent dentition. Conclusion: This study suggested a valid mHealth practice for remote assessment of TDI. A better diagnostic performance in the detection of urgent types of TDI and examination of the primary/mixed dentition was also reported. Future directions include professional development activities involving dental photography and photographic assessment, incorporation of a machine learning technology to aid photographic reviews, and randomized controlled trials in multiple clinical settings.

Individual and contextual determinants associated with traumatic dental injuries in children eight to ten years of age: a multilevel analysis.

Investigate individual and contextual determinants associated with traumatic dental injuries in schoolchildren. A cross-sectional study with 739 pairs of parents and children. Parents answered a sociodemographic questionnaire, the Family Adaptability and Cohesion Evaluation Scale and a questionnaire on the child's use of electronic devices. Examinations of the children were conducted at the school by calibrated examiners using the diagnostic criteria proposed by Andreasen. Contextual variables of the school were also collected. Multilevel Poisson regression for complex samples was performed (p < 0.05). The individual factors associated with the outcome were children of single parents (PR = 2.33; 95% CI: 1.79-2.66), practice of sports (PR = 2.46; 95% CI: 1.70-3.22), the daily use of electronic devices (PR = 1.78; 95% CI: 1.31-1.81), more than 2 h per day of screen time (PR = 3.84; 95% CI: 1.94-4.28) and chaotic family adaptability (PR = 4.22; 95% CI: 3.44-4.99). The contextual variables were studying at a public school (PR = 1.77; 95% CI: 1.02-3.05) and the presence of rigid floor in the school courtyard (PR = 1.99; 95% CI: 1.15-3.15). Individual determinants, studying at a public school and the presence of rigid floor in the school courtyard were associated with traumatic dental.

Oral health status, behavior, and practices among hearing impaired children attending a specialized school in Jordan.

To assess the oral health status and related factors among hearing impaired schoolchildren. A cross-sectional study among 115 hearing impaired schoolchildren enrolled at the School of the Deaf in Jordan. The World Health Organization (WHO) methodology and criteria were applied to collect data on caries, gingival bleeding. The WHO classification modified by Andreasen etal. was used to record traumatic dental injuries (TDIs). Sociodemographic data, oral health practices, and oral health related quality of life information were collected using a structured questionnaire. The prevalence of caries among the study sample was 84.3%, the dominating component was untreated dental caries. Mean decayed, missing, filled primary teeth (dmft) was 8 in the primary dentition and 3.62 in the mixed dentition, mean Decayed, Missing, Filled permanent Teeth (DMFT) was 1.38 in the mixed dentition and 2.87 in the permanent. The overall mean of gingival bleeding percentage among the whole study sample was 70.38%. the prevalence of TDIs was of 11.3% and mostly caused by falls. The prevalence of dental caries and caries experience, rate of gingival bleeding and dental trauma in children with hearing impaired individuals are high compared to figures observed in studies conducted among Jordanian schoolchildren with normal hearing. Dental diseases impact the quality of life of these individuals.

Knowledge Level and Practice of Primary School Teachers Regarding Traumatic Dental Injuries and Their Emergency Management in Twin Cities

Background: Childhood dental trauma frequently occurs at school, with primary school teachers often being the first responders. The immediate response and management by teachers can help mitigate the adverse physical, psychological, and social impacts of dental trauma on children. Despite the significance, there is limited data on the knowledge and practices of primary school teachers regarding the emergency management of dental injuries. Objective: The objective of this study was to evaluate the knowledge level and practices of primary school teachers concerning dental trauma and its emergency management. Methods: This descriptive cross-sectional study was conducted in primary schools of Rawalpindi and Islamabad. A sample of 335 primary school teachers was selected using simple random sampling. Data was collected using a structured questionnaire adapted from Ivanda et al. (10), which included three sections: demographic information, background and satisfaction with current knowledge, and specific knowledge of dental trauma management. The questionnaire consisted of 14 multiple-choice questions, and knowledge was scored out of 14 points. Scores were categorized as good (11.2-14 points), moderate (8.4-11.1 points), or poor (&lt;8.3 points) based on Bloom's cut-off points. Statistical analyses were conducted using Fisher’s exact test, chi-square test, and independent t-test with a significance threshold of p≤0.05. Results: All participants reported they had not received training for traumatic dental injuries (TDIs). The majority (97.9%) demonstrated poor knowledge, with only 2.1% showing moderate knowledge and none achieving a good knowledge level. There was a statistically significant difference in knowledge between private and public sector teachers (p=0.04), but no significant correlations were found between knowledge scores and age, education level, or teaching experience. Conclusion: Traumatic dental injuries occur frequently in schools, and teachers should be well-equipped to handle such emergencies. The study highlights the insufficient knowledge among primary school teachers regarding dental trauma management. Comprehensive training programs are recommended to improve teachers' preparedness, potentially reducing the physical and psychological impacts of dental trauma on children.

Outcomes of apexification in immature traumatised necrotic teeth and risk factors for premature tooth loss: A 20-year longitudinal study.

To evaluate the long-term survival of immature traumatized incisors with pulp necrosis and apical periodontitis after endodontic treatment with two apexification techniques (calcium hydroxide apexification and MTA-apical plug) and to identify major factors affecting the survival of these teeth. Records of 2400 children and adolescents were screened for presence of traumatic dental injuries to immature incisors where endodontic treatment with the two apexification techniques was performed during January 2003 and December 2022, compared to a control group of mature teeth treated with conventional endodontic techniques. The studied variables were age; sex; apexification technique, presence of luxation and hard tissue injuries; preoperative root development stage (RDS), preoperative and postoperative periapical index (PAI), the time-point for tooth loss, and overall survival time in years. Kaplan-Meier estimates were used to graphically present the survival functions and Cox proportional hazard model to calculate hazard ratios (HR, 95% CI). The median survival time was 10 years for calcium hydroxide apexification, 16.1 for MTA-apexification, for luxation injuries other than intrusions and avulsions 15.5 years, for intrusions 12.5 years and for avulsions 6.8 years. The variables with significant negative impact on tooth survival were calcium hydroxide apexification, avulsion and postoperative PAI 3-5. No significant relationships were found for the variables MTA apexification, concussion; subluxation; lateral luxation; extrusion, intrusion, hard tissue injuries, preoperative RDS and PAI scores and postoperative PAI 1-2. After adjustment, the risk for premature tooth loss was 13.5 times higher in calcium hydroxide apexification, approximately 2 to 4 times higher in PAI 3-5, and 5.6 times higher in avulsions. Calcium hydroxide apexification, avulsion, and postoperative PAI 3-5 were identified as prognostic variables with significant negative impact on the risk for premature tooth loss.

Do binge drinking adolescents have a greater number of traumatised teeth? A longitudinal study with 12-year-olds in Brazil.

Binge drinking has been linked to traumatic dental injury (TDI). Once drunk, adolescents are more prone to accidents, which may result in orofacial injury. This study evaluated the possible association of binge drinking with a number of traumatised teeth in a population of 12-year-old Brazilian adolescents in 2013 and 2015. This study was longitudinal, carried out with 588 adolescents at two moments, 2013 and 2015. TDI, overjet and lip protection were assessed by calibrated examiners. Binge drinking data were collected through the Alcohol Use Disorders Identification Test. Sociodemographic indicators were obtained through a questionnaire answered by the parents/guardians. The Poisson regression model with a random effects intercept was estimated. A higher prevalence of traumatised teeth was observed among adolescents who binge drink (IRR = 1.37; 95% CI: 1.05-1.80; p < .05). The prevalence was also significantly higher among adolescents in this age range with a ≥ 3-mm overjet and those with inadequate lip protection (IRR = 1.99; 95% CI: 1.44-2.76; p < .001 and IRR = 3.41; 95% CI: 2.57-4.53; p < .001, respectively). A greater number of traumatised teeth were found among adolescents who reported binge drinking and had severe overjet and inadequate lip coverage.

Are sleep disorders associated with traumatic dental injuries in school children? A cross-sectional study.

To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders. A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed. The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders. Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.

Attitude and Practices of Paediatric Dentists towards Parental Guidance on Dental Trauma. A cross-sectional survey.

There is a lack of sufficient information about the protocols followed by paediatric dentists in informing parents about traumatic dental injuries as a part of anticipatory guidance. Hence, the aim of this study was to assess paediatric dentists' attitudes and practices about parental guidance regarding these injuries. This was a cross-sectional survey conducted using a validated questionnaire emailed through Google form to approximately 2500 paediatric dentists in various world regions. The sampling method used was a list-based sampling frame followed by simple random sampling. Participants were recruited through national member societies of the International Association of Paediatric Dentistry, personal contacts and social media groups. Only paediatric dentists with at least three years of experience after their post-graduation were only included in the study. Their attitudes and practices towards parental education on dental trauma during the child's first and recalled dental visits were assessed as per their age, gender, country of post-graduation qualification and years of experience in the profession. Chi-Square test was used to evaluate the association between the paediatric dentist response and the continent of practice. Kruskal-Wallis H test was used to assess the level of significance within each variable in relation to the continent of practice. A 95% confidence interval with a significance level of α = 0.05 was used. The overall attitude and practice of paediatric dentists toward parental education on traumatic dental injuries were not satisfactory. Many paediatric dentists do not impart education on emergency care and dental trauma prevention in primary teeth. Parents should be informed about oral hygiene instructions and prevention-oriented interventions during the first visit and about managing traumatic dental injuries.

Evaluation of Knowledge, Awareness, and Attitude Towards Management of Displaced Tooth from Socket (Avulsion) Amongst Nursing Fraternity in Mangaluru City: A Cross-Sectional Study

Abstract Introduction The aim of this study was to evaluate knowledge, awareness, and attitude in the management of displaced tooth from socket (avulsion) amongst nursing fraternity in Mangaluru City. Materials and Methods A 20-item questionnaire regarding knowledge, awareness toward management of avulsed tooth was administered to 150 nursing interns. Results Among 150 participants, 47% demonstrated awareness of the storage media for an avulsed tooth. About half of the respondents did not know regarding handling of avulsed tooth. The majority of participants responded positively about attending workshop on dental trauma management. Conclusion Given the frequent encounter with emergencies, it is imperative for nurses to possess sufficient knowledge regarding management of traumatic dental injuries.

Comparative Evaluation of the Effect of Various Storage Media on the Fracture Resistance of the Reattached Tooth Fragment: An Observational Study.

Traumatic injuries are the most disruptive and distressing emergencies and pose a challenge for dental professionals because many different treatment protocols are currently available. They also affect the social and psychological well-being of children. A multidisciplinary approach is involved in the management of traumatic dental injuries to maintain function and esthetics. The aim of this study was to evaluate the fracture resistance of a reattached tooth fragment kept in four storage media, namely Hank's balanced salt solution (HBSS), Tooth Mousse, ginger honey, and probiotic yogurt, for 1, 6, and 24 hours. The study consisted of 84 intact maxillary central incisors. All the teeth were stored in distilled water until used and were embedded in acrylic molds, 1 mm below the cervical end. The teeth were then sectioned to simulate an uncomplicated crown fracture (Ellis class II fracture), and all the teeth were randomly divided into four groups of 21 each. The teeth were then reattached using Tetric N Universal bonding agent and Tetric N Flow flowable composite. Fracture resistance was assessed using a universal testing machine. Statistical analysis was done using a one-way analysis of variance (ANOVA) test and a post hoc Tukey test. The results showed that fracture resistance was highest in the Tooth Mousse group at 6 and 24 hours. Ginger honey exhibited the highest fracture resistance at 1 hour, whereas the probiotic yogurt group showed the lowest values. It was concluded that Tooth Mousse was the best storage medium for storing tooth fragments. Ginger honey can also be used as an alternative storage medium as it is easily available and inexpensive. Naik S, Murry JN, Sharma S, et al. Comparative Evaluation of the Effect of Various Storage Media on the Fracture Resistance of the Reattached Tooth Fragment: An Observational Study. Int J Clin Pediatr Dent 2024;17(6):665-672.

An assessment of Brazilian dentists' knowledge about tooth fragment reattachment: A cross-sectional study.

Crown fractures are common traumatic dental injuries and tooth fragment reattachment is a viable option for restoring a fractured tooth. The aim of this study was to assess the knowledge and experience of dentists in the Federal District regarding the tooth fragment reattachment technique for enamel and dentin fractures. For the cross-sectional observational study, an electronic form was designed with objective and self-report questions for dentists. The data were analyzed using descriptive statistics, with their absolute and relative frequencies. For the analysis of categorical variables, the nonparametric chi-squared or Fisher exact association tests were used in the statistical software R (version 4.2.1). A total of 416 dentists participated in the study (58.9% female and 41.1% male). Of these, 70% declared they knew about fragment reattachment, but only 42.3% reported previous experience with this procedure. The most common storage medium used for the fractured fragment was milk (78.1%), and the bonding material used for reattachment was light-cured composite resin (86.3%). A majority (66.3%) reported that for a patient with enamel and dentin fracture, with the crown fragment in good condition, they would choose to do the reattachment. Dentists demonstrated that they had adequate knowledge about the tooth fragment technique, although many did not have previous experience with this procedure.

Specialists' management of permanent dentition traumatic dental injuries in 7-16-year-olds: A qualitative study.

Specialist paediatric dentists are integral to dental trauma care pathways. General dentists rely on specialist input, more so in complex cases. Little is known about specialists' role in these pathways or the perceived barriers they face. The aim is to explore specialists' role in managing traumatic dental injuries in the permanent dentition in children. Face-to-face (remote video) online semi-structured interviews were undertaken. All UK specialists were invited by email. Purposeful sampling aimed to investigate representation from the devolved nations, presence/absence of working within a managed-clinical network and level of care provision. Interviews were audio-recorded and transcribed verbatim. Transcripts were thematically analysed. Data saturation was reached after nine interviews. Three main themes established were: inconsistent access to care; the need to formalise traumatic dental injuries care pathways; educationally upskilling general dentists. Geographical variation in provision of specialist and out-of-hours/emergency department care meant patients risked not receiving care by the most appropriate individual. Formalizing care pathways by clearly defining the role of each stakeholder (specialist, dentist, medical professionals and parents) and developing a method to assess complexity was perceived to be essential to improving treatment outcomes. Upskilling general dentists in trauma management appeared essential. A potential lack of engagement was raised, with a suggestion that trauma management education should become core continuing-professional development. Specialist input should be available in the management of traumatic dental injuries. Current access to specialist care is inequitable across the UK. Formalizing care pathways and upskilling general dentists could ease inconsistencies.

Clinical photography and documentation after traumatic dental injuries.

Clinical photographic documentation is recommended as part of the standardized clinical evaluation of traumatized patients according to the most current International Association of Dental Traumatology guidelines for the management of traumatic dental injuries (TDIs), published in 2020. The use of current technology such as mobile smartphones and the emergence of teledentistry for direct communication between dentists and with patients have increased the need to improve the knowledge and skills for contemporary clinical photographic documentation procedures at the dental office as well as at the accident site. The purpose of this review is to include findings from the available literature and discuss modern techniques, contemporary equipment, accessories and developments that can be used by both patients and dental professionals for proper clinical documentation after TDIs. Emphasis is given on the positioning and patient management based on the type and severity of the injury, and the selection of the appropriate technique. Moreover, the number and type of clinical photographs for each dental trauma scenario, the suggested timeline for optimal photographic documentation as well as legal considerations involved are also discussed.