Dental Trauma Research Articles

Conservative management of lateral canal biofilm-related persistent intraoral sinus and other complications in traumatized, immature incisors: A case report with 30 months’ follow-up

Conservative or regenerative endodontic treatments are the preferred approaches for managing traumatized (vital or necrotic) immature permanent teeth in growing patients. Diagnosing pulp vitality preoperatively using sensitivity tests can be challenging, especially if multiple teeth are traumatized, potentially leading to the failure of the chosen endodontic treatment. Unexpected complications, such as persistent intraoral sinus related to the lateral canal (often not visible on conventional radiographs) and delayed periradicular bone healing, may also arise. This case report presents the successful conservative management of three traumatized incisors with such complications. A novel intracanal dressing method was used to treat a persistent intraoral sinus related to the lateral canal in the permanent maxillary left central incisor, which was unresponsive to traditional dressing materials and methods, thereby avoiding surgery or extraction. Additionally, delayed bone healing in response to revascularization treatment in the permanent maxillary right central incisor, and the initially involved vital permanent maxillary right lateral incisor, was addressed with re-revascularization and root canal treatment, respectively. This article discusses tailored management strategies and possible reasons for associated complications in traumatized teeth. It emphasizes the importance of high-quality radiographic images, pulp vitality tests based on blood oxygenation, understanding the presence of biofilm in lateral canals, modified dressing methods, appropriate dressing vehicles, and the necessity of patience in treating traumatic dental injuries. Keywords: Biofilm; Conservative Management; Pediatric Dentistry; Root Canal Medicaments; Teeth Injuries

Knowledge of undergraduate and postgraduate dental students about managing traumatic dental injuries based on the 2020 International Association of Dental Traumatology guidelines: A online survey of 10 dental schools from 10 countries.

The knowledge of dental students about managing traumatic dental injuries (TDIs) may not be uniform, depending on global location and dental education. The aim of this study was to evaluate the level of knowledge of undergraduate and postgraduate students specializing in endodontics and pediatric dentistry at 10 dental schools in 10 countries about the 2020 International Association of Dental Traumatology (IADT) guidelines regarding the management of TDIs. A previously published questionnaire was used in the current survey. It was an online survey with 12 questions regarding the management of TDIs and some additional questions regarding sociodemographic and professional profiles of the participants were added. The survey was distributed to final-year undergraduate students and postgraduate students in pediatric dentistry and endodontics from 10 dental schools. Simple frequency distributions and descriptive statistics were predominantly used to describe the data. Differences in the median percentage scores among the student categories were assessed using the Kruskal-Wallis test followed by Dwass-Steel-Critchlow-Fligner pairwise comparisons. A total of 347 undergraduates, 126 postgraduates in endodontics, and 72 postgraduates in pediatric dentistry from 10 dental schools participated in this survey. The postgraduates had a significantly higher percentage score for correct responses compared with the undergraduates. No significant difference was observed between the endodontic and pediatric dentistry postgraduates. The knowledge possessed by undergraduate and postgraduate students concerning the IADT-recommended management of TDIs varied across the globe and some aspects were found to be deficient. This study emphasizes the critical importance of reassessing the teaching and learning activities pertaining to the management of TDIs.

МЕТОДИКА МЕДИЦИНСКОГО СОПРОВОЖДЕНИЯ ПАЦИЕНТОВ ПОСЛЕ ПРОВЕДЕНИЯ ДЕНТАЛЬНОЙ РЕПЛАНТАЦИИ

Modern dentistry is aimed at using minimally invasive interventions to preserve dentition. This fact determines the need for wider use of various types of tooth-preserving operations. In modern conditions, tooth-preserving operations are increasingly being carried out with a predictable successful outcome. Treatment of dental trauma involves complex endodontic or surgical treatment protocols. An important aspect in the rehabilitation of dental injuries is the development of clear diagnostic tactics both at the initial appointment and at all stages of treatment. We observed 127 patients from 2012 to 2022 with diagnoses: complete, incomplete tooth dislocation, uncomplicated or complicated by fractures of the coronal part of the teeth, men and women aged 18 to 40 years. The first group consisted of 66 people with traumatic dislocations of teeth, who sought medical help within 24 hours after the injury, who underwent tooth replantation surgery, endodontic treatment, a complex treatment developed aimed at stopping an acute inflammatory reaction of a post-traumatic nature, and carrying out the necessary splinting measures. The second group consisted of 61 people with traumatic dislocations of teeth who sought medical help after 24 hours or later. Patients in each group were divided into subgroups; in the control subgroups, traditional treatment and rehabilitation after dental replantation were carried out; in the main subgroups, the technique we developed using M-Chip nanomatrices and LED radiation was used. All patients underwent macrohistochemical examination and measurement of dentogingival attachment using a periodontal probe. The results of a macrohistochemical study 7 days after replantation showed that in groups 1b and 2b, whose patients received complex treatment according to the developed method, the area of inflammation of the mucogingival complex was smaller than in patients in groups 1a and 2a, who were treated according to the traditional method. Results of probing of the dentogingival attachment found that in groups 1b and 2b, whose patients received complex treatment using the developed method, the dentogingival attachment corresponds to normal indicators of a healthy periodontal complex than in patients in groups 1a and 2a, who were treated using the traditional method. The inclusion in the complex of rehabilitation measures after dental replantation surgery of drugs that have antiseptic, reparative, hemostatic and immunoadjuvant effects, using LED radiation, increases the effectiveness of these measures by 2-3 times.

Effects of Two Different Methods of Teeth Grinding on Dental Injuries, Skin Lesions, Growth and Behaviour of Suckling Piglets Compared to a Non-Treated Control Group.

Teeth grinding in suckling piglets is performed on many farms to protect the piglets' littermates and the sow's udder from injuries caused by the piglets' canines and third incisors. In this study, the effects of two teeth-grinding methods on the piglets' dental health and welfare were investigated. The piglets of a litter were evenly assigned to a treatment: one-third of littermates were ground with a roller grinding head (RG), one-third with a teacup grinding head (TCG), and one-third were not ground at all (CG). A random sample of 100 animals each from the RG and TCG treatment was examined for tooth injuries, i.e., dental pulp openings. Additionally, behavioural analysis was performed (n = 650 piglets), and skin lesions, growth and mortality were determined (n = 1565 piglets). TCG piglets had a lower risk (p < 0.001) of pulp opening than RG piglets (0.08 ± 0.31 vs. 2.67 ± 1.67 opened pulps per piglet). Mortality, growth, skin lesions and behaviour of piglets were not influenced by treatment (p > 0.05). This study showed that both teeth-grinding methods led to pulp openings. If teeth grinding cannot be avoided on a farm, using the teacup grinding head is recommended concerning animal health and welfare.

Dental Adverse Effects of Anti-CD20 Therapies.

Over the past few years, anti-CD20 therapies like rituximab, ocrelizumab or ofatumumab have seen an increase in interest in the treatment of neurological autoimmune disorders such as multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), or resistant forms of generalized myasthenia gravis (MG). They are generally well-tolerated, but recent reports have highlighted severe dental disorders in patients undergoing anti-CD20 therapies. The aim was to describe a series of cases and to compare with the available scientific literature. We reviewed 6 patient cases with dental disorders during anti-CD20 therapy that were reported to the pharmacovigilance center. A disproportionality analysis was also conducted on Vigibase® for each anti-CD20 and each adverse effect described in the cases. Six cases of dental and gingival conditions in relatively young patients were reported (median age: 40.5 years old [min: 34; max: 79]). Oral conditions were developed in four patients with MS treated with ocrelizumab and in two patients receiving rituximab (one patient with MG and one with NMOSD). The onset of oral conditions ranged from 10 days to 2 years after treatment initiation. Notably, all patients treated with ocrelizumab experienced gingival recession. Various dental pathologies were observed, including tooth loss, dental pain, caries, brittle teeth, dental fractures, dental abscesses, and periodontitis. Analysis of Vigibase® revealed 284 worldwide cases of dental and gingival conditions under ocrelizumab, 386 cases under rituximab, and 80 under ofatumumab. Significant associations were found between these therapies and dental pathologies, particularly tooth abscesses and infections. To our knowledge, this is the first case series reporting dental conditions developed in patients long-term treated with anti-CD20 treatments. This issue, literature data, and Vigilyze® analysis might be considered a safety signal that necessitates being confirmed with more robust data, such as a retrospective study with a control group. Meanwhile, proactive measures are essential like frequent dental checkups and dental hygienic measures to prevent oral health problems associated with anti-CD20 therapies.

Comparative Analysis of Dental Health Outcomes from Two Outreach Camps in Zanzibar, Tanzania: 2019 and 2023

Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral health needs over a four-year span. Methods: The study involved a thorough examination and analysis of clinical dental health data from both outreach camps. In 2019, 224 patients were examined, and in 2023, the number increased to 354. The assessment covered various dental health parameters, including dental caries, DMFT/dmft indices, enamel fluorosis, dental trauma, oral mucosa lesions, and non-carious tooth surface loss. Results: The analysis demonstrated a significant reduction in dental caries among adolescents and teens, decreasing from 62.5% in 2019 to 35.59% in 2023 (p &lt; 0.0001). Similarly, the prevalence of teeth missing due to caries showed marked reductions from 40.2% to 9.04% in adolescents and teens (p &lt; 0.0001) and from 25.89% to 11.86% among preschool and school-aged children (p = 0.004). Moreover, a significant change was observed in the Basic Erosive Wear Examination (BEWE) scores, with cases showing no erosive tooth wear (BEWE = 0) decreasing from 49.1% to 33.3% (p = 0.016), and cases with initial loss of enamel surface texture (BEWE = 1) increasing from 47.3% to 61% (p = 0.044). Conclusions: The outreach camps conducted in 2019 and 2023 showed tangible improvements in certain dental health metrics, particularly a reduction in dental caries and missing teeth due to caries among adolescents and teens. However, the uptick in non-carious tooth surface loss points to emerging dental health concerns. These results underline the importance of sustained and targeted dental health interventions to improve oral health outcomes in underserved communities such as Zanzibar.

A novel surgical treatment approach for the vertical root fracture of posterior teeth: a case report with 24-month review

Background Up to 25% of the tooth extraction after root canal treatment could be attributed to the vertical root fracture (VRF). The treatment choice for teeth with VRF would mostly be the extraction despite some repairing methods were also reported. The repairing treatment result of VRF would mostly depend on the fixation strength and the bioactivity of the repairing materials, especially for the posterior teeth with high masticating stresses. This case report designed a novel surgical treatment approach for the VRF of posterior teeth.Methodsa maxillary premolar with buccal-palatal complete VRF was treated with a new dual-layered repairing approach using adhesive resin + iRoot BP Plus bioceramic cement to fill the modified fracture line with retention forms through the intentional replantation.ResultsAt the 24-month review, the tooth showed desirable periodontal healing and normal function.ConclusionsThis case report indicated that the dual-layered repairing approach might be effective for saving the posterior teeth with VRF. Nevertheless, further clinical trials are needed for its long-term result.

Appraisal of the IADT fellowship - A member survey.

The International Association of Dental Traumatology (IADT) is considered the foremost authority in Dental Traumatology. Fellowship status was introduced in 2015 and is considered an international standard of excellence. The Fellowship Committee of the IADT believed it was essential to survey members seeking information on the benefits of the IADT Fellowship and potential considerations for future development. This survey aimed to explore the perceptions of members of IADT surrounding the fellowship process in terms of interest, accessibility, equality, perceived prestige, and value to the membership. The survey was sent to 546 IADT members, of whom 89 were fellows (as of 31 July 2022) from 74 countries via an email invitation. Answers were analysed using the Chi2 and Fisher's exact test (p < .05). The response rate to the survey was 20.69% (n = 113), including 28 fellows (24.78%). Forty-six respondents (40.71%) were female, and 67 (59.30%) were male. Dentists identified as specialists were significantly more likely to be involved in teaching dental trauma (p = .000008). A majority of respondents (87.76%; 86/98) expressed interest in obtaining fellowship, with increased interest from more recent graduates. Learning opportunities, obtaining expertise, networking and a sense of community and prestige, were key factors in considering fellowship. There was interest in alternate pathways other than examination alone, with 60.2% of 98 respondents suggesting a combination of publications /service to IADT/ reviewer for Dental Traumatology, 57.14% suggesting the submission of case reports, and 42.86% suggesting Honorary Fellowship. Respondents (73%) were willing to participate in online discussion forums and other professional development opportunities. This preference was more notable among non-fellows (75.29%) than fellows (67.85%). The survey indicates the diverse motivations and perceptions regarding the IADT Fellowship, despite the low participation of IADT members. Achieving fellowship status is desired by 87.7% of non-fellows. The majority of respondents were aware of the process, but main concerns were identified as eligibility criteria and examination difficulty. Options for alternate pathways and other initiatives promoting engagement were identified. Further exploration of these issues is required to be representative of the entire IADT membership. Addressing these obstacles could significantly enhance fellowship participation and overall member satisfaction within the IADT community.

A systematic search, heuristic evaluation and analysis of dental trauma mobile applications.

Despite the exponential growth of mobile device applications in promoting awareness on traumatic dental injuries (TDIs), the overall validity of existing applications in content, engagement, usability, functionality, esthetics, and user perception remains largely uncertain. The primary aim was to systematically search and assess the quality, functionality, perceived impact and usability of available applications related to TDIs using the User Version of the Mobile Application Rating Scale (uMARS) and the Coventry, Aberdeen, and London-Revised (CA-LO-RE) scale. A heuristic evaluation was additionally performed. The secondary aim was to categorize existing mobile applications according to their target users, including general population, dentists, dental students, medical healthcare professionals, and researchers. A systematic search for dental trauma applications (free and paid) was conducted using the AppStore and Google Play store. Two reviewers independently performed data extraction and quality assessment for all the included applications using uMARS and CA-LO-RE. A user experience architect conducted a heuristic evaluation. Only 6 of the 3061 initially screened applications were eligible for qualitative and quantitative assessments. These applications' average star uMARS rating was 12.5 (standard deviation [SD] 2.6). The mean and SD for the uMARS objective items were as follows: A-engagement (mean 12.1 [SD 3.3]), B-functionality (mean 15.5 [SD 1.4]), C-esthetics (mean 9.5 [SD 2.5]), and D-information (mean 13 [SD 4.5]). The severity rating for the heuristic evaluation criteria was low to moderate for all the included applications, excluding tooth emergencies with a high severity score. Despite moderate quality, functionality, user perception, behavioural impact and usability scores, the inclusion of advanced features to "engagement" and "usability" in existing trauma based apps will enhance their purpose. A design-thinking approach coupled with interactive features is recommended for future mobile applications on TDIs.

Enhancing Aesthetic and Structural Integrity in Necrotic Permanent Incisor with Open Apex: A Case Report

Traumatic injuries in immature teeth often lead to complications in endodontic treatment due to difficulty in managing the open apex. Also, the restoration of these teeth poses significant challenges due to thin dentin walls, high configuration factors, and other biomechanical and adhesive issues. Standard fibre posts are often not suited for flared root canal preparations, leaving excessive cement space between the post and the tooth structure. To reduce postoperative complications (e.g. root fracture), reinforcement of radicular dentin becomes mandatory after endodontic treatment. The reinforcement of the canal can be done using a fibre post relined with composite resin. Direct anatomical posts offer a promising alternative that minimises the risk of debonding. This case report details the use of platelet rich fibrin as a internal matrix and how mineral trioxide aggregate can be used to form an immediate apical seal for apexification and a custom fiber post technique for reinforcing an immature maxillary central incisor in an 18-year-old patient. Keywords - Adhesive cement, Apical seal, Dentin reinforcement, Esthetics, Fiberglass, MTA, Post and core technique

Comparative analysis of dental trauma in contact and non-contact sports: A systematic review.

Dental traumas in sports are common and have physical, social, psychological, and economic impacts. The aim of this study was to determine, through a systematic review, the prevalence of dental trauma in contact and non-contact sports. This review was submitted to PROSPERO (CRD42023421206). Included studies addressed the prevalence of dental trauma in young athletes and adults above 18 years, excluding reviews, editorials, symposiums, or those evaluating athletes under 18 years. A literature search was conducted using the databases PubMed, Web of Science, Scopus, Embase, LIVIVO, SPORTDiscus, Dentistry & Oral Sciences Source (via EBSCO), and Lilacs and BBO, as well as gray literature. Bias risk was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist. Data were synthesized considering study characteristics, population, sport, and outcomes. R Statistics software was used for all meta-analyses. A total of 1707 articles were identified. After applying eligibility criteria, eight were selected. Three studies, not previously observed, were later added after reading four systematic reviews on a similar topic. Fourteen contact sports and five non-contact sports were analyzed. The prevalence of dental trauma was 11.38% in contact sports and 5.24% in non-contact sports. Regardless of the type of sport, athletes face risks of dental trauma, with contact sports showing higher prevalence. The use of mouthguards is essential across all contact and non-contact sports as a preventive measure.

Oral health vulnerability and its associated risk factors among tribal elderly people in Bangladesh: a primary pilot initiative of national oral health survey

Background Tribal elderly is a vulnerable population due to their geographic location and lack of access to healthcare services including poor oral health. As the primary initiative for representative ethnic oral health survey for elderly, this pilot study aims to assess the oral health status of tribal elderly in Bangladesh and identify the associated risk factors. Methods This cross-sectional pilot survey was conducted among 280 tribal elderlies aged 60 years and above residing in the main tribal residing region in Bangladesh. The data was collected through cluster sampling methods using a semi-structured questionnaire and oral examination. Different statistical tools including frequency distribution, Chi-square association test and multivariable logistic regression model were performed in data analysis. Results The results showed that 25.35% of the tribal elderly had high DMFT score, indicating poor oral health. Respondents’ age, sex, marital status, occupational status, sweet eater, tobacco, and alcohol consumption were significantly associated with oral health. The major oral clinical sign and symptoms were dental carries, teeth sensitivity, loose teeth, broken teeth, calculus and staining in teeth, tongue pain and bad breath. The logistic regression analysis suggested that elderly aged 80 and above had 3.33 times more, males were 4.6 time less, tobacco user (smoked/smokeless) were 2.03 times more and alcohol consumers were 6.83 times more likely to experienced poor oral health condition than their counterparts. Conclusions Elderly individuals were found to be more likely to suffer from poor oral health condition than younger individuals, and certain lifestyle factors such as tobacco and alcohol consumption, meal frequency, and sweet consumption can further increase the risk of poor oral health condition. The findings can be a primary initiative for further investigation on the nationally representative oral health survey among ethnic elderly.

The Impact of E-Cigarettes on Oral Injuries and Bone Fractures

Introduction The rising prevalence of electronic cigarette (e-cigarette) use has prompted concerns regarding its potential health implications. While much attention has focused on respiratory and cardiovascular effects, injuries, oral trauma, and bone fractures linked to e-cigarette use have received less scrutiny. This paper aims to comprehensively review the landscape of injuries, oral trauma, and bone fractures induced by e-cigarettes, shedding light on this underexplored facet of e-cigarette-related harm. Material and Methods This literature review has analyzed 16 papers. Inclusion criteria: researches and case reports published after 2015. PubMed and Google Scholar has been searched to identify the papers. Analysis of the Literature Existing literature suggests a growing incidence of injuries, oral trauma, and bone fractures associated with e-cigarette use, albeit with limited systematic investigation. Mechanisms underlying these injuries range from device malfunctions to inadvertent impacts during use. Case reports highlight a spectrum of injuries, including oral burns, dental trauma, and skeletal fractures, often involving the face and mouth regions. Conclusions Despite the lack of comprehensive epidemiological data emerging evidence underscores the need for heightened awareness and preventive measures to mitigate e-cigarette-related injuries. Enhanced education, regulation of e-cigarette devices, and promotion of safer usage practices are crucial steps towards reducing the burden of e-cigarette-related harm on oral and skeletal health.

Evaluation of the reliability and accuracy of YouTube™ and TikTok™ contents about storage media for avulsed teeth: A cross-sectional study.

The preservation of avulsed teeth is critical in dental trauma management, necessitating effective storage media to ensure viable tooth reimplantation. The urgent need for accurate information has led both professional and non-professional individuals to increasingly seek guidance from video-sharing platforms such as YouTube™ and TikTok™. These platforms have become key resources for advice on such dental emergencies, but the reliability and accuracy of this information have not yet been systematically evaluated. This study aimed to assess the quality, accuracy, and reliability YouTube™ and TikTok™ of videos regarding storage solutions for avulsion injuries. A search was conducted on YouTube™ and TikTok™ on February 4th, 2023, using terms related to traumatic dental injuries, and 53 videos were included. Video demographics such as platform, duration, type, upload date, likes, and comments were recorded. Video content quality, reliability, and accuracy were measured using the Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) benchmarks, and Video Information and Quality Index (VIQI). Research data were analyzed using SPSS IBM 24.0 at a 95% confidence interval. In total, 53 videos were examined. The average scores were JAMA: 1.70/4.00, modified DISCERN: 54.3/80.00, GQS: 3.88/5.00, and VIQI: 13.8/20.00. According to the modified DISCERN index, there were no "very poor" or "poor" quality videos, 49.05% were "moderate," 22.6% were "good," and 28.3% were "very good." No difference was found between YouTube™ and TikTok™ videos in terms of the modified DISCERN index, JAMA scores, GQS, and VIQI scoring (p > .05). Traumatic dental injuries are a common problem among children, and evaluating the reliability of available contents is becoming crucial for appropriate intervention. The study reveals that despite being sourced mainly from dental professionals, the overall quality of videos on avulsed tooth management was mediocre, underscoring the risks associated with misleading or incomplete information in such critical situations.

Reattachment of Fractured Tooth: A Comprehensive Review.

Dental trauma is one of the most prevalent problems encountered in clinical practice. Traumatic injuries involving fractures of the anterior tooth are one of the most common problems among children and adolescents. There is a physical and social impact on patients' quality of life due to traumatic dental injuries (TDIs). Children and adolescents frequently present with a crown fracture that necessitates immediate intervention. Clinicians need to be aware of various treatment modalities for TDIs and have to address these injuries immediately. Due to advances in adhesive technologies, fragment reattachment is the treatment of choice when the fragment is available and well stored. The purpose of this article is to cover various techniques for reattaching fractured fragments and the most current developments in adhesive systems for this purpose.

To Compare and Evaluate the Fracture Resistance of Three Post Endodontic Restorations Including Silver Amalgam, Dual Cure Composite Resin and Fibre Reinforced Composite Resin

Background: Endodontically treated teeth are thought to be more prone to fracture. The last stage in a successful root canal treatment is to restore root canal-treated teeth with a permanent, definitive postendodontic restoration. Dehydration, dentin loss during endodontic procedures, and the elimination of significant anatomic elements like cusps, ridges, and the pulp chamber's arched roof—all of which contribute significantly to the normal tooth's support—are the causes of the fracture of endodontically treated teeth. Consequently, intracoronal strengthening is necessary to prevent tooth fracture, especially in the posterior teeth where compressive stresses brought on by occlusal forces can cause tooth fractures.1 Since core materials typically replace a significant portion of the tooth structure and must withstand multidirectional masticatory forces,their compressive strength is crucial.2  Aim: The purpose of this study was to compare the compressive strengths of three direct post enododontic restorations.  Material and Methods: There are thirty extracted maxillary premolars chosen. After receiving root canal therapy, the teeth were divided randomly into three groups for immediate post-endodontic restorations: (i) silver amalgam (ii)Fiber-reinforced composite resin (iii) dual cure glass- reinforced composite resin . After that, a Universal Testing Machine was used to apply compressive stress on the teeth.  Statistical Analysis: Fracture loads will be compared statistically, and the data will be analysed using version 21.0 of SPSS software, analysis of variance and the Post-hoc test for multiple comparisons.  Result and Conclusion: Within the limits of the study, it showed that the post hoc tests reveal that the mean difference of compressive load strength is significant between all the groups, Amalgam has highest load strength followed by Fiber reinforced composite. Dual cure composite has lowest compressive load strength.

HUBUNGAN POLA ASUH ORANG TUA DAN KARIES TERHADAP OHRQoL PADA ANAK USIA PRASEKOLAH

Background: Children's dental and oral health problems are caused by many factors including parenting style which has a major influence on children's health and development. In Tanah Bumbu District, children aged over 3 years had a proportion of 50.74% with broken teeth, cavities and pain. Dental caries can cause disruption of children's quality of life such as sleep disturbances, eating disorders, loss of concentration in learning, infections, and other dangerous cases in children. Objective: To determine the relationship between parenting style and caries towards OHRQoL in preschool-aged children in Sungai Loban District. Method: Analytic observational study with a cross sectional approach. The sampling technique of non-probability sampling uses quota sampling. The population is all kindergartens in Sungai Loban District, namely 23 kindergartens with 918 children. The minimum sample size was calculated using the correlational analytic formula and the results obtained were 40 respondents consisting of parents and children taken from 3 kindergartens, namely Harapan Bersama Kindergarten, Taman Sari Kindergarten and Tunas Dewata Kindergarten, Sungai Loban District. Results: Most parents' parenting style has a democratic pattern; the average def-t index is 5.5 and belongs to the high category. The results of the Spearman correlation test showed that there was not a relationship between parenting style and OHRQoL (p&gt;0.05). The results of the Spearman correlation test analysis showed that there was a relationship between caries and OHRQoL (p&lt;0.05). Conclusion: There is a relationship between parenting style and caries to OHRQoL in preschool-aged children in Kindergarten in Sungai Loban District.Keywords: Caries, OHRQoL, Parenting, Preschool children.

A Successful Reinforcement and Restoration of an Already Damaged Post and Core in a Teeth with an Existing Crown That Has Received Endodontic Treatment: 3 Case Reports

Once correctly indicated, endodontic retreatment requires the preservation of dental components. Effective treatment of teeth with severe damage to the structure of the tooth relies not only on successful endodontic treatment but also on timely postendodontic tooth repair after the same endodontic. Furthermore, for teeth with intracanal posts, the evolution of endodontic procedures and materials has decreased the indication of surgical treatment. Underneath an undamaged crown is a typical clinical occurrence of broken coronal tooth structure. The tooth can be repaired with a post and core if the underlying root is in good condition, and then, the crown is refabricated. This article outlines a method for the aforementioned scenario that makes use of the current unbroken crown. The entire crown was later rescued, and a damaged post and core were also discovered in the canal. The retrieved metallic post was re-cemented in the post space then the undamaged crown was adjusted to fit it, and the opposing arch maintained occlusion. Next, a composite resin that can be dual-cured and built up was poured into the crown, molding it to fit onto the broken tooth. As we know, the core buildup material has a property of dual curing that means it can be self-cured as well as light-cured. Hence, we waited and allowed it to get set by itself chemically. Then, after we carefully removed the crown from over it, a brand-new composite resin core was discovered and adhered to the tooth structure after that we light-cured it for complete the setting process. After that, dual-cured core build-up composite resin was used to re-cement the crown to the core. Even after a year of follow-up, the method of strengthening the tooth’s core and restoring it with the current crown was shown to be effective.

Comparison of clinical outcomes between single metal-ceramic and zirconia crowns

Statement of problemEvidence comparing the survival of zirconia crowns with metal-ceramic crowns is sparse. Knowledge of their survival and a comparison of their clinical outcomes would improve clinical decision making. PurposeThe purpose of this university-based study was to compare the survival, failures, biological and technical complications encountered with zirconia and metal-ceramic crowns restored and followed up over a similar period. Material and methodsThis retrospective chart review consisted of 403 patients treated at the University of Toronto, Faculty of Dentistry, predoctoral dental clinic in whom zirconia (n=209) and metal-ceramic (n=306) crowns were inserted between September 2015 and July 2016 and followed for up to 7 years. Outcome measures included failure, causes for failure, and complications associated with survival. Inferential statistical analysis included the chi-squared test, t test, Mann-Whitney test, Bonferroni-adjusted z-test, Kaplan-Meier survival test, and logistic regression to examine differences between crown types and explore crown failures (α=.05). ResultsThe mean follow-up period was 3.00 years (median 2.58 years). Forty-one (8.0%) crowns had no follow-up, with no difference in follow-up between crown type: metal-ceramic n=23(7.5%), zirconia n=18(8.6%), χ²(1)=0.20, P=.652). Excluding those with no follow-up, the follow-up time between metal-ceramic (mean=3.07, median=2.58) and zirconia (mean=3.54, median=3.32) crowns was statistically similar (P=.052). There were 62 anterior crowns (12.0%) and 453 posterior crowns (88.0%), χ²(1)=22.40, P<.001, with no difference between groups. Overall, 44 crowns (8.5%) failed, 30 (9.8%) metal-ceramic and 14 (6.7%) zirconia, with no statistical difference in proportion of failed crowns between groups (χ²(1)=1.53, P=.216). There were 35 crowns with biological failures (6.8%), 26 (8.5%) in the metal-ceramic and 9 (4.4%) in the zirconia group, with no statistical difference between groups (χ²(1)=3.33, P=.068). Nine crowns had technical failures (1.7%), 4 (1.4%) in the metal-ceramic group and 5 (2.5%) in the zirconia group, with no statistical difference between groups (χ²(1)=0.73, P=.394). Biological (79.5%) rather than technical complications were found to be the most frequent cause of failure, goodness-of-fit χ²(1)=15.36, P<.001. Tooth fracture (50.0%) specifically was found to be the most frequent cause of failure, χ²(3)=21.27, P<.001. The total number of crowns that survived was 471 (91.5%); 276 (90.1%) were metal-ceramic and 195(93.3%) zirconia. The survival time (years) for metal-ceramic was mean=6.26, 95% CI [6.01–6.51] and for zirconia crowns mean=6.54, 95% CI [6.31–6.77]. Of the crowns that survived, 370 (78.6%) had no clinical complications, and 101 (21.4%) crowns demonstrated similar clinical complications, with no statistical differences between groups. ConclusionsWithin the study follow-up time, the survival of monolithic zirconia and metal-ceramic crowns was 91.5%, with similar clinical complications between groups. Biological complications, especially tooth fracture, were a significantly more frequent complication with both types of crowns.

Awareness of Dental Trauma Management among Primary School Teachers of Visnagar: Knowledge, Attitudes, and Practices Questionnaire-based Cross-sectional Study

Aims: The current study assessed school teachers’ knowledge, attitudes, and practices regarding emergency dental trauma management in Visnagar, Gujarat. Settings and Design: The cross-sectional survey required participants to complete a validated, closed-ended self-administered questionnaire. Subjects and Methods: The questionnaire, which consisted of 15 questions, was completed by 326 primary and secondary school teachers. Demographic information, knowledge about the teeth most commonly affected by trauma, emergency care, and attitudes toward storage media, etc. were included. This questionnaire also tested the willingness of teachers to participate in future dental trauma management workshops. Statistical Analysis Used: An Excel spreadsheet was used to methodically collect and compile the data, which was then subjected to a statistical analysis using SPSS version 20.0. (Chicago, IL, USA: IBM Company, SPSS Inc.) The descriptive data were percentage-based. The Chi-square test was used to do inferential statistics. Results: Among 343, a total of 326 (95.04%) school teachers responded. Forty percentage of teachers possess knowledge regarding the emergency treatment of dental trauma, 47.90% of teachers were aware about pedodontists, and 93% of teachers showed a willingness to participate in training. Conclusions: The current survey findings indicate that educational activities should be developed to improve preschool teachers’ awareness of the need to treat traumatized teeth at once.