Dental Trauma Research Articles

Performance of Bonded Lithium Disilicate Partial-coverage Crowns in the Restoration of Endodontically Treated Posterior Teeth: An Up to Seven-Year Retrospective Study.

To evaluate the clinical performance of adhesively bonded lithium disilicate glass-ceramic (LDG) partial-coverage crowns in restoring posterior endodontically treated teeth (ETT). A total of 121 morphologically compromised posterior ETT were restored with LDG partial-coverage crowns between October 2015 and January 2018. The restorations were fabricated in the laboratory or at the chairside. Two adhesive systems and resin cements were used to cement the restorations. Tooth and restoration survival rates were calculated. The restorations were evaluated clinically using the modified United States Public Health Service (USPHS) criteria for an observation period of 5-7 years. The Cox proportional hazards model was used to estimate relative failure risks such as tooth type, resin cements, gender, and sleep bruxism. The standard chi-squared test was used to compare the survival of different tooth types for significant differences (α=0.05). In addition, survival probability was calculated using the Kaplan-Meier algorithm. Among seven failed cases, one was a tooth fracture, and six were restoration fractures. According to the Kaplan-Meier analysis, the estimated survival rate of the teeth was 99% for seven years, while the estimated survival rate of the restorations was 94.8% for 5 years and 92.8% for 7 years. Tooth type and resin cements did not influence restoration survival rates (p>0.05), while sleep bruxism and male patients might increase the risk of failure (p<0.05). The indirect adhesively bonded LDG partial-coverage crowns of posterior ETT exhibited favorable clinical outcomes. Ceramic fracture was the most common failure pattern.

Modeling fracture in multilayered teeth using the finite volume-based phase field method

The present work, utilizing the finite volume-based phase field method (FV-based PFM), aims to investigate the initiation and propagation of cracks in the second molar of the left mandible under occlusal loading. By reconstructing cone beam computed tomography scans of the patient, the true morphology and internal mesostructure of the entire tooth are implemented into numerical simulations, including both 2D slice models and a realistic 3D model. Weibull functions are introduced to represent the tooth's heterogeneity, enabling the stochastic distribution characteristics of mechanical parameters. The results indicate that stronger heterogeneity leads to greater crack tortuosity, uneven damage distribution, and lower fracture stress. Additionally, different cusp angles (50° and 70°) and pre-existing fissure morphologies (i.e., U-shape, V-shape, IK-shape, I-shape, and IY-shape) also significantly affect the mechanical performance of the tooth. The study reveals that different cusp angles affect the location of crack initiation. Overall, this work demonstrates the utility of the FV-based PFM framework in capturing the complex fracture behavior of teeth, which can contribute to improved clinical treatment and prevention of tooth fractures. The insights gained from this study can inform the design of dental crown restorations and the optimization of cusp inclination and contact during clinical occlusal adjustments.

Radiologic Evaluation of Oral Health Status in Patients Admitted to the Intensive Care Unit: A Multi-Institutional Retrospective Study.

Introduction: Surveys distributed among intensive care unit (ICU) nurses reveal a significant need for dental care, with many acknowledging poor oral hygiene management. Poor oral health in ICU patients is linked to systemic problems, including aspiration pneumonia, necessitating pre-intervention assessments for bacterial diseases and dental risks. This study aims to evaluate the oral health status of ICU patients across three institutions through retrospective analysis. Methods: This retrospective study assessed the oral health status of ICU patients, using computed tomography (CT) images from three institutions over ten years. Through CT images, the oral status was evaluated in terms of total and lost tooth count and the presence of oral lesions (periapical lesions, cysts and tumors, caries, tartar, moderate to severe periodontal bone loss, tooth fractures). Variables included gender, age, the duration of ICU stay, and types of ICU. Statistical analysis was performed using chi-square tests, independent-sample t-tests, and logistic regression analysis. Results: Of the 450 participants, 430 were analyzed, revealing a prevalence of oral lesions in 67.0% of subjects. The prevalence of oral lesions was higher in males (71.5%) than females (57.7%, p = 0.006), and higher in those aged 40 and above (72.1%) compared to those under the age of 40 (47.8%, p < 0.001). This study found significant differences in oral health status based on gender, age, and ICU type, with surgical ICU patients generally having better oral health. Risk factors for oral lesions included gender, age, and duration of ICU stay. Conclusions: Most ICU patients have at least one oral lesion, regardless of the reason for their ICU admission. In particular, male ICU patients aged 40 and above have a higher prevalence of oral lesions, necessitating careful oral health assessment and treatment.

Effect of Different Surface Treatments as Methods of Improving the Mechanical Properties after Repairs of PMMA for Dentures.

Denture fractures are a common problem in dental practice, and their repair is considered a first option to restore their functional properties. However, the inter-material resistance may become compromised. Typically, the bond between these materials weakens. Therefore, various surface treatment methods may be considered to enhance their mechanical properties. Poly(methyl methacrylate) (PMMA) heat-polymerized resin (HPR) was used as the repaired material, cold-polymerized material (CPR) for the repairs, and different variants of alumina abrasive blasting (AB), methyl methacrylate (M), ethyl acetate (EA), methylene chloride (CH), and isopropyl alcohol (IA) treatments were applied. Finally, combined surface treatments were chosen and analyzed. Surface morphologies after treatments were observed by scanning electron microscopy and the flexural, shear, and impact strengths were tested. AB and chemical treatment with CH, M, and EA was used to improve all mechanical properties, and further improvement of the properties could be achieved by combining both types of treatments. Varied changes in surface morphologies were observed. Treatment with IA yielded less favorable results due to the low impact strength. The best results were achieved for the combination of AB and CH, but during the application of CH it was necessary to strictly control the exposure time.

To Assess the Knowledge and Attitude Regarding Dental Trauma and Its Management among School Teachers

ABSTRACT Background: Dental traumas, particularly tooth avulsion, represent a significant dental emergency among children, frequently occurring in schools. The knowledge and immediate response of schoolteachers are crucial for the prognosis of such emergencies. Materials and Methods: This interventional study assessed the knowledge and attitudes of 248 primary school teachers in Rajasthan, India, regarding dental trauma management. Utilizing a questionnaire-based approach, the study was conducted in three phases: preintervention assessment, an informative 45-minute lecture, and a postintervention follow-up. Statistical significance was set at 5%, and the Chi-square test was employed for analysis. Results: The initial survey revealed a lack of knowledge among teachers regarding dental trauma management, with significant improvement observed in the follow-up phase post intervention. Over 90% of participants showed improved knowledge, with statistical significance (P &lt; 0.0001). Conclusion: The study highlights a notable deficiency in school teachers’ knowledge on dental trauma management initially, which significantly improved following an oral health promotion intervention. This underscores the effectiveness of educational programs in enhancing the management of dental emergencies by schoolteachers.

Long-term complications and management of dental trauma in the adult patient - Part 1: fractured teeth, pulpal complications and resorption.

Dental trauma is one of the most common injuries encountered in the younger population. This can have a long-term impact on the patient's overall quality of life as they may have to deal with the sequelae of these injuries for years to come. Young boys experience dental trauma more frequently than young girls and one of the most common outcomes of these injuries are fractured teeth. This first paper in a two-part review series aims to provide an overview of dental trauma followed by a discussion on management of fractured teeth, associated pulpal complications and resorption. These can be uncomplicated fractures involving enamel and/or dentine, or complicated fractures involving enamel, dentine and pulp. They can involve the crown, the crown and root together, or present solely as root fractures. Pulpal complications can lead to pulp necrosis or pulp canal obliteration. Resorption can be internal or external, inflammatory, or replacement type. The management of each of these injuries begins with a thorough assessment followed by initiating emergency treatment to stabilise the presenting condition. This is followed by a long-term treatment plan which aims to address the patients' aesthetic and functional requirements and provide the patient with the most suitable treatment outcome in the hope to improve their sense of wellbeing and overall quality of life.

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

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

OSTEOINDUCTIVE CAPACITY OF PLATELET-RICH FIBRIN VS BIODENTINE FOR MANDIBLE FRACTURE

Highlights Biodentine has undergone thorough research as a bone grafting substance due to its ability to promote bone regeneration and effectively treat root or tooth fractures. PRF and Biodentine can stimulate osteogenesis, affecting bone repair, particularly in mandibular fractures. Abstract Background: Mandibular fracture is one of the most common fractures. The most common treatment for mandibular fractures is fixation. Therefore, xenogeneic agents such as platelet-rich fibrin (PRF) and Biodentine accelerate the reparative process. Biodentine is an interesting active ingredient that can induce bone regeneration. PRF and Biodentine can promote bone healing, but no literature discusses the differences between PRF and Biodentine osteoinduction mechanisms in treating mandibular fractures. Objective: This article aimed to compare the effect of osteoinductive PRF with Biodentine for mandibular fractures. Material and Method: The research was conducted as a scoping review by performing a thorough search of the PubMed, Scopus, Science Direct, Elsevier, and Google Scholar databases. The study was obtained based on literature studies in the form of journals and textbooks in the last ten years (2013-2023). Result: The osteoinductive effect and mechanism of Biodentine in enhancing bone repair are likely correlated with releasing biologically active ions from calcium silicate cement and stimulating gene expression Runx-2. PRF has an osteoinductive role, causing the mechanism of releasing growth factors such as PDGF, VEGF, TGF-β, and IGF that promote the osteogenic process. Conclusion: There was no significant difference in the osteoinduction effect of PRF and Biodentine because these materials have different mechanisms of action for bone repair.

Effect of temperature on rehydration and fracture resistance of reattached tooth fragments after crown fracture: An in vitro study.

Uncomplicated crown fractures of maxillary anterior teeth are common dental injuries, and the bonding of fractured fragments is recommended for management. Rehydration of fragments improves bonding and fracture resistance. Therefore, the aim of this study was to compare the fracture resistance of the reattached tooth fragment of the incisor crown after rehydration using either a steamer or a humidifier. Bovine teeth were used as a model. Fractured fragments were divided into three groups: Group I (no rehydration), Group II (rehydration by humidifier), and Group III (rehydration by steamer). Fragments were reattached using a standard bonding protocol. Fracture resistance was tested using a universal testing machine. Statistical analysis was performed using analysis of variance and Chi-square tests. The force required to fracture the reattached fragments was significantly higher in Group II (humidifier) compared to Group I (no rehydration) (P = 0.005). Group III (steamer) had a force value similar to Group I, indicating no significant improvement in fracture resistance with steamer rehydration. The temperature inside the steam-based chamber reached an average of 95.7°C with 95% humidity, whereas the conventional humidification chamber had an average temperature of 39.2°C and 84% humidity. Within the limitations of the present study, the rehydration protocol using a steam-based chamber was found to have a significantly lower force required to fracture the reattached fragments as compared to humidifier-based chamber. This was not significantly different from the fragments which were reattached without rehydration.

Evaluating the Influence of Acute and Chronic Orofacial Pains on the Overall Comprehensive Quality of Life.

Background Orofacial discomfort refers to various disorders that affect the mouth, jaws, and face. These conditions may substantially influence a person's quality of life (QoL). This kind of pain may be categorised into two primary classifications: acute and chronic. Acute orofacial pain (OFP) usually occurs suddenly and lasts for a short period. It is commonly caused by specific factors such as dental treatments, traumas, or infections. Hence, this study aimed to assess the influence of acute and chronic orofacial discomfort on the overall QoL. Methodology This research used a convenience sample to gather data from the five groups. It was conducted as a cross-sectional study. Four categories of OFP syndromes were utilised: temporomandibular disorders (TMDs), atypical dental pain (ADP), trigeminal neuralgia (TN), and persistent dentoalveolar pain disorder (PDAP). In addition, a control group consisting of individuals who did not experience any discomfort was also included in the study. Participants received a standardised explanation of the questionnaires utilised, and in most instances, they completed them at the clinic under the supervision of one of the investigators. Results The correlations between each version of the Oral Health Impact Profile (OHIP) were statistically significant (p < 0.001), with correlation values ranging from 0.92 to 0.97. When comparing the occurrence of OHIP items across the four pain types, we identified 18 variations that exceeded the 35% prevalence threshold we established for identifying important items that frequently occur out of the 315 comparisons. The question "Have you had a painful aching in your mouth?" showed a low frequency in patients with TN, TMD, and ADP but a significant prevalence in patients with PDAP (90%). This difference in prevalence across pain types was the biggest seen. The question that seemed to distinguish between the pain categories most effectively was "Have you experienced a toothache?" This question had a high occurrence in PDAP (65%) and ADP (60%), perhaps allowing for differentiating these two diseases from TN and TMD. The highest prevalence differences, over 30%, were most often seen when PDAP was included as one of the disorders being compared. ADP had the fewest variances, over 30%, occurring just seven times. Conclusion Both acute and chronic OFPs have a major negative influence on QoL, but they affect it differently and to differing extents. Injury-related acute pain obviously poses rapid and severe restrictions on physical function and causes temporary psychological distress and temporary social exclusion. On the other hand, chronic pain for the patient always implies being locked in a physical world that does not allow him or her to bypass physical limitations, psychological disorders remain constant, and isolation from other people persists for life.

Cone‐beam computed tomography‐based descriptive classification for transverse root fracture

AbstractTransverse root fracture (TRF) is classified as a cervical, middle or apical third root fracture on a periapical radiograph. The International Association of Dental Traumatology (IADT) suggests that cone‐beam computed tomography (CBCT) should be considered, when conventional radiographs provide ‘insufficient’ information for diagnosis and treatment planning. Considering that CBCT can divulge additional information, it would be beneficial to have a clinically pertinent three‐dimensional classification for TRF. The proposed alphanumeric classification includes the traumatised tooth number, describes the number of TRF, the facial and lingual location of each fracture line on the anatomic root, and its position relative to the crest of the alveolar bone. Further, diastasis, displacement of the coronal fragment and status of the alveolar bone at the site of TRF are also documented. This comprehensive classification system would provide a standard format for reporting, aid in referral communication and can be applied for future outcome studies on TRF.

Fracture resistance of endodontically treated root obturated with different root canal sealers( A comparative in vitro study)

Aim: The aim of this study is to evaluate and compare the fracture resistance of endodontically treated root obturated with four different root canal sealers.. Methods: Sixty extracted palatal root of upper molars were collected and sectioned to get a 11mm root length. All root canals were instrumented using edge endo X7 system rotary files and 35# size was the final size used to finish all the canals. After instrumentation the samples were divided into four groups of 15 samples in each according to the type of sealer used, a single cone obturation technique was used: Group 1: obturated with AH Plus sealer and gutta-percha. Group 2: obturated with Neosealer BC sealer and gutta-percha. Group 3: Obturated with MTA-Fillapex sealer and gutta-percha. Group 4: Obturated with OneFill BC sealer and gutta-percha. After incubation period of 7 days at 37°C and 100% humidity the samples covered with thin layer polyvinylsiloxane impression material to simulate a periodontal membrane and then molded in acrylic blocks so as to set the samples ready for fracture resistance test using universal testing machine at a cross head speed of 0.5mm/min., One-way ANOVA and Posthoc tests assessed the data statistically. Results: The results showed that fracture resistance was significantly higher in those canals that were filled with Neosealer BC sealer (69.90N) in comparison to the other different sealers used in the study (p≤0.05). Conclusion: Under the condition of this study, the following conclusions can be derived: The application of any root canal sealers resulted in an enhancement of the resistance to fractures in teeth that have undergone endodontic treatment. Neosealer Bioceramic sealer group showed the highest fracture resistance than other groups. Followed by Onefill bioceramic, MTA Fillapex and Ah plus.

SSRI Induced Sleep Bruxism and Jaw Muscle Dystonia- Management with Low Dose Quetiapine Along with Occlusal Guards (D9944, D9945)- Two Case Reports

Background: Long term use of SSRIs (selective serotonin re uptake inhibitors) sometimes induces a problem called nocturnal or sleep bruxism which is nothing but uncoordinated jaw muscle movements which leads to grinding and clenching of teeth. The undesired effect of SSRIs produces a muscle stiffness, jaw and neck muscle tenderness, continuous toothache, hypersensitivity, tooth fracture and TMJ pain. Different treatment modalities are there to manage this kind of problem without hampering the psychiatric prognosis of the patient. Here two cases of SSRI induced sleep bruxism along with successful managements are discussed which will throw some light to the potential treatment approaches of such rare disorders.

Comorbid health conditions in people with attention-deficit/hyperactivity disorders: An umbrella review of systematic reviews and meta-analyses

BackgroundWe aimed to systematically review meta-analyses on the link between attention-deficit/hyperactivity disorder (ADHD) and a broad range of psychiatric, physical, and behavioral health conditions (PROSPERO; no.CRD42023448907). ResultsWe identified 22 meta-analyses that included 544 primary studies, covering 76 unique conditions in over 234 million participants across 36 countries and six continents. We found high-certainty evidence for the associations between ADHD and neuropsychiatric conditions (bipolar disorders, personality disorders, schizophrenia, and pragmatic language skills), night awakenings, obesity, decayed incipient surfaces, asthma, astigmatism, hyperopia and hypermetropia, strabismus, and suicide ideation. Moderate-certainty evidence suggested that ADHD was associated with headache, mood/affective disorders, depression, bruxism, bone fractures, atopic rhinitis, vision problems, suicide attempts, completed suicide, and all-cause mortality. Low-certainty evidence indicated associations with eating disorders, sleep efficiency, type 2 diabetes, dental trauma prevalence, atopic diseases, and atopic dermatitis. Very low-certainty evidence showed associations between ADHD and several sleep parameters. ConclusionWe found varied levels of evidence for the associations of ADHD with multiple health conditions. Therefore, clinicians should consider a wide range of neurological, psychiatric, sleep and suicide-related, metabolic, musculoskeletal, oral, allergic, and visual conditions, as well as the increased risk of mortality when assessing individuals with ADHD.

A Study on Obstacles in Considering Marital Rape as Rape in India

Marital Rape is the word which depicts the sexual demonstrations committed against the wish of spouse's assent and makes the trepidation in the psyche of females that the actual aggravation would proceed assuming she stands up to 32% of ladies in India who have at any point been hitched have encountered spousal physical, sexual, or close to home viciousness, as per the most recent fifth round of the National Family Health Survey (NHFS-5).It further uncovered that 25% of hitched ladies in the 18-49 years age bunch who have encountered spousal physical or sexual brutality report having actual wounds, including seven percent who have had eye wounds, injuries, separations, or consumes and 6 percent who have had profound injuries, broken bones, broken teeth, or some other serious injury. Objectives that have been put sent by the scientist, for example, to know individuals' viewpoint about conjugal assault and the purpose for why it is as yet detailed least in ammount and battles in considering conjugal assault as rape

Prevalence and Risk Factors of Bone and Dental Lesions in Neotropical Deer.

Bone and dental lesions have been documented in various deer species globally, affecting the efficiency of ingestion and digestion, consequently influencing their general health and leading to a decline in survival and reproductive performance. The present study aimed to characterize bone and dental lesions in the dry skulls of individual deer, estimate the prevalence of these lesions, and assess potential risk factors associated with the development of bone and dental alterations. This study assessed bone and dental lesions in 180 dry skulls of eleven neotropical deer species, originating from both captivity and wildlife conditions, through direct visual inspection. A high prevalence of bone and dental lesions was observed in all analyzed species. Dental calculus was the most common alteration (96.7%), followed by dental wear (71.1%). Animal age positively correlated with most bone and dental alterations, indicating that older animals showed more lesions. Additionally, the prevalence of these alterations was similar between sexes. Moreover, all lesions were more common in captive-bred animals, likely attributed to their older age and a less diverse diet. Blastocerus dichotomus and Mazama americana were most affected by bone resorption and dental trauma and had the highest dental calculus prevalence, along with Subulo gouazoubira and Passalites nemorivagus. All eleven species evaluated in the present study were susceptible to the occurrence of bone and dental lesions. Therefore, monitoring oral health and diet in captivity are fundamental practices for the conservation of these species.

The Role of Orthodontics in the Management of Maxillofacial Fractures in Children: A Review on Contemporary Approaches.

Maxillofacial fractures present complex challenges requiring effective orthodontic management to restore function and aesthetics. This review explores various orthodontic techniques, including fixed braces, maxillomandibular fixation (MMF), functional orthodontic therapy (FOT), and acrylic splints, emphasizing their roles in stabilizing fractures and promoting healing. The management of condylar fractures is discussed, highlighting the benefits of early intervention with functional appliances to facilitate condylar remodeling in children and adolescents. Additionally, the review covers splinting methods for dental and dentoalveolar fractures and the use of open reduction internal fixation (ORIF) for maxillary fractures. It addresses the complications and challenges of fracture management, the need for a multidisciplinary approach, and the limitations of current studies. Future directions include the use of advanced technologies such as virtual surgical planning (VSP) and 3D printing to enhance treatment precision and outcomes. This review provides a comprehensive overview of orthodontic strategies for maxillofacial fractures, offering insights into clinical applications and future advancements.

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.

Equine cheek tooth repulsion using small diameter repulsion pins: 20 cases.

Reported complication rates after dental repulsion for equine exodontia are high (up to 80%), but repulsion methods have changed notably in the last 20 years. Describe the outcome for 20 cases after dental repulsion using small diameter repulsion pins. Retrospective case series. Records of horses that underwent cheek tooth repulsion were reviewed (2014-2023). Inclusion criteria included: mandibular or maxillary cheek tooth extraction where oral extraction failed and repulsion was used to complete extraction, and where clinical follow up information was available. Repulsions were carried out under sedation with a regional nerve block or under a short general anaesthetic, using a small diameter repulsion pin (3-5 mm). Intra-operative radiographs facilitated instrument placement. The alveolus was packed with polymethyl methacrylate post-extraction. Horses were re-examined at 4-6 weeks post-operatively. Twenty cases were included. Patients had a mean age of 10.3 years old (range 5-16 years). The majority (75%) of teeth had pre-existing dental fractures. Maxillary (n = 15) and mandibular cheek teeth (n = 5) were all successfully repulsed, with 16 cases performed with the horse standing and 4 with the horse under general anaesthesia. Intra-operative complications included damage to the mandibular bone (n = 1). Short-term complications (n = 2) included superficial surgical site infection, and dehiscence of one sinus flap. Long-term complications included the recurrence of sinusitis (n = 1) and small intra-alveolar fragments causing persistent bitting problems in another patient. Retrospective study design, small number of cases. When oral extraction fails, cheek tooth repulsion using small diameter repulsion pins is an effective extraction technique. The total intra- and post-operative complication rate was 25%, which is comparable to previously published complication rates for repulsion using Steinmann pins and also those encountered after trans-buccal screw extraction.

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.