Dental Trauma Research Articles

Do orthodontists consider endodontic complications in their orthodontic management of teeth with a history of dental trauma? A vignette survey

BackgroundDental trauma is a frequent injury seen commonly in young children. There is a link between malocclusion and the incidence of traumatic dental injuries. Orthodontic therapy has been suggested as a preventative measure in correcting unfavourable malocclusions and potentially avoiding traumatic dental injuries. To date, it is poorly understood if the complications reported following traumatic dental injuries are amplified during and following orthodontic treatment. The aim of this study was to evaluate whether orthodontists considered the endodontic implications associated with the orthodontic treatment of teeth with a history of dental trauma.MethodA mixed methods vignette survey was designed, piloted, and distributed online to UK registered specialist orthodontists. The survey was split into three parts and consisted of three vignette clinical scenarios with open and closed questions.ResultsA total of 76 orthodontists responded from the United Kingdom. Of the participants, 46% (n = 35) of the orthodontists felt they had insufficient training in dental trauma and 42% (n = 32) lacked confidence in the treatment of traumatic injuries. The study participants reported non-standardised pre- treatment examination, limited dental trauma experience and insufficient training. In addition, 32% (n = 24) of clinicians felt that there is a lack of guidance in the orthodontic management of traumatised teeth and pulpal sequelae.ConclusionOrthodontists are not following a standardised protocol in their examination of teeth with a history of trauma prior to orthodontic treatment. There is a need within the orthodontic specialty to create a standardised protocol to assess teeth with a history of dental trauma.

Interdisciplinary problem-based learning model for standardized dental residency training: from theory to practice in dental trauma management

ObjectiveEnhancing clinical skills and quality of dental residents is critical for standardized training. Conventional standardized training falls short in exposing residents to diverse scenarios and fostering interdisciplinary collaboration, essential for dental trauma management. To address these issues, West China Hospital of Stomatology, Sichuan University introduced an interdisciplinary problem-based learning (IPBL) model to improve residents’ professional quality and practical abilities.MethodsBased on the specific needs of dental residents, the hospital established a PBL framework supported by an interdisciplinary collaborative teaching team with a focus on dental trauma diagnosis and treatment. A comprehensive assessment followed the IPBL course, which informed subsequent course modifications. In a preliminary study, 134 students voluntarily chose whether to participate in the program. At the end of the study, the scores of both groups were compared.Primary resultsThe IPBL model significantly improved the professional ability of dental residents in the diagnosis and treatment of dental trauma, and obtained positive evaluations from residents and mentors. For the quantitative analysis, the Wilcoxon signed-rank test showed an overall improvement in participants’ scores after completing the course.ConclusionThis teaching model provides a new way for the standardized training of dental residents, and helps to cultivate dental professionals with high professional and practical abilities.

Influence of Conservative or Invasive Treatments on the Occurrence of Sequelae in Permanent Successors After Injuries in the Support Tissues of Incisors Deciduous Teeth: A Cohort Study.

To assess the influence of conservative or invasive treatments on the appearance of sequelae in permanent successor teeth (SPT) after injuries in the support tissues of anterior deciduous teeth (ISTDT). This cohort study accompanied 52 children with ISTDT up to the complete eruption of the permanent successor to investigate the presence or not of SPT. Trauma was clinically evaluated according to the International Association for Dental Traumatology. Sex, age at the time of trauma (ATT), type and severity of trauma, sequelae in anterior deciduous teeth (SDT), treatment type (conservative-without exodontia/ invasive-with exodontia), seeking care (immediate/late), and the caregiver's education level (CEL) were collected. Regression models were performed (p = 0.05). Of the children (ATT = 3.6 ± 1.5 years), boys (52/57.1%) were the majority. The teeth (n = 91) injuries were lateral luxation (26/28.6%), intrusion (22/24.1%), concussion (20/22.0%), subluxation (19/20.9%), and extrusion (4/4.4%), that affected only incisors. Most teeth (63/69.2%) received late care, presented SDT (62/68.1%) and were treated conservatively (73/80.2%). There was no association of sex (p = 0.611), SDT (p = 0.705) and seeking care (p = 0.800) with SPT. The treatment type did not influence the SPT occurrence (p = 0.923), independent of the ATT, trauma severity and the educational level of the caregiver. The lower the ATT (p = 0.026) and the more severe the trauma (p = 0.009), the higher the number of SPT. The treatment type of anterior deciduous teeth, mainly considering incisors, did not influence the appearance of SPT, which leads us to always choose the most conservative treatment, independent of the child's age, the injury severity, and the caregiver's educational level.

Quality assessment of clinical practice guidelines and position statements on vital pulp therapy: a systematic review.

To evaluate different Clinical Practice Guidelines (CPGs) and Position Statements (PS) on Vital Pulp Therapy (VPT) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and Appraisal of Guidelines for Research and Evaluation-Recommendation EXcellence (AGREE-REX) tools. Two authors performed the initial search using a set of keywords in six databases. Only CPGs and PS on VPT published during the past five years were included. The included CPGs were appraised independently by six appraisers. AGREE II tool was used to evaluate the methodological quality, and AGREE REX was used to evaluate the quality of recommendations. Intraclass correlation coefficient was used as a reliability indicator among assessors. Four published CPGs were shortlisted. Guidelines established by the European Society of Endodontology (ESE, 2019), German Society of Endodontology and Dental Traumatology (GSEDT, 2019), American Association of Endodontists (AAE, 2021), and Australian Dental Association (ADA, 2021) were analyzed. The ESE PS obtained the highest average score overall. Endodontists must adhere to clinical practice guidelines established by specialty associations or societies. Improving the domains "Rigour of Development" and "Applicability" is necessary to enhance the overall strength of the guidelines. It is imperative to prevent discouragement and confusion among practitioners regarding VPT procedures by ensuring cohesiveness among various endodontic associations. This assessment aids in determining the standard of CPGs among different specialized societies and associations. It also highlights the essential future actions and initiatives needed to establish robust evidence-based standards on VPT. The protocol of this systematic review was registered in PROSPERO (ID: CRD42023429673).

Clinical and radiographic evaluation of two different apexification protocols in traumatized immature permanent incisors.

Dental trauma can cause damage to the pulp tissue in immature teeth. Revascularization therapy is a possible option in the treatment of non-vital, immature permanent teeth with a history of trauma. The aim of this prospective study was to evaluate the radiographic and clinical results of immature teeth with a history of trauma treated by regenerative endodontic procedures and mineral trioxide aggregate apexification techniques. Forty-one patients aged between 7 and 12 years with traumatized immature permanent maxillary incisors were included in the study. These patients were divided into two groups: those who had previously received endodontic treatment and those who had not. Twenty-four patients who applied directly to the university clinic and had not received endodontic treatment before were included in the regenerative endodontic protocol group (Group 1). Seventeen patients who had previously undergone endodontic intervention on their relevant teeth were included in the mineral trioxide aggregate apexification group (Group 2). The patients were followed for a period of 24 months. Clinical success rates were evaluated, and pre-treatment and control radiographs were analyzed to calculate the percentage increase in root dentin width and root length. After 24 months of follow-up, positive periapical healing was detected in the radiographic findings in the majority of cases. In Group 1, a limited increase in root length and root dentin width was observed, while a narrowing in the apical opening was evident. The radiographic evaluation of two of the cases, which could be accessed 11 years later, emphasized the importance of long-term follow-up in assessing the effectiveness of the chosen methods. The revascularization method is a treatment option that has positive results in terms of root development in teeth with necrotic pulp as a result of trauma.

Dental Trauma following Animal Attack: A Case Report

Animal attacks are a common cause of human injuries worldwide, with human-leopard encounters frequently reported in India. Animal attack injuries are increasingly common in trauma centres due to human encroachment into wildlife habitats, leading to more human-animal interactions. These attacks, especially to the face, can cause significant functional, cosmetic, and structural damage. A 40-year-old woman was attacked by a leopard, resulting in tooth mobility, pain, and orofacial lacerations. Initial treatment and primary wound closure were performed in Ratlam, Madhya Pradesh, India. On further examination, necrosis with blackish discolouration of the left ala of the nose was observed, along with scarring on the lips. Tooth 22 exhibited luxation without alveolar bone involvement, leading to proclination. A multidisciplinary treatment approach was adopted, beginning with manual manipulation and repositioning of tooth 22, followed by stabilisation and endodontic treatment. For extraoral management, plastic surgery was performed, involving a paramedian forehead flap and alar cartilage remodelling using left auricular cartilage. The patient underwent follow-ups at one, three, six months and one year. In conclusion, managing dental trauma from animal attacks requires a multidisciplinary approach and ongoing follow-up. By fostering collaboration among healthcare professionals and ensuring vigilant care, we can significantly improve patient outcomes and recovery.

Three-dimensional-printed restorations for prosthetic rehabilitation of localized tooth wear using the Dahl concept: A case report.

A 26-year-old man with localized tooth wear and demand for aesthetic rehabilitation of the anterior teeth presented to our department. The patient reported excessive consumption of energy drinks. Furthermore, multiple trauma and tooth fractures have occurred in the past. In the present case, three-dimensional (3D)-printed restorations were used to restore the vertical dimensions according to the Dahl concept. An indirect build-up using noninvasive restorations has been demonstrated to be beneficial due to its pleasing aesthetic outcome and the advantage of the 3D printing process. Adhesive bonding was adapted from previous studies using direct composite materials. Thus far, whether, and to what extent, the color of these restorations changes remains unclear. Furthermore, the material wear should be evaluated in future studies. Moreover, 3D-printed, noninvasive restorations made of a computer-aided design/computer-aided manufacturing hybrid material are suitable for the application of the Dahl concept. Aesthetic improvement in combination with minimally invasive pretreatment of the teeth and subsequent noninvasive restorations led to the rehabilitation of the vertical dimension of occlusion. After a follow-up period of two years, harmonious occlusal conditions were observed in the posterior region.

Minimally invasive endodontic treatment through the labial/buccal cervical approach - protocol and case series.

Traditional access cavity preparation involves removing the roof of the pulp chamber and smoothing the dentin bulges at the root canal orifice, thereby creating straight-line access. However, this may damage more healthy dental tissue and reduce the tooth's fracture resistance. This case series presents a novel minimally invasive endodontic protocol for one maxillary canine and four mandibular premolars, which required root canal therapy due to labial/buccal cervical decay that caused pulpitis or periapical periodontitis. Our treatment protocol includes the following steps: preoperative assessment, removing decay in the labial/buccal cervical region, preparing an endodontic access cavity utilizing the affected region, establishing a working-length reference line using resin, cleansing the pulp horn with ultrasonic retro-preparation tip, root canal preparation, disinfection, obturation through the labial/buccal cervical access, and final resin restoration. Ideal root canal obsturation outcomes were achieved in all cases, while avoiding the abrasion of tooth tissue at the pulp chamber roof, caused by traditional endodontic access cavity methods. Minimally invasive endodontic treatment through the labial/buccal cervical approach offers clinicians new insights and options for endodontic access design.

Traumatic Dental Injuries' Prevalence across Diverse Healthcare Settings: A Systematic Review and Meta-Analysis.

Traumatic dental injuries (TDI) are a global public health concern, impacting individuals of various age groups. This systematic review aimed to consolidate current evidence on TDI prevalence, providing insights for improved management and prevention strategies. A comprehensive search was conducted across PubMed/MEDLINE, Embase, and Scopus databases for studies published between January 1, 2000, and July 1, 2024. Studies reporting on the prevalence of TDI in various populations were included. We followed PRISMA guidelines in the review process. Descriptive statistics were used to summarize study characteristics, and a random-effects model was applied in the meta-analysis using STATA version 14 to pool prevalence rates, while accounting for inter-study variability. Begg's and Egger's tests were conducted to assess publication bias. The review included data of 151,205 patients from 30 studies across diverse healthcare settings. The prevalence rates varied significantly across studies, ranging from as low as 1.88% to as high as 86.98%. The overall pooled prevalence of TDI, calculated using a random effects model, was 19.48% (95% CI: 11.21% to 27.74%), indicating substantial heterogeneity among the studies (I-squared = 100.0%, p < 0.001). The prevalence varied significantly across different healthcare settings and demographic groups. No evidence of publication bias was found (p > 0.05). This systematic review underscores the high prevalence of TDI and highlights the need for targeted preventive strategies and evidence-based interventions in dental trauma care.

Experimental study on the vibration characteristics of confluence planetary row in health and broken teeth failure

Experimental study on the vibration characteristics of confluence planetary row in health and broken teeth failure

Pulp Calcification and External Reabsortion Resulting from Dental Trauma in Childhood, Associated with the Applicability of Guided Endodontic Treatment – Endoguide: Case Report

Introduction: Pulp canal calcification is characterized by the deposition of calcified tissue along the canal walls. As a result, the root canal can become completely obliterated, making endodontic treatment and its chemical- mechanical preparation difficult and contributing to accidents and complications. The objective of this case report is to understand that digital dentistry has added value in several dental situations. Endoguide provides safety, precision, efficiency, minimizes operative time, and reduces the chances of root canal deviation and damage to surrounding tissues. Methodology: The literature review was carried out through a bibliographic survey on guided endodontic treatment in obliterated canals. The clinical case reported here was treated at the dentistry clinic of the Euro-American University Center (UNIEURO). Case report: A 23-year-old female patient with a history of trauma in the anterior region of the maxilla at least 10 years ago reported that there was no intervention at the time of the incident and detailed how the trauma occurred. The patient presented to the UNIEURO dental clinic complaining of darkening of the crown of tooth 21. Radiographically, significant external resorption was observed and the clinical examination showed marked vestibularization. When performing sensitivity tests on tooth 21, negative responses were obtained. The lower teeth were also the focus of observation for analysis of possible impairment during the trauma that occurred. It was observed that all were vital, except for tooth 21, thus confirming the diagnostic hypothesis of Pulp Calcification. The patient was referred to the radiology clinic with a request for an imaging exam: Computed Tomography on a Prexion device; known for allowing a more detailed view of the root canal system and the periapical region. Subsequently, intraoral scanning was performed at the Voxells clinic, where the Stereo lithography (STL) file was acquired and combined with images in the DICOM (Digital Imaging and Communications in Medicine) file. Subsequently, Trion was responsible for developing the 3D model and printing it to guide the endodontic access surgery in the appropriate position and angle. Conclusion: The guided endodontic technique is safe, effective and faster. It increases predictability, minimizes the risk of deviations and perforations, and promotes greater comfort for the patient and dentist. It is important for the professional to be familiar with this cutting- edge technology and its benefits in the dental world.

Vertical root fractures and cracked teeth: post-endodontic root dentinal status through micro-CT assessment after ex vivo fiber post removal.

This study aimed to investigate cracked teeth and vertical root fracture observable on micro-CT images of extracted roots of mandibular incisors, after fiber post removal. Thirty mandibular incisors were selected with any degree of slight incisal wear inspected with the aid of a stereomicroscope under 12x magnification, in order to have a group of young adult specimens according to the criteria of Hugoson et al. A sample of twelve mandibular incisors were selected, aged between 20 and 30 years old, with similar dentine volume and thickness. The specimens were scanned in a micro-computed tomography (micro-CT) device and submitted to root canal shaping, root canal filling, post space preparation, post placement and post removal. From a total of six experimental endodontic timepoints until post removal of 12 mandibular incisors, 64,800 cross-sectional images were analyzed and no vertical root fracture (VRF) or cracked tooth were detected. Micro-CT assessment after ex vivo fiber post removal did not detect vertical root fracture or cracked tooth formation in the root canal walls of mandibular incisors. This study highlighted that fiber post removal per se was not able to propagate VRF or cracked tooth formation or promoted any interruption of the integrity of human root dentin.

Is Teledentistry as Effective as Clinical Dental Diagnosis in Pediatric Patients?

Teledentistry integrates telecommunications with dental practice, facilitating the exchange of clinical information and images for remote dental consultation and treatment planning. This approach enables dental care access across long distances, addressing the need for flexible healthcare solutions. This study aimed to evaluate the effectiveness of teledentistry compared to clinical in-person dental diagnosis in pediatric patients during the COVID-19 pandemic. The study sample consisted of 200 children aged 3-13 years, each undergoing both teledentistry-based and in-person clinical dental diagnosis. Caries index scores, including DMFT/dmft and DMFS/dmfs, as well as the identification of specific dental conditions such as molar incisor hypomineralization (MIH), black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, were recorded in both diagnostic settings. Statistical analysis was conducted using chi-square, Wilcoxon, and Fisher's Exact tests. The mean age of participants was 7.86 ± 2.40 years. Caries index scores (DMFT/dmft, DMFS/dmfs) showed compatibility between teledentistry and clinical diagnoses. While "d/D, f/F, ds/DS, fs/FS" scores were observed to be higher in clinical diagnoses compared to teledentistry, the difference was not statistically significant (p > 0.05). Scores for "m/M" and "ms/MS" were identical in both diagnostic methods. Additionally, the prevalence of dental anomalies, including MIH, black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, was comparable across both diagnostic approaches. Findings suggest that teledentistry serves as an effective alternative to clinical in-person diagnosis for pediatric dental consultations and treatment planning, demonstrating comparable accuracy in identifying caries and dental anomalies in children.

Evaluating generative pretraining transformer reliability in addressing dental trauma: A cross-sectional observational study on avulsion and intrusion

Abstract Introduction: The advancement of artificial intelligence (AI) has revolutionized digital communication, enhancing interactions between humans and computers. This study explores the application of Chat Generative Pretrained Transformer 3.5 (ChatGPT-3.5), in providing accurate information on dental trauma. Materials and Methods: Utilizing a dataset of 45 self-generated questions across three topics, general dental trauma, avulsion, and intrusion, ChatGPT-3.5 generated responses that were subsequently evaluated by five endodontic experts, each with over a decade of experience. The evaluators used a Likert scale to assess the quality of the AI-generated answers, synthesizing reliable scientific evidence and clinical expertise to ensure a thorough analysis. The data obtained from the evaluators’ scores were organized and analyzed using Microsoft Excel software and the Statistical Package for the Social Sciences version 25. For each question, descriptive statistics including the median and interquartile range were computed. Results: The study found that ChatGPT provided reliable information across the three assessed dental topics. Avulsion was rated the highest (4.40 ± 0.717), significantly outperforming general dental trauma (3.97 ± 0.885) (P = 0.005). Intrusion received a rating of 4.13 ± 0.794, showing no significant difference compared to the other topics. Most evaluator scores fell into the “Good” (44.0%) and “Very Good” (38.7%) categories. This indicates a generally positive appraisal of ChatGPT’s performance, with a fair agreement among evaluators, evidenced by a combined Fleiss’s kappa coefficient of 0.324. However, there was variability, particularly with Evaluator 4’s scores differing significantly from those of evaluators 1 and 2. Conclusions: ChatGPT’s responses on general dental trauma, avulsion, and intrusion were generally rated positively, with avulsion responses deemed the most reliable. The study underscores the need for continuous evaluation to maintain the accuracy, reliability, and safety of AI-generated content in endodontics, suggesting AI should serve as a supplementary tool rather than a primary information source.

A cross-sectional study on awareness regarding management of dental trauma among clinical dental students and interns

Abstract Introduction: Dental trauma could lead to separation or crushing of the dental supporting tissues and esthetic and functional disorders. This study aims to evaluate the knowledge regarding the management of dental trauma among clinical dental students and interns in Benin City, Nigeria. Materials and Methods: This descriptive cross-sectional study utilized a self-administered questionnaire containing 15 closed and open-ended questions to garner data focused on sociodemograhic characteristics and awareness of the management of traumatic dental injury, from respondents. Data from 95 respondents were statistically analyzed and both univariate and bivariate analyses were used in this study. Results: A significant proportion; 77 (81.1%) had a poor overall knowledge of management, although most respondents had knowledge of some of the steps involved in emergency management of dental trauma. The association between respondents’ level of education and their knowledge of the management of dental trauma was found to be statistically significant (P = 0.0001). Respondents at higher level in their dental training were found to have better overall knowledge compared to those at lower levels. Conclusion: The knowledge regarding the management of dental trauma among the respondents was poor. This was associated with the level of study and clinical exposure.

Traumatic dental injuries in permanent teeth among Arab children: prevalence, and associated risk factors-a systematic review and meta-analysis.

There is no clear literature present till date assessing the prevalence of traumatic dental injuries and associated factors in children living in Arab countries. The purpose of this study was to systematically assess the prevalence, trends, and potential risk factors of traumatic dental injury (TDI) in permanent teeth among children and adolescents in Arab countries. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The researchers conducted a comprehensive literature search in various databases, including PubMed, Cochrane library of systematic reviews, Directory of Open Access Journals (DOAJ), Google Scholar, and gray literature sources such as MDS dissertations and manuscripts. To analyze the collected data, the researchers used a random effects model for conducting meta-analyses. Pooled estimates of prevalence and odds ratios were derived, along with 95% confidence intervals (CI), to provide a measure of statistical precision and variability in the findings. For the studies that were considered, trend analysis was done. The risk of bias assessment of included studies was done using Newcastle-Ottawa tool for cross-sectional studies. A total of 545 articles were identified, of which 23 articles fulfilled the inclusion criteria. Quality assessment of included studies showed that twenty studies were of high quality and three studies showed low quality. The frequency of dental trauma in Arab children was 26% (95% CI [10-43]). Children with overjet of more than 3.5 mm were shown to be 1.78 times more likely to have dental injury than children with normal overjet (pooled odds ratio 1.78; 95% CI [1.17-2.70]). Males had a 2.06 times odds of TDI compared to females. Children with insufficient lip coverage had an odds ratio of 2.57, indicating a higher likelihood of oral injuries compared to those with appropriate lip coverage. Significant correlations were obtained between the prevalence of dental trauma and other variables such as male gender, increased overjet, inadequate lip coverage, etc. Future population-based analytical research should concentrate on documenting the incidence and/or prevalence of TDI among marginalized communities in order to better understand the primary causes of TDI.

Risk factors for the appearance of cracks and fractures of teeth according to a survey of dentists

BACKGROUND: Preventive treatment is essential in modern dentistry, resulting in increased attention to the causes and potential predictability of dental pathologies, including tooth cracks and fractures. Currently, there is a lack of comprehensive, detailed studies on this subject. AIM: To assess the detectability of risk factors for tooth cracks and fractures (based on a survey of dentists). MATERIALS AND METHODS: A survey of 52 dentists of various specialties was performed using a special questionnaire on the incidence and causes of tooth cracks and fractures. RESULTS: According to the survey of dentists, the incidence of confirmed tooth cracks and fractures was 6.7% and 4.4% for extracted and treated teeth, respectively. Maxillary premolar roots were the most common site (59.1%), with longitudinal cracks/fractures predominating (68.2%). Of all reported cracks and fractures, 15.6% were only detected during an X-ray or CT examination. Overall, 87.7% of cracks and fractures were detected in devitalized teeth, 79.3% in patients with unreplaced missing teeth, dental cavities, or restoration of more than 50% of the occlusal surface (76.3% and 49.3%, respectively), and 30.6% in patients with root wall thinning. At least 65.0% of tooth destruction cases occurred within 5 years of devitalization, filling, or replacement. CONCLUSION: The study found that the main risk factors for tooth cracks and fractures (more than 10% of extracted and treated teeth) are devitalization and excessive load caused by incomplete dental restoration, as well as significant destruction of the crown, root wall thinning, and a long period following devitalization, filling, or replacement. More than half of all tooth cracks are longitudinal. Maxillary premolars are more prone to cracks and fractures. These factors can be used to predict long-term complications such as tooth cracks and fractures after dental tissue treatment.

Gene expression profiles in human dental pulp stem cells treated short-term with lipopolysaccharides before and after osteoinduction.

Dental pulp stem cells (DPSCs) are essential for reparative dentinogenesis following damage or infection. DPSCs surrounding the blood vessels in the central region of the dental pulp actively proliferate after tooth injury and differentiate into new odontoblast-like cells or odontoblasts to form reparative dentin. However, the signaling pathways involved in undifferentiated and osteodifferentiated DPSCs under inflammatory conditions remain unclear. This study aimed to compare the expression profiles of immortalized undifferentiated and osteo-differentiated human DPSCs (hDPSCs) treated with and without lipopolysaccharide (LPS) to elucidate the molecular regulatory mechanisms involved in inflammatory conditions. We investigated the differences between undifferentiated and osteodifferentiated hDPSCs in response to LPS. RNA-seq analyses of undifferentiated and osteodifferentiated hDPSCs were performed with and without LPS. Whole-transcriptome profiling revealed distinct differences in the expression patterns of LPS-treated undifferentiated and osteodifferentiated DPSCs. Death-associated protein kinase 1 levels downregulated in LPS-treated osteodifferentiated cells, inhibiting apoptosis and enhancing cell survival. After LPS treatment, osteodifferentiated DPSCs exhibited higher expression levels of various inflammatory cytokines and chemokines than undifferentiated DPSCs. This study provides valuable transcriptomic data as a critical resource for uncovering potential therapeutic targets to enhance cell survival and regulate inflammation within the dental pulp. By elucidating the key molecular mechanisms and identifying specific gene expression changes linked to inflammatory and immune responses, these findings provide significant insights into osteo-differentiated hDPSCs.

Prevalence and Pattern of Traumatic Dental Injuries in Children and Adolescents With Severe to Profound Hearing Impairment: A Hospital-Based Cross-Sectional Study.

Traumatic Dental Injuries (TDIs) are an emerging public health problem and a realm of research for oral health enthusiasts. Certain populations can be more vulnerable to injuries such as those with a sensory deficit. Nevertheless, literature is scarce, especially for those with hearing impairment. Therefore, the aim of the study was to compare the prevalence and patterns of TDI in children and adolescents with severe-to profound hearing impairments and children without hearing impairments. Three hundred and ninety participants (195 severe to profound hearing impaired and 195 age and sex-matched controls) between 4 and 18 years were recruited from a tertiary care setting. A single calibrated examiner evaluated TDI for both groups. Among those with TDI, a vestibular function test (VFT) was also performed to assess postural balance. A single examiner from the Department of Otorhinolaryngology evaluated the VFT results. The overall prevalence of TDI was found to be 12.82% among the severe to profound hearing-impaired individuals, and 11.79% in controls. The majority of participants were aged between 7 and 13 years, in the mixed dentition stage, and were males. Among the cases, the majority had profound hearing loss (≥ 91 dB HL) and bilateral ear involvement. The most common type of TDI was uncomplicated crown fractures. Falls were identified as the most common cause of TDI in both groups. Vestibular dysfunction and loss of postural control were identified in 12 out of 14 patients tested with VFT. A significant association was found between TDI and the dentition type, that is, primary dentition was more affected among the severe to profound hearing impaired as compared to controls (p < 0.05). There was no significant association between the severity of hearing impairment and the prevalence of dental trauma in children and adolescents with severe to profound hearing impairment. However, hearing-impaired individuals were susceptible to trauma at an early age compared to their healthy counterparts.

The influence of fiberglass posts on the mechanical behavior of dental fractures in endodontically treated teeth

The aim of this study was to evaluate the fracture resistance of endodontically treated premolars. Six extracted intact mandibular premolars were divided into 3 groups (n=2). All teeth had (MOD) mesio - occlusal -distal preparation + endodontic treatment + composite resin restoration (CR), and one of the groups received glass fiber post + CR. The specimens were loaded on a cusp slope until fracture and then had the values measured. In spite of is known that the loss of dental structure and the presence of fiber post restoration reduced fracture resistance in the tooth-restoration complex, there was no statistically significant difference between the groups in this study.