History Of Dental Trauma Research Articles

Early intervention of unerupted maxillary central incisor: A case series

Early intervention of an impacted maxillary central incisor is crucial to avoid space loss with tipping of the adjacent teeth and allows normal root development. This case series demonstrates the clinical considerations of a surgical-orthodontic approach in managing this eruption anomaly and its challenges. All three cases involved young patients aged 7–9 years with an impacted upper left central incisor and a positive history of dental trauma. An upper sectional fixed appliance was bonded to facilitate the closed eruption of the impacted central incisor. The treatment duration increases when more space is required for the impacted tooth. There was a marginal gingival discrepancy of all the treated central incisors with vertical relapse seen upon review, indicating the need for a careful surgical approach with good hygiene maintenance and a bonded retainer as retention. Early referral for the management of an impacted maxillary central incisor through a surgical-orthodontic approach is often successful, but treatment risks, duration, and retention regimen should be discussed with the parents for informed consent.

The orthodontic-endodontic interface: trauma and pulpal considerations

The interpretation of the clinical signs and symptoms arising from the interdisciplinary relationship between orthodontics and endodontics becomes more complicated when superimposed by dental trauma. A history of dental trauma before or during orthodontic tooth movement may have implications for pulpal health and clinical outcomes. An understanding of the biology is essential for appropriate treatment planning. This review and treatment recommendations will assist dental practitioners in managing orthodontic-endodontic interactions.

Orthodontic management of traumatized teeth: a survey among orthodontists

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

Dental pain in Brazilian preschool children: association with the severity of dental caries and impact on oral health-related quality of life.

This study aimed to verify the association between dental pain and severity of dental caries (caries morbidity stages) and the impact on oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study with 199 children (2-5years old) enrolled at preschools in Capão do Leão-RS, Brazil. The self-report of mothers of children with a history of dental pain in the last 6months and perception of their child's OHRQoL (ECOHIS) were obtained through a structured questionnaire. This questionnaire also collected independent variables. Children's oral examination was performed using the CAST instrument to determine caries morbidity stage. Crude and adjusted Poisson regression analysis was performed. The prevalence of dental pain was 14.57%. The chance of the occurrence of dental pain was higher among children diagnosed in morbidity [Prevalence ratio-PR: 5.29 (95% confidence interval-95% CI 1.91-14.61); p = 0.001] and severe morbidity [RP = 6.12 (95 CI% 2.25-16.64); p < 0.001] stages. Children with dental pain presented higher scores in the total ECOHIS [rate ratio = 7.11 (95% CI 4.55-11.09); p < 0.001] and in all of the domains of this instrument. Furthermore, children with a history of dental trauma [PR = 2.41 (95% CI 1.15-5.04); p < 0.001] and those whose reason for last visit to the dental office was for restorative/endodontic/extraction treatment [PR = 1.29 (95% CI 1.01-6.19); p = 0.049] had a higher prevalence of dental pain. A substantial prevalence of dental pain in the last 6months and negative impact on children's OHRQoL was identified in this sample. Children diagnosed with carious dentin lesions and abscess and fistula were more likely to have dental pain.

Sociodemographic and Behavioural Factors Affecting the Oral-Health-Related Quality of Life as Measured with the Child-OIDP Index in Adolescents.

Environmental factors modulate oral-health-related quality of life (OHRQoL). The aim of this study was to analyse sociodemographic and behavioural factors affecting the OHRQoL in Spanish adolescents, by using the Child-OIDP (Child-Oral Impacts on Daily Performances) index. A cross-sectional study was conducted in 337 adolescent schoolchildren aged 13-15 years. A questionnaire on sociodemographic, behavioural and oral self-perception factors was administered with the Child-OIDP questionnaire. Descriptive statistics, Kruskal-Wallis and Mann-Whitney U-tests, as well as a regression model were used in the data analysis. The overall mean Child-OIDP index was 3.28±6.55. It was statistically significantly higher in females than in males (p < 0.001). Mothers having a managerial job showed statistical association with worse OHRQoL (p < 0.001). Caries experience and history of dental trauma were not associated with the oral-health-related quality of life (p > 0.05). Halitosis statistically significantly affected the activities of daily living (p < 0.001). Perceived dental problems, dental treatment needs, self-assessment of oral health status and satisfaction with oral health were associated with the impact index (p < 0.05). Mothers who were managers, female sex, presence of halitosis, and perceived dental treatment needs were the most important predictors of the impact index, while dietary habits, oral hygiene, and dental visits did not affect it. Knowledge of these factors will help dental professionals to apply adequate preventive and therapeutic measures.

Knowledge of Dental Trauma and Orthodontic Management of Traumatized Teeth by a Group of Lithuanian Orthodontists.

Background and Objectives. There is a deficiency of research on orthodontic movements and management strategies for traumatized teeth to avoid further treatment complications. The aim of the study was to evaluate the knowledge of Lithuanian orthodontists about dental trauma and the orthodontic management of traumatized teeth. Materials and Methods. Lithuanian orthodontists and orthodontic residents were introduced to the purpose, objectives and questionnaire of the study. The questionnaire was developed based on demographics, the participants' personal experience, specific questions about dental traumas and orthodontic treatment tactics for patients with a history of dental trauma. Results. A total of 54 participants (42 orthodontists and 12 orthodontic residents) completed the survey. The overall response rate was 42.9%. The results of the survey revealed that the largest share of the study participants-61%-stated that they had treated traumatized teeth just a few times during the whole practice. Briefly, 53.7% of respondents inquired about the dental trauma history only if they saw signs of complications. The results of the survey revealed that the frequency of correct answers to questions about dental trauma was 63.7%, and that about the orthodontic treatment of traumatized teeth was 54.9%. It is worth noting that one-third of physicians pointed out the lack of information about the orthodontic management of traumatized teeth. Conclusion. The knowledge of Lithuanian orthodontists and orthodontic residents about dental injuries and the orthodontic treatment of traumatized teeth is insufficient. Further educational training is recommended.

Endodontic-orthodontic interactions: a review and treatment recommendations.

The literature is replete with articles describing the many and varied interactions between endodontic treatment and orthodontic tooth movement (OTM), often reporting conflicting views and findings, which creates confusion for clinicians. Original research and review articles have described aspects such as apical root resorption and potential pulpal complications of teeth related to OTM. Some interactions are of relatively minor clinical significance, whilst others may have adverse consequences. A history of dental trauma before or during OTM further complicates the interactions. This review re-assesses the historical literature on endodontic-orthodontic interactions in light of more recent research and presents guidelines for managing clinical situations involving both disciplines. © 2023 Australian Dental Association.

Emergency management of avulsion injuries: from home to clinic: A multicentre cross-sectional survey among medical doctors and general public.

The objective of this multi-centre study was to analyse the knowledge of parents as compared to medical-doctors regarding avulsion-injuries. A validated and piloted questionnaire was circulated among two equal groups (130 participants each) of medical-doctors and the general public. Data was analysed using SPSS version 19. A total of 131 (89%) participants had a university degree and 185 (71%) had a full time employment. One hundred and eighty-seven (72%) participants reported having no previous information regarding avulsion injuries, 195 (75%) considered their level of knowledge inadequate, and 63 (24%) had a previous history of dental trauma. A statistically significant number had information regarding avulsed permanent-teeth replantation (p=0.02) but not deciduous-teeth (p=0.26), whereas only 39 (15%) were aware of the right medium for tooth storage. Having seen or sustained an avulsion-injury and a higher qualification were statistically related to correct responses for some questions. A total of 106 (41%) of the participants wanted to be educated through written-material. In conclusion, the first-aid knowledge regarding tooth avulsion injuries in our population, irrespective of their level of academic education, is poor and needs supervised training.

Post-trauma complex orthodontic approach: the impact of psychological issues of bullying on treatment decision.

ABSTRACTObjective: This article aims to discuss the multidisciplinary approach required in the treatment of cases of impaction and ankylosis of permanent teeth, associated with a history of trauma, considering the psychological state of the child and family when faced with a traumatic case of bullying, by reporting the complex treatment of a central incisor needing to be orthodontically moved across the midline. Conclusion: This clinical case was a major challenge, which included complex multidisciplinary procedures. Results and stability after 26 months of retention indicated successful orthodontic space closure of two maxillary teeth, without the use of implants or prostheses, in an adolescent patient who had a history of dental trauma, alveolar bone loss, and an uncertain initial prognosis.

Orthodontic evaluation of children and adolescents with different types of Foetal Alcohol Syndrome Disorders.

To assess general and oral health status, including the presence of malocclusion and orthodontic treatment needs, in children and adolescents with FASD in relation to different types of this disorder. A total of 67 participants (29 males and 38 females) aged 2.5-17.8years with confirmed diagnosis of FASD were included. The participants were divided into three subgroups: foetal alcohol syndrome (FAS), partial foetal alcohol syndrome (PFAS) and alcohol-related neurodevelopmental disorders (ARND). General health, oral health status, history of dental trauma, presence of dysfunctions or parafunctions, and occlusion were examined. Additionally, the Index of Orthodontic Treatment Need (IOTN) index was calculated. Selected variables were compared to the results obtained from a national monitoring survey on the oral health conditions in Poland. In children and adolescents with FASD, a number of systemic anomalies including alimentary, neurological and musculoskeletal disorders were present. Dysfunctions and parafunctions such as mouth breathing and thumb sucking were frequently recorded. Children with FASD had an increased prevalence of distal occlusion and crossbite compared to the general population. Malocclusions were more often identified in the FAS group. No significant differences in the IOTN between different FASD groups were found. Borderline need for orthodontic treatment was more frequent in children with FASD compared to controls. Early screening for the presence of dysfunctions/parafunctions and malocclusions in children with FASD is recommended, so that orthodontic prophylaxis and state-funded orthodontic care programmes for these children are implemented.

Association between obesity and traumatic dental injuries in pre-school children-A case-control study.

Obese children are more prone to accidents due to poorer motor skills which increase the likelihood of falls and the occurrence of traumatic dental injuries (TDIs). The aim of this study was to determine the association between overweight/obesity and TDI in pre-school children. The case group was formed by children with TDI identified during a clinical examination (n=262). Each pre-school child identified as a case was matched by a peer of the same age, gender and pre-school but without TDI to form the control group (n=262). TDI was evaluated using the criteria proposed by Andreasen. The weight and height of the children were measured for the calculation of the body mass index which was plotted on the growth curve established by the World Health Organization. Socio-demographic variables were collected through questionnaires sent to the parents/guardians. Data analysis involved the determination of frequency distribution, the chi-square test and logistic regression analysis. The sample was composed of 253 children in each group. Among the children in the case group, 15.4% (n=39) were overweight and 15.8% (n=40) were obese. In the control group, 13.8% (n=35) were overweight and 8.3% (n=21) were obese. Children with trauma were more likely to be obese than children without trauma (OR=2.05; 95%CI: 1.14 to 3.67; p=.016). In contrast, TDI was not associated with being overweight. A greater odds of TDI was also associated with an open bite (OR=3.61; 95% CI: 1.64 to 7.96; p=.001) and accentuated overjet (OR=2.19; 95% CI: 1.37 to 3.50; p=.001). Pre-school children with a history of dental trauma were more likely to be obese than those without a history of dental trauma whereas being overweight was not associated with TDI.

Knowledge and Attitude of Guardians in Management of Avulsion of Primary and Permanent Teeth of Children: A Questionnaire-Based Study

Aims: This study aims to assess knowledge and attitude of guardians in management of dental avulsion of the children.&#x0D; Materials and Methods: This cross-sectional study was carried out at Altamash Institute of Dental Medicine, Pakistan, from April to May 2021. A total of 400 parents were recruited. An online self-administered questionnaire was circulated to the parents after taking the informed consent. 17 questions regarding demographics, knowledge and attitude were included. Chi-square test was used for association between demographics and responses of the participants.&#x0D; Results: Of the 400 participants, there were 140 (35%) males and 260 (65%) females. Most of the 180 (45%) participants belonged to 18-30 years age bracket. About 63% of the children did not have past dental trauma history. Predominantly, 80% chose dentists being most appropriate of emergency treatment. 33% believed to visit the dentist within 30minutes for treatment. About 50% participants agreed avulsed teeth can be placed back into its original position. More than half knew different transport mediums, with milk (21%) and Hanks Balanced Salt Solution (19%) being commonly selected. Younger age group and females were more knowledgeable regarding emergency management.&#x0D; Conclusion: Dental avulsion is a common finding in childhood, which mandates proper knowledge for the guardians. There is still a gap present in adequate knowledge for management of such emergencies which mandates organizations of education and awareness programs for both children and adults.

885 Surgical Removal of Unerupted Ectopic Maxillary Central Incisors - A Case Report

Abstract Introduction Maxillary incisors have a significant role on the facial aesthetics of an individual. Following trauma to the primary dentition, the maxillary incisors are vulnerable to eruption failure and occasionally root dilaceration. These teeth can be challenging to treat. Discussion This case report demonstrates the complex management of a 10-year-old male who presented with severely displaced and unerupted maxillary central incisors, following a history of dental trauma when he was 4 years old. Cone beam computed tomography revealed the upper maxillary central incisors to be lying transversely across the maxillary arch with the crowns directed superiorly and significantly close to the floor of the nose. The incisal edges of both crowns perforated the labial cortex of the maxilla. The roots of the maxillary central incisors were dilacerated with the apices directed superiorly. A multi-disciplinary approach was taken, with involvement from both maxillofacial surgery and orthodontic teams. Maxillofacial surgeons completed the surgical removal of the ectopic maxillary central incisors, rather than the more common approach of surgical exposure and orthodontic repositioning. In this case, full alignment of these teeth would most likely have led to perforation of the labial cortical plate of bone. Conclusions Although surgery was complex and technique sensitive, both teeth were successfully removed under general anaesthesia with no iatrogenic damage. The patient underwent fixed orthodontics to align the maxillary lateral incisors as central incisors. A multidisciplinary approach along with careful surgical planning and effective communication with the patient and his mother helped to achieve a satisfactory outcome.

A predictive nomogram: a cross-sectional study on a simple-to-use model for screening 12-year-old children for severe caries in middle schools

BackgroundA nomogram is a tool that transforms complex regression equations into simple and visual graphs and enables clinicians and patients to conveniently compute output probabilities without needing medical knowledge and complex formulas. The aim of this study was to develop and validate a predictive nomogram to screen for severe caries among 12-year-old children based on risk factors in Sichuan Province, China.MethodsA cross-sectional study of 4573 12-year-olds was conducted up to May 2016 in middle schools from three districts and three counties in Sichuan Province, China. All the children underwent oral examinations and completed questionnaires to assess general information, oral impacts on daily performance, dietary habits, subjective health conditions, history of dental trauma, frequency of toothache, dental visits, and knowledge, attitudes, and behaviours toward oral hygiene. Univariate analysis and multivariate logistic regression analysis were used to determine which variables were significantly associated with severe caries (operationalized as DMFT ≥ 3). A nomogram was developed and validated by using the ‘rms’ package and two cross-validation methods.ResultsSevere caries was found in 537 of the 4573 children (11.74%). Multivariate logistic regression analysis revealed that the following variables predicted a higher risk of severe caries: ‘female’ [odds ratio (OR) = 1.985, 95% confidence interval (95% CI): 1.63–2.411], ‘urban’ (OR = 2.389, 95% CI: 1.96–2.91), ‘non-only child’ (OR = 1.317, 95% CI: 1.07–1.625), ‘very poor self-assessment of oral health status’ (OR = 2.157, 95% CI: 1.34–3.467) and ‘visited a dentist less than 6 months’ (OR = 1.861, 95% CI: 1.38–2.505). Multivariate logistic regression analysis also indicated that the following variables predicted a lower risk of severe caries: ‘middle level of urbanization’ (OR = 0.395, 95% CI: 0.32–0.495) and ‘high level of urbanization’ (OR = 0.466, 95% CI: 0.37–0.596). Both the fivefold and leave-one-out cross-validation methods indicated that the nomogram model built by these 6 variables displayed good disease recognition ability.ConclusionsThe nomogram was a simple-to-use model to screen children for severe caries. This model was found to facilitate non-dental professionals in assessing risk values without oral examinations and making referrals to dental professionals.

Cemental tear: Literature review, proposed classification and recommendations for treatment.

Cemental tears are an important condition of relevance to Endodontics but are often overlooked. A cemental tear is the partial or complete detachment of the cementum from the cemento-dentinal junction or along the incremental line within the body of cementum. The limited attention received is most likely due to the limited awareness amongst dental professionals and challenges in accurately diagnosing them, resulting in misdiagnosis and erroneous treatment. The aim of this review is to describe the: (i) epidemiology and predisposing factors; (ii) clinical, radiographic and histological features and (iii) the clinical management and treatment outcomes of cemental tear. The review included 37 articles published in English that comprised eight observational studies and 29 case reports. The prevalence of cemental tears was reported to be lower than 2%; whilst the incidence remains unknown. Internal factors due to the inherent structural weakness of cementum and its interface with the dentine, and external factors that are associated with stress have been proposed as the two mechanisms responsible for the development and propagation of cemental tears. Predisposing factors that have been implicated were tooth type, gender, age, previous root canal treatment, history of dental trauma, occlusal trauma and excessive occlusal force; however, evidence is limited. Common clinical and radiographic manifestations of cemental tears resemble the presentations of primary endodontic diseases, primary periodontal diseases and combined endodontic-periodontal lesions. Clinical management tended to focus on complete removal of the torn fragments and periodontal treatment, often combined with regenerative treatment. In this article, a new classification for cemental tears is developed that consists of classes 0 to 6 and stages A, B, C and D based on the: (i) location and accessibility of the torn cemental fragment; (ii) the pattern and extension of the associated bony defect in relation to the root length and (iii) the number of root surface/s affected by the cemental tear/s and the associated bony defect. Recommendations for treatment strategies are also provided and linked to the classification to aid in streamlining the process of treatment decision making.

Apexification of A Permanent Immature Central Incisor

Aim: To report the induction of apical root development in an open apex central incisor with necrosed pulp by calcium hydroxide Summary: A 27-year‐old female patient came to dental OPD with ache and discoloration of tooth #11 with a history of dental trauma. There was negative response on pulp sensitivity test on tooth #11. Periapical radiograph showed incomplete root formation with wide canal, divergent foramina, and fragile dentinal walls tooth #11. After giving local anesthesia on her first appointment, access was opened, working length was measured and pulp was extirpated. Chemo-mechanical debridement was done with 2.5% sodium hypochlorite solution and application of calcium hydroxide paste was placed. Access was then closed and patient was recalled for subsequent appointments. After a duration of 9-months, radiograph showed the evidence of complete root development with closure of foramina opening. Canal was filled with sealer and Gutta-Percha by thermo-chemical compaction.

Treatment of maxillary osteomyelitis after facial trauma

Osteomyelitis is an inflammatory condition in the medullary spaces or the cortical surface of bones. It can be acute or chronic and extend beyond the original site. Also, it can be caused by several factors, among them as a result of untreated dental trauma. Correct diagnosis and individualized treatment are essential for success. The aim is to report a case of chronic osteomyelitis due to a history of dental trauma in the anterior region of the maxilla in a 21-years-old patient without associated comorbidities, focusing on the success of the therapy employed. It is known that the treatment of osteomyelitis is still a challenge because of the microbiota present. The treatment recommended with higher success rates is the removal of bone sequestration associated with antibiotic therapy, which has shown satisfactory results and maintenance of the dental elements in function.

Use of Cone-beam Computed Tomography as a Critical Component in the Diagnosis of an Infected Nasopalatine Duct Cyst Mimicking Chronic Apical Abscess: A Case Report

Nasopalatine duct cysts (NPDCs) and other nonodontogenic lesions of the oral cavity may mimic odontogenic pathoses. We present a case of a 22-year-old man with a history of dental trauma and a lesion displaying the typical clinical and radiographic signs of a chronic apical abscess— a buccal sinus tract that was traced to a radiolucent area in the periapex of a maxillary central incisor. A comprehensive diagnostic process that included a cone-beam computed tomographic scan and a histopathologic examination of the lesion after complete enucleation led to the final diagnosis of an infected NPDC. The adjacent tooth was vital at the 1-year posttreatment follow-up, and a radiograph demonstrated complete healing of the periradicular structures. This case demonstrates the ability of NPDCs to present clinical and radiographic signs similar to apical inflammatory lesions and the need for a meticulous diagnostic process in order to avoid unnecessary endodontic intervention. The article also discusses the differential diagnoses of nonodontogenic lesions in the premaxillary area.

Profiles of traumatic dental injuries among children aged 0-15years in Cappadocia, Turkey: A retrospective cohort study.

Traumatic dental injuries are among the most serious dental public health problems in children. The aim of this retrospective study was to evaluate the dental trauma profile of primary and permanent teeth among children aged 0-15years who presented to a university hospital. The study included 650 patients (1,000 primary and permanent teeth) who presented with a history of dental trauma to the Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University between 2016 and 2019. Traumatized teeth were assessed according to the Andreasen classification. The following information was recorded: age, gender, teeth affected by trauma, etiologies of trauma, place and season of trauma, type of trauma, type of treatment, and time between the trauma and treatment. In total, 650 patients (240 females, 410 males) and 1,000 incisors (212 primary teeth, 788 permanent teeth) were evaluated. The average age of the patients was 8.89±3.41years, and dental injuries were more frequent between 8 and 10years of age. The maxillary central incisors, both primary (40.1%) and permanent (42.8%), were the most frequently affected teeth. The main cause of traumatic dental injuries was falls. Most accidents occurred at school and home. The most common type of dental injuries recorded was luxation injuries in the primary teeth (21.5%) and enamel-dentin fractures (35.9%) in the permanent teeth. Only 48 teeth were treated during the first hour after injury. The most common type of traumatic injury affecting permanent teeth was enamel-dentin fractures, and primary teeth were luxation injury. Only 4.8% of teeth were treated within the first hour after trauma.

Microguided endodontics: A case report of conservative approach for the management of calcified maxillary lateral incisors

Pulp canal calcification due to dental trauma is described by hard-tissue deposition within the root canal space causing partial or complete obliteration and difficulty in locating canals. Endodontic treatment becomes difficult with increased risk for iatrogenic damage. Guided endodontics is a recent and an alternative solution in such cases. In this case report, a 28-year-old male patient reported with a chief complaint of pain in maxillary lateral incisors and a history of dental trauma that was diagnosed as pulpal necrosis with symptomatic apical periodontitis. The intraoral radiograph was taken, and apical radiolucency was confirmed with cone-beam computed tomography (CBCT) scan. A guided approach was decided for the location of the pulp canal with the use of microendodontic burs. A CBCT scan and an optical surface scan were performed and aligned using software for virtual template designing. The three-dimensional-printed template was positioned on to the tooth and with the help of microendodontic burs; the canal was located and biomechanically prepared using hand instruments. The root canal was obturated, and the cavity was sealed with a composite resin. This method demonstrated an ultraconservative, highly reliable, and successful treatment without the excessive removal of enamel and dentin.