Avulsed Teeth Research Articles

Multidisciplinary Management of A Nasally Displaced Dilacerated Tooth Following Early Childhood Dental Trauma: A Case Report

Traumatic dental injury (TDI) to primary teeth is common in childhood and often not given sufficient attention by parents. Many parents think primary teeth are only transient before permanent successors replace them. One of the serious consequences of TDI to primary teeth is tooth dilaceration of the permanent successor teeth. Luxation injuries, such as intrusion and avulsion to the primary teeth, can give rise to tooth dilaceration of the permanent successor teeth, that some cannot erupt. This case describes dental management of a 12-year-old girl who was concerned about her dental aesthetics because of failed eruption of one of her permanent central incisors. She had a history of tooth avulsion during her childhood to one of her upper front teeth. Parents gave little thought to it and did not seek any treatment, thinking it was only a primary tooth. Investigations showed an unerupted dilacerated right permanent central incisor with the crown nasally orientated. The affected tooth was surgically extracted, the spaces between the maxillary anterior permanent teeth were redistributed orthodontically and the missing tooth in the arch was replaced with a fixed prosthesis. This case highlights the impact of early childhood TDI and one of its dental consequences. Multidisciplinary management approach allows proper discussion between dental specialties on the feasibility of various treatment options and selecting the most suitable treatment to satisfy the patient’s needs from the aesthetic and functional perspectives.

DELAYED REPLANTATION OF AVULSED TOOTH- A CASE REPORT

Aim- Background-Trauma to the oral region occurs frequently and comprise 5% of all injuries. Among all facial injuries, dental injuries are the most common of which avulsions occur in 1–16% of cases. Avulsion is defined as total displacement of the tooth out of its socket. An avulsed tooth can usually be retained by replantation; however, the prognosis depends on the extraoralduration, the condition of the avulsed tooth, patient’s age and root development. In many cases, a replanted tooth survives only a matter of years, during this period it serves as a natural space maintainer whilst growth occurs, and also enables alveolar height to be preserved. Case Description- This case report describes delayed replantation of an avulsed maxillary central incisor in an eleven year old child after trauma.

Repercusiones estéticas, funcionales, psicológicas y económicas de iatrogenia en el tratamiento de la avulsión dental. Relato de caso.

Abstract 
 Introduction: dental avulsion is the complete removal of the tooth out of the socket with aesthetic, functional, psychological, and economic consequences. The International Association of Dental Traumatology establishes that among the actions to favor the prognosis is the immediate reimplantation. Objective: to report a case of probable iatrogenesis in the treatment of dental avulsion and the repercussions on the quality of life of a child. Case Presentation: 9-year-old male patient who suffered a 1-1 avulsion from a direct hit against the swing at school; the mother reports that he was immediately transferred to a private clinic. The tooth was not reimplanted, indicating a fixed partial prosthesis as treatment. Two weeks later, he was presented to the Postgraduate Clinics of the Faculty of Dentistry at the University of El Salvador. It was comprehensively evaluated, and the psychological impact as a result of tooth loss was prioritized. As emergency empathic treatment the crown of the avulsed tooth was used, fixing it with a palatal wire-resin splint, generating evident satisfaction in the patient at the end. Conclusions: Child-Oral index in Daily Performances confirmed an important impact on the quality of life the child as a consequence of the loss of an anterior tooth. According to questioning, it is suspected that iatrogenesis originated from insufficient knowledge of first aid to adequately resolve the avulsion. The incorrect approach generated the irreparable loss of the permanent upper central incisor, with repercussions on the quality of life the patient.
 Keywords: Iatrogenesis; Tooth Avulsion; esthetic; smile; Self-image.

Awareness of Dental Trauma Management among School Teachers in Dammam, Saudi Arabia

Background:Children and young adolescents commonly suffer traumatic dental injuries. Teachers are frequently first responders and responsible for the initial management of the injury; the prognosis of a traumatized tooth is dependent on the initial management.Aim:To evaluate intermediate school teachers’ level of knowledge and attitudes toward dental trauma.Materials and Methods:This is a questionnaire-based cross-sectional study where all teachers from eight non-probability selected intermediate schools in Dammam, Saudi Arabia, were invited for participation. The questionnaire elicited data regarding demographics, teaching experience, knowledge and attitudes regarding dental trauma and its management.Results:A total 398 of 433 invited teachers responded (92%). The male-to-female ratio was 2:1. Only 30% of the respondents had previously participated in first aid training; only 11% specifically also focused on dental traumas. Health-care providers represented the main source of knowledge regarding dental trauma. Bivariate analysis revealed that in terms of attitudes toward dental trauma, urgency of care for luxation injuries was significantly associated with teaching experience (P = 0.042), while the urgency of care for avulsed teeth was significantly associated with dental trauma experience (P = 0.007). The only significant association between teaching experience and knowledge about management of avulsed teeth was regarding which tooth should be replanted (P = 0.041).Conclusions:School teachers in Dammam, Saudi Arabia, lack proper knowledge in dental emergency management. Educational training programs are needed to ensure that teaching staff have adequate knowledge to effectively manage dental traumas.

Evaluation of teachers' knowledge about dental injuries in primary schoolchildren in the city of Isfahan

Dental trauma is a common problem in children, which mostly occurs at school. Traumatic dental injuries often cause unpleasant experiences for children, and immediate and appropriate measures are needed. Its prognosis depends on immediate posttraumatic measures, and schoolteachers can play a key role in the treatment of children. The current study aimed to investigate teachers' knowledge about dental injuries in primary school children in the city of Isfahan. Following a cross-sectional design, the current study was conducted on 248 elementary school teachers who were selected using the simple two-stage random cluster. Then the teachers' knowledge was measured based on a four-choice questionnaire consisted of two parts. According to this questionnaire, teachers were divided into five categories based on their knowledge score which was consist of strongly high knowledge, high knowledge, average knowledge, low awareness, and strongly low knowledge. Data were analyzed using the Spearman correlation coefficient and independent t-test. Statistical significance was considered when P < 0.05. The total knowledge score of teachers was 45.9%. About 61% of the teachers had a history of exposure to dental injuries. Furthermore, 49.6% of them believed milk was the best environment to keep the avulsed teeth. There was no significant association between teachers' knowledge and education level, history of previous trauma, or participation in a training course, but there was a direct association between teachers' knowledge and their work experience (P < 0.05). Female teachers' knowledge score was significantly higher than their male counterparts (P < 0.001). Participants had a moderate level of knowledge about the management of dental traumas. Hence, it is suggested to develop educational programs to increase teachers' awareness about this issue.

Knowledge and Attitude about Emergency Management of Avulsed Tooth Amongst Paramedical Students of Visnagar, Gujarat: A Questionnaire-based Cross-sectional Study

Introduction: Dental trauma has emerged as a significant aspect of dental public health. Traumatized teeth require early and appropriate treatment, which frequently relies on the competence of the dentists, doctors, and nurses who provide the primary care. Aim: To assess the knowledge and attitude of paramedical students about the emergency management of avulsed tooth. Materials and Methods: A cross-sectional questionnaire survey consisting of 17 questions was designed and circulated among 365 paramedical students (nursing, pharmacy and physiotherapy) of Sankalchand Patel University, Visnagar, Gujarat, India, to assess their knowledge and attitude about the emergency management of avulsed tooth. Descriptive statistics were applied by Statistical Package for Social Sciences (SPSS) software version 20.0. Results: Total 260 (71.23%, mean age of 23 years) students responded, with 71 students from Physiotherapy, 106 from Nursing and 83 from Pharmacy. A total of. 178 (68.46%) students comprehend the meaning of avulsion. While 193 (74.23%) students had knowledge that tooth re-implantation is possible. Of all the respondents, 192 students (73.84%) were familiar about the benefit of mouth guards for prevention of sports injury and 125 students (48.07%) opined that it is very important to be acquainted with emergency management of dental trauma. Conclusion: Though the paramedical students had good understanding about tooth avulsion, they were unaware about the emergency management of the situation. This warrants the need of incorporating training programmes dedicated to the subject in their curriculum.

Trauma dentoalveolar induzido por intubação em cirurgia bucomaxilofacial de urgência: relato de caso

ABSTRACT Dental trauma is a common complication in general anesthesia, especially when using nasotracheal intubation during the classic laryngoscopy. Risk factors range from difficult intubation through difficult airways to occlusal changes in the patient, with incisors being widely affected by dental elements. Tooth avulsion is the most frequent type of trauma, followed by lateral dislocation and root fracture. Male patient, 39 years old, presented at the Emergency and Trauma Hospital in Caruaru/PE, a motorcycle accident victim with a bilateral jaw fracture. Given the need to fix fractures, the patient underwent a surgical procedure under general anesthesia. During laryngoscopy, heavy bleeding was observed in the oral cavity. After inspection, root fracture of lateral incisor and avulsion of right central incisor were noted. The avulsionated tooth was not found. An orthopedic image intensifier was used to locate the dental element in the thoracic region. However, it was not possible to determine its location. Therefore, an upper gastrointestinal (UGI) endoscopy was requested, and the dental element was in the digestive tract at the esophagus level. The tooth was removed, and the surgical procedure for osteosynthesis of bilateral mandible fracture was carried on. Dentoalveolar traumas induced by general anesthesia are frequent and require preventive measures since they can directly affect the patient’s physical, economic, and medical conditions, along with anesthesiologists and maxillofacial surgeon’s risk of receiving a civil lawsuit.

Sports Dentistry

Sports is a form of recreation that helps people to get away with everyday stress. It is also associated with the risk of traumatic injury, especially in case of contact sports. Dental injuries that are caused due to sports mostly involve the maxillofacial region. Out of all the sports-related dental injuries, the most complex injury is tooth avulsion and should be considered as real emergency. Protection from sports-related orofacial injuries currently comes in the form of three shielding equipment, namely mouthguards, facemasks, and helmets. Sports dentistry, being the most recent and upcoming field in dentistry, inculcates the prevention, maintenance, and treatment of oral and facial injuries. Dentists must have sound clinical knowledge regarding sports-related dentofacial injuries and should make it a point to inform parents regarding the orofacial injury caused due to sports and regarding various preventive measures that are available.

Avaliação do conhecimento dos acadêmicos dos cursos de pedagogia e educação física

Abstract Introduction Dental trauma is considered a public health problem, being the second most prominent dental emergency, whose greatest occurrence is in schools, assigning teachers the responsibility of administering first aid. Objective To evaluate the knowledge of dental trauma among final-year’s students of pedagogy and physical education courses at the Federal University of Espírito Santo. Material and method A cross-sectional descriptive study was applied. A total of 106 questionnaires were answered by 55 students from the physical education course and 51, from the pedagogy course; comprised of socio-demographic data and knowledge of dental injuries. Statistical analysis was done using the statistical package SPSS 20. Result 98.1% of the interviewees had no training on trauma, 92.5% considered themselves incapable of providing help when facing trauma, but considered the ability important (55.7%). When asked about tooth avulsion, most of them answered that they would not reimplant the tooth, were not aware of the appropriate time window to do so, or how the storage/transportation of the dental element was to be done. Conclusion These future teachers showed unpreparedness and deficient knowledge regarding trauma treatment procedures, favoring unfavorable prognoses which would negatively impact the quality of life of the victims in terms of aesthetic, functional and psychological aspects. Therefore, the need for dental trauma education during their professional training is evident.

Domestic Accidents in Under-Fives: Epidemiology, Diagnosis, Management, and Outcomes

Introduction: Domestic accidents are a public health problem, and under-fives are particularly affected. We report these accidents’ epidemiology, diagnosis, management, and outcomes through this study. Patients and Methods: We conducted a prospective descriptive study for four months in the Albert Royer National Children’s Hospital Center pediatric surgery department in Dakar, Senegal. Of the 149 cases of domestic accidents, 109 were included in this study. Results: Infants (59.6%) were the most affected, with a slight male predominance (50.5%). Accidents occurred on Tuesday in 22.9% of cases and the afternoon in 38.5% of cases. Playing (59.6%) was the main activity, and falling (44%) was the most found mechanism. 78.9% of accidents occurred in the house, with the bedroom (27.5%) being the most represented place. In most cases (67.9%), the consultation was done within the first 24 hours. The upper limbs (48.6%) were the most affected, and fractures (31.2%) were the most frequent injuries. The outcomes were unremarkable in 94.5% of cases, as complications occurred in five patients with three who had an infection, one a persistent limping, and the last, a dental avulsion. No mortality was recorded. Conclusion: Domestic accidents among under-fives are frequent in our environment. Compared to those in older children, they occur similarly in both sexes, more often in the bedroom, and have a better prognosis.

An in vitro evaluation of ice apple water, Aloe vera, and propolis as a storage medium to preserve viability of human periodontal ligament fibroblasts.

A number of media that create the best possible conditions to maintain periodontal ligament (PDL) cell viability after dental avulsion have been reported. The aim of this study is to evaluate ice apple water (IAW), Aloe vera, and propolis as a storage medium to preserve the viability of human PDL fibroblasts. An in vitro comparative type of study was performed on a PDL cell culture model. PDL fibroblasts obtained from the roots of healthy premolars were cultured in Dulbecco's Modified Eagle's Medium (DMEM) and treated with ice apple water (IAW), 7% propolis extract (PE), 30% Aloe vera extract (AVE), positive control DMEM supplemented with fetal bovine serum, negative control (NC) without any agent, and incubated at 37°C for 1 h, 3 h, and 24 h. Cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay after every test period. Optical density was measured at a wavelength of 490 nm. The effects of the test storage media were evaluated by one-way analysis of variance test, followed by post hoc Tukey's multiple comparison test (P < 0.05). Seven percent PE demonstrated the highest capacity of maintaining PDL cell viability at 1 h and 24 h. IAW showed a statistically significantly lower percentage of viable cells at all three test periods as compared to 7% PE. After 3 h, 30% AVE demonstrated maximum viable cells. Within the limitations of this study, propolis at a concentration of 7% was the most effective medium for maintaining PDL cell viability.

Management of External Root Resorption Associated with a Replanted Maxillary Central Incisor in an 11-Year-Old Patient: A Rare Case Report

Avulsion of permanent teeth is one of the serious injuries that require immediate attention in a dental setup and immediate replantation and splinting is the treatment of choice. The replantation of avulsed tooth improves aesthetics, occlusion, and function. Most common complication of tooth replantation is inflammatory external root resorption. Mineral trioxide aggregate is a calcium silicate-based material that maintains high alkaline pH for a longer duration and it helps in preventing inflammatory external root resorption. The purpose of this article is to report the successful management of inflammatory external root resorption associated with a replanted maxillary right central incisor using MTA in an 11-year-old girl with one-year follow-up.

Knowledge of Dental Trauma and Avulsion Management among Senior Year University Students

Knowledge of Dental Trauma and Avulsion Management among Senior Year University Students

Assessment of youth knowledge and attitude toward managing avulsed tooth across Saudi Arabia: A cross sectional study

Assessment of youth knowledge and attitude toward managing avulsed tooth across Saudi Arabia: A cross sectional study

Evaluation of Knowledge on Emergency Management of Avulsed Teeth Among Turkish Medical and Dental Students

Objective: To evaluate the knowledge of medical and dental students regarding the emergency management of avulsed teeth. Material and Methods: This cross-sectional survey study was performed on 1841 students. Medical (n=746) and dental (n=845) students from different universities were included in this study. A questionnaire about the emergency management of avulsed teeth was conducted on the students. Also, 250 medical students from 3rd grade were included in the study and trained. The questionnaire was applied twice, before and after the training on the subject. Results: The mean correct answer scores were similar among the medical students in different grades (p>0.05). There were no statistically significant differences between the trained medical students and clinical dental students' correct answer scores, but there was a significant difference between the pre-clinical (1st-2nd-3rd years) and clinical (4th-5th years) dental students (p<0.01). Conclusion: Medical and preclinical dental students had lack of knowledge about the emergency management of avulsed teeth, while clinical dental and trained medical students were very knowledgeable. This result indicates the importance of education.

Paediatric Prosthetic Rehabilitation using Decoronated Avulsed Teeth

Traumatic Dental Injury (TDI) mostly occurs as a result of any sports injury or an accident. The prognosis of teeth following injury is determined by the kind of TDI, emergency treatment, and the amount of time between emergency treatment and definitive care. Patients with missing anterior teeth lack an impressive appearance aesthetically as well as psychologically. Speech issues and some loss of function can lead to a decline in oral health, which can affect one's quality of life. This case addresses the patient aesthetic concern in anterior region of maxilla of 15-year-old male due to trauma which resulted in avulsion of both centrals and lateral incisor. Patient’s own completely displaced teeth placed in biological tooth functional space maintainer was planned. The use of natural tooth as functional space maintainer method is less expensive, easy to fabricate, easy to modify according to age and produces better aesthetics. It also maintains space loss in growing children.

An in vitro evaluation of efficacy of ViaSpan, aloe vera, gatorade solution, and propolis storage media for maintaining the periodontal ligament cell viability.

Background:Replantation is a commonly performed method for avulsed tooth. A vital periodontal membrane (periodontal ligament [PDL]) is significant for the successful healing of replanted teeth. Hence, various storage media are used to preserve the viability of periodontal cells before replantation.Objectives:The present study was conducted to evaluate the efficacy of ViaSpan, Aloe vera, Gatorade solution, and propolis storage media for maintaining the PDL cell viability.Materials and Methods:The present study was conducted on 40 recently extracted teeth which were randomly divided into four study storage groups: Group I: ViaSpan, Group II: Aloe vera, Group III: Gatorade solution, and Group IV: Propolis. Later they were subjected to centrifugation, and the cells from supernatant were colored with 0.4% trypan blue for determination of viability. The obtained data were statistically evaluated with SPSS package (21.0 version, Inc.; Chicago, IL, USA) using analysis of variance, Mann–Whitney test, and Post hoc tests.Results:The mean viable periodontal cell in Group I was 30.2 cumm, in Group II was 24.6 cumm, Group III was 14.5 cumm, and Group IV in 31.4. The difference was significant (P < 0.01). Post hoc test between different groups revealed a significant difference in mean viable periodontal cells (P < 0.001). Propolis, ViaSpan, and Aloe vera had higher pH and osmolality values.Conclusion:This study found that propolis had higher periodontal cell viability followed by ViaSpan solution and Aloe vera and least in Gatorade solution. Propolis, ViaSpan, and Aloe vera media can be used as a storage media.

Differential gene expression profiles of periodontal soft tissue from rat teeth after immediate and delayed replantation: a pilot study.

PurposeIn dental avulsion, delayed replantation usually has an uncertain prognosis. After tooth replantation, complex inflammatory responses promote a return to periodontal tissue homeostasis. Various types of cytokines are produced in the inflammatory microenvironment, and these cytokines determine the periodontal tissue response. This study aimed to identify the gene expression profiles of replanted teeth and evaluate the functional differences between immediate and delayed replantation.MethodsMaxillary molars from Sprague-Dawley rats were extracted, exposed to a dry environment, and then replanted. The animals were divided into 2 groups according to the extra-oral time: immediate replantation (dry for 5 minutes) and delayed replantation (dry for 60 minutes). Either 3 or 7 days after replantation, the animals were sacrificed. Periodontal soft tissues were harvested for mRNA sequencing. Hallmark gene set enrichment analysis was performed to predict the function of gene-gene interactions. The normalized enrichment score (NES) was calculated to determine functional differences.ResultsThe hallmark gene sets enriched in delayed replantation at 3 days were oxidative phosphorylation (NES=2.82, Q<0.001) and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa light chain enhancer of activated B cells (NF-κB) pathway (NES=1.52, Q=0.034). At 7 days after delayed replantation, TNF-α signaling via the NF-κB pathway (NES=–1.82, Q=0.002), angiogenesis (NES=–1.66, Q=0.01), and the transforming growth factor-beta signaling pathway (NES=–1.46, Q=0.051) were negatively highlighted.ConclusionsDifferentially expressed gene profiles were significantly different between immediate and delayed replantation. TNF-α signaling via the NF-κB pathway was marked during the healing process. However, the enrichment score of this pathway changed in a time-dependent manner between immediate and delayed replantation.

Dental Trauma Management; Knowledge and Attitude of School Teachers in Rural Areas of Punjab

Objective: The purpose of study was to explore the level of knowledge and attitude in handling dental trauma among primary school teachers working in rural areas of Punjab, Pakistan. Method: This descriptive crossectional study was conducted in 47 primary government schools of different rural areas of district Narowal, Punjab, Pakistan. Collected sample size was 215 primary school teachers with minimum qualification of Bachelors in Arts. Data was collected using convenient sampling technique. SPSS version 25.0 was used for analysis and further results formation. Frequencies and Percentages were calculated for gender and qualification whereas mean and standard deviation was calculated for age. Results: Majority of participants reported that their knowledge about dealing with dental emergencies is not adequate 175(81.40%). Majority of participants were interested in having workshops on dealing with dental emergencies in school 160(74.42%). Conclusion: The knowledge and attitude of teachers towards management of dental trauma is lacking and a dire need of awareness programs and teacher training workshops has been felt after conducting this study as management of dental trauma is an important part of student safety management. Keywords: Dental Trauma, Teachers, Tooth Replantation, Tooth Avulsion

The status of knowledge, attitude and practice towards emergency management of avulsed tooth among dental students: A single center cross-sectional study.

To evaluate the awareness of emergency trauma management and the potential role of dentists in handling tooth avulsion injuries. The cross-sectional study was conducted at the Dental Outpatients Department of Jinnah Medical and Dental College, Karachi, from December 2020 to March 2021, and comprised dentists and final year dental students of either gender. Data was collected using a 17-item questionnaire to assess the awareness level regarding the knowledge of traumatic dental emergencies and the role of a dentist in handling a traumatic tooth injury. Data was analysed using SPSS 20. Of the 170 subjects, 52(30.5%) were males and 118(69.4%) were females. Overall, 139(81.8%) subjects had prior knowledge regarding avulsion, 164(96.5%) were aware of the term avulsed tooth, 106(62.4%) considered milk to be the best transport media for an avulsed tooth, 159(93.5%) knew the significance of extra-oral time, and all 170(100%) subjects said they wanted to study more about dental traumatic injuries. There was adequate knowledge about the term avulsion, transport media and extra-oral time, and there was evidence of interest about learning more among the subjects.