Traumatic Dental Injuries Cases Research Articles

Prevalence of Intimate Partner Violence and Endodontic Treatment Needs: Pilot Study.

ObjectiveThe aim of this study was to assess the prevalence and potential association between intimate partner violence (IPV) with traumatic dental injuries (TDIs) and the subsequent need for root canal treatment (RCT).MethodsA total of 100 subjects with TDIs presented at emergency or postgraduate restorative clinics at University Dental Hospital, King Abdulaziz University, Jeddah, Saudi Arabia post-TDI. All study subjects completed the Hurt-Insult-Threaten-Scream (HITS) domestic violence screening tool and were clinically and radiographically examined to determine the type of TDI they suffered along with the pulp and periapical status of affected teeth. Demographic data were also recorded. Based on the findings, management included regular follow-up, splinting, reattachment of broken tooth part, vital pulp therapy and/or RCT as seen appropriate.ResultsMean age of participants was 28.4±5.7 years. Prevalence of IPV among subjects presented with TDIs was 18%. Most of the IPV victims held a bachelor’s degree (67%) and were unemployed (61%). Most of TDI cases were crown fracture (84%) followed by luxation and avulsion (10% and 6%, respectively). Among all TDI cases, 73% required RCT. Crown fracture was the most prevalent TDI among IPV victims followed by luxation and avulsion with prevalence of 56%, 33%, and 11%, respectively. Out of a total of 73 patients requiring RCT, nine were IPV victims (12.3%) which indicated that one of each eight TDI cases requiring RCT might be a potential IPV victim. Half of the IPV victims required RCT to manage their TDIs.ConclusionPrevalence of IPV among TDIs was 18%. IPV screening should be included as routine assessment part for TDIs. Identification of IPV victims could be difficult, however, employment status, type of TDI, and RCT needs were suggested as potential predictors of positive IPV cases.

Perception of elementary school teachers on dental traumatism: an analysis in Amazon region

Traumatic dental injuries (TDI) are highly prevalent lesions in the school environment and its consequences can negatively affect psychological well-being. The aim of this cross-sectional study was to evaluate the perception and management of TDI cases by public elementary school teachers in the city of Belém, in Amazon region. Data were collected, focusing on previous training in first aid on TDI, and its effect on their knowledge and attitudes towards dental avulsion in permanent teeth. Our results show the low level of information on management and the need for teaching training in their work environment.

Diagnosis and Management of Traumatic Dental Injuries Using Intraoral Radiography and Cone-beam Computed Tomography: An In Vivo Investigation

The aim of this study was to compare periapical radiographs (PRs) and upper standard occlusal (USO) radiographs with cone-beam computed tomographic (CBCT) imaging on clinicians' confidence in the diagnosis and management of traumatic dental injuries (TDIs). This study included 35 maxillary anterior teeth from 25 patients with at least 1 PR (parallax view) and a CBCT scan. Fourteen patients also had a USO radiograph. Ten examiners selected a diagnosis and treatment plan, which were compared with a reference standard. Sensitivity, specificity, positive and negative predictor values, and receiver operating characteristic analysis were used to determine the diagnostic accuracy. CBCT imaging exhibited significantly higher sensitivity than both conventional radiographic techniques combined (PRs and PRs + USO radiographs) for all diagnoses (TDI: 99% vs 84%, lateral luxation: 80% vs 34%, extrusions: 92% vs 42%, and cortical plate fracture: 58% vs 1%) other than horizontal root fractures in which the results were close to statistical significance (88% vs 69%). CBCT imaging was significantly more accurate for all diagnoses (TDI: 91% vs 70%, lateral luxations: 83% vs 61%, extrusive luxations: 92% vs 68%, alveolar cortical plate fractures: 78% vs 48%, and horizontal root fractures: 93% vs 82%).Examiners had the most confidence with CBCT imaging and the least confidence in diagnosing using PRs + USO radiographs than with PRs alone. Agreement with management plans was significantly better using CBCT imaging compared with PRs and PRs + USO radiographs. CBCT imaging improved the clinical diagnosis of TDIs. The addition of USO radiographs to PRs did not improve the diagnosis of TDIs in this investigation. CBCT imaging improved confidence in the diagnosis of TDI cases and treatment planning compared with conventional radiography.

Traumatic dental injuries in preschool-age children: Prevalence and risk factors.

This study examined the prevalence, socio‐demographic correlates, and clinical predictors of traumatic dental injuries (TDIs) in the primary dentition among a community‐based sample of preschool‐age children. The sample comprised 1,546 preschool‐age children (mean age 49 [range: 24–71] months) in North Carolina public preschools, enrolled in a population‐based investigation among young children and their parents in North Carolina. Information on socio‐demographic, extraoral, and intraoral characteristics was collected and analyzed with bivariate and multivariate methods, including logistic regression modeling and marginal effects estimation. The prevalence of dental trauma was 47% and 8% of TDI cases were “severe” (pulp exposure, tooth displacement, discolored or necrotic tooth, or tooth loss). In bivariate analyses, overjet and lip incompetence were significantly associated with TDI. Overjet remained positively associated with severe trauma in multivariate analysis, OR = 1.4, 95% confidence interval (CI) [1.2, 1.6], corresponding to an absolute 1.3%, 95% CI [0.7, 1.8], increase in the likelihood of severe trauma, per millimeter of overjet. Children with increased overjet (>3 mm) were 3.8, 95% CI [2.0, 7.4], times as likely to have experienced severe TDI compared with those with ≤3 mm. Overjet is a strong risk factor for TDIs in the primary dentition. Incorporating and operationalizing this information may help TDI prevention and related anticipatory guidance for families of preschool‐age children.

Traumatic Dental Injuries among Adolescents In Republic of Moldova.

Objectives: The aim of this investigation was to evaluate the epidemiological data on dental injuries in permanent teeth among seventh and tenth grade schoolchildren in the Republic of Moldova. Study design: The pathfinder study model was chosen to evaluate the prevalence of Traumatic Dental Injuries (TDI). Schoolchildren ages 12 and 15 years old were examined: In the capital city (four schools), in two other major cities-(two schools each city), and in four villages (one per each village) in accordance with the WHO's recommendations. Results: A total of 720 seventh and tenth grade schoolchildren were examined. The overall prevalence of TDI was found to be 16.4% (total of 118 children). The prevalence of TDI was greater in the older age cohort (p<0.05). Children from rural areas presented with greater prevalence of TDI compared to children who live in urban region (p<0.03). The maxillary central incisors were found to be the most common teeth affected by trauma constituting 57.1% of the evaluated TDI cases. Enamel fracture was the main type of TDI (83%). Conclusions: The TDI mainly involved enamel fractures. Urban schoolchildren show lower rates of TDI compared to rural schoolchildren.

Validation and usability of a mobile phone application for epidemiological surveillance of traumatic dental injuries.

Traumatic dental injuries (TDI) are a public health problem, given their prevalence and consequences. However, their epidemiology is uncertain due to a general lack of quality data capture. The aim of this study was to evaluate the validity and usability of a mobile phone-based application for community-based surveillance of traumatic dental injuries. A mobile phone-based application, Dental Trauma Tracker (DTT), was developed. This system involves a mobile application for general users to report TDIs and a Web application for researchers to generate epidemiological data. The DTT evaluation used mixed methods and was conducted in three phases: (a) validation of a trauma identification system using preselected TDI images; (b) design evaluation by experts; and (c) usability evaluation measured by the reporting of three fictitious TDI cases and using the System Usability Scale (SUS). In the first phase, 182 participants participated. Most images showed over 95% accuracy, indicating that they adequately represented the type of dentoalveolar trauma being evaluated (κ=0.75). The design evaluation identified nine usability problems-four of them with a "High priority" to be fixed, four with "Low priority," and one "No fix necessary." A total of 29 volunteers participated in the usability evaluation. The mean time for users to complete all of the reports was 7.8±3.0minutes. Mean SUS score was 67.4±21.9 (Range: 0-100; worst to best). The global agreement between cases registered with the gold standard was also "Substantial" (κ=0.71). This preliminary evaluation confirmed the App's usability, using a sample of potential users, as well as reporting on the results of an expert panel review of the DTT. These are the minimum requirements necessary before further expansion and widespread implementation occurs to confirm these results.

Demographic Characteristic Of Patient With Traumatic Dental Injury Attending Kulliyyah Of Dentistry IIUM Kuantan Campus

Introduction: Traumatic dental injuries (TDI) refer to injury to the teeth and/or peridontium and perioral soft tissues. To date, very few dental trauma studies conducted in the university setting, thus the aim of this research is to provide an epidemiological data of TDI cases among patients attending Kulliyyah of Dentistry (KOD), IIUM Kuantan Campus. Materials and Methods: A total of 32 patient's record with TDI were retrieved from 2012 to June 2016. The inclusion criteria are patients attended KOD for management of dental trauma and diagnosis of TDI was properly documented. Patients attending KOD with complaint other than dental trauma and no proper diagnosis documented were excluded. The classification of dental trauma used is based on WHO Dental Trauma Classification (1978). For cases that were doubtful or with insufficient information, decision was made after further discussion with another examiner. Results: The mean age was 12.31 years old with the highest number of cases occurs in the 6-15 year-old group (37.5%) and male to female ratio of 3:2. Uncomplicated crown fracture was the most common injury in primary and permanent dentition (38% and 67%, respectively). Falls attribute 62.5% of the causes of TDI. November and December recorded the highest number of occurance of TDI cases (25% respectively). Conclusion(s): There is low occurance of TDI cases in KOD. The occurance of TDI cases is associated with school holiday

Increased risk of dental trauma in patients with allergic rhinitis: A nationwide population-based cohort study.

Allergic rhinitis (AR) is associated with various developmental issues that affecting dentition. We aimed to determine whether AR is associated with an increased risk of traumatic dental injuries (TDIs) in Taiwanese individuals. We used the Taiwan National Health Insurance Research Database (NHIRD) to conduct a nested case-control study. We compared an AR cohort with a matched cohort of patients without AR. New TDI cases were determined during our study period. To compare TDI risk between our study cohorts, we used Cox proportional regression analysis, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated to quantify the association between AR exposure and TDI risk. In total, 76749 patients with AR (31715 male; 45034 female) were identified. In the AR and the non-AR cohorts, 312 patients in total had TDI. Patients with AR had a significantly higher risk of TDI than those without AR (aHR = 1.92; 95% CI = 1.459–2.525; P < 0.001). The risk of TDI was markedly higher in the AR cohort, except in the 3–12-year-old group, and with a CCI ≥ 1. AR patients had a future risk of TDI, indicating a potentially linked disease pathophysiology. The association between AR and TDI is greater among general patients. Clinicians and caregivers should be aware of potential TDI co-morbidity in patients with AR.

Traumatic dental injuries among 12- and 15-year-old adolescents in Georgia: results of the pathfinder study.

Traumatic dental injuries (TDI) are a widespread pathology with serious dental public health concerns. The aim of this pathfinder study was to collect initial epidemiological data on oral health in Republic of Georgia. As part of this study, the prevalence and severity of TDI in permanent teeth among seventh- and tenth-grade schoolchildren were evaluated. Schoolchildren were examined in four schools in the capital city of Tbilisi, two schools in two other major cities, and one school in four additional villages. In addition to demographical data, the following parameters were collected and recorded: Overjet (OJ), lip competence, number and type/location of the teeth with TDI and Type of TDI. The study population comprised of children aged 12 (seventh grade) and 15 years old (10th grade). A total of 823 7th- and 10th-grade schoolchildren were examined. The overall prevalence of TDI among Georgian population was found to be 10.4% (86 children). The prevalence of TDI was greater in the older age cohort (P < 0.05). Lip posture did not seem to have a marked effect on TDI. Children with an OJ greater than 5 mm were more likely to present with dental injuries compared to children with an OJ equal to or smaller than 5 mm (P < 0.05). Children from rural areas presented with greater prevalence of TDI compared to their urban counterparts (P < 0.05). The maxillary central incisors were the most common teeth to be affected by trauma accounting for 85.2% of the TDI cases. Enamel fracture was the main type of TDI (91.3%). The prevalence of TDI in Georgian schoolchildren, as presented in this survey, population was found to be rather moderate and involved mainly minor superficial injuries. Rural communities have shown in this report substantial higher rates; thus, educational program might be directed mostly to these regions to children, teachers, and healthcare providers.

Traumatic dental injuries as reported during school hours in Bergen.

To identify existing guidelines for managing traumatic dental injuries (TDIs) in the schools of Bergen, to ascertain the frequency of occurrence of such injuries, and to estimate the need for further information among teachers and school administrators. The study, undertaken among teachers and school administrators of elementary and lower secondary schools in Bergen municipality, was questionnaire-based and included a cross section of staff. The structured short questionnaire included items registering TDIs during 2009, existence of routines or guidelines for managing TDIs, previous relevant training, and request for TDI education or information. The statistical methods included frequency tables and logistic regression analysis. The response rate was 73%. The incidence proportion of TDIs was measured to 0.74% of children at risk, varying according to children's classes (peak at third class: 1.68% of children in the population). No schools had adequate written guidelines for handling TDIs. Previous education on the subject was scarce. In 20 schools, there was no perceived need for TDI-related education or information. The schools' routines for TDI reporting, who was in charge of the reporting, acquired TDI education and expressed need for TDI information or education, did not influence the number of reported TDI cases. This study has produced reliable information that schools in the municipality of Bergen could improve ways of reporting and managing TDIs. As teachers with skills in handling TDIs could help to improve the prognosis for injured teeth, some types of educational intervention in schools should be launched.

Over two hundred million injuries to anterior teeth attributable to large overjet: a meta-analysis.

The association between large overjet and traumatic dental injuries (TDIs) to anterior teeth is documented. However, observational studies are discrepant and generalizability (i.e. external validity) of meta-analyses is limited. Therefore, this meta-analysis sought to reconcile such discrepancies seeking to provide reliable risk estimates which could be generalizable at global level. Literature search (years 1990-2014) was performed (Scopus, GOOGLE Scholar, Medline). Selected primary studies were divided into subsets: 'primary teeth, overjet threshold 3-4 mm' (Primary3); 'permanent teeth, overjet threshold 3-4 mm' (Permanent3); 'permanent teeth, overjet threshold 6 ± 1 mm' (Permanent6). The adjusted odds ratios (ORs) were extracted. To obtain the highest level of reliability (i.e. internal validity), the pooled OR estimates were assessed accounting for between-study heterogeneity, publication bias and confounding. Result robustness was investigated with sensitivity and subgroup analyses. Fifty-four primary studies from Africa, America, Asia and Europe were included. The sampled individuals were children, adolescents and adults. Overall, there were >10 000 patients with TDI. The pooled OR estimates resulted 2.31 (95% confidence interval - 95CI, 1.01-5.27), 2.01 (95CI, 1.39-2.91) and 2.24 (95CI, 1.56-3.21) for Primary3, Permanent3 and Permant6, respectively. Sensitivity and subgroup analyses corroborated these estimates. Reliability and generalizability of pooled ORs were high enough and made it possible to assess that the fraction of global TDIs attributable to large overjet is 21.8% (95CI, 9.7-34.5%) and that large overjet is co-responsible for 235 008 000 global TDI cases (95CI, 104,760,000-372,168,000). This high global burden of TDI suggests that preventive measures must be implemented in patients with large overjet.

Impact of traumatic dental injuries with unmet treatment need on daily life among Albanian adolescents: a case-control study

Traumatic dental injuries (TDI) are common in children and adolescences. Neglected or inadequate treatment may lead to psychosocial distress during late adolescence. To investigate the potential impact of traumatic dental injuries (TDI) with unmet treatment need, on the quality of life of 16-19 year-olds in Tirana, Albania. A case-control survey (1:2) was conducted in public high schools in Albania, comprising 95 subjects affected by TDI with unmet treatment need based on objective clinical signs. Controls (n = 190) with no history of TDI were matched by age, sex and belonging to the same school class and group of friends as the respective case. The Oral Impact on Daily Performances (OIDP) index was used to measure the impacts. DMFT, Community Periodontal Index and the Aesthetic Component of the Index of Orthodontic Treatment Need as well as social parameters were recorded. The response rate was 98%. Overall, the impact prevalence of OIDP was 88.4% among the cases, and 58.9% among the controls (P < 0.001). The most prevalent OIDP impact was 'smiling and showing teeth without embarrassment': cases had significantly higher values than controls (78.9% vs 31.6%). Multiple conditional logistic regression analysis was used to disclose the effect of TDI with unmet treatment need on quality of life by adjusting for possible confounders. Compared to the control group, TDI cases with unmet treatment need are at greater overall risk of impacts measured as OIDP, with an odds ratio of 3.9 (95% CI: 1.6-9.1). TDI with unmet treatment need in this sample of adolescents is associated with reduced OHRQoL. Compared to adolescents with no history of TDI, those affected by TDI with unmet treatment need are at greater risk of suffering impacts on OHRQoL in the form of OIDP.