Treatment Of Traumatic Dental Injuries Research Articles

Treatment of Traumatic Dental Injuries in the Public Dental Services—A Qualitative Exploration of Perceived Challenges and Needs

ABSTRACTBackground/AimThis study explored perceived challenges in the management of traumatic dental injuries (TDI) among general dentists in the public dental service (PDS) of Vestland County in Western Norway and their needs for improving treatment care for TDI patients.Participants and MethodsThis qualitative study conducted three focus group discussions. We recruited a purposive sample of seven general dentists employed in the PDS in Vestland County in Western Norway. The three focus groups consisted of two, two, and three participants, respectively. The focus group discussion took place via the Microsoft electronic platform Teams, and it was visual, and audio recorded. Transcripts of the interviews were analyzed using systematic text condensation.ResultsThe general dentists in this study experienced the management of TDI as a set of complex procedures that require good theoretical knowledge, clinical experience, skills, and teamwork. We were able to group these challenges into three results categories: (1) proficiency challenges, (2) the challenge of stress and discomfort during dental procedures, and (3) the challenge of the organization of the PDS. The participants also expressed the need for practical courses, calibration, and refresher courses in dental traumatology. Their needs fell into two categories: (1) regular, clinically relevant continuing professional development and (2) collective efforts in TDI management.ConclusionIncreasing awareness of the challenges in TDI management and addressing the need for improved dental treatment for TDI patients may lead to targeted programs to enhance dentists' knowledge and skills. There is considerable potential for training dentists in dental traumatology.

Management of Dental Trauma of Senior-Year Medical Students Attending Medical School in Tokat

Aim: Since trauma often requires immediate intervention, the initial care of patients is typically provided by emergency room physicians. Emergency departments prioritize the treatment of conditions that threaten the patient's overall health, which can lead to overlooking the treatment of traumatic dental injuries. Early intervention in dental and surrounding tissue injuries is crucial for prognosis. Therefore, it is important to assess the knowledge and awareness of dental trauma among medical doctors, who are often the first responders in trauma cases. The aim of this study is to evaluate the knowledge and approaches of senior-year medical students regarding dental traumas in Tokat city, Türkiye. Materials and Methods: For this cross-sectional study, a validated questionnaire consisting of 10 questions previously used in similar studies was used. Students completed the questionnaire online using the Google® Forms program. The data obtained in this study were analyzed using the SPSS v23 (Chicago, IL, USA) software package program. Frequency and percentage values were obtained. Results: While 7.1% of the students stated that they would reimplant the avulsed tooth, 71.4% stated that they would refer the patient to the dentist. While 42.8% of the students preferred sterile saline solution for handling the avulsed tooth, 20.2% preferred wet gauze. While 85.7% of the students found the level of knowledge about oral and dental injuries insufficient, 71.4% stated that they would like to participate in an educational program on this subject. Conclusions: It has been observed that senior medical school students have insufficient knowledge about intervening in injuries to teeth and surrounding tissues. Curriculum regulation and training programs are required to improve students' knowledge and awareness about injuries to teeth and surrounding tissues. Students should also be informed that they can access the free IADT ToothSOS Mobile App on the International Association for Dental Trauma (IADT) website (http://www.iadt-dental-trauma.org), which can guide them on emergency response to dental trauma when they encounter dental trauma.

Frequency and Patterns of Traumatic Dental Injuries Reported at Islamabad Dental Hospital: A Retrospective Study.

Background: Traumatic dental injuries (TDIs) are increasingly becoming a public health concern, with a significant number of cases presenting to emergency departments worldwide. They affect a diverse age range, particularly children and adolescents, and are influenced by various etiological factors such as falls, sports injuries, and road traffic accidents. Previous studies have indicated a gender predisposition, with males more frequently affected, and a pattern of injury that varies by region. Objective: This study aimed to investigate the frequency and patterns of TDIs treated at the Department of Operative Dentistry, Islamabad Dental Hospital, and to analyze the management strategies employed. Methods: A retrospective cross-sectional analysis was conducted, examining patient records from 2015 to 2022. Approval was obtained from the institutional review board, aligning with the Declaration of Helsinki. Data from complete TDIs forms were extracted, detailing the type of injury, timing, and treatment administered. Statistical analysis was performed using SPSS v.23, with chi-square tests applied to examine the association between the type of trauma and demographic variables. Results: A total of 88 teeth with TDIs were recorded. The most common injuries were complicated crown fractures (28.4%) and root fractures (17.0%), with splinting (31.8%) and root canal treatments (29.5%) being the most frequent management procedures. Male patients were predominantly affected. Notably, adult cases surpassed those of children and adolescents, contrary to global trends. Conclusion: TDIs constitute a significant portion of dental emergency cases, with specific patterns and treatments that vary by demographics. Immediate and appropriate management, guided by current guidelines, is essential. Efforts should focus on increasing awareness and providing adequate training to healthcare providers for timely and effective treatment of TDIs.

Pattern of Traumatic Dental Injuries and Treatment Receipt among Children Attending the University Dental Hospital in Saudi Arabia

ABSTRACT Objective: The aim of this study was to investigate the pattern and distribution of traumatic injuries to primary and permanent anterior teeth in 2–14-year-old pediatric dental patients in AlHassa region of Saudi Arabia. Methods: The study sample consisted of pediatric dental patients visiting the university dental complex seeking treatment for traumatic dental injuries (TDIs) during the period from February 2022 to April 2023. Data were collected by means of interviewing the children and/or parents regarding the history of trauma and clinical examination for evidence of dental trauma to primary and permanent teeth. Results: A total of 122 children (184 teeth) including 78 (63.9%) boys and 44 (36.1%) girls sustained traumatic injuries to their teeth. The most common reason for dental trauma was falls, and maxillary right central incisor was the most frequently affected permanent teeth. Enamel-dentine fractures in permanent teeth and luxation injuries among primary teeth were predominantly noted. Majority of the injuries (47.5%) have been found to have not received timely attention for treatment. Conclusions: Early treatment of dental trauma should be emphasized, and preventive strategies targeted at parents and teachers at the community level are needed to promote and reduce the burden of TDIs.

Seeking treatment for traumatic dental injuries in schoolchildren: A multilevel analysis.

To investigate individual and contextual factors associated with seeking treatment for traumatic dental injuries. A cross-sectional study was conducted with 739 pairs of guardians and children. Guardians answered a questionnaire addressing sociodemographic characteristics, seeking treatment for a tooth injury in the child, and the Oral Health Literacy-Adult Questionnaire. Descriptive analysis and unadjusted and adjusted multilevel Poisson regression analysis (p<0.05). The prevalence of seeking treatment for traumatic dental injury was 44.7%. Sociodemographic variables associated were white skin of the child (PR = 1.30; 95% CI: 1.08-1.76), mother's age older than 35 years (PR = 1.70; 95% CI: 1.50-1.90), married parents (PR = 1.93; 95% CI: 1.70-2.23), guardians with more than eight years of schooling (PR = 2.00; 95% CI: 1.76-2.23), with adequate oral health literacy (PR = 3.33; 95% CI: 3.01-3.62) and the daily use of electronic devices by the child (PR = 1.26; 95% CI: 1.02-1.50). On the contextual level, attending a private school (PR = 1.77; 95% CI: 1.02-3.05) and the number of primary care units with oral health teams in the school district (PR = 1.78; 95% CI: 1.12-2.38) remained associated. Among the children who suffered TDI, adequate oral health literacy on the part of the parents stood out among the factors associated with seeking treatment.

Çocuk diş hekimliği kliniğine travmatik diş yaralanmaları nedeniyle başvuran hastaların değerlendirilmesi: retrospektif bir çalışma

Purpose: The purpose of this study was to evaluate the prevalence of traumatic dental injuries (TDIs), as well as to evaluate different factors associated with TDIs among children and adolescents referred over three-year period to the Pamukkale University, Faculty of Dentistry, Department of Pediatric Dentistry, Denizli. &#x0D; Materials and methods: Dental trauma records of patients were reviewed regarding demographic data, affected teeth, type and etiology of TDIs, location and season of TDIs, time elapsed following TDIs and initial treatment, and treatment of TDIs.&#x0D; Results: Data associated with 258 patients, 471 traumatized teeth (primary teeth:152, permanent teeth:319) were analyzed. Both the primary and permanent maxillary central incisors were the most common affected teeth by TDIs. Primary teeth showed a higher frequency of periodontal tissue injuries (75.00%) and lower frequency of dental hard tissue injuries (21.05%) compared with permanent teeth (49.84% and 58.62%, respectively). Falls were the main etiological factor of TDIs both in the primary (73.68%) and permanent (58.31%) teeth. Only 27 patients (5.49%) were referred to the clinic within one hour following TDIs. &#x0D; Conclusion: Early management of TDIs is important to improve the prognosis of traumatized teeth and prevent post-traumatic complications. The low rate of early referral indicates the need for educational and preventive programs regarding TDIs among the patients, parents/legal guardians, and teachers.

Evaluation of intern’s knowledge of dental trauma using mobile phone app: An institution-based study

Aim: The aim of this study was to evaluate dental interns’ knowledge regarding the treatment of traumatic dental injuries. Materials and methods: A total of 110 dental interns participated in the study.Quiz questions from the INJURED TOOTH mobile app were given to the interns of a dental college. They were asked to attempt the quiz at the beginning of their clinical posting in paediatric dentistry. A second quiz with the same questions was conducted after the completion of their clinical posting. The quiz was in English language and consisted of 37 questions based on crown fracture, crown root fracture, luxation injury, root fracture, avulsion, and others. The data available from filled forms were entered in Microsoft Excel. Quantitative analysis was done using IBM SPSS version 22.0 (IBM Corporation, Chicago, US), the p-value of less than 0.05 was considered significant. Results: The knowledge of interns before their clinical postings were insufficient (65.47%). The knowledge was significantly improved after the completion of their clinical posting (76.13%). The mean score of knowledge on crown fracture among the participants before and after the clinical postings was 69.17% and 80.48% respectively. For crown root fracture- 82.17% and 84.33% , for luxation Injuries- 53.83% and 70%, for root fracture - 56.55% and 74.52%, for avulsion 67.71 and 75.21% and for other traumatic injuries - 64.17% and 71.67% Conclusion: The results of the current study demonstrate that dental interns lack the necessary knowledge to treat dental injuries. This highlights the need to introduce subjects relevant to dental trauma into the curriculum and use a variety of teaching strategies, such as problem-based learning, to increase the understanding of dental interns about dental trauma and its management.

TRAUMATIC DENTAL INJURIES: ETIOLOGY, PREVALENCE AND POSSIBLE OUTCOMES

Traumatic dental injuries are significant public health problem because of its frequency, impact on economic productivity and quality of life. It is not a disease and no individual is ever at zero risk of sustaining these potentially life-changing injuries. Traumatic dental injuries occur most frequently in children and young adults. Older adults also suffer from traumatic dental injuries but at significantly lower rates than individuals in the younger cohorts. Luxation injuries are the most common traumatic dental injuries in the primary dentition, whereas crown fractures are more commonly reported for the permanent teeth. Proper diagnosis, treatment planning and follow up are very important to assure a favorable outcome. The aim was to overview the etiology, prevalence and possible outcomes of dental trauma. An electronic search of Medline (PubMed), Cochrane, SSCI (Social Citation Index), SCI (Science Citation Index) databases from 2000 to the present, using the following search words: tooth injuries, tooth trauma, traumatized teeth, dental trauma, dentoalveolar trauma, oral trauma, epidemiology, etiology, prevalence, prevention, pulp necrosis, inflammatory resorption, ankylosis, cervical resorption, was performed. The current revision represents the best evidence based on the available literature and expert opinions. During last decade traumatic dental injuries were recognized as public dental health problem worldwide. Prevalence of traumatic dental injuries varies between countries. According to the existing data they are more prevalent in permanent than in primary dentition. All treatment procedures in case of dental trauma are directed to minimize undesired consequences despite that treatment of traumatic dental injuries in the young patient is often complicated and can continue during the rest of his/her life. The changing lifestyle and requirements of modern society lead to an emergence of new patterns of dental trauma. Successful treatment of traumatic injuries depends on timely action by the patient and a quick and accurate diagnosis by the dentist. Although most injuries are minor and of an urgent nature, displaced or missing teeth are true emergencies. The mismanagement of traumatic dental injuries has provided much information as well as questions for research that have resulted in the increased retention of teeth with as little treatment as possible. Maintaining pulp vitality when possible, utilizing the therapeutic effects of calcium hydroxide, and returning teeth to function as soon as possible are keys to predictable prognosis. It is the responsibility of the dentist to stay current on the latest techniques available to treat traumatic injuries. The charts included provide most of the potential emergency treatment possibilities, recommended follow-up treatment, and final treatment outcomes essential to providing the best care for our child patients. It is also the responsibility of the dentist to use evidence-based research when adopting treatment protocols.

Introducing dental trauma (a non-curricular topic) into medical education: A viewpoint.

The aim of this paper is focused on expanding medical students' knowledge and understanding of a non-core curricular subject not normally offered in the medical curriculum. The critical juncture explored how to introduce a health-related subject into medical education that complements without competing for space/time in medical students' core studies. Using dental trauma as an example, this paper supports the opportunity for medical students to learn online about managing dental injuries and to raise their awareness of the need for accurate diagnosis and treatment of traumatic dental injuries before they graduate as medical doctors.

Magnitude and pattern of combination traumatic dental injuries: An institution based retrospective study in Nepal

Introduction: Traumatic dental injuries can occur as combination injuries, where both fracture and luxation injuries occur concomitantly in the same tooth. The aim of this study was to evaluate prevalence of concomitant fracture and luxation injury (combination dental injuries) in permanent teeth. Methods: A total of 455 traumatized anterior teeth from 175 patients (131 males and 44 females; age ranged from 14 to 70 years), coming for treatment of traumatic dental injuries over a five-year period from January 2016 to December 2020 were included in the study. Patient’s age and sex, type of injury, type and number of injured teeth were recorded from the clinical and radiographic examination records. Descriptive statistical methods were used for data analysis. Results: A total of 257 teeth (56.48%) had fracture injury only, while 150 teeth (32.96%) were found to have luxation injury only. The most common isolated fracture injury was enamel-dentin fracture (n=93; 22.85%) and the most common isolated luxation injury was subluxation (n=77; 18.91%). A low prevalence of combination injury was observed in 48 teeth (10.54%). Enamel-dentin fracture (52.08%) was the most common fracture injury type presenting with a concomitant luxation injury. Similarly, the most frequent luxation injury type presenting with a concomitant crown fracture injury was subluxation (56.25%). The most common combination injury was enamel-dentin fracture in combination with subluxation injury (n=15; 31.25%). Conclusions: The magnitude of combination injury was low in this study and was frequently observed in males of young age groups. The most common combination injury was enamel-dentin fracture in combination with subluxation injury.

Evaluation of Quality and Readability of Online Information on Treatments of Traumatic Dental Injuries

Background: Traumatic dental injuries is a common public health issue all over the world. The aim of this study was to investigate the quality and readability of web based information regarding treatments of traumatic dental injuries. Methods: An internet search was carried out using Google search engine with four different keywords (''treatment of broken teeth'', ''treatment of tooth trauma'', ''treatment of anterior tooth fractures in children'', ''fractured teeth treatments'') related to treatments of traumatic dental injuries. The duplicate websites, links to research studies, advertisements, discussion groups, videos and images were excluded from the evaluation. The quality of the written information regarding treatments of traumatic dental injuries in websites were analyzed with DISCERN toolkit. The readability of the written information was evaluated with Flesch-Kincaid grade level (FKGL), Flesch-Kincaid Reading Ease (FKRE) and Simple Measure of Gobbledygook reading grade level (SMOG) index. Results: A total of 120 webpages were identified but only 42 of them were remained after exclusion criterias. Among these websites, 25 (59.5%) of them were belonged to private dental clinics, 9 (21.4%) of them were belonged to informative pages about health and dentistry and 8 (19.1%) of them were belonged to professional organizations' websites. The average DISCERN score was 42.4 and ranged between 24 to 62. The average FKRE was 50.7 ± 14. which is equivalent to a reading level of 10th to 12nd grade. The average FKGL score for was 8.5 ± 2.8 and the average SMOG score was 7.3 ± 2.0 for all the websites. Conclusions: The results of the present study showed that the quality of information on the investigated websites was fair according to the DISCERN toolkit and too difficult to read and interpret for the general population. Healthcare information providers should focus on improving the quality and readability of the information regarding treatment of traumatic dental injuries.

Retrospective study on 696 cases of traumatic dental injuries of primary dentition in Xi'an, China.

The aim of the present study was to explore the epidemiological characteristics and treatment of traumatic dental injuries of primary dentition (TDI-p) in Xi'an, China. Data of children with TDI-p admitted between January 2018 and December 2019 at the Department of Pediatric Dentistry, Xi'an Jiaotong University Stomatology Hospital were retrospectively analysed. The epidemiological distribution characteristics and related treatment information of TDI-p were described. Compared with permanent dentition, TDI-p has its particularities, such as type of trauma, treatment procedure, and behavioural management. More attention should be paid to TDI-p by both dentists and guardians.

Evaluation of general dentist's and dental student's knowledge about emergency management of dentoalveolar trauma in Bojnurd, North Khorasan, Iran

Background: Traumatic dental injuries (TDIs) are one of the most common dental problems among children and adolescents, which usually occur in the anterior parts of the mouth and have great impact on the patient's physical and mental health. Therefore, dentist's knowledge and effective measures in the treatment of TDI are the most important factors in improving the prognosis of these teeth. Aims: The aim of this study was to evaluate the knowledge of general dentists working in Bojnurd and also 6th-year dental students about the treatment of such injuries. Materials and Methods: In this cross-sectional study, a questionnaire was provided to 70 general dentists and 6th-year dental students, including personal information and questions related to the knowledge of general dentists, on how to deal with various TDIs by available methods. Data were analyzed using t-test, Chi-square test, Kruskal–Wallis test, and analysis of variance, Spearman's, and Pearson's correlation coefficient. Results: Regarding general dentists' knowledge about dentoalveolar trauma: 39 (55.7%) were moderate, 28 (40%) were good, and 3 (4.3%) were excellent. The mean value knowledge of dentists and dental students was 8.18 ± 1.98. There was no significant relationship between age, gender, place of work, university of study, desire for education, and self-evaluation of dentists and level of awareness (P = 0.26, P = 0.61, P = 0.47, P = 0.93, P = 0.35, and P = 0.57, respectively). Conclusions: The results of our study indicate that majority of the participants are moderately aware of TDIs and the type of treatment, and due to the increasing prevalence of dental trauma and its high complications, especially in children, the need to make appropriate plans to update the level of knowledge of general dentists in the management and treatment of TDI increases.

Parental awareness of on-site management of traumatic dental injuries: An online survey.

Despite the high prevalence of traumatic dental injuries (TDIs), parents generally lack awareness about dental trauma emergency management. This preliminary study's goal was to assess parents'/guardians' awareness of the treatment of tooth fractures/avulsion. A preformed questionnaire in e-format was sent to parents of school-going children. Kolmogorov-Smirnov test and Shapiro-Wilks's test were employed to test the normality of data. In addition, a Chi-square test was performed for quantitative variables. P ≤ 0.05 was considered statistically significant. A response rate of 82.1% was achieved. Approximately 19.6% of parents reported dental injuries, with the majority (51.9%) occurring at home. In avulsion, 54.8% of parents believed that reinserting the tooth back into the socket was possible. For tooth fractures, 36.2% of parents believed that the fractured tooth could be glued. Tap water was preferred as a storage medium (43.3%). An insignificant association was observed with regard to storage media (P > 0.05). Inadequate understanding of the treatment of TDI by the primary caregiver leads to ineffective interventions at the scene of the accident and a poor prognosis for otherwise treatable cases.

Pediatricians' Knowledge of Emergency Management of Dental Injuries and Use of Mouthguards: A Cross-Sectional Survey.

Aim: Dental injuries are one of the most frequent oral health problems in children and adolescents. This study aimed to evaluate Croatian pediatricians’ knowledge and practice regarding dental injuries management and the use of mouthguards as means of protection against traumatic injuries. Materials and methods: A questionnaire-based cross-sectional survey conducted among 186 pediatricians examined their demographic characteristics, knowledge and experience with dental injuries. Student t-test or one-way ANOVA, with Tukey’s post-hoc were used to analyze obtained data (p ≤ 0.05). Results: The overall mean score of knowledge on the management of dental injuries was 3.6 ± 1.53 points. Male pediatricians (p = 0.016), those who witnessed dental injuries (p = 0.003), and those who had more than ten years of pediatric practice (p = 0.027) showed better knowledge. The results of multiple linear regression analysis demonstrated impact between pediatricians’ knowledge in the emergency treatment of traumatic dental injuries concerning the level of health care (practice settings) (β = −0.254, p = 0.002) and the number of patients treated by a pediatrician per day (β = −0.187, p = 0.030). Conclusion: Pediatricians have a low level of knowledge regarding the primary care of traumatic dental injuries. An additional course on dental injurie management should be recommended as part of the physician and pediatricians’ educational training.

Management of Oblique Root Fracture Using Mineral Trioxide Aggregate: A Case Report

Management of Oblique Root Fracture Using Mineral Trioxide Aggregate: A Case Report

Prevalence and patterns of traumatic dental injuries in primary teeth: a 3-year retrospective overview study in Vienna

ObjectivesThe aim of this study was to retrospectively identify the prevalence, patterns, and accident types of traumatic dental injuries (TDIs) in children with primary teeth in Vienna, Austria.Material and methodsThe investigation was conducted as a retrospective overview study including all children with TDIs in primary teeth at the University Dental Clinic of Vienna (Austria) between 2014 and 2016. Dental records including age, gender, location of trauma, type of trauma, cause of TDI, and location of traumatic incident were obtained. Furthermore, the time of presentation and the time span between TDI and initial treatment were evaluated.ResultsThe sample comprised TDIs in 243 patients with 403 primary teeth. In a ratio of 1:1.45, boys were significantly more involved than girls. Upper central and lateral incisors were most frequently affected (n = 371, 92.1%). Dislocations were the most common type of injury (n = 298, 74%) with subluxations being the most prevalent form (n = 85, 28.5%). In 23% (n = 92), fractures were observed. The majority of traumatic incidents occurred at home (88.5%).ConclusionThe injury characteristics are comparable to what has previously been reported in other studies in pediatric populations.Clinical relevanceTDIs are a prevalent event in children worldwide and incisors are the most affected teeth in the primary dentition. Thus, dental practitioners should be able to handle these injuries.

Knowledge and skills of emergency physicians in managing traumatic dental injuries

PurposeEmergency departments are frequently confronted with traumatic dental injuries (TDIs). The prognosis of the injured tooth is related to early dental trauma management. For this reason, physicians must be familiar with the appropriate management of TDI. This study aimed to investigate the knowledge and skills of German emergency physicians regarding TDI.MethodsAn electronic questionnaire was sent to 438 emergency departments throughout Germany. Four hundred and twenty seven questionnaires were evaluated and included in the analysis. The survey contained questions about physician characteristics and assessed their knowledge and skills of managing dental trauma. For statistical analysis, the Kruskal–Wallis, Mann–Whitney U test or ANOVA test was used as appropriate. Rank correlations were performed with the Spearman’s rank correlation.ResultsOut of 427 participants, 256 (59.95%) stated they had no or insufficient knowledge, and 266 (71.12%) stated they had no skills in dental trauma management. Almost 76% of the participants had no previous knowledge of dentistry. Only 7.28% knew the right procedure for replanting an avulsed tooth. Just 26.06% would choose the right medium for temporary tooth storage. Having a dentist in the family (p = 0.0074) or clinical exposure to patients with dental trauma (p = 0.0384) influenced the results of the knowledge score.ConclusionThe knowledge and skills in dental trauma management among German emergency physicians are generally inadequate. Targeted training courses are necessary to ensure early and adequate TDI treatment to reduce the resulting medical and societal costs as much as possible.

Evaluation of Clinical and Radiographic Findings among Patients with Traumatic Dental Injuries Seeking Delayed Treatment.

Background Time elapsed between trauma and treatment greatly influences the prognosis of traumatic dental injuries (TDIs). The aim of this study was to analyze clinical and radiographic findings related to complications of TDIs among patients seeking delayed treatment of such injuries. Materials and Methods 123 permanent teeth with a history of previous TDIs were included in the study. Clinical findings analyzed were the type of fracture, type and number of injured teeth, crown discoloration, and pulpal status of the injured tooth (pulpal diagnosis). The radiographic findings analyzed included pulp canal obliteration (PCO), root resorption (RR), and periapical radiolucency (PR). Statistical analysis included descriptive analysis. Results Tooth discoloration was the most common presenting complaint (53.65%), while fall (48.78%) was the most frequent cause of trauma. The range of time duration between trauma and presentation for treatment was 5 months to 30 years (average time 12.82 years). Pulp necrosis (PN) was the most common complication (90.24%). Almost half of the teeth with PN had fracture injury and discoloration along with a high frequency of PR (78.37%). Even teeth with a normal appearance were found to have a high incidence of PN (76.92%) and PR (53.84%). The crown discoloration was the second most frequent finding (48.78%). Many teeth (41.66%) with vital pulp were also discolored. Most of the teeth (79.31%) with yellowish discoloration and all teeth with brownish discoloration were nonvital. A high frequency of PN (90%) and PR (78.33%) was found in teeth with discoloration. PR was the most common radiographic finding (69.10%), while PCO and RR were observed in 17.88% and 21.13% of teeth, respectively. Conclusion The findings of this study support the fact that delayed treatment of TDIs leads to increased complications. PN was the most common complication followed by tooth discoloration, RR, and PCO among patients seeking delayed treatment after TDIs.

Impact of traumatic dental injury treatment on the Oral Health-Related Quality of Life of children, adolescents, and their family: Systematic review and meta-analysis.

Measures of oral health-related quality of life (OHRQoL) are useful in clinical trials to evaluate treatment outcomes. To detect the treatment impact of traumatic dental injuries (TDI) on OHRQoL is extremely relevant. The aim of this study was to assess whether there is scientific evidence of the impact of TDI treatment on OHRQoL of children, adolescents, and their families. A systematic review and meta-analysis were conducted selecting articles from PubMed, Web of Science, Scopus, Cochrane Library, and Virtual Health Library until May 22nd, 2020. The gray literature, clinical trial registers, and a manual search were performed. Two independent reviewers selected the studies, extracted the data, and assessed the ROBINS-I risk of bias. A meta-analysis was performed using RevMan 5.4 program. The certainty of the evidence was evaluated using the GRADE system. In the electronic search, 413 abstracts and one registered study were found. After removing the duplicates and eligibility application, six studies were included. Individually, the studies presented low to moderate risk of bias and they found that TDI treatment reduces the negative impact on OHRQoL. In the meta-analysis, TDI treatment improved OHRQoL for 8- to 10-year-old children (p=.03; CI 5.19 [0.62, 9.75]) (detected by CPQ 8-10 questionnaire). In the perception of parents, the children, and adolescents who had suffered TDI also had their OHRQoL improved (p=.04; CI 14.77 [0.95, 28.60]) (detected by PPQ and P-CPQ questionnaire) but both evaluations had very low certainty of evidence. Treatment of traumatic dental injuries reduces the impact on the OHRQoL of children and adolescents. However, more studies are necessary to detect the TDI treatment influence on OHRQoL of preschoolers and in the family as well to estimate the effects due to outcomes that had a very low certainty of evidence (#CRD42018091210).