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At least 199 records · Page 11Linked to original sources
PubMed1997

Rigid fixation with teeth in the line of mandibular fractures.

The treatment results and the incidence of complications were evaluated retrospectively in a group of 68 patients. They all had mandibular fractures with a tooth in the line of fracture and were treated using miniplates for fixation. The follow up ranged from 1 to 6 years (mean 2.6 years) and 90 fracture sites were involved. Results showed that the incidence of complications when the tooth was extracted was higher (3/12) than when it was left in place (8/78). With regard to both healing of the fracture and fate of the tooth in the line of fracture, it is recommended to retain teeth in the line of fracture, unless there is an absolute indication for extraction. It is advisable to monitor the vitality of teeth adjacent to the fracture line for at least one year.

Analysis of Variance↗
PubMed1998

Surgical extrusion of intruded immature permanent incisors: case report and review of the literature.

This report presents a case of intrusive luxation of immature maxillary central incisors with concomitant uncomplicated crown fractures in an 8-year-old boy. The intruded teeth with open apices were repositioned with surgical extrusion and endodontically treated through use of calcium hydroxide paste. Six months after initiation of apexification, definitive apical stops had formed. The canals were then permanently obturated, and the crowns were restored with composite resin. Clinical and radiographic examination 24 months after the surgical extrusion revealed satisfactory apical healing and healthy supporting tissues.

Calcification, Physiologic↗
PubMed1990

Treatment of traumatic dental injuries. Shift in strategy.

A more conservative approach to the treatment of traumatic dental injuries has been made possible by knowledge concerning the pathogenesis of external root resorption, increased knowledge about wound healing processes in the pulp and periodontium, as well as by advances in restorative dentistry (reattachment of crown fragments with a dentin bonding system, the use of adhesive bridges, and advances in autotransplantation and implantation). However, a rethinking by the public, clinicians, and third-party payers is necessary for these procedures to gain wider acceptance. The present article describes the state of the art of treating dental trauma in the hope that these advances can become an accepted part of the dental trauma armamentarium and not merely scientific curiosities.

Cost-Benefit Analysis↗
PubMed2000

Traumatic dental injuries and Alpine skiing.

The purpose of this study was to determine the occurrence and type of traumatic dental injuries after maxillofacial injuries as a result of Alpine skiing. During an 8-year period (from January 1991 to December 1998) 7600 patients with facial injuries were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria. Of 784 patients with skiing-related facial injuries (524 males, 260 females) 326 (41.6%) sustained injuries to 639 teeth. The age groups predominantly affected were between 7 and 32 years. Luxation injuries occurred in 338 (53%) teeth, fractures accounted for 270 tooth injuries (42%), and only 35 (5%) were lost at the place of the accident. Of skiers with traumatic dental injuries 58% had concomitant soft tissue injuries, while 23.3% had associated facial bone fractures. The most common causes of injury were falls in 42% (329 patients) and collisions with other persons in 24.1% (189 patients). Being hit by one's own sports equipment (11%) was the third most common cause. Collisions with obstacles accounted for 9% and lift accidents for 5.6% of injuries. The probability of suffering dentoalveolar trauma during skiing varied depending on the injury mechanism. There was a 2-fold risk for dentoalveolar trauma when colliding with objects, a 3.5-fold risk when hit by one's own equipment and a 8.5-fold risk during lift accidents. Dental injuries occurred in about 2% of all injured skiers. Dental health professionals should be aware of the high incidence and the distribution of dental trauma and facial injuries caused by skiing.

Accidental Falls↗
PubMed2000

Urinary catecholamine levels and incidence of dentofacial injuries in children: a 2-year prospective study.

Urinary catecholamines have been used to measure emotionally stressful states which may have an impact on dentofacial injuries. This prospective study investigated the hypothesis that urinary catecholamines such as epinephrine, norepinephrine and dopamine do not affect significantly the incidence of dentofacial injuries in children. As a test of this hypothesis 204 children, males and females, aged 8 to 10 years, were included in the study. After a first examination, each subject was re-examined, at one-year intervals, over a period of two years. Dentofacial injuries were recorded by a clinical examination and a questionnaire. Three 24-h urine samples, with an interval of one year between each, were collected and analyzed by the high performance liquid chromatography technique to assay the catecholamine content. Socio-economic factors were recorded by a questionnaire. Using the panel of data collected, the logistic multiple regression model was employed to test whether the incidence of dentofacial injuries was affected by the studied variables. The 95% probability level was used. Specificity and sensitivity as well as the positive and negative predictive rates were computed. The results showed that epinephrine had a significant correlation with the incidence of dentofacial injuries. Other factors found to have a significant impact were child's age and gender. The values of sensitivity and specificity were 81% and 69% respectively, while the positive and negative predictive rates were 68% and 82% respectively. The data, therefore, provided evidence that emotionally stressful states measured by the urinary catecholamines were prominent etiologic factors of dentofacial injury.

Accidents↗
PubMed2000

Bone-like tissue growth in the root canal of immature permanent teeth after traumatic injuries.

Following a severe traumatic incident to permanent immature teeth, the growth of calcified tissue in the pulp space may occasionally occur. This calcified tissue may be diffuse or in intimate contact with the dentine. It has been suggested that a wide open apex, severe damage to the root sheath, and the absence of infection are only some of the predisposing factors leading to this metaplasia of pulp tissue into bone-like tissue. Five cases are described.

Adolescent↗
PubMed2001

Healing of 208 intra-alveolar root fractures in patients aged 7-17 years.

This retrospective study consisted of 208 root-fractured, 168 splinted and 40 not splinted incisors in young individuals (aged 7-17 years) treated in the period 1959-1973 at the Pedodontic Department, Eastman Institute, Stockholm. Clinical and radiographic analyses showed that 69 teeth (33%) had developed hard tissue (fusion) healing of fragments. Interposition of periodontal ligament (PDL) and bone between the fragments was found in 17 teeth (8%). Interposition of PDL alone was found in 74 teeth (36%). Finally, non-healing with pulp necrosis and inflammatory changes between fragments was seen in 48 teeth (23%). Various clinical factors were analyzed for their relationship to the healing outcome with respect to healing/no healing and type of healing (hard tissue versus interposition of bone and/or PDL). Immature root and positive pulp sensitivity at time of injury was found to be significantly related to both pulp healing and hard tissue repair of the fracture. The same applied to concussion or subluxation of the coronal fragment compared to luxation with displacement (extrusive or lateral luxation). This relation was also represented by the variable millimeter diastasis between fragments before and after repositioning. Repositioning appeared to enhance the likelihood of both pulp healing and hard tissue repair. A positive effect of splinting, splinting methods (cap splints or orthodontic bands with an arch wire) or splinting periods could not be demonstrated on either pulp healing or type of healing (hard tissue versus interposition of bone and/or PDL). In conclusion, the findings from this retrospective study have cast doubts on the efficacy of long-term splinting and the types of splint used for root fracture healing. It is suggested that the role of splinting and splinting methods be examined in further studies.

Adolescent↗
PubMed2001

Effect of topical alendronate on root resorption of dried replanted dog teeth.

Alendronate (ALN) is a third generation bisphosphonate with demonstrated osteoclast inhibitory activity that may slow down the resorptive process after severe traumatic injuries. Eighty-two premolar roots of five mongrel dogs were endodontically treated and restored, extracted and treated as follows: 70 roots were bench dried for either 40 or 60 min. Thirty-eight of these roots were then soaked for 5 min in a 1 mM solution of ALN in Hanks' Balanced Salt Solution (HBSS) and replanted. Thirty-two roots were soaked for 5 min in HBSS and replanted. In the remaining 12 roots which were not exposed to the bench drying procedure, a 0.5 mM deep lingual mid-root cemental defect was made. Six of these roots were soaked in a 1 mM solution of ALN in HBSS for 5 min and replanted. The other six roots were soaked for 5 min in HBSS and replanted. Historical negative and positive controls were used from similarly treated teeth in our previous studies. After 4 months the dogs were killed and the roots prepared for histological evaluation. Five-microm-thick cross-sections of the root and surrounding tissue taken every 70 microm were evaluated for healing according to the criteria of Andreasen. In the 12 roots with cemental defects, healing with cementum of the damaged root surface was evaluated. In addition, residual root mass was also measured to determine the extent of root structure loss for each soaking method. Cemental healing took place in all 12 artificially damaged roots, indicating that these soaking media did not inhibit cementogenesis. The alendronate-soaked roots had statistically significantly more healing than the roots soaked in HBSS without alendronate. This improvement in healing was seen in all dogs except one and in all teeth except the first premolar. Soaking in alendronate also resulted in significantly less loss in root mass due to resorption compared to those teeth soaked in HBSS without alendronate.

Administration, Topical↗
PubMed2001

Extraction as a treatment alternative follows repeated trauma in a severely handicapped patient.

Handicapped patients with protruding maxillary incisors are prone to repeated dental trauma. A 13-year-old girl with cerebral palsy, severe mental retardation and seizure disorder was referred to our department for restoring the traumatized anterior teeth. Despite drug combination, the frequency of seizure attack was around 10 times a month. The oral examination showed multiple caries, gingival hyperplasia, class II malocclusion with 14 mm overjet and deep overbite. During the first 3 years of a 7-year follow-up period, six episodes of anterior tooth trauma due to seizure attack occurred. The trauma-related treatment performed included endodontic therapy, multiple composite restorations, apical repositional flap, and finally extraction of all four upper incisors with fabrication of a semi-fixed band-retained denture. The denture restored normal overbite and overjet with improved esthetics. For 4 years following the fabrication of denture, no trauma occurred to the anterior teeth in later seizure attacks. Considering inadequate control of seizure disorder, little ability of the patient to receive comprehensive orthodontic treatment, poor prognosis of restorations, and possible future injuries, the removal of non-functional, nonesthetic, trauma-susceptible incisor teeth can be justified as an alternative to tooth preservation.

Adolescent↗
PubMed2001

Knowledge-based system for structured examination, diagnosis and therapy in treatment of traumatised teeth.

Dental trauma in children and adolescents is a common problem, and the prevalence of these injuries has increased in the last 10-20 years. A dental injury should always be considered an emergency and, thus, be treated immediately to relieve pain, facilitate reduction of displaced teeth, reconstruct lost hard tissue, and improve prognosis. Rational therapy depends upon a correct diagnosis, which can be achieved with the aid of various examination techniques. It must be understood that an incomplete examination can lead to inaccurate diagnosis and less successful treatment. Good knowledge of traumatology and models of treatments can also reduce stress and anxiety for both the patient and the dental team. Knowledge-based Systems (KBS) are a practical implementation of Artificial Intelligence. In complex domains which humans find difficult to understand, KBS can assist in making decisions and can also add knowledge. The aim of this paper is to describe the structure of a knowledge-based system for structured examination, diagnosis and therapy for traumatised primary and permanent teeth. A commercially available program was used as developmental tool for the programming (XpertRule, Attar, London, UK). The paper presents a model for a computerised decision support system for traumatology.

Adolescent↗
PubMed2001

Increased lifetime prevalence of dental trauma is associated with previous non-dental injuries, mental distress and high alcohol consumption.

The purpose of the study was to assess the lifetime prevalence of dental injuries and risk factors involved in a general population-based birth cohort. The study population consisted of 5737 subjects who had participated in a health survey at the age of 31 years. Altogether 52% of the participants were women. This partly computer-based health survey included two questionnaires on previous dental and non-dental injuries, general health, occupational status and lifestyle. The current study was based on these questionnaires. The lifetime prevalence of dental fractures was 43% and the lifetime prevalence of dental luxations and exarticulations 14%. Men more commonly had dental injuries than women. Particularly mental distress and a history of previous injuries were shown to increase the risk for dental injuries. Furthermore, overweight and high alcohol consumption were positively associated with a high lifetime prevalence of tooth trauma. Regular physical activity decreased trauma occurrence. Socioeconomic status further affected the lifetime prevalence of dental injuries. The conclusion of the study was that personal, social and physical factors played a role in the occurrence of dental trauma.

Adult↗
PubMed2001

Effect of enamel matrix derivative (EMDOGAIN) upon periodontal healing after replantation of permanent incisors in beagle dogs.

This study histologically assessed the effect of enamel matrix derivative (EMDOGAIN) on periodontal healing in re-implanted teeth in nine Beagle dogs. Incisors in dogs were re-implanted after 15, 30 and 60 min of dry storage with and without the application of EMDOGAIN. The pulps were removed in all teeth. In groups 1 and 2, dog teeth were splinted and the dogs sacrificed after 8 and 12 weeks, respectively. In group 3, dog teeth were not splinted and sacrifice took place after 12 weeks. The histological parameters studied were healed PDL, surface, inflammatory and replacement resorption. Univariable and multivariable analysis of data was performed. Increased incidence of healed PDL was inversely proportional to extraalveolar time. No significant differences were noticed between splinted and non-splinted teeth. The EMDOGAIN group showed a higher incidence of healed PDL, while controls showed a higher incidence of ankylosis. The effect of EMDOGAIN was more pronounced at the 12-week interval.

Analysis of Variance↗
PubMed2001

Oral trauma in Brazilian patients aged 0-3 years.

The aim of the present investigation was to gather data pertaining to dental trauma in 1654 patients aged 0-3 years, attended at the Baby Clinic of the School of Dentistry at Araçatuba-UNESP, Brazil. The prevalence of traumatic injuries was 16.3%. There was greater involvement of boys (62.6%), of children aged 1-2 years (39.9%) and of the maxillary central incisors (86%). Falls were more often the etiology for dental injuries (58.3%). There was a predominance of uncomplicated crown fractures (48.4%).

Accidental Falls↗
PubMed2001

Traumatized permanent teeth in Brazilian children assisted at the Federal University of Santa Catarina, Brazil.

The goal of this study was to determine factors related to the occurrence of dental trauma in permanent teeth of children assisted at the Pediatric Dentistry Clinic of the Federal University of Santa Catarina (UFSC) Florianópolis, Brazil. During a period of 18 months, 36 children between 7 and 12 years of age had 72 traumatized teeth treated. The children were all assisted by one professional, a dentist working as a trainee of the Pediatric Dentistry Clinic. The occurrence of trauma was higher in male patients (61.3%) and in children between 8 and 9 years old with an average age of mean=9.4 years. In the group assisted, 63.9% of the children had more than one traumatized tooth and trauma reoccurred 19.4% of the time. The maxillary anterior teeth represented 96.1% of the cases and the central incisor teeth were the most affected. Both sides of the mouth had approximately the same number of traumas. Fractures were more frequent (51.4%) than luxations (48.6%). Enamel/dentin crown fractures represented 51.4% of the total traumatized teeth. Falls were the main cause of trauma (83.3%). A dental professional assisted 36.1% of the children in some way during the first 24 h after the incident. The study concluded that the permanent dentition is mostly affected by crown fractures that occur especially on maxillary central incisor teeth in patients between 8 and 9 years of age. The major etiological factor is falls that affected more than one tooth. Re-occurrence of trauma is fairly common.

Accidental Falls↗
PubMed2001

A retrospective study of traumatic dental injuries in a Brazilian dental trauma clinic.

The purpose of this retrospective study was to analyse data from the records of patients seen in the dental trauma emergency clinic in a general hospital in the city of Recife, Brazil, during the years 1997-1999, according to sex, age, cause, number of injured teeth, type of tooth and type of trauma. The records of all patients seen by dentists were collected. Altogether, 250 patients from 1 to 59 years of age presenting 403 dental injuries were examined and/or treated. The causes of dento-alveolar trauma were classified in five categories: home injuries, street injuries, school injuries, sports activities, violence. The type of trauma was classified by dentists working at the dental trauma clinic on the basis of Andreasen's classification. The gender difference in the number of cases of trauma was statistically significant (males 63.2% vs females 36.8) (P<0.0001). Fracture in enamel only (51.6%) and fractures in dentine (40.8%) were the most commonly occurring types of injury. Injuries were most frequently diagnosed as serious among the youngest patients (up to 15 years of age); 82.4% of intrusive luxation cases were diagnosed in the 1-5 years age group. The main causes of tooth injury were falls (72.4%), collisions with objects (9.2%), violence (8.0%), traffic accidents (6.8%) and sports (3.6%). Trauma caused by violence was found to be statistically significant in the 6-15 years age group (P<0.0005).

Accidental Falls↗