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At least 271 records · Page 15Linked to original sources
PubMed2004

Establishment and evaluation of a trauma clinic based in a primary care setting.

OBJECTIVES: The aim of this study was to establish and evaluate a referral centre for the treatment of children with traumatized teeth in an area remote from a dental hospital. SETTING: The study was conducted in a Community Dental Service clinic in Cheshire, UK. METHODS: A dentist from the Cheshire Community Dental Service was trained in the treatment and management of traumatized teeth. Invite referrals to the trauma clinic in a health centre. The number and types of patients referred and treated at the trauma clinic were monitored. In addition, the parents of referred children and referring dentists were asked to comment on the acceptability of the service. RESULTS: During the first 12 months, 49 patients with 74 traumatized teeth were referred to the trauma clinic. The majority of the patients were referred by their dentist because problems arose following their initial management. Both parents and referring dentists were very satisfied with the service. CONCLUSIONS: The trauma clinic fulfilled a clinical need, and was well received by the parents of children referred to the clinic and by the local dentists.

Attitude of Health Personnel↗
PubMed2005

A case of Tourette syndrome presenting with oral self-injurious behaviour.

Self-injurious behaviour (SIB) is deliberate harm to the body without suicidal intent, and the condition occurs in a number of psychiatric, behavioural and developmental disorders. This case report describes a 4-year-old female with SIB who presented to a paediatric dentist after the self-extraction of teeth as a result of oral motor tics. The girl repetitively ground her teeth in a monophasic lateral motion that resulted in luxation of her maxillary right primary canine, and produced generalized oral and facial pain. The parents consulted the dentist about their child's complaint of toothache. The oral findings were unexcephonable except for a mobile primary canine, but there was a history of unusual behaviour including hyperactivity, and after multidisciplinary consultation and exclusion of other systemic diseases, the subject was diagnosed as suffering from Tourette syndrome (TS). Preventive treatment using a dental splint was provided. Noncontingent reinforcement therapy was successfully used to diminish the subject's SIB.

Behavior Therapy↗
PubMed2004

Laser Doppler flowmetry of luxated permanent incisors: a receiver operator characteristic analysis.

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood-flow (PBF). Dental luxation injuries have been associated with significant PBF reduction. The purpose of this study was to describe diagnostic characteristics for different session-related threshold PBF values for detection of specific adverse outcomes. In 61 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous control tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken 12 weeks (session I) and 24 weeks (session II) after splint removal. The ability of session I-related PBF measurements at 2.8, 6.4 and 10.1 PU levels, and of session II-related ameasurements at 2.4, 6.3 and 10.2 PU levels to identify adverse outcomes occurring 36 weeks after splint removal was investigated. Adverse outcomes were classified as type I (periapical radiolucency), type II (grey discoloration), and type III (periapical radiolucency and grey discoloration of crown). Receiver operator characteristic curves were used to evaluate the sensitivity and specificity of PBF assessments. There was no significant difference in PBF values between session I and session II (P > 0.05) for teeth without an adverse outcome, and those with a type I, II or III outcome (P > 0.05). The PBF measurements did not change over time for the contralateral incisors (P > 0.05). A type I, II and III outcome occurred in 36, 21 and 12% of the incisors, respectively. The best likelihood ratio was found for the PBF 6.4 PU level at session I and incisors associated with a type I (20.8) and type II outcome (15.2). The PBV of 6.4 PU demonstrated a sensitivity of 96% and a specificity of 59% for type I outcomes, and a sensitivity of 100% and a specificity of 50% for type II outcomes. The data suggest the LDF test to be a valuable diagnostic adjunct for luxated teeth showing signs of adverse outcomes.

Adolescent↗
PubMed1996

Promotion of mouthguards among amateur football players in Victoria.

Wearing mouthguards while playing contact sports reduces the prevalence and severity of orofacial injuries. We report on a 1991-92 promotion of mouthguard use among amateur football players in Melbourne. Four questionnaires were completed by players (1991 season: middle: n = 638, 49 per cent response: late: n = 770, 51 per cent: 1992: early: n = 505, 26 per cent: late: n = 698, 54 per cent), in four age groups (16-19, 20-23, 24-29, 30-44 years), about perceived mouthguard value and usage, injury experience, and awareness of a promotional message. Over the two seasons, mouthguard ownership and consistent wear increased and dental injuries decreased. Ownership of mouthguards increased among: 20-23 year olds and 30-44 year olds (13 and 16 per cent); managers, tradespersons, salespersons, labourers and the unemployed (14-19 per cent); residents of northern and western regions (12 and 13 per cent); those with 6 to 10 years of education (29 per cent); players in old boys' networks (13 per cent); and those with English as a first language (8 per cent). Consistent wear was high at matches (89 per cent) but low at training (13 per cent), owing to perceived lack of physical contact. Of dental injuries reported by 25-31 per cent, fractures predominated over luxations and avulsions. Fractures and avulsions were more common at matches than training; luxations predominated at training. When a mouthguard was not worn, the likelihood of a fractured or avulsed tooth was at least twice that when a mouthguard was worn. Some injuries occurred despite the wearing of mouthguards. The promotional message appeared effective in increasing mouthguard use; newspapers and football journals provided effective message locations for players, and ground signs and the electronic scoreboard for spectators.

Adolescent↗
PubMed1988

Traumatic dental injuries in nursery schoolchildren from Baghdad, Iraq.

The purpose of this study was to determine, by age and sex, 1) the prevalence of traumatic injuries to primary incisors and canines, and 2) their distribution according to type in nursery schoolchildren from the city of Baghdad. The sample consisted of 2389 children aged 1-4 yr enrolled in 39 nursery schools. The prevalence of injuries was 24.4% (24.5% in boys and 24.3% in girls). The largest percentage of injuries was demonstrated by the 4-yr-old children. There were no differences between boys and girls in their susceptibility to traumatic dental injuries. Combining both sexes, the most common type of injury was the enamel fracture (83.8%), followed by concussion (7.4%) and enamel-dentin fracture (6.2%).

Age Factors↗
PubMed1988

Incidence of dental trauma in the Western Australian School Dental Service.

A prospective study was undertaken to determine the annual incidence of trauma to the anterior permanent teeth of children enrolled in the Western Australian School Dental Service. The population comprised 66,500 6-12-yr-old children. 1.66 children and 2.05 teeth per 100 children received trauma. Of the children incurring trauma the incidence per 100 erupted teeth was 11.7. 80.5% of children traumatised one tooth only per incident, but 35% of all teeth that were traumatised involved trauma to two or more teeth. 88% of all traumatised teeth were central incisors. Girls received proportionately more trauma to the maxillary dental arch than did boys. Fracture involving both the enamel and the dentine was the most commonly recorded class of trauma (42.7% of cases). There was no obvious pattern to the overall distribution of trauma through the week or the year. Approximately one-third of all traumata occurred at school, one-third at home, and the remainder elsewhere. Trauma to the maxillary dental arch occurred most frequently at home, while trauma to more than one tooth (multiple trauma) occurred most commonly at school. Trauma incidence resulting from falling or being pushed was almost twice as high among girls as among boys. Bicycle accidents caused a higher than average rate of multiple trauma and of pulpal exposure.

Accidents, Home↗
PubMed1977

Long-term prognosis of traumatized permanent anterior teeth showing calcifying processes in the pulp cavity.

122 traumatized teeth with radiographic evidence of abnormal hard tissue formation in the pulp cavity were examined 10-23 years (mean 16 years) after the time of injury. Judged radiographically, partial obliteration (pulp chamber not discernible, root canal markedly narrowed but clearly visible) had occurred in 44 teeth (36%). Normal periradicular conditions were found in all teeth with partial obliteration. Seventy-eight teeth (64%) were recorded as totally obliterated. Pathologic periradicular changes indicating pulp necrosis as a sequel to the total obliteration was observed in 16 teeth (21%). The late development of pulp necrosis was significantly related to teeth classified as severely injured, and to teeth with complete root formation at the time of injury. Furthermore, a comparatively rapid progress of the calcifying process appeared to be correlated with periradicular radiolucency.

Dental Pulp Calcification↗
PubMed1980

Criteria for diagnosis of pulp necrosis in traumatized permanent incisors.

Records and radiographs of 108 patients (6-18 years) with 134 root canal treated incisors were examined. Subluxation was the most common type of injury, followed by intrusive, extrusive or lingual luxation, exarticulation and uncomplicated crown fracture. Negative response to electric stimulation was noted in 107 teeth from the first examination. In 23 teeth an initial positive response changed to negative within 3 weeks to 9 months, whereas persistent positive reactions were recorded in four teeth. The diagnosis of necrosis was based on the following observations: negative vitality and radiographic changes (76 teeth), negative vitality and discoloration (45 teeth), negative vitality only (nine teeth), positive vitality and radiographic changes (four teeth). External inflammatory root resorption confirmed the diagnosis of necrosis in all replanted teeth and in 13 of 16 intruded teeth. Discoloration and periapical lesions were the most important diagnostic factors following subluxation, extrusive and lingual luxation. Necrosis was disclosed within 4 months in 117 teeth (87%). Diagnoses based on negative vitality and discoloration were made within 6 days to 3 months in all but one case. All external root resorptions and 37 of the 49 periapical lesions were observed within 3 weeks to 4 months of the injury.

Adolescent↗
PubMed1997

Pulp calcifications in traumatized primary incisors. A morphological and inductive analysis study.

The purpose of this study was to investigate histopathological changes in primary teeth following trauma, and to look for possible correlations between the morphology of pulpal calcification and clinical findings. The material consisted of 123 primary teeth from 98 Danish children aged 9-108 months (mean age 33.5 +/- 19.7 months) at the time of injury. The specimens were analyzed by means of light and scanning and transmission electron microscopy. Data from the clinical investigation and from predetermined ranked parameters from the histological analysis were processed in a computerized inductive analysis program. The results, describing patterns of co-variation, are presented as a decision tree. The most common diagnosis was intrusion luxation (54%). In 41% of all teeth, the degree of obliteration was less than 1/4 of the pulpal lumen. In most cases (79%), no denticles were visible. When present, 80% of the denticles had a bone-like appearance. Tissues occluding the pulpal lumen were either dentin-like (49%), bone-like (19%), or fibrotic (9%). It could be concluded that these varying responses could not be correlated with explicit clinical diagnoses. However, in certain combinations, histological parameters could be correlated to clinical findings.

Bone and Bones↗
PubMed2004

Pulp revascularization of replanted immature dog teeth after treatment with minocycline and doxycycline assessed by laser Doppler flowmetry, radiography, and histology.

This study investigated the effect of topical antibiotic treatment on pulp revascularization in replanted teeth. Thirty-four immature teeth were selected from three young dogs. Baseline radiographs and laser Doppler flowmetry (LDF) readings were obtained. Specimens were randomly divided into four groups: Thirty-eight teeth were extracted, kept dry for 5 min, and either (Group 1) covered with minocycline mixture (G1, n = 11), (Group 2) soaked in doxycycline (G2, n = 11), or (Group 3) soaked in saline (G3-negative control, n = 6), and replanted. Teeth in Group 4 were not extracted (positive control, n = 6). Postoperative radiographs and LDF readings were obtained for 2 months after replantation. After sacrifice, the jaws were collected and processed for light microscopy. Pre- and postreplantation LDF readings and radiographs, and histologic findings were analyzed to assess revascularization. Pulp revascularization occurred in 91% (G1), 73% (G2), and 33% (G3) of the specimens. In conclusion, minocycline facilitates pulp revascularization in replanted immature teeth after replantation.

Animals↗
PubMed2004

Influence of the type of dental trauma on the pulp vitality and the time elapsed until treatment: a study in patients aged 0-3 years.

The purpose of the present study was to determine the influence of the type of trauma on the pulp vitality and the time elapsed until seeking dental care in children aged 0-3 years seen at the Baby Clinic of the Araçatuba Dental School, UNESP. A total of 1813 records were analyzed. Two hundred and three patients, corresponding to 302 traumatized teeth, were assessed clinically and radiographically. Hard-tissue injuries were the most frequent (52%), with a predominance of enamel crown fractures (41.4%), followed by concussions (12.6%) and intrusions (11.6%). Clinical and radiographic examination revealed that 72% of the traumatized teeth maintained pulp vitality. In the case of supporting-tissue lesions, 51.1% of the patients sought care within 1-15 days after injury, while in the case of hard-tissue injuries, 52.7% sought care only after 16 days. The results showed that supporting-tissue injuries had a significant influence on the faster seeking of dental care.

Child, Preschool↗