Traumatismo dentoalveolar en niños y adultos del sistema de salud de la Armada de Chile, 2014-2019

Objetivo: Describir los casos notificados de traumatismos dentoalveolares en dientes temporales y definitivos en la Unidad Clínica de Traumatismo Dentoalveolar de la Armada de Chile en el período 2014-2019. Materiales y Métodos: Descriptivo de tipo transversal. Se incluyeron todos los casos atendidos con diagnóstico de traumatismo dentoalveolar entre 2 a 80 años en la población estudiada. Se realizó un análisis descriptivo utilizando medidas de tendencia central y un modelo de regresión logística. Resultados: Se analizó un total de 326 casos, predominando el género masculino, con una edad media de 25,4 años. El 38% correspondieron a subluxación, siendo la etiología más frecuente la caída con un 69% y el lugar de ocurrencia, el hogar con un 35,6%. La mayoría de los beneficiarios correspondieron a familiares con derecho a atención en el sistema naval, y demoraron menos de 7 días en consultar con un 54.6%. Conclusión: El tipo de traumatismo dentoalveolar más frecuente fue la subluxación. En cuanto a la etiología, destacan las caídas y golpes con objetos, en su mayoría, en el hogar, afectando principalmente a hombres menores de 30 años. El tiempo en consultar e iniciar el tratamiento correspondiente, fue dentro de 7 días.

Objective: To describe the reported cases of dentoalveolar trauma in temporary and permanent teeth in the Clinical Unit of Dentoalveolar Trauma of the Chilean Army in the period 2014-2019. Materials and Methods: Cross-sectional descriptive study. All cases attended with a diagnosis of dentoalveolar trauma between 2 and 80 years old were included in the study population. A descriptive analysis was performed using measures of central tendency and a logistic regression model. Results: A total of 326 cases were analyzed, predominantly male gender, with a mean age of 25.4 years. Thirty-eight percent corresponded to subluxation, the most frequent etiology being fall with 69% and the place of the event, home with 35.6%. Most of the beneficiaries were family members entitled to care in the army system, and took less than 7 days to come for attention with 54.6%. Conclusion: The most frequent type of dentoalveolar trauma was subluxation. As for the etiology, falls and hits with objects stand out, mostly at home, affecting mainly men under 30 years of age. The time to come for consultation and start the corresponding treatment was within 7 days.

Sinopsis de la Situación de Salud Oral en Chile - Parte IV: Traumatismo Dentoalveolar

RESUMEN: Objetivo: Sintetizar los resultados de estudios epidemiológicos sobre Traumatismo Dentoalveolar (TDA) en la población chilena. Material y métodos: Se realizó una revisión sistemática de la literatura para identificar estudios poblacionales a nivel nacional, regional, provincial y comunal, además de datos de servicios dentales de atención primaria y secundaria sobre TDA en Chile. Resultados: Se incluyeron 2 estudios con representatividad nacional y 8 realizados en centros de atención en salud. A nivel nacional, la prevalencia de TDA a los 6 años fue de un 2.57%, y a los 12 años, 4.97%. En los estudios realizados en centros de salud, el diagnóstico más prevalente en dentición primaria fueron las lesiones de tejidos de soporte y en dentición permanente, la fractura coronaria. Fue más frecuente la afectación de un solo diente, y los incisivos centrales superiores fueron los dientes más afectados. Conclusiones: Los estudios representativos de la población en Chile son escasos, realizados hace más de una década y representativos sólo de la población de 6 y 12 años, lo cual pone de manifiesto la necesidad de mayor información epidemiológica sobre el TDA en la población chilena.

ABSTRACT: Aim: To summarize the evidence on epidemiological studies about traumatic dental injuries (TDI) in Chile. Methods: A systematic literature review was carried out in two databases to identify population studies at national, regional, provincial and community levels, as well as reports from primary and secondary dental care services, regarding TDI in Chile. Results: Two studies with national representation and eight studies from primary and secondary healthcare centers were included in the analysis. National prevalence for 6-year-old children was 2.57%, and 4.97% for 12-year-old children. While the most frequent diagnosis in primary dentition was traumatic injury involving tooth-supporting tissues, the most commonly reported diagnosis in permanent dentition was crown fracture. Single tooth affection was more frequent, and the upper central incisors were the most affected teeth. Conclusions: Data on representative studies about TDIs in Chile are scarce. Few studies, carried out more than a decade ago and only on 6- and 12-year-old children are available. There is a need for further epidemiological information about TDIs in Chile.

Sports-related facial trauma in the Indian population - A systematic review

Background: Sports injuries are a growing concern which requires immediate attention. Dental injuries are the most common type of orofacial injuries sustained during sports activities. Objectives: This study aims to review the prevalence of sports-related facial trauma in India, to identify the most common types of oro-facial injury incurred due to sports, and to assess the level of awareness regarding preventive measures used in sports. Methodology: The present review was performed in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. All articles published from 2005 to 2019 on sports-related facial trauma were analyzed. PubMed, Google Scholar, and Cochrane reviews databases were searched using primary keywords. Results: A total of 24 articles published in the period of 2005–2019 were included. The prevalence of sports-related facial trauma was found to be the highest in the study conducted by Selva et al., in 2018, at a rate of 75%, whereas it was found to be minimal in the study conducted by Bali et al. in 2013. While the awareness of mouthguards was reported the highest in a study conducted by Ramagoni et al., in 2007. Conclusion: This study shows that there is a definite need to improve the awareness as well as the usage of protective gear, from the level of schooling, where children are introduced to sports. Prevention of sports-related facial trauma is essential to avoid the serious and lifelong consequences which could be the aftermath of such injuries.

Avaliação comparativa entre terapia endodôntica convencional e técnica não instrumental: um relato de caso / Comparative evaluation between conventional endodontic therapy and a non-instrumental technique: a case report

Objetivo: A necrose da polpa dentária é uma complicação causada principalmente por cáries e lesões traumáticas. Não há consenso sobre a melhor técnica e materiais para o tratamento endodôntico na dentição decídua. O objetivo foi apresentar um relato de caso clínico em que foram realizadas diferentes abordagens endodônticas em dentes homólogos traumatizados e necróticos. Métodos: Um menino de um ano e oito meses sofreu traumatismo dento-alveolar após queda e procurou o projeto de extensão de traumatismos na dentição decídua da Faculdade de Odontologia da UFMG em outubro de 2018 para avaliação clínica e radiográfica. O incisivo central superior esquerdo apresentou fratura de esmalte e dentina sem exposição pulpar, enquanto o incisivo central superior direito apresentou luxação intrusiva leve. Ambos apresentaram o desenvolvimento de lesões periapicais. Resultados: Os dentes foram tratados respectivamente com a técnica não instrumental com pasta CTZ e com terapia endodôntica convencional com pasta Guedes-Pinto. Os acompanhamentos clínico e radiográfico após os tratamentos revelaram dentes assintomáticos e evidência de cicatrização periapical. Conclusão: O uso da pasta CTZ apresentou resultados satisfatórios e semelhantes à terapia tradicional em curto prazo no relato de caso apresentado.

Aim: Dental pulp necrosis is a complication caused mainly by dental caries and lesions. No consensus has been reached on the best technique and materials for endodontic treatment in the primary dentition. The objective was to present a clinical case report in which different endodontic approaches were performed in traumatized and necrotic homologous teeth. Methods: A one-year-and-eight-month-old boy suffered dentoalveolar trauma after a fall and sought out the Deciduous Trauma Dental Center of the Federal University of Minas Gerais in October 2018 for clinical and radiographic evaluation. The left maxillary central incisor presented enamel and dentin fracture without pulp exposure, while the right maxillary central incisor presented a small intrusive dislocation. Both presented the development of periapical lesions. Results: The teeth were treated respectively, using the non-instrumental technique with CTZ paste and the conventional endodontic therapy with Guedes-Pinto paste. Clinical and radiographic follow-ups after treatments revealed asymptomatic teeth and evidence of periapical healing. Conclusion: The use of CTZ paste in this case report presented satisfactory and similar results to traditional therapy in the short term.

Prevalencia de trauma dentoalveolar en la parroquia urbana Hermano Miguel / Prevalence of dentoalveolar trauma in the Hermano Miguel urban church

Resumen Introducción: Los traumatismos dentoalveolares (TDA) son eventos que ocurren frecuentemente, llegando a comprometer órganos dentarios, sus tejidos de soporte, los maxilares y los tejidos blandos de la cara. Las estadísticas revelan cifras significativas en cuanto a la incidencia y prevalencia de estos accidentes, por lo que son considerados como un problema de salud pública global. Objetivo: Determinar la prevalencia de trauma dentoalveolar (TDA) en la parroquia urbana Hermano Miguel del cantón Cuenca- Ecuador en el año 2019. Materiales y Métodos: La investigación forma parte del proyecto "Macro estudio epidemiológico del trauma dentoalveolar en niños, adolescentes y adultos, del Cantón Cuenca, 2019" de la Universidad Católica de Cuenca. El diseño de investigación fue descriptivo/analítico y retrospectivo. Se utilizó un cuestionario validado por expertos, obteniendo información de 320 personas en 78 viviendas de entre 2 y 11 habitantes (M=4; DE=2) en 11 cuadras escogidas de forma aleatoria. Resultados: La prevalencia de trauma en la muestra fue del 8.1% (n=26); en el 28.2% (n=22) de viviendas visitadas se registraron una (23.1%) o dos (5.1%) personas con golpes en los dientes. Conclusión: El traumatismo dentoalveolar, por la frecuencia con que se presenta, se considera una urgencia odontológica de suma importancia para mantener en boca la pieza dentaria afectada y los tejidos involucrados; se considera que la arcada superior recibe más traumatismos y las causas más frecuentes suelen ser las caídas.

Abstract Introduction: Dentoalveolar trauma (DTA) are events that occur frequently, compromising dental organs, their supporting tissues, the jaws and the soft tissues of the face. Statistics reveal significant figures regarding the incidence and prevalence of these accidents, which is why they are considered a global public health problem. Objective: To determine the prevalence of Dentoalveolar Trauma (TDA) in the urban parish of Hermano Miguel in the canton of Cuenca- Ecuador in 2019. Materials and Methods: The research is part of the "Macro epidemiological study of dentoalveolar trauma in children, adolescents and adults in Cuenca Canton, 2019" of the Catholic University of Cuenca. The research design is descriptive/analytical and retrospective. A questionnaire validated by experts was used, obtaining information from 320 people in 78 dwellings of between 2 and 11 inhabitants (M=4; SD=2) from 11 randomly selected blocks. Results: The prevalence of trauma in the sample was 8.1% (n=26); in 28.2% (n=22) of the dwellings visited, one (23.1%) or two (5.1%) persons were recorded with blows to the teeth. Conclusion: Dentoalveolar trauma, due to the frequency with which it occurs, is considered a dental emergency of utmost importance to keep the affected tooth and the tissues involved in the mouth; it is considered that the upper arch received more trauma and the most frequent causes were falls.

Research progress on periodontal regeneration of replanted teeth after complete avulsion / 口腔疾病防治

@#Complete avulsion of teeth are one of the most serious traumatic dental injuries. The preferred treatment is tooth replantation. When teeth usually cannot be treated in time, the periodontal membrane on the root surface becomes necrotic , and the success rate of replantation is greatly reduced. How to use seed cells, growth factors and scaffold materials to promote periodontal tissue regeneration, improve periodontal membrane healing of replanted teeth, and achieve successful replantation of completely dislocated teeth is an urgent problem. Periodontal ligament stem cells (PDLSCs) express stem cell markers, have the potential to undergo multicellular differentiation and have important application value in periodontal tissue regeneration and repair. Fibroblast growth factor-2 (FGF-2), basic fibroblast growth factor (bFGF), lysobisphosphatidic acids (LPA) and other related regulatory factors promote periodontal tissue regeneration. Seed cells combined with scaffold materials can promote periodontal tissue regeneration and repair periodontal tissue defects. At present, studies have shown that PDLSCs and other seed cells have the potential for periodontal tissue regeneration and have been widely studied in experimental animal models of periodontitis and bone defects. However, there are few reports on the application of replanted teeth after complete avulsion, and its mechanism is not clear. In this paper, the research progress of periodontal tissue regeneration after total dislocation replantation is reviewed. We expect to apply periodontal tissue regeneration research to the replantation of fully dislocated teeth to achieve periodontal membrane healing of fully dislocated replanted teeth to provide a theoretical basis for future clinical work.

Relationship of Traumatic Dental Injuries to the Permanent Anterior Teeth in Relation to Occlusal Relationship among 7-14 Years Old School Children - A Cross Sectional Survey

Introduction: Dental trauma is an irreversible pathologyand it is a commonly encountered problem in school childrenwhich after occurrence is characterized by lifelong debilitatingeffects because of physical, psychological discomfort andpain. Thus a study was conducted to assess the prevalence ofthe traumatic dental injuries to the permanent anterior teeth inrelation to occlusal relationship among 7-14 years old schoolchildren in Chitradurga townMaterial and Methods: Descriptive cross sectional studywas conducted among 3,363, 7-14 years old school childrenof Chitradurga Town. WHO (ICD-DA) 1995 Classificationwas used for assessing traumatic dental injuries and Angle’sclassification with Dewey’s Modification was used forrecording occlusal relationship. Fifteen Primary and HigherPrimary Schools and Five High schools were selected usingsimple random sampling procedure. Children aged 7-14 yearswere included in the study. Data was recorded using speciallydesigned proforma. The collected data was subjected tostatistical analysis.Results: Among 3,363 children examined prevalence rate was5.5% with higher prevalence in boys than girls. Prevalenceof traumatic dental injuries was more in the age group of10-12 years. Traumatic injuries of permanent anterior teethinvolved both maxillary and mandibular teeth with the higherprevalence in Maxillary anterior’s. Enamel fracture was thehighest (87.8%). Children with Class I type 2 and class IIdivision 1 occlusal relation exhibited very highly significantnumber of dental injuries.Conclusion: Prevalence of traumatic dental injuries wasmore in the age group of 10-12 years. Children with ClassI and class II division 1 occlusal relation exhibited veryhighly significant number of dental injuries than other type ofocclusal relationship

Evaluation of knowledge regarding emergency management of avulsed traumatic dental injuries in children among general dental practitioners in India

Context: Traumatic dental injuries (TDIs) leading to dental avulsion occur very frequently in society. Management of avulsion is critical for the dentist, as it requires appropriate knowledge. Aim: The study was conducted to evaluate the knowledge of the general dental practitioners (GDPs) regarding the emergency management of TDI leading to avulsion in children. Setting and Design: Questionnaire-based cross-sectional survey design was utilized to assess the knowledge. Subjects and Methods: Data for this cross-sectional survey were collected through questionnaires from July to September 2014. A total of 278 GDP were contacted and requested to fill a pretested questionnaire to assess the knowledge regarding tooth avulsion. The GDPs were grouped on the basis of their educational qualification and years of clinical experience. Statistical Analysis Used: Chi-square test was used for intra- and inter-group comparison. Results: A total of 224 (80.57%) GDPs consented to participate in the survey. Markedly low knowledge levels were noted in the sample irrespective of educational qualification and years of experience with respect to replantation of the avulsed primary tooth, holding the root instead of the crown, choice of appropriate storage medium for transportation of avulsed teeth, use of medications, and splinting type and time. Clinical experience and higher educational qualification of GDPs revealed statistical significant difference in the methods of management for TDI leading to avulsion. Conclusion: Higher professional education and added clinical experience were associated with better knowledge in the management of TDI leading to avulsion. The finding warrants the need for informative educational programs to update and boost the knowledge of practicing dentists regarding emergency management of avulsed teeth.

Trauma maxilofacial en el Servicio de Urgencias del Hospital Universitario "General Calixto García". 2016-2017 / Maxillofacial Trauma in the Emergency Service of General Calixto García University Hospital. 2016-2017

Introducción: La región maxilofacial es vulnerable a lesiones. En Cuba son escasos los estudios realizados sobre la atención en la urgencia dentro de la traumatología maxilofacial, por lo que surgió la motivación para realizar esta investigación. Objetivo: Caracterizar desde el punto de vista clínico-epidemiológico el trauma maxilofacial en el Servicio de Urgencias del Hospital General Calixto García en el período de junio 2016 a junio 2017. Material y Métodos: Se realizó un estudio descriptivo de corte transversal del universo de pacientes (2412 pacientes) atendidos en el Servicio de Urgencias del Hospital Universitario General Calixto García, desde junio del 2016 a junio del 2017; que tuvieron como diagnóstico trauma maxilofacial. Las variables empleadas fueron: grupos de edad, sexo, factor etiológico, tipo de lesión, conducta terapéutica. Resultados: En el estudio los pacientes con edades comprendidas entre 19 y 30 años representaron 41,0 por ciento; el sexo masculino 69,0 por ciento y los accidentes de tránsito 34,6 por ciento. Las lesiones de tejido duro más frecuentes fueron las fracturas nasales (13,9 por ciento); y de tejidos blandos las heridas puramente tegumentarias (82,1 por ciento). La colocación de vendajes se utilizó en 89,1 por ciento, y la sutura de heridas en 84,1 por ciento. Conclusiones: El comportamiento del trauma maxilofacial en el Servicio de Urgencias del Hospital Universitario General Calixto García, muestra que es predominante en hombres de edad intermedia y debido a accidentes de tránsito. Hay superioridad de lesiones de tejido blando y dentro de estas, de heridas puramente tegumentarias. La conducta conservadora, en su modalidad de colocación de vendaje, es la más empleada(AU)

Introduction: The maxillofacial region is vulnerable to injuries. In Cuba, few studies related to urgent care services have been carried out in maxillofacial traumatology, which led to an increase of motivation to conduct this research. Objective: To characterize maxillofacial trauma from a clinical and epidemiological point of view in patients treated in General Calixto García Hospital from June 2016 to June 2017. Material and Methods: A descriptive cross-sectional study was conducted with the universe of patients (2412 ones) that were treated in the Emergency Service of General Calixto García University Hospital with the diagnosis of maxillofacial trauma from June 2016 to June 2017. The variables used were: age groups, sex, etiological factor, type of injury, and therapeutic behavior. Results: In the study, the patients aged between 19 and 30 years represented 41.0 percent; the male sex 69.0 percent; and the traffic accidents 34.6 percent. The most frequent hard tissue injuries were nasal fractures (13.9 percent); and the soft tissue injuries were purely integumentary wounds (82.1 percent). Bandage placement was used in 89.1 percent, and wound suture in 84.1 percent. Conclusions: The behavior of the maxillofacial trauma in the Emergency Service of General Calixto García University Hospital, showed that it predominates in men of middle age due to traffic accidents. Soft tissue injuries were the predominant type of injuries, among them, the purely integumentary wounds. The conservative behavior in its modality of bandage placement was the most commonly used(AU)

Protector bucal por laminado a presión en paciente deportista / Pressure lamination technique mouthguard for athlete patient

RESUMEN: El traumatismo dentoalveolar incluye un conjunto de lesiones que afectan a los dientes y/o estructuras de soporte a consecuencia de un impacto violento directo o indirecto. Debido a que por lo general comprometen el sector anterior generan cambios físicos, fonéticos, psicológicos y dietarios, que pueden afectar significativamente la calidad de vida de pacientes afectados por este traumatismo. Los protectores bucales son considerados la principal medida para minimizar y/o evitar estos traumatismos. El presente artículo describe el tratamiento y procedimientos para realizar un protector bucal por laminado a presión en un paciente deportista con historia previa de traumatismo dentoalveolar en incisivos centrales superiores.

ABSTRACT: Traumatic dental injuries involve lesions that affect teeth and/or adjacent supporting structures as a consequence of direct or indirect violent impact. Due to As it affects the anterior teeth, in most of the cases, it provokes changes in the physical appearance, altering phonetics, psychology and the diet of the affected subject. These changes may significantly alter the quality of life of patients affected by this type of trauma. Mouthguards are considered the primary appliance for minimizing and/or avoiding dental trauma. The present article describes the treatment and procedures to perform a mouthguard by pressure lamination technique in a patient that who practices sports and with a history of trauma affecting the upper central incisors.

Traumatismos alveolodentários e fatores associados em crianças assistidas em um curso de Odontologia no sul do Brasil / Traumatic dental injuries and associated factors in children assisted in a school of Dentistry in Southern Brazil

Aim: To estimate the prevalence of traumatic dental injuries (TDI) and investigate demographic and socioeconomic factors associated among children attending at School of Dentistry, Southern Brazil. Methods: A cross-sectional study was carried out with 374 children attending the Pediatric Clinic, from School of Dentistry at the Universidade Luterana do Brasil, Canoas, Southern Brazil. Information from parents/caregivers on socioeconomic factors were obtained with an structured questionnaire. Children were clinically examined and TDI was recorded following Andreasen criteria. Poisson regression with robust variance was employed to determine factors associated with TDI. Results: A total of 15.0% of children exhibited TDI (95% CI 11.5-19.0%). The most common dental injuries involved hard tissues (enamel fracture, enamel and dentine fracture). Adjusted analysis revealed that the probability of TDI was almost 90% higher in older children (10 to 12 years) compared to children who were 7 to 9 years old; (PR 1.89; 95% CI 1.05­3.43), two fold higher in children from older mothers (≥ 35 years) (PR 2.01; 95% CI 1.23­3.30), and 66% higher in children from mothers with lower education (≤8 years) (PR 1.66; 95% CI 1.02­2.70). Conclusion: Our findings showed a high prevalence of TDI. Moreover, sociodemographic factors, specially, maternal schooling and aging were associated with the outcome. Epidemiological studies of specific groups allowed in the organization of health services and elaboration of preventive and curative strategies.

Objetivo: estimar a prevalência de traumatismos alveolodentários (TAD) e investigar fatores sociodemográficos associados em crianças assistidas em um Curso de Odontologia no Sul do Brasil. Métodos: Um estudo transversal foi realizado com 374 crianças atendidas na Clínica Infantil do Curso de Odontologia da Universidade Luterana do Brasil, Canoas, Brasil. Informações sobre fatores sociodemográficos foram obtidas com pais ou cuidadores por meio de um questionário estruturado. As crianças foram clinicamente examinadas e TAD foram registrados, conforme critério de Andreasen. Regressão de Poisson com variância robusta foi empregada para determinar os fatores associados com o desfecho. Resultados: A prevalência de TAD foi de 15,0% (IC 95% 11,0-19,0%). As lesões mais comuns foram lesões aos tecidos duros (fratura de esmalte e de esmalte e dentina), especialmente na dentição permanente. A análise ajustada mostrou que a probabilidade de TAD foi quase 90% maior em crianças de maior idade (10 a 12 anos) em relação a crianças de 7 a 9 anos (RP 1,89; IC 95% 1,05­3,43), duas vezes maior em filhos de mães com maior idade (≥ 35 anos) (RP 2,01; IC 95% 1,23­3,30) e 66% maior em crianças de mães com menor escolaridade (≤8 anos) (RP 1,66; IC 95% 1,02­2,70). Conclusão: Observou-se uma alta prevalência de TAD. Além disso, fatores sociodemográficos, especialmente escolaridade e idade materna, estiveram associados ao desfecho. Estudos epidemiológicos de grupos específicos permitem a organização de serviços de saúde e a elaboração de estratégias preventivas e curativas.

Tratamiento restaurador de lesiones dentales traumáticas. Reporte de tres casos clínicos / Restorative treatment of traumatic dental injuries. Report of three clinical cases

RESUMEN: Las lesiones dentales traumáticas (LDT) son comunes, siendo las principales causas: golpes por caídas u objetos, traumatismos deportivos, actividades físicas de ocio y accidentes automovilísticos. Casi todos los casos abarcan los dientes anteriores, con mayor frecuencia los incisivos centrales superiores. De las clasificaciones de LDT, se describe la propuesta por Andreassen y aceptada por la OMS en su «Clasificación internacional de las enfermedades¼ desde 1978. Sumando tecnologías a la práctica odontológica, el diseño asistido por computadora y la fabricación asistida por computadora (CAD/CAM), proporcionan al rehabilitador nuevas modalidades de tratamiento, mejorando el diseño y la aplicación de restauraciones cerámicas libres de metal, que a lo largo de la última década ha demostrado un buen desempeño clínico. Se presentan a la clínica de la Especialidad de Odontología Restauradora Avanzada, tres pacientes, de los cuales el primero se presentó en las primeras 48 horas luego de la LDT en centrales y lateral derecho; dos pacientes presentaban LDT de uno de los incisivos centrales, el primero un adulto de 28 años de edad con una evolución de cinco años y sin ningún tratamiento ejecutado aún; el segundo caso, un niño de nueve años de edad que se presenta con un tratamiento de sistemas de conductos con una evolución de seis meses.

ABSTRACT: Traumatic dental injuries (TDI) are very common, they are mainly originated from blows caused by objects or due to falls, sport injuries as well as injuries sustained during leisure activities and car accidents. Most cases involve anterior teeth, of which upper central incisors are more frequently affected. Andreassen's TDI classification, sanctioned by WHO in 1978 in «International disease classification ¼, is described here. When new technologies are incorporated into dental practice, computer-assisted design and computer-assisted manufacture (CAD/CAM) provide the restorative clinician with new treatment options, thus improving design and application of metal-free ceramic restorations, which, along last decade, have haven proven to provide suitable clinical performance. Three patients were treated at the Advanced Restorative Dental Graduate Program clinic. The first one sought treatment within the first 48 hours after TDI, in central and right lateral teeth; two patients exhibited TDI in one central incisor, the first one was a 28 year old male with a five year evolution of the injury and no previous treatment, the second case was a nine year old child who arrived having been subjected to root canal treatment, with a six month evolution.

Factores predisponentes de trauma dental en escolares del municipio Rafael Freyre / Predisposing Factors for Dental Trauma in Students from Rafael Freyre Municipality

Introducción: los traumatismos dentales representan uno de los más serios problemas de salud pública de los niños y adolescentes. Objetivo: identificar los factores predisponentes de trauma dentario en escolares de la escuela primaria. Método: se realizó un estudio descriptivo transversal, en escolares de 5 a 12 años de la escuela primaria "28 de septiembre" del Municipio Rafael Freyre, en el período de enero a junio de 2016. El universo de estudio y la muestra estuvo constituido por 236 niños. Se estudiaron algunas variables como edad, sexo, hábitos bucales deformantes, competencia labial y resalte. Resultados: las edades de 9 y 10 años fueron las más afectadas representadas por 47 escolares para el 19,9%. Predominó el sexo masculino (68,1%) en escolares con lesión traumática. El hábito bucal deformante más frecuente fue la succión digital en el 82,9%. El 65,9% de los pacientes que sufrieron lesiones traumáticas tenían una relación labial incompetente. El 80,9% de los escolares con trauma dental presentaban resalte aumentado. Conclusiones: los factores predisponentes más frecuentes fueron el resalte aumentado, el perfil convexo y la presencia de hábitos bucales deformantes entre los cuales la succión digital y la respiración bucal fueron los más representativos.

Introduction: dental trauma is one of the one of the most serious problems of public health in children and adolescents. Objective: identify the predisposing factors of dental trauma in children of the elementary school. Method: a descriptive cross-sectional study was conducted with students aged 5-12 from "28 de September" elementary school in the municipality of Rafael Freyre from January to June 2016.The universe and the sample of study was constituted for 236 children. The variables studied were age, sex, type of deforming oral habit, labial competence and overbite. Results: the ages between 9-10 were the most affected ones represented with 47 children (19.9%). There was a predominance of the male sex (68.1%) among students with traumatic injuries. Thumb sucking was the most common deforming oral habit (82.9%). Bilabial incompetence was found in 65.9% of the children with history of traumatic injuries. Increased overbite was found in 80.9% of the children with dental trauma. Conclusions: the most common predisposing factors were increased overjet, bilabial incompetence, and deforming oral habits. Thumb sucking and the buccal respiration were the prevailing ones.

Critérios de avaliação penal por juízes, peritos e especialistas em odontologia legal ­ parte I: lesões dentais decorrentes de agressão / Criminal evaluation criteria for judges, experts and specialists in forensic dentistry - part I: dental injuries resulting of aggression

Com o passar dos anos tem se constatado um aumento da violência, e como consequência, do número de exames de corpo de delito envolvendo a face e cavidade bucal. Mesmo existindo coeficientes dos índices estético, mastigatório e fonético, nota-se uma evidente falta de padronização na avaliação e enquadramento das lesões dentais de acordo com o artigo 129 do Código Penal. Devido a este fato o presente estudo avaliou a maneira como os juízes, peritos dos Institutos Médico-Legais (IMLs), entre eles médicos e cirurgiões dentistas, e especialistas em Odontologia Legal, tipificam as lesões dentais; assim como comparou as convergências e divergências das opiniões desses profissionais e discutiu os aspectos éticos e legais pertinentes ao tema. Nesse objetivo, foi confeccionado um questionário com questões estruturadas, que foi entregue aos voluntários, juntamente com duas cópias do termo de consentimento livre e esclarecido (TCLE). O projeto da presente pesquisa foi aprovado pelo Comitê de Ética em Pesquisa sob o protocolo nº 076/2009. A amostra participante da pesquisa totalizou 82 profissionais, atuantes nos Estados de São Paulo, Rio de Janeiro e Mato Grosso, que qualificaram supostas lesões dentais de acordo com o artigo 129 do Código Penal. Conclui-se que apesar da existência de uma tendência à convergência nas opiniões dos profissionais, quando observadas as porcentagens maiores, existe uma oscilação na interpretação das questões, fato que dificulta a aplicação de um critério único. Pelo contrário, se existissem parâmetros para tal fim, diminuiriam as possibilidades de variações na forma de interpretação entre profissionais diretamente ligados no processo, no tocante aos danos sofridos pela vítima.

Through the years, it has been noticed an increase of violence and forensic examination cases related to the face and oral cavity. Although there are aesthetic, phonetic and masticatory indexes, there is an obvious lack of criteria for the assessment and classification of dental injuries in accordance to 129 Article of the Penal Code. Due to this fact, this study analyzed how judges, medical and dental forensic experts, and specialists in forensic dentistry typify the dental injuries, as well as checked the convergence and divergence of opinions of these professionals and discussed the ethical and legal issues referred to this topic. In this goal, it was made a questionnaire with structured questions, which was delivered to the volunteers, along two copies of the informed consent (IC). The project of this research was approved by the Research Ethics Committee (protocol nº 076/2009). The sample consisted of 82 professionals from the States of São Paulo, Rio de Janeiro and Mato Grosso, that qualified supposed dental injuries in accordance with 129 Article of the Penal Code. It was concluded that despite of the existence of a convergent tendency in the points of view of professionals, while observing the highest percentages, there are discrepancies in the interpretation of the questions, that difficult the application of a single criterion. Although, if there was a parameter for this purpose, it would minimize the possibility of different interpretations among the professionals directly involved in the process, when related to the damages suffered by the victim.

Prevalencia de trauma dentoalveolar en la parroquia urbana Hermano Miguel

Introducción: Los traumatismos dentoalveolares (TDA) son eventos que ocurren frecuentemente, llegando a comprometer órganos dentarios, sus tejidos de soporte, los maxilares y los tejidos blandos de la cara. Las estadísticas revelan cifras significativas en cuanto a la incidencia y prevalencia de estos accidentes, por lo que son considerados como un problema de salud pública global. Objetivo: Determinar la prevalencia de trauma dentoalveolar (TDA) en la parroquia urbana Hermano Miguel del cantón Cuenca- Ecuador en el año 2019. Materiales y Métodos: La investigación forma parte del proyecto "Macro estudio epidemiológico del trauma dentoalveolar en niños, adolescentes y adultos, del Cantón Cuenca, 2019" de la Universidad Católica de Cuenca. El diseño de investigación fue descriptivo/analítico y retrospectivo. Se utilizó un cuestionario validado por expertos, obteniendo información de 320 personas en 78 viviendas de entre 2 y 11 habitantes (M=4; DE=2) en 11 cuadras escogidas de forma aleatoria. Resultados: La prevalencia de trauma en la muestra fue del 8.1% (n=26); en el 28.2% (n=22) de viviendas visitadas se registraron una (23.1%) o dos (5.1%) personas con golpes en los dientes. Conclusión: El traumatismo dentoalveolar, por la frecuencia con que se presenta, se considera una urgencia odontológica de suma importancia para mantener en boca la pieza dentaria afectada y los tejidos involucrados; se considera que la arcada superior recibe más traumatismos y las causas más frecuentes suelen ser las caídas.

Introduction: Dentoalveolar trauma (DTA) are events that occur frequently, compromising dental organs, their supporting tissues, the jaws and the soft tissues of the face. Statistics reveal significant figures regarding the incidence and prevalence of these accidents, which is why they are considered a global public health problem. Objective: To determine the prevalence of Dentoalveolar Trauma (TDA) in the urban parish of Hermano Miguel in the canton of Cuenca- Ecuador in 2019. Materials and Methods: The research is part of the "Macro epidemiological study of dentoalveolar trauma in children, adolescents and adults in Cuenca Canton, 2019" of the Catholic University of Cuenca. The research design is descriptive/analytical and retrospective. A questionnaire validated by experts was used, obtaining information from 320 people in 78 dwellings of between 2 and 11 inhabitants (M=4; SD=2) from 11 randomly selected blocks. Results: The prevalence of trauma in the sample was 8.1% (n=26); in 28.2% (n=22) of the dwellings visited, one (23.1%) or two (5.1%) persons were recorded with blows to the teeth. Conclusion: Dentoalveolar trauma, due to the frequency with which it occurs, is considered a dental emergency of utmost importance to keep the affected tooth and the tissues involved in the mouth; it is considered that the upper arch received more trauma and the most frequent causes were falls.

Factores predisponentes del trauma dental, Escuela Primaria República de Angola (2012-2013) / Predisposing factors for dental trauma, República de Angola elementary school, 2012-2013

Introducción: las lesiones traumáticas dentarias constituyen en la actualidad un problema de salud. La literatura científica señala un grupo de factores predisponentes para los traumas dentarios, sobre los cuales se puede actuar preventivamente. Métodos: se realizó un estudio descriptivo transversal, en niños y niñas de 7 a 12 años de la escuela primaria República de Angola del Municipio Boyeros, en el período del 2012 al 2013. Las variables utilizadas fueron: edad, sexo, presencia de lesión traumática, tipo de hábitos bucales deformantes, perfil, competencia labial, resalte, sobrepase. Las medidas de resumen empleadas fueron las frecuencias absolutas y porcentajes. Objetivo: identificar la frecuencia de factores predisponentes al trauma dentario en los escolares estudiados. Resultados: las edades de 11 y 12 años fueron las más afectadas representadas por 65 educandos para un 67 por ciento. Predominó el sexo masculino (68 por ciento) en escolares con lesión traumática. El hábito bucal deformante más frecuente fue la succión digital para (57,7 por ciento). Tenían perfil convexo 97 (73,2 por ciento) escolares de los que sufrieron un trauma. El 88,7 por ciento de los escolares con trauma dental presentaban resalte aumentado. El 83,5 por ciento de los que sufrieron lesiones traumáticas tenían una relación labial incompetente. Se observa que el 48,5 por ciento de los niños que tuvieron trauma presentaban un sobrepase negativo. Conclusiones: los factores predisponentes más frecuentes fueron el resalte aumentado, el perfil convexo, la incompetencia bilabial, el sobrepase negativo y la presencia de hábitos bucales deformantes entre los cuales la succión digital ocupa el primer lugar(AU)

Introduction: traumatic dental injuries are a current health problem. The scientific literature on the subject refers to a number of predisposing factors for dental trauma which may be acted upon preventively. Methods: a descriptive cross-sectional study was conducted with boys and girls aged 7-12 from República de Angola elementary school in the municipality of Boyeros from 2012 to 2013. The variables studied were age, sex, presence of traumatic injury, type of deforming oral habit, profile, labial competence, overbite, overjet. The summary measurements used were absolute frequencies and percentages. Objective: identify the frequency of predisposing factors for dental trauma among the school age children studied. Results: the 11-12 age group was the best represented with 65 children (67 percent). There was a predominance of the male sex (68 percent) among children with traumatic injuries. The most common deforming oral habit was thumb sucking (57.7 percent). Of the children with antecedents of traumatic injuries, 97 had a convex profile (73.2 percent). Increased overjet was found in 88.7 percent of the children with dental trauma. Bilabial incompetence was found in 83.5 percent of the children with antecedents of traumatic injuries. Of the children with dental trauma, 48.5 percent had a negative overjet. Conclusions: the most common predisposing factors were increased overjet, convex profile, bilabial incompetence, negative overjet and deforming oral habits, among which thumb sucking was predominant(AU)

Patrones Epidemiológicos del Trauma Dentoalveolar (PatologíaGES) en Pacientes Adultos Atendidos en un Centro de Trauma de Chile Durante 2 Períodos / Epidemiological Patterns of Traumatic Dental Injuries (GES Disease) in Adult Patients Treated at a Chilean National Trauma Center during 2 Periods

El trauma dentoalveolar (TDA) constituye un conjunto de lesiones que comprometen los dientes o a sus estructuras periodontales. En Chile, desde el año 2007, la primera consulta/tratamiento de urgencia del TDA está cubierta por la Ley N 19.966, para todas las personas afiliadas al Fondo Nacional de Salud (FONASA) y a las Instituciones de Salud Previsional Privadas (ISAPRE) a través del Programa de Garantías Explícitas en Salud (GES). Escasos estudios nacionales se han realizado en TDA de adultos y ninguno en relación al impacto del GES en estas lesiones. Se realizó un estudio retrospectivo, descriptivo y transversal de TDA con los Datos de Urgencia de todos los pacientes adultos atendidos en el Hospital de Urgencia Asistencia Pública. Se compararon las variables clínicas, etiológicas, demográficas y sociales entre 2 períodos: pre-GES (1 de Julio de 2005 al 30 de Junio de 2006) y post-GES (1 de julio de 2012 al 31 junio de 2013). En los 2 períodos se observó una mayor frecuencia de TDA en el sexo masculino del grupo de 20­29 años, producidos en la mayoría de los casos por violencia interpersonal. Sin embargo se observó en el período post-GES una mayor consulta de TDA por Accidente vehículo-motorizado, presentándose lesiones de mayor gravedad. A pesar de la implementación del GES, se observó una alta frecuencia de TDA no tratados, esto podría deberse a la gravedad del estado sistémico del paciente (postergando el tratamiento de TDA), a la falta de insumos o a la inequidad en la entrega de recursos a los servicios de salud. Es necesario realizar más estudios y vigilancia de parte de la autoridad sanitaria para mejorar las garantías del GES en el tratamiento de los TDA.

Traumatic dental injury (TDI) is a group of injuries that affect hard dental tissues and/or periodontal structures. Since 2007 the first emergency treatment/consult of TDI, for both the National Health Fund (FONASA) and profit private insurer (ISAPRE) affiliates, is guaranteed in the Regulation of Explicit Health Guarantees (GES) established by Chilean Law 19.966. Few national TDI studies in adults have been carried out, and none in relation to the impact of GES in this type of lesion. A retrospective cross sectional study of emergency charts of all adult patients attended at the Hospital de Urgencia Asistencia Pública. Etiological, clinical, demographic and social variables were compared between 2 time periods, Pre-GES period (July, 1 2005 to June, 30 June 2006) versus Post-GES period (July, 1 2012 to June, 31 2013). A high incidence of TDI caused by interpersonal violence in males between 20 and 29 years old was observed in both periods. However, an increased TDI with more severe injuries caused by automobile accident was observed during the post-GES period. In spite of GES implementation, high frequency of non-treated TDI was seen in the present study, this could be due to the severity of the patient´s systemic condition (delaying the TDI treatment), a lack of resources and/or inequity in the delivery of these healthcare resources. More studies and surveillance programs by the Government are needed to improve TDI treatment guarantees, and as well as regular assessment of GES compliance.

University student's dental and maxillofacial fractures characteristics and epidemiology in sports / Características e epidemiologia das fraturas maxilo-faciais no esporte em estudantes universitários

Current study analyzes the characteristics and epidemiology of oral and nasal fractures and knowledge degree regarding the use of a mouthguard by an amateur university handball team in Brazil. A cross-sectional study comprised 138 students who practiced the sport. They were interviewed on dental and nasal fractures and on the need of mouthguards in games such as amateur handball. Data were processed by descriptive analysis. Results showed that 19.6% had suffered some type of dental injury during the practice of sports, namely 40 fractured teeth; 12% had fractured nasal bones; 57% underwent head and neck injuries; 32% were unaware of the need to use a mouthguard during sports; 68% had heard of mouthguards, but only 4.5% of the interviewees made use of this protection device. There was a high prevalence of nasal and dental fractures in the group under analysis. The upper central incisors were most susceptible to fracture. Even though most athletes knew a mouthguard was needed during sports activities, only 4.5% actually used one.

O presente estudo analisou as características epidemilógicas de fraturas orais e nasais, bem como o grau de conhecimento sobre o uso de um protetor bucal no esporte amador, cujo corpus é a equipe de handebol da Universidade no Brasil. Em um estudo transversal foram entrevistados 138 atletas sobre a ocorrência de fraturas dentais e nasais, além de seu conhecimento acerca da necessidade na prática de handebol amador universitário; os dados foram tabulados e apresentados por meio de análise descritiva. Um total de 19,6% sofreu algum tipo de lesão dental durante a prática do esporte, totalizando 40 dentes fraturados, 12% sofreram fraturas dos ossos nasais, 57% sofreram ferimentos na cabeça e pescoço, 32% não sabiam da necessidade de usar um protetor bucal para o esporte; 68% referiram já ter ouvido falar de protetores bucais, mas apenas 4,5% dos entrevistados fizeram uso deste dispositivo de proteção. Houve alta prevalência de fraturas nasais e dentais no grupo analisado. Os incisivos centrais superiores foram os dentes mais suscetíveis a fraturas. Mesmo que a maioria dos atletas saiba da necessidade de usar um protetor bucal, apenas 4,5% realmente fazem uso desse equipamento.

Exploratory study of the prevalence of traumatic injuries in preschool children in the city of Macapá, Brazil

Objective:To verify the prevalence of dental trauma and the most common types of trauma in primary dentition of preschool children in the city of Macapá, Brazil. Material and Methods:A convenience sample of 177 preschool children aged 1-4 years of both genders was examined. Data collection occurred in public schools in different regions examiner. For comparison of data, statistical Chi-square test was applied, arranged in order of frequency (p<0.05). Results:The prevalenceof traumatic injuries was 46.3%,there was no statistically significant difference between genders (p = 0.09). The least affected age group was 1 year old (p=<0.001). The most common type of injury was enamel fracture (88.3%) and the most affected teeth were upper central deciduous incisors (70.1%) and upper lateral deciduous incisors (17.6%). Conclusion:Due to the high prevalence of dental trauma in this population, preventive and educational measures are needed to reduce the number of cases both in the private network and in promotions of public and community health

Predisposing Factors for Traumatic Dental Injury in Primary Teeth and Seeking of Post-trauma Care

The aim of the present study was to investigate predisposing factors for traumatic dental injury (TDI) in the primary dentition and seeking of dental care after the occurrence of TDI. A randomized population-based cross-sectional study was carried out with 814 children aged 3 to 5 years enrolled at public and private preschools in the city of Campina Grande, PB, Brazil. Parents were asked to fill out a questionnaire on demographic data and the child's history of TDI. TDI was evaluated by clinical examinations performed by three previously calibrated dentists (Kappa: 0.85 to 0.90). Bivariate and multivariate Poisson regression models were constructed for TDI and the parent-reported search for dental care (α=0.05). The prevalence of TDI was 34.6%. The most common type of TDI was enamel fracture (55.0%). The central incisors were the most frequently affected teeth (87.5%). Predictors for TDI in the primary dentition were household income >U$312.50 (PR: 1.355; 95% CI: 1.050-1.724) and overjet >2 mm (PR: 1.539; 95% CI: 1.219-1.942). The predictor for seeking dental care following TDI was parent's age >30 years (PR: 1.753; 95% CI: 1.039-2.960). Household income and overjet were associated with TDI. Among children having suffered TDI, parent's age is a crucial determinant for seeking dental care.

O objetivo do presente estudo foi avaliar os fatores predisponentes para o traumatismo dentário (TD) na dentição decídua e a procura por tratamento odontológico após a ocorrência do TD. Um estudo transversal de base populacional randomizado foi realizado com 814 crianças entre 3 e 5 anos de idade, matriculadas em pré-escolas públicas e privadas da cidade de Campina Grande, PB, Brasil. Um questionário foi preenchido pelos pais sobre dados sociodemográficos e histórico de TD da criança. TD foi avaliado através de exames clínicos realizados por três dentistas previamente calibrados (Kappa: 0,85-0,90). Modelos de regressão de Poisson bivariado e multivariado foram realizados para TD e a procura por tratamento odontológico após o TD (α=0.05). A prevalência de TD foi de 34,6%. O tipo mais comum de TD foi a fratura de esmalte (55,0%) e os incisivos centrais superiores foram os dentes mais acometidos (87,5%). Preditores para o TD na dentição decídua foram renda familiar >U$312.50 (RP: 1,355; IC 95%: 1,050-1,724) e overjet >2 mm (RP: 1,539; IC 95%: 1,219-1,942). O fator preditor para a procura de tratamento odontológico após TD foi a idade dos pais >30 anos (RP: 1,753; IC 95%: 1,039-2,960). Renda familiar e overjet foram associados com o TD. Entre as crianças que sofreram TD, a idade dos pais foi um determinante crucial para a procura de tratamento odontológico.