Age-Related Pattern of Dental Trauma in a Nigerian Tertiary Health Institution

Abstract Objective: To evaluate the pattern of traumatic dental injuries among children, adolescents, and adults. Material and Methods: This was a cross-sectional analytic study of children and adults who presented with dental trauma. Data utilized for this study were sociodemographic characteristics, history of the traumatic incident, presenting complaints, traumatized teeth and classification of the traumatized tissues using Ellis and Davey's classification. Results: A total of 163 participants with 307 traumatized teeth were included in the study. The participants' age ranged from 2 years to 75 years, with a mean age of 25.36 ±15.4 years. Children <10 years were the least represented (14.7%), adolescents 10-19 years accounted for 23.9%., young adults 20 to 40 years were the most represented (44.8%) and older adults >40 years (16.6%). A higher proportion of the study participants were female 83 (50.9%) and the most prevalent complaint was broken teeth (57.1%) The most prevalent aetiology of the trauma documented was fall (36.2%). The most prevalent injury type was extended crown fracture with noticeable dentinal involvement without pulp exposure. There was a statistically significant association between injury type, aetiology and age group. Conclusion: Traumatic dental injuries affect children, adolescents and adults alike. The central incisors were the most vulnerable teeth across all age groups. Age was significantly associated with the etiology of dental trauma and injury type (AU).

Population Knowledge and Attitude Toward Emergency Management of Avulsed Permanent Teeth

Abstract Objective: To evaluate the knowledge of patients treated in a public University concerning dental avulsion and its emergency first-aid management. Material and Methods: Three hundred patients were invited to answer a questionnaire about demographic characteristics, attitude and knowledge of first-aid management of dental avulsion. Chi-square test was used to assess the association between knowledge about dental replantation and education level. Results: Female gender (66.7%) aged from 31 to 40 years (31.3%) with high school education (50.3%) predominated among all the participants. It was not found a difference between education level and management of avulsed permanent teeth (p=0.076), and 66% of the respondents were not able to do the replantation. In relation to the management of avulsed tooth, 42.7% of the respondents would brush the tooth and if the replantation was not possible, most of them would choose inappropriate media for storage. The association between the storage medium and educational level showed to be statistically significant (p=0.043). Conclusion: It was possible to notice the lack of knowledge about this subject, and it could result in the worst prognosis. In avulsion cases, the subsequent root resorptions may lead to the loss of the child's tooth. It is important to implement educational campaigns to spread knowledge and improve success rates of permanent avulsed teeth

Nivel de aprendizaje sobre traumatismos dentoalveolares en estudiantes del último año de la carrera de odontología / Level of learning on dentoalveolar trauma in students at the final year of the dentistry career

En la Facultad de Odontología de la Universidad de Buenos Aires, en la asignatura Clínica Integral para Niños y Adolescentes, los estudiantes del último año de la Carrera de Odontología realizan procedimientos clínicos y prácticos indispensables en la atención inicial de las urgencias en niños y adolescentes, restituyendo la integridad coronaria en lesiones producidas por traumatismos en piezas primarias y permanentes. Estudios publicados sobre la temática refieren que la mayoría de los estudiantes de pregrado no están lo suficientemente calificados, o tienen un conocimiento insuficiente para manejar situaciones de urgencias en traumatología dental. Sin embargo, se ha demostrado que existe un impacto positivo entre los estudiantes luego de recibir una clase teórica. El objetivo es determinar el nivel de conocimientos de los estudiantes de odontología del último año de la carrera en el manejo de los traumatismos dentoalveolares en niños y adolescentes, antes y después de recibir las clases teóricas (modalidad online) sobre esta temática (AU)

Assessment of the Need for Dental Treatment Resulting From Dental Trauma in 12-Year-Old Brazilian Schoolchildren: A Cross-Sectional Study

Abstract Objective: To identify the need for restorative treatment in 12-year-old Brazilian schoolchildren with dental trauma and its association with clinical and socioeconomic factors. Material and Methods: A cross-sectional population-based study was carried out with sample composed of 588 12-year-old students from the city of Diamantina, Minas Gerais, Brazil. Data were collected from August to November 2016 through clinical examination, adopting the Andreasen classification and semi-structured questionnaire to verify the etiology and location of the accident that resulted in dental trauma. Statistical analysis included the frequency distribution and bi and multivariate analysis, with 5% significance level. Results: The presence of 219 traumatized teeth in 176 students was observed (29.9%). The main lesion was enamel fracture (41.4%), followed by enamel and dentin fracture (39.4%). The presence of restorative treatment was observed only in 11.5% of students. Fall (43.5%) was the most frequent etiology, followed by accidents on the streets (35.8%). Need for treatment was present in 53.4% of adolescents. Statistically significant association between males (p=0.010), severe overjet (p<0.0001) and inadequate lip protection (p<0.0001) and presence of dental trauma was observed. Maternal schooling over 8 years of study was statistically associated with need for restorative treatment (OR = 2.047; CI: 1.099-3.813; p=0.023). Conclusion: Prevalence of dental trauma, need for restorative treatment and number of adolescents with no access to restorative treatment in this study were high, point out that the health system is unable to satisfactorily prevent dental trauma and absorb all dental treatment demand resulting from dental trauma.

Avaliação clínica e radiográfica de intrusão dentária na dentição decídua: relato de caso / Clinical and radiographic evaluation of dental intrusion in the decidualdentition: case report

Introdução:A intrusão resulta no deslocamento do dente no sentido axial para o interior do osso alveolar, podendo causar injúrias à estrutura periodontal e ao tecido pulpar através do esmagamento e ruptura das fibras do ligamento periodontal e do aporte vascular.Objetivo:abordar a ocorrência de um traumatismo dentário do tipo intrusivo, na dentição decídua, descrevendo aspectos relacionados ao diagnóstico, tratamento e proservação da unidade dentária. Relato de caso:Paciente, quatro anos de idade, gênero feminino, apresentou traumatismo dentário condizente com o diagnóstico de luxação intrusiva, foi estabelecido um tratamento conservador, preservando o elemento dentário no arco até que ocorresse a esfoliação do mesmo. No presente caso, obteve-se um bom prognóstico, visto que foi percebida a reerupção do elemento dentário no período de dois meses.Conclusões:O conhecimento das técnicas de manipulação dos traumatismos dento-alveolares e dos tecidos moles é imprescindível para a realização de um tratamento adequado dessas condições. Desta maneira, é importante o cirurgião-dentista ter habilidades no manejo da criança para um correto diagnóstico, estabelecendo um adequado tratamento, para melhor prognostico da unidade dentária (AU).

Introduction:Intrusion results in axial displacement of the tooth into the alveolar bone and may cause damage to the periodontal structure and pulp tissue by crushing and rupturing the periodontal ligament fibers and vascular input.Objective:To address the occurrence of intrusive dental trauma in the deciduous dentition, describing aspects related to the diagnosis, treatment and proservation of the dental unit. Case report:Patient, four years old, female, had dental trauma consistent with the diagnosis of intrusive dislocation, a conservative treatment was established, preserving the dental element in the arch until exfoliation occurred. In the present case, a good prognosis was obtained, since it was noticed the re-erection of the dental element in the period of two months. Conclusions:The knowledge of the techniques of manipulation of dento-alveolar and soft tissue trauma is essential for the adequate treatment of these conditions. In this way, it is important for the dental surgeon to have skills in the management of the child for a correct diagnosis, establishing an appropriate treatment, for a better prognosis of the dental unit (AU).

Oral health behaviors, dental injuries and mouthguard awareness among a sample of portuguese athletes: a cross sectional study / Comportamientos de salud bucal, lesiones dentales y conciencia del uso de protectores bucales entre una muestra de atletas portugueses: estudio transversal

Aim: To determine the oral health behaviors, the prevalence of dental injuries, the level of information about first-aid procedures in the case of dental avulsion and the mouthguard awareness in a sample of Portuguese athletes. Materials and Methods: Cross-sectional researchamong 1,048 athletes from the district of Viseu, Portugal. A self-administered questionnaire included demographic data and questions about: I) oral hygiene habits, II) occurrence of orofacial trauma, III) use of mouthguards and IV) athletes' knowledge regarding first-aid management in case of dental avulsion was given. The comparison between different variables was made by Chi-square test with level of significant set at p-value ≤0.05. Results: The mean age of the sample (76.24% male) was 18.14±8.17 years. Overall, the results demonstrated a low use of dental floss (25.48%) and a high number of athletes (21.94%) that had not visited a dentist in more than a year. The prevalence of dental trauma was 5.06% and the most common dental injuries experienced by athletes were crown fractures (60.38%). Nearly half of the participants (45.23%) reported not knowing how to act following a dental avulsion. The rate of mouthguard use was very low (9.73%). There was a significant relationship between the prevalence of dental injuries and the use of mouthguards (p=0.000; Cramér's V=0.145). Conclusion: The prevalence of dental trauma in our population was low. A low number of athletes use a mouthguard and there is a lack of knowledge concerning dental trauma issues. Prevention programs and promoting actions among this population are important and should be adopted.

Objetivo: Determinar los comportamientos de salud bucal, la prevalencia delesiones dentales, el nivel de información sobre los procedimientos de primeros auxilios en el caso de la avulsión dental y el conocimiento de los protectores bucales en una muestra de atletas portugueses. Materiales y métodos: estudio transversal de 1048 atletas del distrito de Viseu, Portugal. Se utilizó un cuestionario auto administrado que incluyó datos demográficos y preguntas sobre: I) hábitos de higiene bucal, II) ocurrencia de traumatismos orofaciales, III) uso de protectores bucales y IV) conocimiento de los atletas sobre el manejo de primeros auxilios en caso de avulsión dental. La comparación entre diferentes variables se realizó mediante la prueba de chi-cuadrado con el nivel de significancia establecido en p≤0.05. Resultados: La edad promedia de la muestra (76,24% hombres) fue de 18,14±8,17 años. En general, los resultados demostraron un bajo uso de hilo dental (25,48%) y un alto número de atletas (21,94%) que no habían visitado un dentista en más de un año. La prevalencia de trauma dental fue de 5,06% y las lesiones dentales más comunes que experimentaron los atletas fueron las fracturas de corona (60,38%). Casi la mitad de los participantes (45,23%) informaron que no sabían cómo actuar después de una avulsión dental. La tasa de uso de protectores bucales fue muy baja (9,73%). Hubo una relación significativa entre la prevalencia de lesiones dentales y el uso de protectores bucales (p=0,000; V de Cramer=0,145). Conclusión: la prevalencia de trauma dental en nuestra población fue baja. Un número bajo de atletas usa un protector bucal y hay una falta de conocimiento sobre temas de trauma dental. Programas de prevención y acciones de promoción entre esta población son importantes y deben ser adoptados.

Clinical and Radiographic Sequelae in Primary Teeth due to Dental Trauma

Objective: To evaluate the presence of clinical and radiographic sequelae in primary teeth affected by dental trauma and its association with age at the time of trauma in children attended at a Public Higher Education Institution. Material and Methods: This is a longitudinal clinical study, in which 229 patients with history of dental trauma in primary teeth were examined, totaling 390 traumatized teeth. Relative frequency analysis was used, and for associations, the Chi-square test was used to verify the relationship of age at the time of trauma with variables such as type of trauma. Results: The most prevalent age group was over 24 months, and fall from own height as the main etiological factor; 71.0% of traumas had involvement of 2 teeth, 9.5% had history of anterior trauma and 66.6% of traumas involved supporting tissues. Regarding the type of injury to dental tissue, the most prevalent was enamel fracture (58.3%) and to periodontium, lateral dislocation (30.8%). Children older than two years had less trauma related to dental tissue (p<0.01), higher number of injuries to the periodontium (p=0.03); and most of them did not present extra-oral changes associated with trauma (p=0.01). During the 12- month period, 325 teeth were examined, and the most frequent clinical sequelae observed was crown discoloration. In the radiographic evaluation, inflammatory root resorption was the most prevalent. Conclusion: Children older than two years presented more injuries to the periodontium. After 12 months, the main clinical sequelae observed was enamel discoloration and the main radiographic sequelae was inflammatory root resorption.

Avaliação penal de lesões dentais por peritos odontolegistas de Instituto Médico Legal - Brasil / Evaluación penal de lesiones dentales por expertos odontolegistas de Instituto Médico Legal - Brasil / Assessment of dental injuries by forensic odontology experts from the Legal Medicine Institute, Brazil

Introdução: o Código Penal Brasileiro tipifica, em seu artigo 129, o crime de lesão corporal como sendo a ofensa à integridade corporal ou a saúde de outrem. As penas previstas para este crime são graduadas de acordo com o resultado gerado pela lesão, sendo este estabelecido por meio do exame pericial requisitado pela autoridade competente. As lesões dentais são frequentes neste tipo de exame, sendo que as suas resultantes, expressas no Código Penal Brasileiro, são muito discutidas no âmbito pericial, existindo muitas divergências entre examinadores distintos. Objetivo: verificar a interpretação penal de lesões em dentes ântero-superiores por Peritos Oficiais Odontolegistas do Instituto Médico Legal Nina Rodrigues (Salvador, Bahia, Brasil). Métodos: foram analisados 2 738 laudos emitidos no período de janeiro de 2007 a dezembro de 2011, por estes peritos nesse intervalo de cinco anos. O critério de inclusão foi a descrição de acometimento de dente permanente na região ântero-superior e o critério de exclusão foi o não enquadramento com segurança em algum tipo de lesão especificada. A coleta de dados foi feita por um único indivíduo, o qual teve acesso aos laudos. As lesões dentais descritas nos laudos foram classificadas e codificadas, de forma a facilitar as anotações e os estudos estatísticos por meio do teste do Qui-Quadrado e teste Kappa (software R, versão 2.15.2, R Development Core Team, 2012) (p≥ 0,05). Resultados: dos 2 738 laudos, 277 atenderam os critérios de inclusão, em que 32,16 porcento descreviam fraturas dentais coronárias simples, 31,72 porcento como fraturas complexas e 36,12 porcento como avulsão. Os resultados obtidos apresentaram uma forte associação entre o perito examinador e a resultante penal estabelecida, na análise de lesões dentais. Conclusão: conclui-se que a avaliação penal das lesões dentais mostrou-se fortemente subjetiva, sendo necessários maiores estudos e discussões a respeito do tema, de forma a minimizar a subjetividade(AU)

Introducción: el Código Penal brasileño tipifica en su artículo 129, el delito de lesiones corporales como la ofensa a la integridad corporal o la salud de los demás. Las penas por este delito se clasifican de acuerdo con los resultados generados por la lesión, que se establece a través de un examen forense ordenado por la autoridad competente. Lesiones dentales son comunes en este tipo de examen, y del análisis de sus resultados a partir del Código Penal brasileño, es tema de frecuentes debates entre expertos forenses, con muchas divergencias entre los distintos examinadores. Objetivo: investigar la interpretación penal de las lesiones en los dientes anteriores superiores por expertos Oodontolegistas Oficial Forense Instituto Nina Rodrigues (Salvador, Bahia, Brasil). Métodos: se analizaron 2 738 informes emitidos entre enero de 2007 y diciembre de 2011, por los expertos en un intervalo de cinco años. El criterio de inclusión fue la descripción de la afectación de los dientes permanentes en la región anterior superior y el criterio de exclusión fue no haber implicación segura en algún tipo de lesión especificada. La reunión de datos fue hecha por un solo individuo, que tuvo acceso a los informes. Lesiones dentales que se describen en los informes fueron clasificadas y codificadas con el fin de facilitar las notas y estudios estadísticos mediante la prueba de chi cuadrado y la prueba de Kappa (software R, versión 2.15.2, Core Development Team R, 2012) (p≥ 0,05). Resultados: de los 2 738 informes, 277 cumplieron con los criterios de inclusión, en los cuales 32,16 por ciento describe fracturas dentales simples coronarias, 31,72 por ciento fracturas complejas y 36,12 por ciento como avulsión. Los resultados muestran una fuerte asociación entre el experto forense y criminal establecido que resulta en el análisis de las lesiones dentales. Conclusiones: se concluye que la evaluación penal de lesiones dentales era fuertemente subjetiva, lo que requiere más estudios y debates sobre el tema, con el fin de reducir al mínimo la subjetividad(AU)

Introduction: Article 129 of the Brazilian Penal Code defines the crime of bodily harm as damage to the physical integrity or the health of others. Penalties for this crime are graded in keeping with the consequences of the injury, determined by forensic examination indicated by the corresponding authority. Dental injuries are common in this type of examination, and analysis of results based on the Brazilian Penal Code is the object of frequent debate among forensic experts, with many divergences between the various examiners. Objective: Analyze the penal interpretation of injuries to upper front teeth provided by official forensic odontology experts from Nina Rodrigues Forensic Institute (Salvador, Bahia, Brazil). Methods: Analysis was conducted of 2 738 expert reports issued in the five-year period extending from January 2007 to December 2011. The inclusion criterion was description of injury to permanent upper front teeth, whereas the exclusion criterion was lack of certainty as to the consequences of the injury specified. Data were gathered by a single individual, who had access to the reports. The dental injuries described in the reports were classified and encoded to facilitate annotation and the performance of statistical studies based on chi-square estimation and the kappa test (R software version 2.15.2, R Core Development Team, 2012) (p≥ 0.05). Results: Of the 2 738 reports, 277 met the inclusion criterion. Of the injuries described therein, 32.16 percent were classified as simple dental crown fractures, 31.72 percent as complex fractures, and 36.12 percent as avulsions. Results show the close relationship between forensic experts and criminal investigators in the analysis of dental injuries. Conclusions: Penal assessment of dental injuries was markedly subjective, requiring further study and discussion to minimize such subjectivity(AU)

Evaluation of cases of concussion and subluxation in the permanent dentition: a retrospective study

Abstract Objectives This study evaluated the evolution of cases of concussion and subluxation through a retrospective study of 20 years. Material and Methods Were examined clinical and radiographic records of 1,309 patients who underwent treatment of dentoalveolar trauma in the discipline of Integrated Clinic of the School of Dentistry of Araçatuba, UNESP, of which we selected 137 whose patients had concussion and subluxation injuries, with average age of 23.3 (SD - 10.96). The variables collected were: gender, age, history of previous and actual trauma, treatments performed, the presence of necrotic pulp, and time elapsed until the same trauma. The concussion and subluxation groups were subjected to statistical analyses using the SPSS 16.0 version software (α=0.05), Chi-square, and t-tests. Results Of the 301 teeth involved, 49 (16.3%) suffered concussion and 252 (83.7%), subluxation, being the upper anterior teeth the most affected (75.1%) for both conditions. Subluxation and concussion traumas were more prevalent in men aged 10 to 20 years, most caused by cycling accidents (36.2%). There was a concomitant presence of crown fracture in 21% of cases of concussion and 34.7% of subluxation. Pulp necrosis was detected in 16.3% (concussion) and 27.1% (subluxation) (p=0.12), and most occurred within 6 months after the trauma (p=0.29). The pulp necrosis shows a positive correlation with motorcycle accidents (p=0.01), direct impact (p≤0.0001), crown fracture with pulp exposure (p≤0.0001), darkening of the crown (p=0.004) and spontaneous pain (p≤0.0001); and negative correlation with indirect impact (p≤0.0001). Conclusions Although concussion and subluxation traumas are considered of minor degrees, they must be monitored, since the possibility of pulp necrosis exists, and its early treatment favors a good prognosis.

Prevalence and etiology of dental trauma in schoolchildren aged 6 to 12 years

Aim: To investigate the prevalence and etiological factors of dental trauma in school-age children aged 6 to 12 years. Methods: A study was developed in children and adolescents between the ages of 6 and 12 of both genders enrolled in 3 municipal public schools. An oral examination of the permanent or deciduous incisors was performed, if they were still present in the oral cavity, to evaluate the presence of dental trauma, need for treatment and sequels, and the method of examination and classification of dental trauma of O'Brien. Results: The prevalence of dental trauma was 4.03% (n=29). The most verified traumas were enamel crack / enamel fracture and enamel / dentin fracture without pulp exposure. It was observed that the most affected teeth were the permanent upper central incisors and the age at which trauma was most observed was 11 years, the main etiological factor was fall from a height, in 65.3% of schoolchildren (n=19). Conclusion: The prevalence of dental trauma was 4.03%, with no statistically significant difference between genders. The permanent right upper central incisor was the most affected, occurring predominantly at home and at school. The dissemination of information about dental trauma and emergency protocols to parents and teachers need to be encouraged

Retrospective Study of Traumatic Dental Injuries of Patients Treated at a Dental Trauma Clinic in Santiago, Chile / Estudio retrospectivo de Casos Atendidos en Clínica de Traumatología Dentoalveolar en Santiago, Chile

ABSTRACT: The aim of this study was to carry out a retrospective study of cases seen at the Child and Adult Dental Traumatology Clinic, Faculty of Dentistry, Universidad de Chile, Santiago. A retrospective study was carried out analysing the records of patients seen at the Dental Traumatology Clinic, Faculty of Dentistry, Universidad de Chile from January 2012 to March 2017. The inclusion criteria was that patient complaint was due to dental trauma. Data were tabulated indicating age and sex of the patient, cause, day, and tooth involved and the initial diagnosis of the dental trauma. Chi-square, Shapiro Wilk normality test and Mann-Whitney test were used for frequency analyses. A total of 117 dental records were analysed, 90 of these met the inclusion criteria. The age range of the sample was 5 to 60 years, and the average age was 14.3 years. Most injuries occurred in patients during the first and second decades of their life. Of the patients, 59.3 % were men and 40.7 % were women. The most frequent dental traumas were complicated and uncomplicated crown fractures, followed by root fractures. In the majority of the cases analysed, only one tooth was affected, and the tooth most frequently traumatized was the right upper central incisor, followed by the left upper central incisor. The most frequent dental trauma of the cases treated at the Child and Adult Dental Traumatology Clinic, Faculty of Dentistry, Universidad de Chile, Santiago, between 2012 and 2017 were crown fractures.

RESUMEN: El objetivo fue realizar un estudio retrospectivo de los casos que acuden a la clínica de Traumatología Dentoalveolar (TDA) Pediátrica y del Adulto de la Clínica de Odontología de la Universidad de Chile. Se realizó un estudio retrospectivo analizando las fichas de pacientes atendidos en la Clínica de TDA de la Facultad de Odontología, Universidad de Chile desde enero 2012 hasta marzo 2017. El criterio de inclusión fue motivo de consulta por traumatismo dentoalveolar inmediato. Se tabularon datos consignando sexo y edad del paciente, causa, día, diente involucrado y diagnóstico inicial del TDA. Para los análisis de frecuencia se utilizó Chi-cuadrado, el test de normalidad de Shapiro Wilk y test de Mann-Whitney. Se analizaron un total de 117 fichas, donde 90 cumplieron con los criterios de inclusión. El rango de edad de la muestra fue de 5 a 60 años, con un promedio de 14,3 años. Siendo la primera y la segunda década de vida donde ocurren con mayor frecuencia los traumatismos. El 59,3 % eran hombres y 40,7 % mujeres. El TDA más frecuente fueron las fracturas coronarias complicadas y no complicadas, seguido por fracturas radiculares. En la mayoría de los casos analizados sólo un diente se encontraba afectado. El diente más frecuentemente traumatizado fue el incisivo central superior derecho, seguido por el izquierdo. Las causas más frecuentes de traumatismo fueron por caída y golpe. De los casos atendidos en la clínica de TDA de la Universidad de Chile entre 2012 y 2017 el traumatismo más frecuente es la fractura coronaria.

Lesões endodôntico-periodontais: do diagnóstico ao tratamento / Endodontic-periodontal lesions: from diagnosis to treatment

As doenças endodôntico-periodontais até hoje representam um desafio para o cirurgião-dentista. Uma única lesão pode apresentar sinais de envolvimento endodôntico e periodontal, o que pode induzir o cirurgião-dentista à realização de um tratamento inadequado. O diagnóstico da doença geralmente é difícil devido às íntimas conexões anatômicas e vasculares entre a polpa e o periodonto. Além disso, o fato dessas doenças serem frequentemente avaliadas como entidades diferentes dificulta ainda mais o diagnóstico. A avaliação do prognóstico e o tratamento também podem ser desafiadores. Microrganismos, trauma, reabsorções radiculares e perfurações estão entre os fatores etiológicos e contribuintes para o desenvolvimento e progressão da doença. Frequentemente, o dente acometido por uma lesão endodôntico-periodontal é condenado devido à falta de conhecimento do cirurgião-dentista. É fundamental reconhecer a relação entre as doenças para o manejo adequado da lesão. A realização de um diagnóstico preciso é um determinante crítico do resultado do tratamento. O presente estudo revisou a literatura relacionada à etiologia, classificação e tratamento dessa doença. A revisão foi feita através de consulta ao pubmed e foram incluídos artigos publicados entre 1974 e 2016. Os termos "lesão endoperio", "lesão endodôntico-periodontal" e "doença endodônticoperiodontal" foram as palavras-chave utilizadas no levantamento. Concluiu-se que é necessário abordar e tratar de forma multidisciplinar, sendo o tratamento direcionado à causa principal diagnosticada. Na lesão combinada verdadeira, o tratamento endodôntico deve preceder o periodontal.(AU)

Until these days endodontic-periodontal lesions remains a challenge to dentists. A single lesion may show signs of endodontic and periodontal involvement, which can induce the dentist to perform an inadequate treatment. The diagnosis is often difficult due to the intimate anatomical and vascular connections between the pulp and periodontium. Furthermore, the fact that these diseases are often evaluated as different entities complicates the diagnosis. Prognosis assessment and treatment can also be challenging. Microorganisms, trauma, perforations and radicular resorptions are among the etiologic factors and contributors to the development and progression of the disease. Often the tooth affected by an endodontic-periodontal lesion is doomed due to lack of knowledge of the dentist. It is important to recognize the relationship between the diseases for the proper management of the injury. This study reviewed the literature related to the etiology, classification and treatment of this disease. The reviewwas done through consultation with pubmed and articles published between 1974 and 2016 were included. The terms "endo perio lesion", "endodontic periodontal lesion" and "endodontic periodontal disease" were the key words used in the survey.It was concluded that it must be addressed and treated in a multidisciplinary way. Treatment should be directed to the main cause. In true combine lesion, endodontic treatment should precede periodontal.(AU)

Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study

Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p < 0.001), whereas radiographic sequelae did not (0.236). The predicted risk of color change was 29.0% (95%CI 19-41) for teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

Tooth injury in anaesthesiology / Lesão dentária na anestesiologia

BACKGROUND AND OBJECTIVES: Dental injury is the most common complication of general anaesthesia and has significant physical, economic and forensic consequences. The aim of this study is to review on the characteristics of dental injury associated with anaesthesiology and existing methods of prevention. CONTENTS: In this review, the time of anaesthesia in which the dental injury occurs, the affected teeth, the most frequent type of injury, established risk factors, prevention strategies, protection devices and medico-legal implications inherent to its occurrence are approached. CONCLUSIONS: Before initiating any medical procedure that requires the use of classic laryngoscopy, a thorough and detailed pre-aesthetic evaluation of the dental status of the patient is imperative, in order to identify teeth at risk, analyze the presence of factors associated with difficult intubation and outline a prevention strategy that is tailored to the risk of dental injury of each patient.

JUSTIFICATIVA E OBJETIVOS: A lesão dentária é a complicação mais comum da anestesia geral e apresenta importantes consequências físicas, econômicas e médico-legais. O objetivo deste estudo é fazer uma revisão sobre as características da lesão dentária associada a anestesiologia e os métodos de prevenção existentes. CONTEÚDO: Nesta revisão são abordados o momento da anestesia em que a lesão dentária ocorre, os dentes acometidos, o tipo de lesão mais frequente, os fatores de risco estabelecidos, as estratégias de prevenção, os dispositivos de proteção e as implicações médico-legais inerentes à sua ocorrência. CONCLUSÕES: Antes de iniciar qualquer procedimento médico que exija o recurso à laringoscopia clássica é imperativa uma avaliação pré-anestésica minuciosa e detalhada do estado dentário do doente, de forma a identificar os dentes em risco, analisar a presença de fatores associados a dificuldades de intubação e delinear uma estratégia de prevenção que seja adaptada ao risco de lesão dentária de cada doente.

Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children

Monitoring traumatic dental injury (TDI) in primary teeth through epidemiological cross-sectional surveys provides descriptive information relevant to the development of public policies focused on the prevention of such injuries for the target population. The aim of this study was to assess the prevalence of TDI in 5- to 6-year-old Brazilian children and its association with biological and socioeconomic factors. A total of 684 children aged 5 to 6 years old, from 11 public schools in the city of Barueri (Brazil) were evaluated. Clinical examinations were carried out in the schools, by two trained and calibrated examiners. Gauze and a mouth mirror were used for the examinations. The reported TDIs were classified according to the Andreasen (2007) criteria for primary teeth. The results showed that 52.3% of the children had TDI. Enamel fracture (63.4%) was the most frequently observed sign of TDI, and the most affected teeth were the primary maxillary central incisors (26.9% maxillary right central incisor and 24% maxillary left central incisor). There was no association between the presence of TDI and biological or socioeconomic factors. In conclusion, the prevalence of TDI was high and had no statistically significant association with biological and socioeconomic factors.

Prevalence, Etiology and Treatment Needs of Traumatic Dental Injuries in Schoolchildren aged 12 years at Brasília, Brazil

To investigate the prevalence of dental trauma, its causes, sites and age at the occurrence of injuries and treatment needs related to dental trauma in schoolchildren aged 12 years at Brasília, DF, Brazil.Material and Methods:A cross-sectional, population-based study was conducted on a sample of 1,389 schoolchildren of public and private schools. Two questionnaires were used: one targeted to parents/legal caretakers and the other responded by the schoolchildren. The criteria for classification of trauma used in the ChildrenÆs Dental Survey in the United Kingdom were adopted. The examinations were performed by two trained and calibrated examiners (inter and intra-examiner kappa: 0.85 to 1.00). The association between dental trauma and the study variables was evaluated by the chi-square test.Results:A total of 1,445 students were examined, with a response rate of 80.48%. Prevalence of 14.63% (public schools) and 23.40% (private schools) of dental trauma was found...(AU)

The most common cause of dental trauma was fall (7.87%), followed by collision with objects or persons(5.03%), inadequate use of the teeth (2.33%), sports accidents (2.11%) and car accidents (0.66%). It was observed that 256 students presented injury to at least one tooth, with predominance of enamel fracture (88.67%) followed by discoloration (5.47%), enamel and dentin fracture (3.90%) and tooth loss (1.95 %). The teeth most affected by trauma were the maxillary central incisors. The accidents occurred predominantly at home (44.25%) and at the school (26.99%). Only 28.51% had received treatment for the injuries.Conclusion:Dental trauma in the study population was significant, presenting diverse etiology and expressive treatment needs, indicating the importance of preventive programs to inform the population on the possible complications after trauma, as well as the need to follow-up traumatized teeth to avoid subsequent problems...

Knowledge level of physical educators regarding dental trauma in a brazilian subpopulation

To evaluate the knowledge of physical education professionals and athletes about dental trauma. The state of Paraiba Brazil has 3.9 million inhabitants and innumerable centers of physical activities.Material and Methods:The sample consisted of 103 physical education professionals and 101 gym-goers, randomly chosen, in the city of João Pessoa, Brazil. The participants filled out a specific questionnaire for each group (teachers and students) regarding their knowledge about dental trauma and how they would proceed in such situations. Descriptive statistics and the chi-square and FischerÆs exact tests were used at 1% significance to test for significant differences in the sample.Results:Most of the professionals did not have adequate knowledge about the concept of dental avulsion (77.7%), and only 14 of them reported having sought a dentist after an avulsion. Of the students, 10.9% reported having suffered any dental injury during physical activity, and only 4 of them reported having sought a dentist soon after the accident. Regarding the most appropriate means to transport an avulsed tooth, saline solution was most cited by both the physical education teachers (56.3%) and the students (60.4%).Conclusion:This study revealed a level of lay knowledge regarding dental trauma; the number of participants who knew the correct way to act in such situations was small. For most of the individuals surveyed, the dissemination of information on the subject through educational programs would contribute to knowledge on how to address dental trauma...

Traumatismo dentario.15 a 18 años. Escuela Militar Camilo Cienfuegos. Sancti Spíritus 2011 / Dental trauma between 15 - 18 years old. Camilo Cienfuegos Military School. Sancti Spíritus 2011

Fundamento: los traumatismos dentarios representan la segunda causa de atención odontopediátrica que afecta la población menor de 19 años. Objetivo: identificar el traumatismo dentario en la población de 15 a 18 años de la Escuela Militar Camilo Cienfuegos de Sancti Spíritus. Metodología: se realizó un estudio descriptivo. La población fueron 417 estudiantes, de ellos se obtuvo una muestra de 121 adolescentes con traumas dentarios, con previo consentimiento informado. Las variables: edad, sexo, etiología y tipo de trauma, así como el diente afectado, factores de riesgo y el tratamiento recibido. Para el procesamiento de la información se utilizó la frecuencia absoluta y relativa. Resultados: el grupo de edad más afectado fue el de 15-16 años con predominio del masculino. El diente más afectado fue el incisivo central superior derecho y la fractura no complicada de corona tuvo mayor incidencia seguido de la infracción o infractura del esmalte. Conclusiones: los traumatismos dentales se presentaron en la mayoría de los estudiantes de 15-18 años que a su vez no recibieron atención estomatológica lo que afecta la conservación del órgano dentario.

Backgroud: Dental traumas represents the second cause of pediatric dentistry care affecting the population under 19 years old. Objective: to identify the dental traumas in the population between 15-18 years old at Camilo Cienfuegos Military School from Sancti Spíritus city. Methodology: a descriptive study was carried out. The population was composed by 417 students with a simple of 121 adolescents with dental trauma with a previous consent. The variables were age, sex, etiology and type of trauma as well as the tooth affected, risk factors and treatment received. For the processing of the information the absolute and relative frequency were used. Results: the age group mostly affected was between 15-16 years old, prevailing males. The most affected tooth was the central right upper incisive and the non complicated fracture of crown had the most incidence followed by the infraction of the enamel. Conclusions: Dental traumas were present in the majority of the students between 15-18 years old and at the same time they did not receive dental care which affects greatly the preservation of the dental organ.

Traumatismo dentário e impacto na qualidade de vida de adolescentes brasileiros e suas famílias / Traumatic dental injury and impact on quality of life among Brazilian adolescents and families

O objetivo do estudo foi avaliar o impacto dos traumatismos dentários na qualidade de vida relacionada à saúde bucal (QVRSB) de adolescentes brasileiros e suas famílias. Foi realizado um estudo de base populacional com adolescentes de 11-14 anos de idade e suas famílias, no município de belo Horizonte, Brasil. Este estudo será apresentado em formato de dois artigos científicos. O primeiro artigo descreve um estudo caso-controle, aninhado a um estudo transversal, com uma amostra de 1.215 adolescentes. A QVRSB foi mesurada por meio da versão brasileira do Child perceptions Questionnaire (CPQ 11-14) - Impact Short Form (ISF:16), autoaplicada aos adolescentes. Foi conduzida a análise Two Step Clustre para definir os casos e controles baseado nos escores...

Estudo transversal em escolares de 12 anos de idade sobre a necessidade de tratamento, etiologia e ocorrência de traumatismo dentário em Montes Claros, Brasil / Cross-sectional study on treatment needs, etiology and occurrence of traumatic dental injuries among 12-year old schoolchildren in Montes Claros, Brazil

Objetivo: Avaliar a necessidade de tratamento, etiologia e o local de ocorrência do acidente que resultou em traumatismo dentário nos incisivos permanentes de escolares com 12 anos de idade, na cidade de Montes Claros.Materiais e Métodos: Para cálculo amostral utilizou-se a variabilidade populacional máxima (0,25), com nível de confiança de 95%, Z α /2 = 1,96; erro de estimação de 4%, d = 0,03. O tamanho da amostra mínima calculada foi 546 crianças, sendo acrescido de 10%, totalizando 638 crianças, selecionadas aleatoriamente nas escolas públicas e particulares. Em um primeiro momento foi investigada a prevalência de traumatismo dentário por meio de exames clínicos adotando a classificação Children ́s Dental Health Survey do UK, realizado por um dentista treinado e calibrado (Kappa= 0,87 e 0,96). As crianças foram examinadas naescola sob luz artificial. Após os exames foi aplicado um questionário semi-estruturado direcionado às crianças a fim de investigar o conhecimento da ocorrência de traumatismo dentário, etiologia e local do acidente. Para obtenção dos resultados foi realizada análise descritiva e univariada (teste qui-quadrado). Resultados: Aprevalência de traumatismos dentários foi de 34,9% em 605 exames clínicos realizados (94,8%). O traumatismodentário estava presente em 279 incisivos permanentes. A necessidade de tratamento restaurador foi observadaem 35,8% dentes (n= 100), sendo que 13,97% deles apresentavam tratamento restaurador (n= 39). O principal fator etiológico foi a queda (49,7%) e a maioria dos escolares relatou que o traumatismo dentário havia ocorrido em casa (48,2%).Conclusão: A necessidade de tratamento restaurador devido ao traumatismo dentário foi elevada e o principal fator etiológico foram as quedas ocorridas em casa.