Evaluating intrusive injuries in primary dentition from computed tomographic scans: a preliminary report.

CONTEXT: Children sustaining maxillofacial trauma may undergo computed tomographic (CT) examination to exclude potential complications, which pave way for spread of infection into the meningeal region. Following treatment, these children report for management of their dental injuries as out-patients for which a separate conventional radiographic examination is usually done. The usefulness of the initial maxillofacial CT scan in evaluating dental injuries needs to be assessed so as to possibly avoid children from being subjected to a separate radiographic examination. AIMS: The objective of this study was to evaluate the ability of pediatric dentists to assess intrusive injuries in primary dentition from preexisting maxillofacial CT scans of children. SETTINGS AND DESIGN: Hospital based cross-sectional study. SUBJECTS AND METHODS: Among 70 pediatric patients who were admitted following maxillofacial injuries, 10 children underwent CT examination. CT segments displaying the tooth bearing portions of the jaw were reformatted using the Dentascan software and three precalibrated pediatric dentists clinically examined the selected children and with the use of Dentascan based CT sections assessed the relative position of the intruded teeth in relation to the permanent successor and planned treatment for each individual intruded tooth. STATISTICAL ANALYSIS: Fleiss Kappa statistics. RESULTS: There was perfect agreement between the interpretations of all participants (κ = 1.0000, 95% confidence interval = 0.6861-1.3139) and the interpretations of each participant with the "gold standard" evaluator (κ = 1.000). CONCLUSION: Maxillofacial CT scans made to assess maxillofacial injuries in children can also be reliably used for assessing intrusive injuries in primary dentition.

Pulse granuloma as a complication following dental trauma in children.

Contamination and subsequent retention of foreign bodies within wound surfaces may negatively influence healing following maxillofacial injuries. Larger foreign bodies that produce embedded or impalement injuries of soft tissues are easily detected. However, smaller contaminants, such as sand, gravel, food particles, wood splinters, and glass fibers, may not be easily identified in the initial examination, and their remnants may remain within the injury site even after debridement. Tissue reactions depend on the host response, type of foreign body, and nature of the wound surface. The purposes of this report are to: (1) detail the diagnosis and management of a peripheral pulse granuloma following retention of food particles within gingival sulci during a dental injury; and (2) provide a brief review of the diagnosis of foreign body-induced granulomas following maxillofacial injuries in children.

A comparative evaluation of root canal length measurement techniques in primary teeth.

PURPOSE: The purpose of this 3-staged, in vivo, crossover study was to comparatively evaluate the accuracy of radiograph-based and apex locator-based measurements of working length in primary molars with physiological root resorption. METHODS: Endodontic access cavity preparations were performed on 13 primary molars in 10 cooperative pediatric dental outpatients who met the selection criteria. Calibrated investigators estimated the root canal length in a total of 30 canals in these 13 primary molars using both apex locators and radiographs. Following determination of working length, the teeth were extracted for in vitro measurement of the actual root canal length. The root canal lengths obtained through these 3 techniques were compared statistically and assessed for the presence of significant differences. RESULTS: Significant correlation (intraclass correlation=0.99, P<.001) could be detected between working length measurements obtained using both the techniques and direct measurements of root canals. Acceptable measures of working length (+1 mm of actual length) could be obtained in 97% and 93% of canals using apex locators and radiographs, respectively. CONCLUSION: Apex locators can be considered a viable substitute for radiographs in estimating working length during pulpectomies of primary teeth.

Neonatal sublingual traumatic ulceration - case report & review of the literature.

Traumatic ulceration of the ventral surface of the tongue is a rare condition observed in neonates with natal or neonatal teeth. These lesions are initiated and exacerbated by the continuous contact between the tongue and natal/neonatal teeth during physiologic activities such as suckling and swallowing, which in turn may interfere with proper feeding, putting the neonate at risk for nutritional deficiencies. Sublingual traumatic ulcers may also be the presenting sign of an underlying developmental or neurologic disorder. This case report details the management of a sublingual traumatic ulcer in a 20-day-old infant, along with a review of the treatment modalities available for management of this condition, especially in neonates.