Epidemiology and severity of traumatic dental injuries in permanent teeth: A 20-year retrospective study.

This study aimed to assess the traumatic dental injuries (TDIs) in permanent dentition among patients who attended at the outpatient clinic of a Brazilian dental school, during the last 20 years, and to investigate factors associated with the severity of these injuries. Clinical records of patients who attended a specialized center for dental trauma care in Brazil presenting at least one TDI in a permanent tooth, between the years 2000 and 2019, were reviewed. The data recorded were sex, age, affected arch, etiology, number, and type of the teeth affected, and classification and severity of the TDIs. The diagnosis and classification of the TDIs were based on the guidelines of the International Association of Dental Traumatology (IADT). The severity of each patient's injuries was defined as mild, moderate, or severe. Descriptive statistics, chi-square and multinomial regression analyses were used to evaluate the results. The significance level was set at 5%. A total of 837 clinical records were included, totaling 2357 teeth. Males were more prevalent than females. The patients' age ranged from 5 to 71 years. The most common traumas were avulsion (n=512) and uncomplicated enamel-dentin fracture (n=488). Univariate analyses showed that there was a statistically significant association between age group (p=0.004), etiology (p=0.000) and number of teeth affected (p=0.000) with severity of dental trauma. In conclusion, TDIs that occurred in Piracicaba and region are epidemiologically similar to those found worldwide, and that more severe injuries are related to age range, etiology and number of teeth affected.

Factors associated with the survival of primary maxillary anterior teeth after intrusive luxation: a retrospective longitudinal study.

PURPOSE: To evaluate the survival rate of primary maxillary anterior teeth following intrusive luxation and identify associated factors. METHODS: A retrospective longitudinal study was conducted at a primary dental trauma centre using 88 dental records of children with intrusive luxation between 2007 and 2018. The variables of interest were time the tooth remained in the alveolus, degree of intrusion, accentuated overjet, lip protection, visible plaque, compromised germ of the permanent successor, clinical signs of infectious and inflammatory processes, endodontic treatment, pulp canal obliteration, sex, age at the time of trauma, family income, mother's schooling, and immediate care. Descriptive, bivariate, and Cox regression analyses were performed (p < 0.05; 95% CI). RESULTS: The 88 dental records of children with intrusive luxation included 128 teeth. Survival rate throughout the follow-up period was 65.6% (n = 84). Age older than three years and eight months (HR 2.28; 95% CI 1.04-4.99; p = 0.039), the development of an infectious process (HR 3.51; 95% CI 1.39-8.86; p = 0.008), development of an inflammatory process (HR 2.35; 95% CI 1.17-4.71; p = 0.016) and compromised germ of the permanent successor (HR 4.38; 95% CI 1.99-9.61; p < 0.001) were associated with a lower survival rate of intruded primary maxillary anterior teeth. CONCLUSION: The survival rate during the follow-up period of intruded primary maxillary anterior teeth was considered high. A significantly lower survival rate was associated with age, the occurrence of an infectious process and inflammatory process, and the compromised germ of the permanent successor.

Sinopsis de la Situación de Salud Oral en Chile - Parte IV: Traumatismo Dentoalveolar / Synopsis of the Oral Health Situation in Chile - Part IV: Traumatic Dental Injuries

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.

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.

Nivel de información sobre protectores bucales y avulsión dentaria en entrenadores deportivos / Level of information on oral protectors and dental avulsion in sport trainers

Introducción: La práctica deportiva conlleva un alto riesgo de traumatismos dentoalveolares, por lo que es necesario que los entrenadores y deportistas conozcan sobre el uso adecuado de los protectores bucales y el procedimiento de urgencia ante la aparición de un trauma dental. Objetivo: Determinar el nivel de información sobre protectores bucales y avulsión dentaria en entrenadores deportivos. Métodos: Se realizó un estudio descriptivo de corte transversal, durante el mes de febrero de 2020, en la Escuela de Iniciación Deportiva Escolar Provincial Lino Salabarría Pupo de Sancti Spíritus. Para ello se seleccionó una muestra probabilística, representativa y aleatoria de 25 entrenadores de los deportes de combate y juego con pelotas, a los cuales se le aplicó una encuesta estructurada sobre protectores bucales y avulsión dentaria. Resultados: Entre los integrantes de la serie, 76 % eran universitarios y 52 % poseían más de 10 años de experiencia profesional. Asimismo, se obtuvo que 88 % recomendaran el uso del protector bucal a sus deportistas, pero la mayoría desconocía sus características, funciones y tipos, así como la conducta a seguir ante la ocurrencia de una avulsión dentaria. Conclusiones: El nivel de información sobre protectores bucales y avulsión dentaria en los entrenadores deportivos fue deficiente, lo que demostró que es necesaria la educación en dicho tema. De hecho, los estomatólogos tienen la tarea de realizar campañas para incentivar y educar en el uso de los protectores bucales y en el procedimiento correcto de urgencia si ocurriera un trauma dentoalveolar.

Introduction: The sport practice bears a high risk of dentoalveolar trauma, reason why it is necessary that trainers and sportsmen know on the appropriate use of oral protectors and the emergency procedure in view of the emergence of a dental trauma. Objective: To determine the level of information on oral protectors and dental avulsion in sport trainers. Methods: A descriptive and cross-sectional study was carried out during February, 2020, in the Lino Salabarría Pupo Provincial Initiation Sport School in Sancti Spíritus. A probabilistic, representative and random sample of 25 trainers from combat sports and ball games was selected, to whom an structured survey on oral protectors and dental avulsion was applied. Results: Among the members of the series, 76 % were university students and 52 % had more than 10 years of professional experience. Also, it was obtained that 88 % recommended the use of the oral protector to their sportsmen, but most of them ignored its characteristics, functions and types, as well as the way to behave considering the occurrence of a dental avulsion. Conclusions: The level of information on oral protectors and dental avulsion in the sport trainers was poor, what demonstrated that the education on this topic is necessary. In fact, dentists have the task of carrying out campaigns to motivate and educate in the use of oral protectors and in the correct emergency procedure in case a dentoalveolar trauma happened.

Traumatic injuries in primary dentition and their immediate and long-term consequences: a 10-year retrospective study from the State University of Rio de Janeiro, Brazil.

BACKGROUND/AIM: Dental trauma is a highly prevalent problem worldwide. The aim of this study was to describe characteristics of trauma to anterior primary teeth and its sequelae for primary and successor teeth over a 10-year period of assistance at the paediatric dental traumatology clinic in the State University of Rio de Janeiro, Brazil. MATERIALS AND METHODS: The data were obtained from the dental records of children assisted from 2006 to 2016. Inclusion criteria were trauma to anterior primary teeth; aged <1 to 9 years at the time of trauma; and at least one follow-up appointment. The data concerning traumatized teeth, child's age, soft tissue injuries, types of traumatic dental injuries and sequelae in both dentitions were collected. RESULTS: Of the 1230 dental records, 483 (39.3%) were eligible, consisting of 815 teeth. The mean age at the time of trauma was 37.4 months (239 males and 244 females). The most important characteristics were: tooth 51 was most affected; falls, at home, on a ceramic floor, were the main cause; gingival laceration, enamel fracture and intrusive luxation were the most frequent types of trauma; premature tooth loss of primary teeth and enamel discoloration in their successor were the most frequent sequelae; and injuries in the periodontal tissue were demonstrated as the highest risk for sequelae in successors (OR, 3.798; p< 0.001). CONCLUSIONS: Most traumatic injuries occur in young children, in their home environment. Consequences for the primary teeth were more frequent compared to the permanent successor tooth. Traumatized primary teeth involving periodontal tissue have more chances to result in sequelae to their successor teeth.

How does orofacial trauma in children affect the developing dentition? Long-term treatment and associated complications.

Each year, millions of children are injured and live with the consequences of those injuries. Through infancy and childhood, orofacial trauma caused by falls or being struck by or against objects occurs in children. The long-term implications on the developing permanent teeth are little known, even when the oral region is the second most frequently injured body area in children under 6 years of age. During this period, the developing permanent teeth may be directly involved after trauma, causing mild to severe hypoplasia, displacement, damage to the tooth germ, or an extended range of morphofunctional disturbances. In some cases, the effects of oral and dental injuries caused by trauma appear later with the eruption of the permanent incisors when ectopic eruption, malalignments, and other developmental disturbances become visible. Therefore, long-term follow up of the patient in order to diagnose and treat associated complications becomes essential. Critical points for facing the consequences of orofacial trauma on the developing dentition are to recognize the impact of orofacial trauma in young children and the dentist's role in providing anticipatory guidance to parents and health care professionals, differentiate between mild and severe disturbances affecting the developing permanent teeth after oral injuries in early childhood, recognize the importance of follow-up controls, and recognize the importance of early referral to a pediatric dentist and orthodontist for diagnosis and treatment planning.

Atitudes imediatas dos praticantes de artes marciais frente à avulsão dentária / Immediate attitudes of martial arts practitioners against dental avulsion

Objetivo: O objetivo do presente estudo foi avaliar o nível de conhecimento dos praticantes de artes marciais da cidade de Juazeiro do Norte, Ceará, sobre avulsão dentária e como proceder mediante aos cuidados imediatos frente à ocorrência de avulsão dentária.Métodos: Um estudo transversal de carácter exploratório foi realizado com uma amostra de conveniência de 60 praticantes de artes marciais. As informações sobre avulsão dentária, experiências e condutas emergenciais frente a avulsão dentária e uso de protetores bucais e equipamentos de proteção foram coletadas através de um questionário autoaplicado. As análises dos dados envolveram estatísticas descritivas de frequência absoluta e relativa de todas as variáveis do estudo. Resultados: A média de idade dos participantes foi de 26,88 anos (DP ± 5,06), sendo 73,3% (n = 44) pertencentes ao sexo masculino. Do total de praticantes de artes marciais entrevistados, 48% praticavam Muay Thai e 18% Taekwondo. O estudo mostrou que apesar de 61,7% do total de entrevistados terem relatado saber o que era traumatismo dentário e 23,3% destes terem presenciado algum tipo de trauma dentário, 85,0% relataram não saber como proceder mediante os casos de avulsão. Entretanto, 95,0% consideraram esta informação como necessária para a prática de esportes. A maioria dos indivíduos praticantes de artes marciais (63,3%) relatou utilizar protetores bucais. Conclusão: A maioria dos praticantes de artes marciais entrevistados relatou saber o que o era traumatismo dentário, mas desconheciam como proceder diante dos casos de avulsão. A maioria dos entrevistados reconhecem a importância e afirmaram utilizar protetores bucais e equipamentos de proteção individual durante as práticas desportivas. (AU)

Aim:The present study sought to evaluate the level of knowledge of martial arts practitioners in the city of Juazeiro do Norte, Ceará, against dental avulsion and how to proceed through immediate care in the event of dental avulsion. Methods:A cross-sectional study was conducted with a convenience sample of 60 martial arts practitioners. Information on dental avulsion, experiences, and emergency behaviors against dental avulsion, as well as the use of mouth guards and protective equipment, were collected through a self-administered questionnaire. Data analysis involved descriptive statistics of the absolute and relative frequency of all variables in the study. Results: The mean age of the participants was 26.88 years (SD ± 5.06), of which 73.3% (n = 44) were males. Of the total number of martial arts practitioners, 48% practiced Muay Thai and 18% Taekwondo. The study showed that 61.7% of the respondents said they had knowledge about what dental trauma was, although only 23.3% had witnessed some type of dental trauma. In addition, 85.0% have never received guidance on how to proceed in cases of avulsion, but 95.0% consider this information to be necessary for the practice of sports. The majority of the individuals who practice martial arts (63.3%) use mouth guards. Conclusion: It was concluded that most of the martial arts practitioners interviewed in the present study do not have knowledge about dental avulsion and about the necessary immediate procedures in the event of dental avulsion. However, most of participants use mouth guards, wear personal protective equipment, and recognize the importance of these during sports practices. (AU)

Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study.

OBJECTIVE: This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors. METHODS: The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors. RESULTS: The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05). CONCLUSION: Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

A 12-Year Retrospective Study of Avulsion Cases in a Public Brazilian Dental Trauma Service.

This study assessed the epidemiological characteristics and management of the permanent teeth avulsion cases attended in a Brazilian dental trauma service from December 2005 to August 2016. A retrospective study was conducted of case records of 93 patients involving 139 avulsed teeth. Data included sex, age, trauma etiology, location of the accident, number and position of avulsed teeth, and presence and type of associated traumatic lesions. Management of the avulsed teeth was addressed as: time elapsed until teeth were retrieved from the accident's location; teeth's cleaning method and storage media; time elapsed until seeking treatment and replantation. The majority of the patients were children from 6-10 (31.2%) and 11-15 years old (26.9%). Male patients were more affected than female. Bicycle accident was the main etiological factor (31.2%). In 56 (60.2%) cases, traumatic lesions to neighboring teeth were present. In 55 (59.1%) cases, lesions to adjacent soft tissues were reported. In 82 (88.2%) cases, patients requested treatment at the same day of the accident. Sixty-four teeth (46.0%) were immediately retrieved and 28 (20.1%) were not found. Forty-two teeth (30.2%) were kept dry. Only one tooth (0.7%) was immediately replanted at the accident's site, while 51 teeth (36.7%) were not replanted. Numerous avulsed teeth were inappropriately managed and immediate replantation was not frequent. Public policies must be created to raise awareness towards the particularities of avulsion cases.

A 12-Year Retrospective Study of Avulsion Cases in a Public Brazilian Dental Trauma Service

Abstract This study assessed the epidemiological characteristics and management of the permanent teeth avulsion cases attended in a Brazilian dental trauma service from December 2005 to August 2016. A retrospective study was conducted of case records of 93 patients involving 139 avulsed teeth. Data included sex, age, trauma etiology, location of the accident, number and position of avulsed teeth, and presence and type of associated traumatic lesions. Management of the avulsed teeth was addressed as: time elapsed until teeth were retrieved from the accident's location; teeth's cleaning method and storage media; time elapsed until seeking treatment and replantation. The majority of the patients were children from 6-10 (31.2%) and 11-15 years old (26.9%). Male patients were more affected than female. Bicycle accident was the main etiological factor (31.2%). In 56 (60.2%) cases, traumatic lesions to neighboring teeth were present. In 55 (59.1%) cases, lesions to adjacent soft tissues were reported. In 82 (88.2%) cases, patients requested treatment at the same day of the accident. Sixty-four teeth (46.0%) were immediately retrieved and 28 (20.1%) were not found. Forty-two teeth (30.2%) were kept dry. Only one tooth (0.7%) was immediately replanted at the accident's site, while 51 teeth (36.7%) were not replanted. Numerous avulsed teeth were inappropriately managed and immediate replantation was not frequent. Public policies must be created to raise awareness towards the particularities of avulsion cases.

Resumo Este estudo avaliou as características epidemiológicas e de manejo dos casos de avulsão de dentes permanentes atendidos em um serviço de trauma dental de dezembro de 2005 a agosto de 2016. Foi realizado um estudo retrospectivo de 93 casos, envolvendo 139 dentes avulsionados. Os dados incluíram sexo, idade, etiologia do trauma, localização do acidente, número e posição dos dentes avulsionados e presença e tipo de lesões traumáticas associadas. O manejo dos dentes foi abordado de modo a analisar: o tempo decorrido até que os dentes fossem recuperados do local do acidente; Método de limpeza dos dentes e meios de armazenamento; Tempo decorrido até a busca por tratamento e reimplante dental. A maioria dos pacientes eram crianças de 6-10 (31,2%) e 11-15 anos (26,9%). Os pacientes do sexo masculino foram mais acometidos que do feminino. O acidente de bicicleta foi o principal fator etiológico (31,2%). Em 56 (60,2%) casos, ocorreram lesões traumáticas aos dentes vizinhos. Em 55 (59,1%) casos foram relatadas lesões de tecidos moles. Em 82 (88,2%) casos, os pacientes solicitaram tratamento no mesmo dia do acidente. Sessenta e quatro dentes (46,0%) foram imediatamente recuperados e 28 (20,1%) não foram encontrados. Quarenta e dois dentes (30,2%) foram mantidos secos. Apenas um dente (0,7%) foi imediatamente reimplantado no local do acidente, enquanto 51 dentes (36,7%) não foram reimplantados. Numerosos dentes avulsionados foram manejados de forma inadequada e o reimplante imediato não foi frequente. Devem ser criadas políticas públicas para a conscientização da população sobre as particularidades dos casos de avulsão dental.

Characteristics of Maxillofacial Trauma Among Alcohol and Drug Users.

The aim of the current study was to identify and compare the characteristics of maxillofacial trauma in alcohol and drug users with those of nonusers. A retrospective study was conducted using the medical records of patients treated for facial trauma between April 1999 and March 2012 at the Maxillofacial Surgery Division of the Piracicaba Dental School. The data were analyzed by descriptive analysis, binary logistic regression, and correlational analysis using SPSS 18.0 software. The results were considered relevant at P < 0.05. Medical records of 3724 patients with facial trauma were analyzed, of which 173 were illicit drug users and 19.36% reported alcohol intake. The use of illicit drugs was reported by 4.64%. The prevalent etiological factor among drug and alcohol users was interpersonal violence. The mandible was the face part most affected by fractures. Male patients exhibited increased odds of experiencing fractures (OR = 1.43), as did users of illicit drugs (OR = 1.62), when compared with nonusers. When faced with maxillofacial trauma, male drug users exhibited an increased chance of experiencing fractures. This knowledge should be used as a baseline to implement more efficient prevention strategies for this population.

Work absenteeism by parents because of oral conditions in preschool children.

OBJECTIVE: The aim of the present study was to evaluate the influence of oral conditions in preschool children and associated factors on work absenteeism experienced by parents or guardians. METHODS: A preschool-based, cross-sectional study was conducted of 837 children, 3-5 years of age, in Campina Grande, Brazil. Parents or guardians answered the Brazilian version of the Early Childhood Oral Health Impact Scale. The item 'taken time off work' was the dependent variable. Questionnaires addressing sociodemographic variables, history of toothache and health perceptions (general and oral) were also administered. Clinical examinations for dental caries and traumatic dental injury (TDI) were performed by three dentists who had undergone training and calibration exercises. Cohen's kappa (κ) was 0.83-0.88 for interexaminer agreement and 0.85-0.90 for intra-examiner agreement. Descriptive, analytical statistics were conducted, followed by logistic regression for complex samples (α = 5%). RESULTS: The prevalence of parents' or guardians' work absenteeism because of the oral conditions of their children was 9.2%. The following variables were significantly associated with work absenteeism: mother's low schooling [odds ratio (OR) = 2.31; 95% confidence interval (95% CI): 1.31-4.07]; history of toothache (OR = 6.33; 95% CI: 3.18-12.61); and avulsion or luxation types of TDI (OR = 8.54; 95% CI: 1.80-40.53). CONCLUSION: Other oral conditions that do not generally cause pain, such as dental caries with a low degree of severity or inactive dental caries and uncomplicated TDI, were not associated with parents' or guardians' work absenteeism of preschool children. It is concluded that toothache, avulsion, luxation and a low degree of mother's schooling are associated with work absenteeism.

Traumatic dental injuries in primary teeth: severity and related factors observed at a specialist treatment centre in Brazil.

AIM: This retrospective study aimed to analyse demographic data and the severity of traumatic dental injuries (TDIs) to the primary dentition based on children's dental records at a university clinic. STUDY DESIGN: A cross-sectional retrospective study. METHODS: The records of all patients were analysed according to gender, age, aetiology, teeth involved, number of affected teeth, place of occurrence, witness to the trauma, time elapsed between trauma occurrence and care-seeking, type of trauma and severity of injury. RESULTS: A total of 576 children aged 8-89 months suffered injuries to 1,043 teeth. Severe injuries were the most prevalent (45.5%). These occurred at all ages, but their frequency was higher in children aged between 13 and 24 months. The prevalence of mild injury was higher when the cause was a fall from one's own height. No differences were detected in severity according to the place of occurrence and witnesses of the accident. The prevalence of severe injury was higher in cases where three or more teeth were involved. CONCLUSIONS: In this specialist treatment centre, severe injuries were the most common TDIs, which occurred in children aged 13-24 months, mainly due to falls and most occurred at home. Professionals must be prepared to deliver the best and most efficient care to this population.

Estudo retrospectivo de 92 dentes decíduos avulsionados em 69 crianças atendidas em um serviço de urgência odontológica / A retrospective study of 92 avulsed primary teeth in 69 children assisted at a dental urgency service

O objetivo deste estudo foi avaliar os aspectos epidemiológicos da avulsão de dentes decíduos. A amostra do estudo foi composta por 69 pacientes (92 dentes avulsionados) atendidos no Serviço de Urgência Odontológica da Faculdade de Odontologia da Universidade Federal de Goiás, entre os anos de 1998 e 2005. As seguintes informações foram retiradas dos registros odontológicos de cada paciente: gênero, idade, fator etiológico, distribuição sazonal, grupo dentário, número de dentes avulsionados e tipo de tratamento. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Observou-se elevada ocorrência de avulsões em meninos (52.17%) com 4 anos de idade (31.88%). Os principais fatores etiológicos foram quedas (82.61%) e acidentes de trânsito (5.80%). A maioria dos episódios de avulsão ocorreu durante os dias da semana (82.61%). A distribuição sazonal evidenciou elevado número de traumatismos nos períodos de março a junho (outono; n=28; 40.58%) e setembro a dezembro (primavera; n=18; 26.09%). O dente mais comumente afetado foi o incisivo central superior (68.48%), seguido pelo incisivo lateral superior (22.83%). As modalidades terapêuticas mais comumente realizadas foram exame clínico e anamnese (64 dentes; 69.57%) e mantenedor de espaço (18 dentes; 19.58%). Verificou-se elevado número de avulsões dentárias em meninos, com idade inferior a 4 anos e decorrentes de quedas...

The purpose of this study was to evaluate the epidemiological aspects associated with avulsion of primary teeth. The sample consisted of 92 avulsed teeth of 69 patients seen at the dental urgency service of the Dental School of the Federal University of Goiás, Brazil, from 1998 to 2005. The data obtained from the records included children's gender and age, causes of tooth avulsion, daily and monthly distribution, type and number of avulsed teeth and the treatment procedures. Frequency distribution and the chi-square test were calculated. The level of significance was set at 5% for all analyses. The highest incidence was found among boys (52.17%) aged 4 years (31.88%). The main etiologic factors were falls (82.61%) and traffic accidents (5.80%). Most cases occurred during weekdays (82.61%), from March to June (autumn; n=28; 40.58%) and from September to December (spring; n=18; 26.09%). Most avulsed teeth were maxillary central incisors (68.48%), followed by maxillary lateral incisors (22.83%). The most frequent treatments were analysis of clinical history and clinical exam (64 teeth; 69.57%) and space maintainer (18 teeth; 19.57%). The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. There was a high number of avulsed primary teeth in boys aged less than 4 years and caused by falls...

Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period.

INTRODUCTION: This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. MATERIALS AND METHODS: Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. RESULTS: Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). DISCUSSION: Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.

Prevalencia de las lesiones traumáticas que afectan a los tejidos de sostén en piezas dentarias permanentes de pacientes escolares / Prevalence of tooth-supporting structure traumatic injuries in permanent teeth of schoolchildren

Los traumatismos osteoperiodontales son lesiones que involucran tanto los tejidos dentarios como los tejidos de sostén. Constituyen una de las causas más frecuentes en la consulta de urgencia de niños y adolescentes. Las lesiones de los tejidos de sostén se dan en gran porcentaje y son: la concusión, subluxación, luxación lateral, extgrusión, intrusión y avulsión dentaria. El objetivo de este trabajo fue analizar la prevalencia de las lesiones traumáticas de los tejidos de sostén en piezas dentarias permanentes. Materiales y métodos: se estudiaron 200 pacientes de 7 a 15 años de edad con 242 traumatismos. Los casos clínicos fueron tratados bajo protocolos estandarizados y luego registrados estadísticamente. Resultados y discusión: de un total de 200 pacientes, el 69 por ciento eran masculinos y el 31 por ciento femeninos. Respecto a la edad el 64 por ciento de los traumatismos se presentaron en pacientes de 7 a 10 años y el 36 por ciento de 11 a 15 años de edad. De las 242 lesiones traumáticas estudiadas, el 51 por ciento se produjeron por accidentes en la escuela, 43 por ciento como consecuencia de la práctica de diversos deportes y un 6 por ciento correspondió a otras causas. De los 242 casos clínicos, se reconoció que el 28 por ciento corresponden a concusiones y subluxaciones. El 17 por ciento del total fueron luxaciones laterales de las cuales el 11 por ciento presentaron abombamiento de tabla y el 6 por ciento fractura de tabla. El 20 por ciento concernieron a luxaciones extrusivas y el 9 por ciento fueron luxaciones intrusivas. Por último, las avusiones dentales se prsentaron en un 30 por ciento, de éstas el 9 por ciento con ligamento periodontal vital y el 21 por ciento con ligamento periodontal no vital. Conclusiones. Los traumatismos osteoperiodontales son lesiones cada vez más frecuentes en pacientes escolares. Representan la segunda causa de pérdida de estas piezas luego de la caries dental. Es fundamental hacer hincapie en la prevención.

Prevalencia de traumatismos dentoalveolares en pacientes infantiles del complejo asistencial Dr. Sótero del Río / Prevalence of dental trauma of infants attended at Dr. Sótero del Río Hospital

En el presente estudio descriptivo de incidencia, 604 niños menores de 15 años fueron examinados y atendidos en la Clínica de Odontopediatría del Complejo Asistencial Dr. Sotero del Río, con diagnóstico de Traumatismo Dentoalveolar (TDA), desde Enero a Diciembre del 2010. El propósito de este estudio fue caracterizar los TDA de acuerdo a la clasificación de Andreasen y Andreasen, determinar su frecuencia y distribución estacional, tipo y número de dientes afectados, distribución de género y edad, lugar de ocurrencia y causa. Para ambas denticiones, en conjunto, más de dos dientes comprometidos presentaron una frecuencia de 58.77 por ciento. Los análisis se dividieron por dentición y hubo 636 dientes definitivos y 414 temporales. En dentición definitiva se observó una mayor frecuencia en Mayo (15.36 por ciento), Abril (13.02 por ciento) y Noviembre (13.02 por ciento). Las fracturas coronarias no complicadas son las más frecuentes (40.88 por ciento) y los dientes más afectados fueron los incisivos centrales maxilares (77.66 por ciento). Los niños sufren más TDA que las niñas (64.97 por ciento). La mayor frecuencia de TDA para ambos géneros es a los 8 años. La principal causa fue caídas en el colegio (46.87 por ciento). En dentición temporal se observó mayor cantidad de casos en primavera-verano (53.74 por ciento). Siendo más frecuente en los meses Noviembre y Febrero (30.84 por ciento). Subluxación fue el diagnostico más frecuentes con un 39.61 por ciento. Los dientes más afectados fueron los incisivos centrales maxilares en un 82.13 por ciento. El género masculino fue el más afectado (62.56 por ciento). La edad en que se observó mayor frecuencia de TDA fueron los 2 años. La principal causa fue caídas en la casa (29.07 por ciento).

In this incidence descriptive study 604 infants less than fifteen years of age were examined and attended at the Pedodontic Clinic from Dr. Sótero del Río hospital with a diagnostic of dental trauma between January and December 2010. The purpose of this research protocol was to characterize dental trauma according to the Andreasen and Andreasen classification, and also to determine their frequency, seasonal distribution, type and number of the affected teeth, place of occurrence and trauma´s cause. All diagnostics were divided by dentition, 636 were from permanent and 414 from deciduous dentition. For both dentitions trauma in two teeth and more were in a frequency of 58.77 percent. On permanent dentition a mayor frequency of trauma was observed in May (15.36 percent), April (13.02 percent) and November (13.02 percent). The most frequent trauma was uncomplicated crown fracture (40.88 percent) and the most frequent teeth affected were the upper central incisors (77.66 percent). Boys suffered more trauma than girls (64.97 percent). The highest frequencies of trauma for both genders occurred at eight years of age. The main causes of traumas were: falls at school (46.87 percent). On deciduous dentition a mayor frequency of trauma was observed in spring and summer (53.74 percent) where November and February concentrated the highest rates (30.84 percent). Sub-luxation was the most frequent diagnostic at 39.61 percent. The most frequent teeth affected were also the upper central incisors at 82.13 percent. Boys also suffered more trauma than girls (62.56 percent). The highest frequencies of trauma for both genders occurred at two years of age. The main cause was home falls (29.07 percent).

Prevalencia de las lesiones traumáticas que afectan a los tejidos de sostén en piezas dentarias permanentes de pacientes escolares / Prevalence of tooth-supporting structure traumatic injuries in permanent teeth of schoolchildren

Los traumatismos osteoperiodontales son lesiones que involucran tanto los tejidos dentarios como los tejidos de sostén. Constituyen una de las causas más frecuentes en la consulta de urgencia de niños y adolescentes. Las lesiones de los tejidos de sostén se dan en gran porcentaje y son: la concusión, subluxación, luxación lateral, extgrusión, intrusión y avulsión dentaria. El objetivo de este trabajo fue analizar la prevalencia de las lesiones traumáticas de los tejidos de sostén en piezas dentarias permanentes. Materiales y métodos: se estudiaron 200 pacientes de 7 a 15 años de edad con 242 traumatismos. Los casos clínicos fueron tratados bajo protocolos estandarizados y luego registrados estadísticamente. Resultados y discusión: de un total de 200 pacientes, el 69 por ciento eran masculinos y el 31 por ciento femeninos. Respecto a la edad el 64 por ciento de los traumatismos se presentaron en pacientes de 7 a 10 años y el 36 por ciento de 11 a 15 años de edad. De las 242 lesiones traumáticas estudiadas, el 51 por ciento se produjeron por accidentes en la escuela, 43 por ciento como consecuencia de la práctica de diversos deportes y un 6 por ciento correspondió a otras causas. De los 242 casos clínicos, se reconoció que el 28 por ciento corresponden a concusiones y subluxaciones. El 17 por ciento del total fueron luxaciones laterales de las cuales el 11 por ciento presentaron abombamiento de tabla y el 6 por ciento fractura de tabla. El 20 por ciento concernieron a luxaciones extrusivas y el 9 por ciento fueron luxaciones intrusivas. Por último, las avusiones dentales se prsentaron en un 30 por ciento, de éstas el 9 por ciento con ligamento periodontal vital y el 21 por ciento con ligamento periodontal no vital. Conclusiones. Los traumatismos osteoperiodontales son lesiones cada vez más frecuentes en pacientes escolares. Representan la segunda causa de pérdida de estas piezas luego de la caries dental. Es fundamental hacer hincapie en la prevención. (AU)

Knowledge on tooth avulsion in a population of students enrolled in health science programs in Brazil / Conhecimento sobre avulsão dentária de uma população de estudantes de cursos de saúde do Brasil

Aim: To evaluate the level of knowledge on tooth avulsion among undergraduate students enrolled in Nursing, Physical Education, and Dentistry programs at the Caruaru Association of Higher Education (ASCES), as well as to analyze these results according to the variables of age, gender, prior information, and prior experience at the time when the questionnaire was applied. Materials and Methods: A multiplechoice, structured questionnaire was administered to students at three different time moments: at the beginningof the study, immediately after a lecture on tooth avulsion, and 3 months later in Caruaru, PE, Brazil. The significance level was set at 5%. Results: Results showed that the knowledge of students at the beginning of the study was low. However, the mean number of correct answers increased significantly for all three groups of students immediately after the lecture; 3 months later, almost all classes still showed significantly higher mean results when compared to findings from the beginning of the study. Students with prior experience, or whohad received information previously, attained a significantly higher average of correct answers. Conclusion: The level of knowledge on tooth avulsion at the beginning of the study was low for the students of Physical Education and Nursing as compared to dental students. An increased amount of time devoted to theoretical and practical teaching activities on tooth avulsion during college and after graduation would be extremely important to consolidate such knowledge.