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Background/aim: Oral injuries such as oral soft tissue lacerations and contusions can occur in basketball by mechanisms such as running into other players or falling. Given a high enough impact force, dental injuries such as tooth fractures and avulsions can occur. Previous research has studied the different types of oral injuries as well as the mechanisms that cause them. Yet, the mechanisms resulting in dental injuries have remained unexplored. The aims of this study were to investigate the distribution of different oral injuries within each injury mechanism and evaluate which mechanisms were most likely to lead to a dental injury., Materials and Methods: This is a retrospective cohort study using the National Electronic Injury Surveillance System (NEISS). Subjects who experienced oral injuries from basketball between January 1, 2003 and December 31, 2022 were included in this study. The independent variable was the injury mechanism. The dependent variable was the dental injury outcome (yes/no). Multivariate logistic regression was used to measure the association between the injury mechanism and the dental injury outcome. A p < .05 was considered statistically significant., Results: This study included 4419 subjects who experienced oral injuries (national estimate, 138,980). Approximately 14.7% of oral injuries were dental injuries. Subjects experiencing collisions with objects such as walls or the basketball hoop (odds ratio (OR), 4.39; p < .001), falls (OR, 3.35; p < .001), or contact with the basketball (OR, 1.77; p = .006) had significantly higher odds of sustaining a dental injury relative to those experiencing contact with another player., Conclusions: Basketball players experiencing contact to the mouth have high odds of sustaining a dental injury. An understanding of injury mechanisms is important for medical teams to manage these injuries and for coaches to educate athletes on safe and proper playing styles. Furthermore, healthcare providers and basketball staff should encourage athletes to wear mouthguards to reduce the risk of traumatic dental injuries., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The recognition and reporting of child abuse and neglect continues to be a challenge in the healthcare setting. All healthcare providers, including dentists, should be aware of the high prevalence of orofacial injuries and conditions that are concerning for abuse and neglect. Sentinel injuries may appear trivial and do not require medical attention, but are unlikely caused by accidental mechanisms and, if not properly identified, often precede more severe abusive injuries. Concerning orofacial findings can manifest as bruising, eye injuries, intraoral injuries, pharyngeal perforations, facial bone fractures, and sexually transmitted infections. Abusive caregivers are likely to give inadequate explanations or no history at all to explain concerning findings. Medical providers' failure to make mandated reports about their concerns to the appropriate agencies can have significant long-term impacts on the physical and psychological well-being of children., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The literature identifies that medical students receive little or no formal dental trauma assessment and management teaching during medical school. The result of this is that many medical doctors are unaware of the urgency of emergency dental trauma care for patients. To bridge this important gap in medical education, medical educators should look to introduce basic dental trauma teaching into undergraduates' final year of medical school. This initiative would benefit medical doctors in either general medical practice or specialties that assess and manage trauma. This opinion article aims to present the authors' reasons for strongly supporting dental trauma teaching being included and suggests an e-learning approach for its integration into the medical education curriculum., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aims: Ketamine sedation has not been reported to be widely used as a pharmacological behavioural management strategy to facilitate the treatment of acute paediatric oro-dental trauma. The aim of this study was to investigate the safety and effectiveness of intramuscular ketamine sedation for managing paediatric oro-dental trauma in a paediatric Emergency Department (ED)., Methods: The database of all paediatric procedural sedations performed in the hospital ED from 01 January 2014 to 31 December 2016 was reviewed to identify cases where intramuscular ketamine sedation was administered for dentists' treatment of oro-dental trauma. Patient demographics and epidemiological data, the type and number of sedation-related adverse events, and interventions performed were extracted from the database. Clinical notes were reviewed to verify the dental diagnoses and dental treatment performed. Adverse events were further risk stratified using the World SIVA adverse event reporting tool., Results: In the study period, 167 intramuscular ketamine sedations were administered by ED doctors for dental treatment of oro-dental trauma. The patients' median age was 3.6 years (range 1.1 to 12 years). All dental procedures were successfully completed. Nineteen adverse events were reported (11.4%, n = 19) with the most common being emesis (9.0%) followed by transient desaturation (1.8%) and hypersalivation (0.6%). The lowest oxygen saturation level was 90%. None of the patients aspirated, and none required assisted ventilation or chest compression. The most common dental diagnosis was primary tooth luxation (49.1%). The most common dental treatment was primary teeth extraction (70.7%). When adverse events were stratified using the World SIVA tool, there were only 17 (10.2%) minor risk outcomes., Conclusions: The data support the safety and effectiveness of intramuscular ketamine sedation administered by trained ED doctors to facilitate the management of paediatric oro-dental trauma emergencies., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: Prevalence and incidence of diabetes are increasing and many dental trauma patients today have diabetes. The implications of delayed wound healing, associated with diabetes mellitus, on oral mucosal wound healing have not been investigated extensively. The aim of this study was to investigate the implications of diabetes mellitus on the cellular, vascular, and fibroblastic changes induced by laceration on the oral mucosa of Wistar rats., Materials and Methods: Sixteen female Wistar rats were randomly assigned into two groups: 1. Experimental Streptozotocin-induced diabetic group (8 rats). 2. Control group (8 rats). A standardized laceration injury was induced from the corner of the mouth to the mid-check penetrating through dermal and oral mucosal contaminated by saliva. Samples were taken from the rats after sacrificing them on days 1,3,7, and 10. Inflammation was evaluated both qualitatively and quantitatively. Two investigators evaluated samples in a blinded manner., Results: Histology reports indicated delayed wound healing patterns in diabetic rats through days 1, 3, 7, and 10 when compared to controls. Inflammation was also noted to be consistently present more often in diabetic rats. Furthermore, polymorphonuclear cell count was consistently higher in diabetic rats., Conclusion: The results suggest that oral mucosa wound healing is delayed in diabetic Wistar rats compared to non-diabetic rats in terms of wound closure, angiogenesis, and polymorphonuclear cells number. Furthermore, it is also suggested that wound healing is impaired both in the early and late stages of soft tissue wound healing., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Toothbrushes are the most common cause of foreign body injury to the oral cavity in children, but complete impalement by a toothbrush is an extremely rare occurrence and has not been reported previously. This report describes a 28-month-old girl who fell from a 1m ledge while brushing her teeth. Her toothbrush penetrated the oral cavity and could not be removed, and so she was rushed to the hospital with the toothbrush in place. Contrast-enhanced computed tomography showed penetration of the toothbrush from the oral cavity into and through the right posterior neck at the level of the bifurcation of the common carotid artery. Angiography was performed under general anesthesia, and the toothbrush was removed. In consultation with pediatricians, antibiotic infusion therapy was started, and the patient was extubated on the 5th post-operative day. There were no complications even after eating was resumed, and the patient was discharged on the 13th post-operative day. A toothbrush is an essential item in daily life, but it can cause serious injuries in children in some circumstances., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aim: The yearly cost of sports injuries, which affects Swedish society, is estimated to 3 billion SEK (460 million USD). Injuries in ice hockey represent at least 270 million SEK (42 million USD). Despite the high number of injuries, mouth and face guards are rarely used in Swedish ice hockey. The major aim of this study was to examine the attitudes of mouth and face guards in two ice hockey clubs in Sweden (one elite and one division 3 club). A second purpose was to determine why some players use mouth and face guards, while others do not. A third goal was to present a material that ice hockey clubs could use for further discussions., Materials and Method: A phenomenographic analysis of focus groups interviews., Results: The phenomenographic analysis of the data resulted in 12 categories. Within each category, issues, activities and engagement of the participants were described. Further, similarities and differences in the discussions between the elite club and the division 3 club were described. The following categories were found to engage the participants the most: 'Ice hockey is a high-velocity collision sport in which injuries are expected', 'Attitudes towards personal protection guards' and 'Suggested measures'., Conclusions: The participants were aware of the risk of playing ice hockey, but they know little about the consequences of a dental injury. Although ice hockey players wish to protect themselves, they refuse to accept just any mouth or face guard. Through the discussions about reducing dental and jaw injuries by routine use of protection devices, many reform proposals were presented that could be useful in future discussions., (© 2013 John Wiley & Sons A/S.)

Objective: The primary objective of this study was to determine the prevalence of oral lesions of autoimmune etiology (OLAIE) in a cohort of patients with primary Sjögren's syndrome (pSS)., Materials and Methods: A multi-center retrospective cohort study was conducted at the oral medicine practices of Carolinas Medical Center (CMC), Baylor College of Dentistry (BCD), and the University of Florida (UF). Each site performed a chart review of patients with well-characterized pSS. Clinical variables such as OLAIE, traumatic lesions, and medical conditions were compiled at each site. The association between clinical variables and the presence of OLAIE was then assessed for significance., Results: We evaluated 155 patients diagnosed with pSS. Nineteen patients with pSS (12.3%) had an OLAIE. CMC reported 11 (21.2%) patients with OLAIE, while BCD and UF reported 4 (7.3%) and 4 (8.3%), respectively. Eleven of the 19 (58%) patients with OLAIE had lichen planus, 6 (32%) had aphthous stomatitis, 1 (5%) had chronic ulcerative stomatitis, and 1 (5%) had lesions of systemic connective tissue disease by immunofluorescence., Conclusion: The results of our analysis suggest that patients with pSS have a 12% prevalence of OLAIE with a wide range (7.3-21.2%) found between practices. This difference is likely related to the different screening protocols for oral dryness between sites., (© 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Self-inflicted oral injuries of organic origin are particularly common in certain diseases, syndromes, and systemic disorders. In this article, we discuss the characteristics of these oral lesions and their treatment., Literature Search: The authors have reviewed the most relevant literature relating to oral self-injury through a search in textbooks and published articles included in the Medline database for the years 1970-2010, and selected published cases from the last two decades., Results: The majority of the literature on oral self-injury is in the form of case reports. Self-injury is particularly prevalent in patients with Lesch-Nyhan syndrome, a heterogeneous group of neurological disorders, congenital insensitivity to pain with anhidrosis, and mental retardation. It is most common in males in the early years of life, and the sites most frequently involved are the lower lip and the tongue. Therapeutic approaches in these patients have included psychological and pharmacological treatment, intraoral devices, and surgical procedures., Clinical Implications: Intraoral devices are the best therapeutic option for self-injury of organic origin, although this approach is not free of complications. The current lack of standardized treatment protocols for oral self-injury means that therapy must be individualized., (© 2012 John Wiley & Sons A/S.)

Orofacial injuries are increasingly considered a public health problem in high impact sports. The purposes of this study were: to assess orofacial trauma (OT) history in basketball players, in relation to wearing mouthguards (MG), facial types, presence of mouth breathing and player's position in the game, also to check athletes' level of knowledge about trauma and MGs. Questionnaires were given to category A-1 adult athletes registered in 2006/07 in the State of São Paulo and Brazilian Basketball Confederation Championships, and National Team members. Of the total sample (n=388), 50% of athletes sustained orofacial injuries; dental trauma accounted for 69.7%, with emphasis on maxillary central incisors, followed by soft tissue (60.8%), in which lip injuries were the most prevalent. No relationship was found between trauma history and player's position (P=0.19), facial type (P=0.97), presence of mouth breathing (P=0.98), but there was statistically significant association between the prevalence of OT and lack of MG use (P≤0.0001). Of all the athletes affected, only 1% wore a MG at the time of the trauma, 26.5% did not know about the MGs and 10.6% did not know their functions. When trauma occurred, 79.6% replied one must look for the tooth at the accident site, 50% knew it must be stored in liquid, as replantation was possible (62.3%) and 75.8% believed elapsed time could influence prognosis. Basketball is a high impact sport with high prevalence of OT, particularly maxillary central incisor and lip injuries, but athletes did not use MGs. There should be more educational campaigns to inform players about orofacial injuries and their prevention in Brazilian basketball., (© 2011 John Wiley & Sons A/S.)

Purpose:  This is a unique case report of a self-inflicted orbital injury that presented as a simple upper vestibulum laceration. A 43-year-old man presented to the Oral and Maxillofacial Surgery Unit with a small laceration in his mouth and complaints of pain in his left eye due to a snooker cue penetration. Upon admission, clinical findings included a small laceration on the upper left vestibulum and a subdermal hematoma in the left eye lid with restricted movements of the left eye. Further examination revealed remote trauma to the orbit, penetrating through the oral cavity, passing the maxillary sinus, and the orbital floor causing traumatic optic neuropathy with partial visual loss. The patient was treated conservatively with antibiotics and corticosteroids and a 6-week follow up., Conclusion:  In cases of remote penetrating injury, meticulous examination revealing precise injury mechanism is crucial. All cases of Dento-maxillofacial trauma should include a high degree of clinical suspicion for ocular injury, requiring early diagnosis and treatment to reduce risk of visual loss., (© 2011 John Wiley & Sons A/S.)

Aim:  The aims were to identify the predominant causes and types of orofacial injury in young children attending clinics at a University Dental School in Dunedin, New Zealand., Material and Methods:  A retrospective analysis of data from the records of all children aged 0-10years who had been seen for orofacial trauma in 1999 and 2000 was undertaken., Results and Conclusions: Three hundred traumatic incidents in 288 children were analysed; 86.6% had causes noted. In very young children, most injuries were because of falls, while collisions, falling and sports were responsible for more injuries in school-aged children. Playground equipment and ride-on vehicles played a role particularly in the older children. There were no incidents of trauma as a result of road traffic accidents. Ten injuries were caused by animals, mainly dogs. Location was recorded for two-thirds of accidents: the predominant place was at home, followed by school. No seasonal variation was apparent. There were 228 non-dental injuries, of which the majority were to the lips. The predominant dental injuries in both dentitions were concussions and subluxations with a significantly higher occurrence of both in the primary dentition (P<0.001). Upper central incisors were most often involved. The age distribution for boys and girls was similar. In conclusion, the causes and types of orofacial trauma in this group of young New Zealand school children attending a university dental school were similar to other studies, except for the high proportion of concussions recorded in both dentitions. While the injuries were well described, not all records noted the cause or location. This has resulted in changes to the standard recording form to provide consistency in data capture. Information from this study will also be used to support child injury prevention strategies in New Zealand., (© 2011 John Wiley & Sons A/S.)

The objective of this study was to investigate the occurrence of eye injuries and orofacial traumas in floorball. In addition, the athletes' habits of wearing protective goggles and mouthguards was surveyed, and an assessment was made of the general level of knowledge amongst athletes and coaches about preventive and first aid measures after a dental trauma and the resulting consequences. The study was conducted by the same interviewer in Switzerland and Sweden during the 2009/2010 season using a standardized questionnaire. A total of 608 individuals (565 athletes and 43 coaches) belonging to the amateur and semi-professional leagues in the two countries were individually interviewed. Although 72.7% of all athletes had observed and 27.7% of field players had sustained an injury to the eye or its vicinity, only 25 athletes (4.9%) wore protective eyewear. Similarly, despite 31.7% of all players having observed a dental or jaw injury and 11.3% of interviewed field players having suffered one, only one athlete wore a mouthguard on a regular basis. Participants from Switzerland were significantly better informed than participants from Sweden with regard to first aid measures. The results of this study show that floorball has an equally high risk for dental trauma as handball. Further investigations of dental injuries in floorball would be valuable in order to provide players, coaches, parents and sporting federations with the necessary information to make decisions regarding the use of mouthguards. It is strongly recommended that protective eyewear should be made mandatory., (© 2010 John Wiley & Sons A/S.)

Introduction: Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia., Materials and Methods: A retrospective record review was carried out using hospital records of all patients who sustained oral and maxillofacial injury at the Department of Oral Surgery, Seremban Hospital, Negeri Sembilan, Malaysia between 1998 and 2002. Information related to demographics, aetiology of trauma, vehicles involved in collision, location of injuries and treatment modalities were reviewed., Results: Two thousand nine hundred and eighty-six patients sustained oral and maxillofacial injuries. Of these patients, 79.2% were men and the remaining were women. Among all the races, Malays had the highest involvement (50.6%) followed by Indians (24.5%), Chinese (19.6%) and others (5.3%). There were statistically significant results on the association of aetiology and the ethnic groups, in the age group of 30 years or less and male gender (P < 0.001). The most common injury was the soft-tissue injury followed by dental and dentoalveolar injuries and bony fracture. Among all facial fractures, 66.3% were managed conservatively, 13% were treated surgically and 19.7% did not have any intervention. In relation to dental and dentoalveolar injuries, 64.8% had treatment in the form of splinting, restorations or dental extraction. The rest of the patients (35.2%) were referred to their dentists or did not have any active treatment at Seremban Hospital., Conclusion: Most of the dental and facial injuries in Seremban Hospital were caused by MVA and were predominantly managed using conservative methods., (© 2011 John Wiley & Sons A/S.)

Background: Prospective studies evaluating the incidence of dental injuries in anaesthesia are scarce or absent. The aim of this study was to compare the incidence of oral trauma in patients submitted to laryngoscopy and orotracheal intubation with those anaesthetized with a laryngeal mask., Material and Methods: This observational study was performed in the University Hospital, with blind evaluation. We evaluated 121 patients older than 18 years old who were submitted to elective surgery under general anaesthesia. Patients were excluded if they were pregnant, underwent surgery of the mouth or required nasal intubation. Laryngoscopy and orotracheal tube were used in 70 patients and laryngeal mask in 51. Twelve to 24 h before anaesthesia and after surgery, all patients underwent a detailed oral examination performed by an anaesthesiology and a senior dentist, both blind to anaesthetic management details. Injuries of the teeth were diagnosed based on WHO's classification system modified by Andreasen., Results: Oral injuries were found in 84.1% of the patients after laryngoscopy and 19.6% after laryngeal mask insertion (P < 0.001). Corresponding values for teeth injuries were, respectively, 38.6% and 2.0% (P < 0.001). The great majority were enamel fractures of the maxillary incisors. This means that patients submitted to laryngoscopy had a significantly higher incidence of oral injuries compared with those having laryngeal mask insertion (unadjusted OR 21, 99; CI 0.95: 8.55-56.55)., Conclusion: Minor oral trauma is significantly more frequent after endotracheal intubation than after use of the laryngeal mask. This is true for injuries of the teeth, inferior lip and tongue. Further studies are needed to evaluate on a long-term basis the clinical relevance of the dental injuries we found., (© 2011 John Wiley & Sons A/S.)

One of the commonly encountered dental emergencies is dentoalveolar traumatic injuries (DTIs). Unfortunately, DTIs result in fractured, displaced, or lost anterior teeth and this could have significant negative functional, esthetic, speech, and psychological effects on children thus affecting their quality of life. Although it is impossible to guarantee permanent retention of a traumatized tooth, patient age, severity of injury, and timely treatment and follow up of the tooth using recommended procedures can maximize the chances for success. This review examines the recent trends in the management of DTI to primary and young permanent teeth. Electronic search of scientific papers written in English from 1990s to 2009 was accomplished using Pub Med search engine. Dental practitioners should follow current literature and consider carefully evidenced-based recommendations that may enhance periodontal healing and revascularization of avulsed permanent teeth., (© 2011 John Wiley & Sons A/S.)

Introduction: Claims for tooth damage following intubation are increasing. An anaesthetic chart (AC) has been proposed to describe patient's pre-existent dental diseases and any possible lesions caused during intubation and extubation., Materials and Methods: We conducted a retrospective study of 235 cases of dental lesions reported in litigation files from January 2000 to June 2009. Based on preoperative oral inspection the anaesthetist decided whether or not to use a protective aid. Two different tooth protectors were applied: (i) a standard mouthguard and (ii) silicone impression putty., Results: The study population consisted of 110 female (age 6-88 years) and 125 male patients (11-90 years) patients. In 66% of cases greater risk of perianesthetic dental injury was reported in the AC due to pre-existing poor dentition. In intubation procedures without protective devices dental subluxation/luxation occurred in 55% of patients, dental avulsion in 43%, exfoliation in 2%, and soft tissue damage in five patients. One patient suffered from transient facial nerve paralysis. The costs of treatments and of impression materials, as well as the total value of compensation for injuries are reported., Discussion: Definition and demonstrability of damages on the AC is important in order to separate the cases worthy of compensation from the non-compensable ones, as to evaluate the possibility of solving the litigation by extrajudicial channels. There are cases in which, based on AC reporting and device adoption the damage resulted to be compensable, but the costs were defined on different estimates of lesions. The use of a protective device makes it possible to down-modulate the damage compensation., Conclusion: The analysis of litigation records and 'incident reports' has suggested that the choice of accurate proceeding and the use of protection aids could reduce the number of claims, insurance premiums and the costs of litigation process, thus improving physician-patient relationship., (© 2011 John Wiley & Sons A/S.)

Orofacial injuries resulting from violence are a fairly common event. In Portugal, however, the impact of these injuries remains to be elucidated. This study aims to analyze the injuries and permanent consequences of orofacial trauma (in a three-dimensional perspective: organic, functional and situational), resulting from violence. To do so, a retrospective analysis of all violence-related forensic reports performed in the North Branch of the National Institute of Legal Medicine, during 2007, was carried out (n = 513). It was found that most victims were men with a mean age of 35.4 (SD = 15.1). Most aggressions were due to punches and/or kicks. The most frequent orofacial injuries were lip injuries (57.7%), followed by extra-oral soft tissue injuries (35.9%), gingival and oral mucosa injuries (29.2%), and teeth and/or periodontal injuries (17.5%). The most frequent long-term consequences concerned the teeth and periodontal area (14.0%), followed by the lip area (7.4%), and gingival and oral mucosa tissues (3.9%). In terms of the effect on functions and life situations, it was found that chewing and embarrassment in social life events were the most prevalent (43.6% and 83.6%, respectively). These results showed that orofacial trauma from violence-related events can damage a person's quality of life, especially those concerning the teeth area, as a result of their implications in normal function and in life situations., (© 2010 John Wiley & Sons A/S.)

Dento-alveolar process fracture is an important and common event in the dental office practice usually managed under the well-established protocols, but sometimes this kind of lesion is evaluated in the hospital emergency rooms without attention to the dental injuries. In this type of trauma, the time between the injury and the definitive resolution is essential for the treatment success, usually 1 h in cases of dento-alveolar fractures (tooth and alveolar bone). This paper describes the management of a patient with unusual dento-alveolar fracture caused by gunshot and treated using screw fixation.

Aims: This is the first study in Kuwait to determine the prevalence, etiology, classification of trauma, teeth involved, place of injury and treatment received after dental trauma in preschool children., Material and Methods: A total of 500 preschool children presenting at a dental screening day in all governorates of Kuwait were clinically examined for signs of trauma to their primary teeth. The parents were then interviewed and a prevalidated questionnaire was completed with the demographic data of the participant and history of the dental trauma., Results: A total of 243 (48.6%) males and 257 (51.4%) females were screened. The age range was 2-6 years (mean age of 4.31 +/- 1.03 years). Fifty-six children (68 teeth) suffered trauma to their primary teeth making a prevalence of 11.2%. Majority of dental traumas occurred at home (n = 49, 87.5%) followed by at street (n = 4, 7.1%) and at school (n = 3, 5.4%). The most common reason of oral trauma was falls (n = 53, 94.6%).The most commonly affected tooth was the maxillary right primary central incisor (n = 29, 42.6%) followed by the maxillary left primary central incisor (n = 26, 38.2%). There were 20 teeth with enamel fractures (29.4%), 18 teeth had enamel- dentin fractures (26.5%) and 10 teeth had complicated crown fractures (14.7%). There were 17 luxated teeth (25%) and only three primary teeth (4.4%) were avulsed. The only statistically significant relation found in this study was between the type of trauma and the type of the treatment provided. Of the traumatized teeth, 23 (33.8%) did not receive any type of dental or medical care., Conclusion: In spite of the low prevalence of dental trauma in Kuwaiti preschool children, it is highly recommended to plan a community wide trauma prevention campaign targeting parents, children and medical/dental care providers.

Background: Cerebral palsy (CP) is one of the most frequent conditions encountered in the daily practice of dentists who treat special-needs individuals and it seems that traumatic dental injuries are often present in these cases. The aim of this study was to investigate and describe the prevalence related to traumatic dental injury (TDI) in individuals with CP attending rehabilitation treatment at the Lar Escola Sao Francisco Rehabilitation Center in São Paulo, Brazil., Material and Methods: The sample included 100 individuals with a medical diagnosis of CP (SG) aged 1-15 years (mean 7 years 2 months +/-SD 3 years 4 months) and 100 non-disabled individuals (CG), aged 1-15 years (mean 7 years 5 months +/- SD 4 years 0 month), presenting the same socioeconomic level as SG. Data were collected through clinical examinations according to Andreasen criteria and interviews., Results: According to the Gross Motor Function Classification, the SG presented 34.0% of individuals that walked with or without assistive mobility devices and 66.0% required a wheelchair for mobility. The TDI prevalence observed for CG was 32.0% (n = 32), with 20.0% (n = 20) for SG, showing no statistically significant difference (P = 0.053). For both groups, the teeth most affected were the maxillary central incisors. Crown fracture without pulp exposure was the most frequent type of injury (31.2%) in CG and enamel fracture (30.0%), in SG. The groups differed significantly regarding dental treatment received after TDI (P = 0.012), with CG presenting higher percentages of treated individuals, Conclusions: The data suggest that the TDI prevalence in individuals presenting CP and attending rehabilitation treatment was similar compared with non-disabled individuals, but they received less treatment.

The aim of this study was to identify the types and etiologies of dento-alveolar injuries among patients who were treated for injuries to maxillary and/or mandibular permanent teeth at the Gulhane Medical Academy, Department of Pediatric Dentistry, Center of Dental Sciences in Ankara, Turkey to provide a basis for determining optimal treatment approaches and educational needs. From a total of 4956 children aged 6-12 years (mean age: 8.91 +/- 1.95) applying to the Center, 472 children (9.5%) were found to have suffered dental injuries during a period of 2 years. Injuries were classified according to drawings and texts based on the WHO classification system, as modified by Andreasen and Andreasen. Injury rates were highest among children age 6 and ages 8-10. The most frequently injured permanent teeth were the maxillary central incisors (88.2%), and the maxillary right central permanent incisor made up 47.2% of all injured teeth. The most common cause of dental trauma was falling while walking or running (40.3%). Most injuries involved a single tooth (64.8%). The most common type of injury was enamel fracture (44.6%). There was a significant difference in gender, where boys more often suffered from a dental hard tissue and pulp injury than girls (P = 0.019), whereas there was no difference in gender (P = 0.248) in the distribution of periodontal injuries. Injuries were found to occur more frequently during the summer (P < 0.001). Children with increased overjet were 2.19 times more likely to have dental injuries than other children. Considering that the incidence of traumatic dental injury is highest among children ages 6 and ages 8-10 as well as the fact that patients with increased overjet are more prone to dental trauma, preventive orthodontic treatment in early mixed dentition may play an important role in reducing traumatic dental injuries.

An evaluation of dental and maxillofacial trauma in a level 1 trauma center in Israel was carried out to assess the causes of trauma and the relationship between the injuries to the patient's age, gender and ethnicity. Analysis was based on data from the Israel Trauma Registry. Patients hospitalized in a level 1 trauma center from January 1, 2000 to December 31, 2005 were analyzed according to age, gender, time, place, ethnicity and cause of injury. Files of 22 558 trauma patients were reviewed. Maxillofacial and tooth injuries were separated and further analyzed according to the above parameters. Maxillofacial or dental injuries were observed in 1668 (7.4%) of the trauma patients, caused by motor vehicle accidents (39.2%), falls (30.9%), and intentional injuries (21.2%). Most occurred on the street/road (46.5%), at home (18.8%), and in public buildings (12.4%). Arab patients suffered more from vehicle accidents while Jewish patients presented more intentional injuries. Men were hospitalized three times more than women, and young people were at greater risk. The most frequent age of trauma was 19-28 years (27.6%). Ethnic differences were particularly noticeable for intentional injuries and vehicle accidents. This emphasizes that a larger percentage of the Arab population suffered from dental and maxillofacial injuries. Further dental health education and training for primary caregivers are warranted.

The multidisciplinary nature of the follow-up evaluations of traumatic dental injuries (TDI) requires that both the lay public and practitioners possess knowledge of the treatment strategies involved. The aim of this paper was to assess the level of knowledge of elementary public schoolteachers, parents and dentists of the city of Joaçaba, Southern Brazil, about the emergency management of TDI. Three independent cross sectional studies were carried out involving samples of elementary public schoolteachers (n = 245), parents (n = 107) and dentists (n = 85) in the city in 2001. Data were collected through structured interviews for schoolteachers and dentists, and questionnaires for parents, containing questions about socio-demographic characteristics and about incidents resulting in TDI. The responses in the three studies showed a wide variability of indicated procedures for the situations of TDI proposed. The results of association studies showed that older schoolteachers (P = 0.003), older dentists (P = 0.013) and dentists who had graduated more recently (P = 0.032) chose significantly more correct answers in some TDI incidents. The answers of schoolteachers, parents and dentists showed a wide variability of indicated procedures for the situations proposed. The great majority of them would not follow the approaches most recommended in the literature. A greater importance should be placed on TDI through educational campaigns aiming schoolteachers and parents and also through undergraduation and postgraduation dental curricula in order of improving its management.

Background: One of the key aspects of improving the dental care we offer to our patients is in basing our practice on the best available evidence., Aim: The main purpose of this paper is to present some basic ways of searching reliable papers on Internet and to introduce some techniques to facilitate the development of strategic search skill to improve the quality of dental care, using dental trauma as an example., Materials and Methods: After formulation of a clinical question on a dental trauma issue, a comparison was made between: data collected in PubMed using a given term; data collected in PubMed using the Medical Subject Headings vocabulary (Mesh) and data collected using the principles of evidence-based research, all by an independent researcher. A number of papers searched about a clinical question on dental trauma and a brief commentary about each Internet research database is presented. The authors reported that the best sites available to perform the sample search were those produced by academic centers, professional organizations and government-sponsored. To get evidence-based clinical papers we did internet search on PubMed, Cochrane, Center of Evidence-Based Dentistry and Knowledge Finder using the clinical question "Emergency Treatment for Avulsed Tooth"., Results: All searched databases were efficient for scientific journals, but when we used the PI strategy, the search seemed to be more relevant and specific. The Cochrane, Center of Evidence-Based Dentistry and Knowledge Finder presented more reliable papers to answer our clinical question about dental trauma treatment., Conclusion: It is imperative that dentists understand the advantages of searching the Internet and learning to use it effectively to guide practice and assist their patients in their pursuit for better oral health.

Background: Military fighters are one of the highest risk populations for dental and oro-facial trauma. The aim of this study was to evaluate the incidence and etiology of oro-facial injuries among active duty paratroopers in the Israeli Defense Forces., Methods: Paratroopers from selected companies were interviewed using a structured questionnaire regarding oro-facial trauma during active service years. The study consisted of 311 male paratroopers, with a mean age of 21.1 years (+/- 1.7). Mean duration of military service until the study was conducted was 25.9 months (+/- 6.9)., Results: Oro-facial injuries during military service was found in 87 (28.0%) of the participants, with an incidence rate of 129.6 cases per 1000-fighter-years. Extra-oral lacerations (lip, chin, cheek/facial muscles) were the most common injury. Tooth injuries were reported by 48 of the participants, of whom 44 (50.6%) suffered from dental fractures and four (4.6%) from subluxation/luxation. Most oro-facial injuries occurred in an isolated training or operational field. Thirty-seven participants (42.5%) reported postevent disturbance and 10 (11.5%) reported loss of operative activities because of the event (mean 8.6 +/- 4.0 day loss)., Conclusions: Military paratroopers are highly predisposed to oro-facial trauma. Besides the physical and mental associated damage, these injuries result in the interference of their continuous daily activity. Prevention, mouth-guard usage and treatment intervention are two important actions that should be adopted to reduce trauma and its interference.

Background/aim: There is little epidemiological research regarding dental trauma in Australia. Previous research has largely focused on specific sub-populations with data not necessarily applicable to a general rural Australian population. Studies from other countries have presented variable data and the relevance of their findings to the Australian setting is questionable. The aim of this study was to investigate the prevalence, causes and presentation of dental trauma in a large rural centre in Australia., Materials and Methods: A retrospective analysis was performed of the dental records of 323 consecutive patients who had attended a private general dental practice in Bunbury, Western Australia following an injury to their teeth and/or mouths during the period from May 2000 to December 2005 (inclusive). Injuries were classified using the Andreasen system (1994). Data analysis was carried out using spss software and Chi-Square tests were performed with the level of significance set at 5%., Results: There were 528 teeth injured and eight patients had only soft tissue injuries. Males (68.1%) significantly outnumbered females (31.9%) and the ages ranged from 10 months to 78 years. The highest number of injuries occurred in children and adolescents, specifically the 0- to 4-year age group followed by the 5- to 9-year age and 10- to 14-year age groups. Trauma was most frequently the result of falls, accidents while playing and participating in sports activities., Conclusions: The maxillary central incisors were the most commonly injured teeth in both the primary and permanent dentitions. Uncomplicated crown fractures were the most common injury followed by luxations and subluxations. No significant differences in frequency were reported for the different days of the week, the different months or seasons of the year. Only one-third of the patients presented for dental treatment within 24 h of the injury while the remainder delayed seeking treatment for varying times up to 1 year.

In order to fill the discrepancy between the necessity of providing prompt and proper treatment to dental trauma patients, and the inadequate knowledge among medics and corpsmen, as well as the lack of instructions in first-aid textbook and manuals, and after reviewing the dental literature, a simple algorithm for non-professional first-aid management for various injuries to hard (teeth) and soft oral tissues, is presented. The recommended management of tooth avulsion, subluxation and luxation, crown fracture and lip, tongue or gingival laceration included in the algorithm. Along with a list of after-hour dental clinics, this symptoms- and clinical-appearance-based algorithm is suited to tuck easily into a pocket for quick utilization by medics/corpsmen in an emergency situation. Although the algorithm was developed for the usage of military non-dental health-care providers, this method could be adjusted and employed in the civilian environment as well.

Beginning in January 2000, all individuals participating in basic military training at Fort Leonard Wood, Missouri, were issued boil-and-bite mouthguards. From January 2000 to March 2001, trainees were required to wear mouthguards only for a single activity, pugil stick training. After March 2001, mouthguards were required for four activities including pugil stick training, unarmed combat, rifle/bayonet training, and the confidence/obstacle course. Dentists systematically tracked trainees who reported to the dental clinic with orofacial injuries during three periods: January 2000-March 2001 (phase 1), April-September 2001 (phase 2) and September 2002-June 2003 (phase 3). Orofacial injury rates were 3.35, 1.89 and 1.91 cases/10,000 person-years in phases 1, 2 and 3, respectively. The overall risk of an orofacial injury was 1.76 (95% confidence interval = 1.03-3.02) times higher in phase 1 compared with the combined phases 2 and 3 (P = 0.006). Thus, orofacial injury rates were lower when mouthguards were required for four training activities as opposed to one training activity. Mouthguards are now required at all five Army basic training sites when trainees are performing any of the four training activities.

Few population-based studies of traumatic dental injury in adults have been undertaken. The objective of this study was to assess the prevalence and severity of injuries to the mouth and teeth among adults aged 18-50 years living in the Canadian province of Ontario. A telephone survey was undertaken based on random digit dialling and 2001 adults in the target age range were interviewed. Overall, 15.5% reported a history of injury to the mouth and teeth. Of these, one-third reported two or more episodes of injury. Males were more likely than females to report injury and to have experienced more than one injury. There was no association with age but a U-shaped relationship with education. When asked about the nature of the worst injury experienced, 85% with a history of trauma reported damage to the teeth and of these, 38.5% reported one or more teeth were chipped and 26.0% broke one or more teeth. One quarter (25.4%) reported avulsions and 6.5% reported luxations. Other types of injury were reported by 3.5%. Two-thirds of the injuries reported occurred before the age of 18 years and one-third after this age. One-fifth of those with tooth injuries had not been treated by a health professional. This was not associated with the nature of the damage that occurred; rather subjects from the lower educational groups were less likely than those from higher educational groups to have received treatment. There was a significant association between injuries to the mouth and teeth and injuries in other body locations. One-third of those reporting two or more episodes of the latter reported having experienced injuries to the mouth and teeth. The results of this self-report study indicate that dental trauma constitutes a significant health issue among adults and that a minority may be injury prone. Health promotion programmes to reduce the incidence of injury among lower socioeconomic groups are needed since these have high rates of injury and the lowest rate of receipt of treatment.

The aim of this prospective study was to determine in a population of pediatric patients with febrile convulsions the prevalence and pattern of orofacial and dental injuries caused by traditional remedies used in a suburban Nigerian community. Over the study period of 28 months, 75 cases of febrile convulsion presented to the Children's Emergency unit of our hospital. Of these, 27 children (36%) sustained orofacial injuries caused by forceful insertion of a spoon into the mouth (96.3%) or a bite (3.7%) during convulsive episodes. The ages of the patients ranged from 12 to 84 months with a mean 39.8 +/- 18.3 months. There were 15 males and 11 females with a male to female ratio of 1.4:1. The orofacial and dental injuries sustained from prehospital treatment at home were lacerations and bruising of soft tissues including lips, tongue, mucosa and commissures and tooth subluxation, displacement or avulsion. Other injuries sustained outside the mouth include second-degree burns to the feet, a chin laceration and facial bruises resulting from a fall. Many oral injuries were overlooked by pediatricians. Prompt recognition and appropriate management of febrile convulsion would be of great benefit to the pediatric patients.

Unlabelled: This prospective study examined the yearly incidence of traumatic injuries to primary teeth. The aim of the study was to find out more about dental injuries to primary teeth in Norwegian children. The study was performed in one county of Norway involving approximately 20,000 children in the age group 1-8 years. Twenty-seven public dental clinics and 42 dentists participated. The dentists attended information and calibration meetings and received illustrations of the classification of dental trauma as well as examples of how to fill in the forms correctly. Two hundred and sixty-six children were involved, including 447 primary teeth, recorded during a 1-year registration period (2003). The dental trauma incidence was 1.3% with 3.5-year old being the most accident-prone. Boys were significantly more often injured than girls, 164 versus 102 (P < 0.001). The upper central incisors were most involved (92%), with a non-significant difference between the right and left side. The minor periodontal injuries dominated (59%). Hard tissue injuries were far less frequent (13%). Avulsions were observed in 6.5% and intrusions in 7.5% of the injured children, being 5.5% and 5% of the injured teeth. Most of the injuries occurred either at home (38%) or at kindergarten (32%). Sixty-two percentage were falling accidents often sustained during children's play, and 25% were pure playing accidents., Conclusion: In Norwegian children aged 1-8 years, with a predominance of boys, the most common primary tooth injuries were minor luxations of the maxillary central incisors, sustained at an age of 3.5 years. As the traumas often occurred during children's play and/or were the consequence of falls, these are difficult to prevent. However, follow ups should be carried out to disclose pulpal or periodontal complications and/or developmental disturbances of the permanent successors.

The replacement of anterior teeth with an implant-supported restoration is recognized as an efficient and successful treatment. One of the rare complications that can occur with dental implants is the fracture of either the implant or the superstructure because of biomechanical overload or occlusal force. In contrast to the permanent dentition, there is limited information about how osseointegrated implants or the periimplantary bone behave after dental trauma. This article presents a case of trauma to anterior implants and illustrates the effects to the titanium screw and the surrounding tissue., (Copyright Blackwell Munksgaard, 2004)

- The objective of this study was to assess the perceptions of secondary school sports' coaches about oro-facial injuries and mouth protector usage in sports by the adolescent athletes. A 10-item, self-completion questionnaire was distributed to 42 coaches from 23 secondary schools randomly selected from different parts of Ibadan city in Nigeria between May and June, 2002. The questionnaire sought information on why a mouth protector (mouthguard) is used, when it is required; the types of mouth protector used, the major reasons for choosing a specific mouth protector, and personal feeling as to whether mouthguards prevent oral injury. Descriptive statistics were used for the data while the chi-square statistic was employed to test the significance of association between variables. All the coaches, 25 (59.5%) males and 17 (40.5%) females with age range of 19-51 years and mean age of 38.07 +/- 8.97 years (mean +/- SD), completed and returned the forms (100% completion rate). 95.2% of the coaches believed that mouthguards prevent oral injuries and 95.2% of them also would like more information on different types of mouthguard, while 4.8% each felt otherwise. The main factor determining the choice of the type of mouthguard for athletes by the coaches was the quality of oral protection (57.1%), and the next was the cost (23.8%). Acceptance of mouthguard was scored as positive by 88.1% of the athletes. 81.0% of the coaches felt that mouthguard should be worn at all times (during practices and competitions) while 19.0% would prefer the use during competitions only. The majority of the coaches (71.4%) believed that boxing needs mouthguards, 2.4% each indicated football (soccer) and Judo while 11.9% of the coaches did not indicate any sport. The majority of these Nigerian coaches agreed on the protective effectiveness of mouthguard against sport-related oro-facial injuries, but they are yet to be adequately informed about mouthguards generally so as to correctly advise and influence these adolescent athletes in this regard.

Basketball is a popular sport in Australia. Although orofacial injuries are common, mouthguard (MG) wear in basketball appears to be low. The purposes of this study were: to measure mouthguard wear by basketball players before and after a promotional intervention; to assess players' knowledge of the value of mouthguards for prevention of injury; and to describe their experience of orofacial injury. Two questionnaires (baseline and follow-up) were administered to a convenience sample of 496 basketball players in Victoria, Australia. Players recruited were youths (12-15-year olds, n = 208) and adults (18 years and over, n = 288), from all basketball levels (social to elite). Completion of the baseline questionnaire was followed immediately by an intervention comprising written and verbal information, a mouthguard blank and instructions on mouthguard construction. The follow-up questionnaire was mailed to all respondents 10-12 weeks later; 135 youths (65%) and 157 adults (54%) completed this. Mouthguard wear at baseline was low but was more frequent at games (62%) than at training (25%). Despite 90% of players acknowledging the protective value of a mouthguard, wear by youths did not increase following the intervention, and wear by adults increased by only 14% for training and 10% at games. Previous orofacial injury was recorded at baseline by 23% of players, but few had requested compensation from Basketball Australia (youths, 17%; adults, 30%). Two predictor variables were statistically identified as related to mouthguard wear: previous orofacial injury and age group. Mouthguard wear was significantly more frequent amongst players with previous injury; such players were 2.76 times more likely to be wearers than those without previous injury. Youths were 2.31 times more likely to wear mouthguards than adults. Only 34 players (12% of respondents at follow-up) had a mouthguard constructed from the blank provided. Although youth and adult groups differed, the overall extent of mouthguard use was disappointingly low. Despite wide recognition of mouthguard value, the intervention had little effect on promoting their use.

A stratified epidemiological survey was carried out among the best French rugby players to assess the prevalence of trauma to the lower or middle part of the face (TLMPF) and the frequency at which the mouthguards (MGs) were worn. The 1140 randomized players (elite 1, elite 2 and national 1 clubs) filled in the same form anonymously. The variables were first subjected to univariate analysis (Chi-square, anova). Secondly, they were included in a multivariate model (logistic regression). Some 29.57% of players had already been affected by a TLMPF. The risk increased for the oldest forward players. It also increased with the number of yearly competitions and number of hours of weekly training. Some 64.3% of players used a MG. The frequency at which it was worn increased with the number of yearly competitions, for those who had experinced a previous trauma and for the pack players who had been playing for a long time.

Objective: We evaluated the prevalence of hepatitis virus infection in a large population of patients in terms of diseases requiring oral surgery., Design: Retrospective case survey., Subjects and Methods: Prevalence of hepatitis B and C virus (HBV, HCV) infection were compared between oral diseases such as inflammation, cysts, cancer, trauma, benign tumors, impacted teeth, or jaw deformity in dental inpatients (n = 5830) with adjustment for age, gender, and history of surgery., Results: Of 4402 inpatients, 94 had HB surface(s) antigen (2.1%), while 151 of 2613 were seropositive for HCV (5.8%). Prevalences of HBs antigen and HCV antibody exceeded those in the general population. HBs antigen was more prevalent in patients with benign oral tumors than in patients with impacted teeth, whether or not adjustment was made for age (odds ratios, 4.246 and 5.055 with and without age adjustment, respectively; P < 0.05). On the other hand, HCV antibody was more prevalent in patients with oral cancer than in those with impacted teeth before adjustment for age (odds ratios, 2.433; P < 0.05), but this difference was reversed with age adjustment (odds ratios, 0.443; P < 0.05)., Conclusion: HBs antigen was more prevalent in patients with benign oral tumors, while HCV antibody was higher in patients with oral cancer. However, this increased incidence of HCV antibody apparently was a reflection of age. HCV infection may not have an etiologically important association with oral cancer.

The aim of the present investigation was to gather data pertaining to dental trauma in 1654 patients aged 0-3 years, attended at the Baby Clinic of the School of Dentistry at Araçatuba-UNESP, Brazil. The prevalence of traumatic injuries was 16.3%. There was greater involvement of boys (62.6%), of children aged 1-2 years (39.9%) and of the maxillary central incisors (86%). Falls were more often the etiology for dental injuries (58.3%). There was a predominance of uncomplicated crown fractures (48.4%).