Search

It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS). Of a possible 890 members, 188 responded (21%) in the second round and 105 in the third (12%). Eighteen (37%) of the 49 proposed learning outcomes were rated very important and all of them were retained in the syllabus after the third round. Thirty (61%) items were retained with a consensus of 51% or above in the final round. The Delphi technique is a useful addition to the armamentarium of those involved in education, and has been used effectively in syllabus design. We achieved good consensus on the items to be included and the syllabus will be piloted locally., (Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Orofacial injuries and diseases occur in athletes, and they may not always have access to dentists. Therefore team physicians should be aware of the common injuries and initial management. Treatment of dental injuries will depend on whether the teeth are primary or permanent. The most common type of fracture is crown fracture, but there are other dental injuries that can lead to future complications if not treated promptly and monitored closely. Tooth avulsions need to be handled properly, and athletes should see a dentist as soon as possible. Despite the urgency of some injuries, other orofacial injuries or diseases, such as lacerations and caries, should not be overlooked. Proper education and use of mouth guards can assist athletes in reducing their risk of orofacial injuries.

The aim of the study was to evaluate the knowledge of dental trauma management in the southern part of Hungary among parents, teachers, medical doctors and dentists. A cross-sectional study was performed among the mentioned groups, with a structured questionnaire. The participants consisted of 275 people, most of them were parents (185), the other groups were smaller (30-30). 73.62% of parents recognised that the maxillary incisor of a 9-year-old girl is probably a permanent tooth. In case of the coronal fracture of this tooth 65.03% responded correctly. The correct response rate for the management of an avulsed tooth was only 39.26%, but in case of loss of consciousness 92.64% would act correctly. The Chi-square test indicated that there was a significant association between the correct recognition of the type of incisor and higher education (p < 0.01), and the number of seen TDIs. The 76.7% of the parents was not satisfied with his knowledge about TDLs, and 74.9% was interested in more information. In our study the parents performed generally better compared to other studies, but compared to the other three groups their results were worse. The knowledge of the teachers and the doctors was almost equivalent. The dentist had the best results. The level of knowledge of dental trauma management was inadequate among parents, but the teachers and doctors should improve their knowledge too. We suggest that it's necessary to start educational campaigns among groups that could be the primary caregivers of traumatic dental injuries.

Practical Relevance: Maxillofacial and traumatic dentoalveolar injuries can cause pain and inflammation, and reduce function of the mouth, impacting a cat's quality of life. Many traumatically induced feline fractures have been reported to involve the mandible or skull and, in cats with maxillofacial trauma, traumatic dentoalveolar injuries are particularly prevalent. Traumatic dentoalveolar injuries can also often be found in otherwise healthy cats., Clinical Challenges: Some traumatic dentoalveolar injuries require emergency treatment; timely recognition and managment is therefore important for achieving the optimal outcome. Multiple approaches exist for the management and repair of maxillofacial traumatic injuries. However, those for traumatic dentoalveolar injuries may be more limited., Audience: This review is aimed at feline and general practitioners, as well as veterinarians with expertise in dentistry., Evidence Base: The authors draw on their clinical experience and evidence from the literature, where appropriate, to produce an overview of foundation guidelines. It is hoped that this will serve as a stimulus for deeper consideration as to what constitutes 'best practice' principles for cats with traumatic dentoalveolar and maxillofacial injuries., (© ISFM and AAFP 2014.)

A 37-year-old woman was referred to the author by the American Academy of Cosmetic Dentistry's "Give Back a Smile" program. The program helps facilitate dental treatment and support services for adults who have suffered dental injuries to the smile zone as a result of domestic or sexual violence. The woman presented with a broken jaw and fractured teeth. This case report describes the treatment planning decisions and a successful outcome.

Dentoalveolar trauma and dislocations of the temporomandibular joint are common reasons for patients to present to EDs in Australia. The majority of medical practitioners receive very little formal training in the management of these injuries and might not have ready access to dental services out of hours for advice. This article focuses on the emergency assessment, triage and non-specialist management of dentoalveolar trauma and injuries to the temporomandibular joint., (© 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.)

Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome. The Hebrew Edition is part of the IADT global effort to provide a worldwide accessibility to these guidelines. This third part will discuss injuries in the primary dentition.

Purpose: This study aims to review the literature regarding the evolution of current thoughts on the management of teeth in the line of mandibular fractures (MFs)., Methods: An electronic search in PubMed was undertaken in June 2012. The titles and abstracts from these results were read to identify studies within the selection criteria-studies reporting clinical series of MFs in which the management of teeth in the fracture line was analyzed., Results: The search strategy initially yielded 731 references. Twenty-seven studies were identified without repetition within the selection criteria. Additional hand searching yielded 12 additional papers., Conclusions: It is suggested that rigid fixation systems and the use of antimicrobial agents have reduced the incidence of infection in cases of teeth in the line of MFs. Tooth buds in the line of MFs should not be removed or replaced in the (alleged) proper position despite the degree of displacement, since studies showed that even tooth buds in the early stage of calcification and those involved in widely displaced fracture sites continued development and erupted. Its removal should be considered in cases of infection, which is a predictive factor of abnormality and/or impaction. Intact teeth in the fracture line should be left in situ if they show no evidence of severe loosening or inflammatory change. Permanent teeth maintained in the line of fracture should be followed up clinically and radiographically for at least 1 year to ensure that any unnecessary endodontic treatment is avoided. Teeth in the line of fracture that prevents reduction of fractures, teeth with fractured roots, a partially impacted wisdom tooth with pericoronitis, and a tooth with extensive periapical lesion should be removed. Teeth in the line of MFs should also be removed when located in sites where there is extensive periodontal damage, with broken alveolar walls, resulting in the formation of a deep pocket (making optimal healing doubtful).

The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb, Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries.

The American Academy of Pediatrics and its Section on Oral Health have developed this clinical report for pediatricians and primary care physicians regarding the diagnosis, evaluation, and management of dental trauma in children aged 1 to 21 years. This report was developed through a comprehensive search and analysis of the medical and dental literature and expert consensus. Guidelines published and updated by the International Association of Dental Traumatology (www.dentaltraumaguide.com) are an excellent resource for both dental and nondental health care providers.

Background: Clinical forensic examinations of alleged torture victims have been performed by forensic pathologists at the University of Copenhagen since 1995. In 13.2%/33 of these cases the examinations were supplemented by a forensic odontological clinical examination. In this study the forensic odontological cases from the years 1997-2011 are presented and discussed., Methods: This study includes 33 reports from alleged torture victims (4 females, 29 males) who have been examined by a forensic odontologist at the Copenhagen School of Dentistry in the years 1997-2011.The material available consisted of copies of medical forensic reports and the forensic odontological reports including x-rays. BACKGROUND data, anamnestic data and results of the forensic odontological clinical examinations were registered as well as the conclusion of the clinical examinations., Findings: The forensic odontological clinical examinations were complicated by the presence of unspecific injuries and various degrees of active oral pathology. In 27 of the cases it was concluded that the findings were consistent with the alleged torture, in six of the cases the findings were concluded to be highly consistent with the alleged torture.

Changing ambient pressure can lead to medical conditions in body cavities filled with air. Intraoral pain elicited by changes in pressure is referred to as barodontalgia. Dental barotraumas are defined as pressure-induced damages of teeth and restorations. The pathophysiologic background so far is not completely clear. The present study deals with dental and orofacial symptoms which can occur as a result of pressure variations. With the aid of cantonal administrations, diving associations, and tunnel construction firms, 520 pressure-exposed individuals (499 scuba/ professional divers, 21 caisson workers operating at excess pressure) were questioned regarding dental problems. A personal interview was conducted with affected individuals. Problems in the dental area were experienced by 15% of all respondents. Toothaches were suffered by 10.2% of the participants. Tooth injuries occurred in 6.3% of all interviewees (26 fractured amalgam restorations, 4 crown fractures, 3 losses of tooth fragments). A proportion of 11.3% among the respondents complained about temporomandibular joint problems or mucosal irritations (for example aphthae) related to the mouthpieces. Barotraumas outside the dental area were incurred by 31.9% of the divers. Of these, 69.9% concerned the ears and 65.6% occurred during the descent. Based on the results obtained from the survey and taking into account the current literature, recommendations for the prevention of barotraumas in divers and caisson workers were prepared. Diagnostic exclusion of dental pathologies and avoidance of retentive reconstruction materials are important factors for the prevention of barodontalgias and dental barotraumas.

Unlabelled: Treatment of dental trauma can be an infrequent, unpredictable and stressful experience for a dental practitioner. Correct diagnosis and management of such cases is of primary importance in the prognosis of the affected dentition. We have therefore constructed a number of easy to follow algorithms in management, both short and long term, for the range of traumatic injuries that can affect the permanent dentition., Clinical Relevance: Immediate as well as longer term management of dental trauma cases can be difficult, therefore a clear treatment plan is of great importance in successful results.

Objectives: The aim of the present study was to assess parents' recognition of dental trauma in their children., Methods: A cross-sectional study was conducted in Belo Horizonte, Brazil, with 519 randomly selected children between 1 and 3 years of age. The parents answered questions on the occurrence of previous dental trauma, caregiver's schooling and the impact of dental trauma on activities and quality of life of the children. The children were also clinically examined for presence of dental trauma. Descriptive analysis, the chi-squared test, Mann-Whitney test and Poisson regression analysis were performed. The calculation of effect size was used to test the clinical significance of the findings., Results: A total of 41.2% (n = 214) of the children had at least one tooth with dental trauma. Among the parents of the children with dental trauma, 42.5% (n = 91) had not recognized the trauma. Mean caregiver's schooling was 8.9 ± 3.3 years of study. The schooling of caregivers who were unaware of the dental trauma was lower (mean: 5.3 ± 2.5 years of study) than that of those who were aware of the trauma (10.4 ± 2.1 years of study; P < 0.001). The recognition of dental trauma was more prevalent among parents of children over 24 months of age (PR: 3.5; 95% CI: 2.2-5.6), those whose children experienced an impact of oral health status on quality of life (PR: 1.2; 95% CI: 1.1-1.4) and those with a higher level of schooling (PR: 1.2; 95% CI: 1.1-1.2)., Conclusion: A large portion of parents do not recognize the occurrence of dental trauma in their toddlers. The age of the child, impact of oral health status on quality of life and caregiver's schooling were directly associated with parents' recognition of dental trauma in children aged 12 to 36 months., (© 2012 John Wiley & Sons A/S.)

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.

Child abuse and neglect are prevalent issues that permeate all ethnic, cultural and socioeconomic segments of society. Parents of abused children frequently change physicians in order to prevent detection, but they are more likely to continue to visit the child's dentist. Most states recognize four major types of maltreatment: neglect; physical abuse; psychological maltreatment; and sexual abuse. The American Academy of Pediatric Dentistry defines dental neglect as "the willful failure of parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection." The oral health practitioner must uphold his or her legal and ethical responsibility if there is suspicion, record and report the incidence. It may help save a child from further abuse.

Appropriate and timely management of traumatic injury to the teeth and their supporting structures plays an important role in determining long-term outcome. This article reviews the relevant anatomy and describes the initial diagnosis and treatment approach to dentoalveolar traumatic injury and fractures of the mandible. Procedures for initial stabilization and appropriate referral are also discussed., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Pulp and periradicular testing is crucial to the initial trauma evaluation and to subsequent monitoring of the traumatized teeth and supporting structures. An accurate diagnosis serves as the basis for therapeutic intervention and helps to ensure that destruction of the dental structures will be minimized and function will be regained. The purpose of this review is to present the current best evidence for accurate diagnostic testing of the pulp and periapex of traumatized teeth. Five databases were searched for literature pertaining to pulpal testing and trauma. Widely recognized textbooks were also consulted. Currently used pulp vitality testing is constrained by its subjective character and by the fact that it is a measure of neuronal status and not true pulpal viability. Tests that measure tissue perfusion more accurately reflect pulpal vitality, but they are not available commercially. This review discusses the specificity, sensitivity, and accuracy of commonly used tests, with emphasis on the applicability of certain tests to specific patient presentations in trauma. Factors that influence test selection are discussed, and specific recommendations are made on the basis of best evidence. Although differences exist between the various studies as to the accuracy of commonly used pulpal and periradicular tests, most of these have acceptable predictive value. Pulpal and periradicular tests in the trauma patient should be used in conjunction with clinical and radiographic observations to arrive at a diagnosis and treatment plan.

Pulp and periradicular testing is crucial to the initial trauma evaluation and to subsequent monitoring of the traumatized teeth and supporting structures. An accurate diagnosis serves as the basis for therapeutic intervention and helps to ensure that destruction of the dental structures will be minimized and function will be regained. The purpose of this review is to present the current best evidence for accurate diagnostic testing of the pulp and periapex of traumatized teeth. Five databases were searched for literature pertaining to pulpal testing and trauma. Widely recognized textbooks were also consulted. Currently used pulp vitality testing is constrained by its subjective character and by the fact that it is a measure of neuronal status and not true pulpal viability. Tests that measure tissue perfusion more accurately reflect pulpal vitality, but they are not available commercially. This review discusses the specificity, sensitivity, and accuracy of commonly used tests, with emphasis on the applicability of certain tests to specific patient presentations in trauma. Factors that influence test selection are discussed, and specific recommendations are made on the basis of best evidence. Although differences exist between the various studies as to the accuracy of commonly used pulpal and periradicular tests, most of these have acceptable predictive value. Pulpal and periradicular tests in the trauma patient should be used in conjunction with clinical and radiographic observations to arrive at a diagnosis and treatment plan., (Copyright © 2013 American Academy of Pediatric Dentistry and American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Over a three-year period we devised, developed, and implemented a simple proforma, validated by a previous audit, to improve the accuracy of data collected on maxillofacial trauma. It covers both sides of an A4 sheet and functions as an aide-memoire for junior staff and prompts the comprehensive recording of all necessary medicolegal details should further documentation be required by the police, judiciary, or compensatory body., (Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The current diversity of opinions in endodontic diagnosis has been a source of interest and academic debate by clinicians and researchers. Currently, no single pulp testing technique can reliably diagnose all pulpal conditions neither it has been proven to be superior in all aspects. Despite improvements of various aspects of this process, there are no historically dramatic changes, or consensus for pulpal status in health or disease in addition to a lack of relative systematic reviews. In this review, the past, present and future most debated and critically questioned issues of endodontic diagnosis are discussed. The aim of this review is to provide insights in future diagnostic modalities and areas for further study in endodontic practice pertinent to diagnosis.

Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often combined, the result is that more than 100 trauma scenarios exist, when the two dentitions are combined. Each of these trauma scenarios has a specific treatment demand and prospect for healing. With such a complexity in diagnosis and treatment, it is obvious that even experienced practitioners may have problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.DentalTraumaGuide.org. It is the aspiration that the use of this Guide may lead the practitioner to offer an evidence-based diagnosis and treatment., (© 2012 John Wiley & Sons A/S.)

Aim: Approach to dental trauma should always be based on a careful examination of the traumatised area, including both hard and soft tissues, to ascertain the presence of a foreign body and to assess the best treatment and follow-up. In this work a case of an orthodontic bracket migrated to the upper lip and retained there for 10 years, following a trauma is discussed., Case Report: The patient complained symptomatic swelling of the upper lip; palpation and x-rays showed the presence of a foreign body, identified as an orthodontic bracket. Medical history revealed that patient had a dental trauma 10 years prior. The foreign body was localised and removed. At the two week follow-up visit after surgical incision of the lip, signs and symptoms (i.e. the swollen lip) were resolved. This case emphasises the importance of accurate management of the traumatic event, through proper diagnosis and therapy of both hard and soft tissues, even if the examination if the patient is performed years after the dental trauma.

Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome., (© 2012 John Wiley & Sons A/S.)

Diagnosis and treatment for traumatic dental injuries are very complex owing to the multiple trauma entities represented by six luxation types and nine fracture types affecting both the primary and the permanent dentition. When it is further considered that fracture and luxation injuries are often combined, the result is that more than 100 trauma scenarios exist, when the two dentitions are combined. Each of these trauma scenarios has a specific treatment demand and prospect for healing. With such a complexity in diagnosis and treatment, it is obvious that even experienced practitioners may have problems in selecting proper treatment for some of these trauma types. To remedy this situation, an Internet-based knowledge base consisting of 4000 dental trauma cases with long-term follow up is now available to the public and the professions on the Internet using the address http://www.DentalTraumaGuide.org. It is the aspiration that the use of this Guide may lead the practitioner to offer an evidence-based diagnosis and treatment., (© 2012 John Wiley & Sons A/S.)

Crown dilaceration of permanent teeth occurs due to the non-axial displacement of the already formed hard tissue portion of the developing crown at an angle to their longitudinal axis due to trauma to the primary predecessors. This is a rare condition, representing only 3% of the total of injuries to developing teeth and usually occurs in permanent maxillary incisors because of the close proximity of their tooth germs to the primary incisors, which are more susceptible to trauma. This alteration frequently results from the intrusion of a primary tooth when the child is around 2 years of age, at which time half of the crown of the permanent successor is already formed. Teeth with dilacerated crowns may either erupt with buccal or lingual displacement or remain impacted. The treatment may involve endodontic, orthodontic, restorative and prosthetic procedures. This paper reports the restorative treatment proposed to reestablish the esthetics and function of the affected teeth in three cases of crown dilaceration in permanent maxillary incisors after trauma to their primary predecessors.

We conducted a comparison of the preoperative airway and teeth status assessment with a dedicated postoperative assessment. We included 211 patients with a preoperative airway and teeth assessment performed by the designated physicians at the department of anaesthesia. 27% of the patients had an incomplete preoperative assessment. 66% were not informed about the risk of damages to the teeth and 16% of the patients were postoperatively considered to have periodontitis compared to only 3% preoperatively. Postoperatively we found, that many more patients had an overall poor dental status.

In the present case of a 9-year-old girl with prominent swelling in the mental and facial regions after trauma, repeated magnetic resonance (MR) examinations were performed to evaluate areas of incision, because the swelling became worse and more prominent despite intravenous antibiotic treatment. However, there was no evidence of respiratory tract impingement or deformation, including obliteration, on MR imaging. Therefore, surgical treatment involving an incision because of facial region swelling was cancelled, and the intravenous antibiotic therapy was continued. To prevent misdiagnosis and over-treatment of young children with inflammation of the oral and maxillofacial regions, dentists, including pediatric dentists, should be aware of the clinical usefulness of MR examinations. In particular, MR examinations are non-invasive for young children, because there is no X-ray exposure, and they can be used repetitively. At the same time, the present case demonstrated that it is very difficult to understand and predict changes in the inflammation process associated with children's facial trauma., (© 2011 John Wiley & Sons A/S.)

The objective of the study presented here was to examine the incidence of bruxism in patients suffering from temporomandibular disorders. Two cohorts of patients suffering from temporomandibular disorders were evaluated. One group, composed of 163 patients, was asked specifically about the occurrence of bruxism, while the other group, composed of 200 patients, was not specifically asked about bruxism (self-reporting). The incidence of bruxism was only 20.5% for the group that only self-reported bruxism, while the incidence was 65% when asked specifically about bruxism. It is critical to ask specifically about bruxism. Patients are more likely to report bruxism when asked specifically about it. It is important to incorporate this as part of a TMD evaluation.

Aim: To assess the clinical time (diagnosis and treatment times) to manage traumatic dental injuries (TDIs) in children attending paediatric dental clinics in Nigeria., Study Design: Cross sectional observational pilot study on children presenting at four government hospitals in South West Nigeria over a 3-month period., Methods: Dental injury was classified using the method recommended by Andreasen et al. [2003]. A standardized protocol was followed and the details of the diagnosis time, treatment time and total clinical time for management of different traumatic injuries to the primary and permanent dentition were recorded and calculated on a data collection form., Results: There were 73 dental injuries in 39 children. For the primary dentition, complicated crown fracture had the highest average total treatment time namely 76.0±48.1 minutes as well as the highest average number of visits (2.6 visits). More time was spent manageing the same level of injury in the permanent dentition than in the primary dentition. For the permanent dentition, extrusive luxation injury had the highest average total treatment time (103.3±11.5 minutes)., Conclusion: The clinical time for management of dental injuries in children was relatively high and varied by type of injury.

Acute conditions are mainly caused by inflammatory and infectious reactions in the dental pulp, periodontal tissues, periapical bone and the tissues around partially impacted teeth. Pain may also be related to traumatic injuries to the teeth and jaws as well as sequelae after oral surgery. Emergency treatment involves incision of abscesses, root canal treatment, irrigation with antiseptics, immobilisation of teeth or fractured bones, and prescription of analgetics. Antibiotics are only indicated in cases in which there is a risk that an infection spreads to adjacent regions or a risk of fever and malaise.

Orthodontic treatment, like any aspect of general dentistry, exposes the clinician to the risk of malpractice and litigation. While for orthodontists this issue has not been a major concern over the last century, risk management has, over the last decade, become a significant issue in orthodontic practice. The patient-orthodontist contact may be classified into pre-treatment, active treatment and post-treatment periods. Risk management issues pertinent to each time period are discussed in this article with the intention of increasing the clinician's awareness of potential problems. Armed with this knowledge the overriding message for the clinician is to practise orthodontics with the philosophy of prevention and avoidance. To the best of your ability, avoid giving patients a reason to institute legal proceedings.

Unlabelled: Dento-alveolar trauma presents commonly in general dental practice, but may prove difficult to manage for those unfamiliar with it. Timely and well-informed intervention can significantly improve the clinical outcome for the patient. This article aims to inform the clinician on best current practice for the assessment and initial management of dental traumatic injuries, incorporating current international guidelines and practical arrangements for follow-up care., Clinical Relevance: The dental trauma patient often presents to the general dental practitioner and the appropriate emergency management plays a vital role in relieving pain, protecting the dentino-pulpal complex, reducing displaced teeth and improving prognosis.

Background/aim: The Periotest method is a technique for the objective assessment of tooth mobility. The aims of this study were to determine normal Periotest values in the vertical and horizontal dimensions of periodontally healthy teeth in individuals aged 20-35 years and investigate the reliability of Periotest in terms of intra-series and inter-series reproducibility before and after applying a dental trauma splint in vivo., Materials and Methods: Periotest values were measured in periodontally healthy dental students (n = 33; mean age 24.7 years) at reproducible measuring points in the vertical and horizontal dimensions, before and after splint insertion. Three readings were taken per series to observe the intra-series reproducibility; three series were measured to test inter-series reproducibility (Friedman-test; P

Dentinal hypersensitivity is defined as short and transient painful response of exposed dentin, usually cervical, to different stimuli, such as thermal, mechanical osmotic or chemical. The etiology of dentinal hypersensitivity is open tubules (because of enamel loss or gingival recession), allowing painful stimulus to reach the pulp. The hydrodynamic theory explains the mechanism through which pain is aroused. When treating dentinal hypersensitivity, dentists always have to rule out other pathologies, such as carries, leakage, postoperative sensitivity, cracked tooth etc., and only then assess pain intensity and treat the tooth. Treatment always starts with prevention of both stimulus and exposure of dentin, and reducing predisposing factors. The treatment options include OTC products, such as fluoride and/or potassium enriched mouth washes and dentifrices, or in-office treatments, such as high content fluoride varnishes and gels, potassium oxalate chelating agents, Glutaraldehyde containing tissue fixating agents, bonding materials, low viscosity glass ionomers and even non-conservative treatments such as root canal therapy or mucogingival surgical interventions.

A complete medical and dental evaluation is imperative following traumatic dental injuries, which are emergent situations that need a quick assessment and appropriate management. The proper diagnosis and treatment rendered determines the prognosis of the case. Proper documentation is important for medicolegal reasons and for baseline reference regarding the traumatic injury. Future treatment modalities and outcomes can be better managed with accurate documentation at the initial assessment.

This article overviews the diagnosis and management of traumatic injuries to primary teeth. The child's age, ability to cooperate for treatment, and the potential for collateral damage to developing permanent teeth can complicate the management of these injuries. The etiology of these injuries is reviewed including the disturbing role of child abuse. Serious medical complications including head injury, cervical spine injury, and tetanus are discussed. Diagnostic methods and the rationale for treatment of luxation injuries, crown, and crown/root fractures are included. Treatment priorities should include adequate pain control, safe management of the child's behavior, and protection of the developing permanent teeth.

Teeth, periodontium, and supporting alveolar bone are frequently involved in trauma and account for approximately 15% of all emergency room visits. The cause of the dentoalveolar trauma varies in different demographics but generally results from falls, playground accidents, domestic violence, bicycle accidents, motor vehicle accidents, assaults, altercations, and sports injuries. Dentoalveolar injuries should be considered an emergency situation because successful management of the injury requires proper diagnosis and treatment within a limited time to achieve better outcomes.

Diagnosis and treatment of traumatic dental injuries is a complex task and the diagnostic process of reaching a correct diagnosis and treatment can sometimes be very difficult. Traumatic dental injures often occur as combination injuries between one of the 6 luxations and the 9 fracture types resulting in 54 trauma scenarios of which many have specific requirements for treatment The situation is further complicated by the fact that the two dentitions have very different treatment demands. As a result it's impossible even for experienced practitioners to provide evidence-based treatment on the basis of personal experience alone. Based on 60 clinical studies of 4000 cases with long-term follow-up treatment and prognosis has been determined for almost all fractures and luxation and their combinations. Information on treatment and prognosis relating to these 4000 cases will now in the future be available on the internet at: "www.DentalTraumaGuide.org". We hope that the Dental Trauma Guide can help improve the knowledge about dental traumatology worldwide and hereby improve the quality of treatment.

Aim: To determine the recall rate in an endodontic practice and to evaluate specified variables as to their effect on the rate of patients returning for recall., Methodology: The records of 7105 patients treated by one endodontist between 1975 and 1998 were reviewed. Recorded variables included chart number, patient gender and age, treated tooth number, pulp status, presence of spontaneous pain at initial visit, history of trauma to treated tooth, previous root canal treatment in the treated tooth, and presence of endodontic recall., Results: The recall rate was 49% for the 5641 patients who completed endodontic treatment. Odds ratio analysis showed that females returned for recall at a rate that was significantly higher than males (52% vs. 44%). Odds ratio and chi square analysis revealed that a diagnosis of pulp necrosis or previous root filling resulted in a higher than expected recall rate while a diagnosis of irreversible pulpitis resulted in a lower than expected recall rate (p < 0.001). Patients aged 6-40 years of age returned at a lower rate than expected and those aged 41-80 returned at a higher rate than expected (p < 0.001). There was no significant difference in recall rate for patients reporting spontaneous pain or history of trauma with the treated tooth. The type of treated tooth had no effect on patient recall rate., Conclusions: Forty-nine per cent of patients returned for recall after a minimum of 6 months with patient age, patient gender and pulp status affecting the rate of recall significantly.

Posttraumatic facial restoration requires the marriage of both aesthetic and reconstructive principles. An outline for the treatment of traumatic facial injuries is presented.