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Traumatic dental injuries (TDI) or tooth trauma have a global prevalence of 10-15%. These are often the cause of first visit to emergency room. Prognosis of teeth after injury is dependent on type of TDI, emergency treatment and time elapsed till definitive care. The low level of awareness among general public and medical practitioners often leads to delay in seeking treatment which often leads to pain, severe symptoms and poor prognosis. Pediatricians can play a significant role in identification of TDI, health advise, emergency care and referral to dentists. This paper highlights the important features to be noted in children with history of TDI and the key steps which needs to be taken in these situations.

Aim: The aim of this study is to produce a clinical therapy protocol for a group of 20 athletes between the ages of 8 and 14, who all suffered traumas affecting hard dental and periodontal tissues., Materials and Methods: This study involves a group of 20 athletes (10 male and 10 female) who had suffered dental traumas of varying severity. In order to collect the data, two classification systems were used: one for hard tissue traumas and another for periodontal lesions. The athletes were subdivided into lesion groups, treated depending on the type of lesions and then followed-up over a period of 5 years. A statistical analysis was carried out to study the association between type of lesions, types of sports and the number of teeth involved., Results: We found that recovery time ranged from 3 to 5 days for uncomplicated fractures and up to 14 days for luxations. Only four complications were registered during the follow-up period and these were most likely due to the severity of the trauma. Out of the 20 athletes, 16 had begun and maintained the habit of using mouth protection devices when practicing their sport. The statistical analysis focused on the possible association between the risk levels of a sport and the typical lesions and complications that usually occur. Due to their high frequency, the two types of lesions taken into account in our study were complicated fractures (FP) and luxated/fractured teeth (LF). The average number of teeth involved varied according to the sport's risk level (medium or high) with averages of 1.6 teeth involved for medium-risk sports and 2.0 teeth for high-risk sports., Conclusions: What emerged in particular was the regular progress in the recovery time needed for the injuries sustained, with few complications or delays in rehabilitation; we also noted that the numerous athletes who habitually used mouthguards while competing during the recovery period did not suffer any recurrences of injuries or further complications. Regarding the results of our statistical analysis, no association was found between the sport's risk, the types of lesions and the occurrence of complications. In addition, analysis of the average number of teeth involved showed that there is no statistical evidence to reject the hypothesis that the ratios remain the same in the two groups.

This paper outlines the involvement of dentists in the treatment of patients following the terror attack at Manchester Arena on 22 May 2017. It predominantly describes the role of the authors - a paediatric dental consultant and maxillofacial surgery dental core trainee (DCT). As a result of the incident a number of patients suffered oro-facial injuries, with many treated at Central Manchester Foundation Trust Hospitals' Manchester Royal Infirmary and Royal Manchester Children's Hospital. The major incident response of the trust is discussed, as are the presentation of blast injuries and corresponding NHS guidance. Two paediatric cases present the role of the paediatric dental consultant in the acute, intermediate and long-term management of these patients. The presentation of unique dento-alveolar injuries in the context of other trauma and their subsequent treatment demanded true multidisciplinary management. The importance of teeth and oral health to physical and psycho-social wellbeing and recovery was clear and recognised by other teams involved in the patients' management. The experience reinforced the overall impact dental health has on physical and psycho-social health, and how a holistic approach is integral to treatment of major trauma.

Background/aims: Population-based studies that investigate the impact of TDI on oral health-related quality of life (OHRQoL) among school children and its association with socioeconomic factors are scarce and offer conflicting results. The aim of this study was to evaluate the impact of TDI on OHRQoL among school children and its association with socioeconomic status., Materials and Methods: A cross-sectional study was conducted with 588 12-year-old children enrolled in public and private schools in the urban areas in the city of Diamantina (southeastern Brazil). Clinical examinations were performed for the diagnosis of traumatic dental injury based on Andreasen's classification. The Child Perceptions Questionnaire (CPQ 11-14 ), which has been validated for the population in Brazil, was employed to evaluate oral health-related quality of life. Socioeconomic status and overjet were also analyzed. Statistical analysis involved the chi-square test and logistic regression., Results: A total of 29.4% of the students exhibited some type of trauma to at least one tooth. A negative impact on oral health-related quality of life was found in 53.1% of the sample. Traumatic dental injury was associated with a high impact on oral health-related quality of life [OR = 1.61 (95% CI: 1.08-2.39)] and overjet >3 mm [OR = 5.42 (95% CI: 3.66-8.02)]. However, no statistically significant associations were found between TDI and socioeconomic status., Conclusions: Prevalence of traumatic dental injury was high among the children who participated in the study, and it was associated with a high impact on oral health-related quality of life as well as overjet >3 mm., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: The purpose of this study was to determine variables associated with adverse outcomes among traumatized permanent teeth in a university pediatric dental clinic., Methods: Electronic charts of children treated at a university-based dental clinic for trauma in permanent teeth were analyzed. Variables evaluated included demographics (age, sex, American Society of Anesthesiologists classification, and insurance type), affected tooth location, trauma characteristics, type of dental trauma, elapsed time between trauma and initial treatment, elapsed time between the initial and final treatment, initial treatment type, and initial and final restoration type. Adverse outcomes were defined as root canal treatment, decoronation, and extraction. Associations between adverse outcomes and each variable of interest were calculated using chi-square and Fisher's exact test and logistic regression. The significance level was set at five percent., Results: Adverse outcomes were significantly associated with the type of dental trauma (P=0.001), presence of luxation injury (P=0.048), initial dental treatment (P<0.001), and initial dental restoration type (P=0.019)., Conclusions: Treating dental trauma in permanent teeth in a timely manner can strongly impact their prognosis.

With advances in the understanding of healing processes of the periodontium, pulp and alveolar bone following various injuries, the role of splinting has become relatively well defined. This is generally reflected in the guidelines for trauma management published by the International Association of Dental Traumatology. While the widespread use of composite resin as an adhesive in various functional/flexible splinting systems has over many years allowed ease of application, removal of the material is not only time consuming but more seriously accompanied by minor or major iatrogenic damage to enamel. Dental materials science has continued to provide new materials and amongst them the development of resin activated glass-ionomer cement suitable for orthodontic bracket cementation has allowed the development of an alternative simplified splinting regimen for traumatized teeth which offers ease of application and removal with minimal or no iatrogenic damage to enamel., (© 2016 Australian Dental Association.)

Background: Patients who sustain dental trauma commonly present to their general practitioner (GP) or the emergency department, especial-ly to seek help after hours. It is important, therefore, for medical practitioners to correctly diagnose and manage these patients., Objective: The purpose of this paper is to familiarise GPs with different presentations of dental-related trauma, and a brief management plan for each condition., Discussion: Time is of the utmost importance when dealing with trauma in the dentition. Initial management of dental trauma, primarily by GPs working in rural or remote areas, can have a significant impact on the prognosis of oral hard and soft tissues.

The objective of this study was to determine the epidemiology of traumatic dentoalveolar injuries (TDI) in dogs and cats and to evaluate the applicability of a human classification system for TDI in dogs and cats. All patients diagnosed with a TDI were identified from the University of Wisconsin-Madison School of Veterinary Medicine Dentistry and Oral Surgery Service case log and the hospital patient processing software. The study population consisted of 621 dogs and cats, in a total of 660 patient visits from 2004 to 2012, admitted for oral treatment and subsequently diagnosed with at least one TDI Medical records including diagnostic imaging studies were reviewed to group the injury according to a classification system used in humans for TDI. Patient signalment, tooth injured, and number of injuries per patient were recorded and tabulated. The overall prevalence of TDI was 26.2%. The mean +/- SD number of TDI per patient was 1.45 +/- 0.85. All 14 classes of TDI recognized by the classification system utilized in humans were identified, and all (100%) TDI identified in this study were classifiable using this system. Enamel-dentin-pulp fracture was the most common TDI (49.6%). The most commonly injured teeth were the mandibular or maxillary canine teeth (35.5%). The most common age for dogs and cats with TDI were 3-6 years (33.0%) and 7-10 years (31.3%). With a frequency of 1 in 4 animals, TDI are common and represent a significant pet health concern. Most TDI are considered severe and require timely, and sometimes immediate, treatment. The adoption and utilization of a complete classification system, such as the one used in this study, is recommended in order to improve future epidemiological study of TDI in animals.

Dental trauma is sudden, unscheduled, and the dentist and staff must be adequately equipped to expeditiously and properly treat the patient to assure the best possible outcome. This paper reviews current dental trauma guidelines to provide the correct treatment protocol to ensure the best prognosis. The case report illustrates the technique of avulsion care, RCT care, and functional splinting in a successful manner.

Aim: Some of the commonly encountered dental emergencies are traumatic dental injuries. The aim of this study was to evaluate traumatic dental injuries with regard to age, gender, etiology, classification of trauma, teeth involved, place of injury, and treatment received by patients who were referred over a 2-year period to the Istanbul University, Faculty of Dentistry, Clinics of Pedodontics, Istanbul, Turkey., Materials and Methods: The study was based on the clinical data of 154 patients (337 traumatized teeth). The children were examined clinically for dental injuries by the same investigator. The following information was recorded: age, gender, etiology, localization, place, number of injured teeth, type of trauma, type of tooth, time elapsed between injury and treatment, and treatment provided. Traumatized teeth were assessed according to the classification of the World Health Organization slightly modified., Results: A total of 154 patients aged 1-13 years presented a total of 337 traumatized teeth (255 permanent and 82 primary). 94 boys (61%) and 60 girls (39%) with a mean age of 7.91 ± 3.15 years participated in the study. Dental injuries were frequent in the 6-12 year age group. The most common type of dental injuries recorded was luxation injuries (43.3%), uncomplicated crown fractures (20.5%), and complicated crown fractures (19.4%). The main causes were falls (55.2%) and being struck by an object (22.1%). The most frequent treatment was examination only (31.8%)., Conclusions: In childhood, a correct diagnosis may affect the management methods and prevent the occurrence of complications after treatment for traumatic dental injuries. Therefore, continuing education programs offering the latest updates in the management of traumatized teeth should be provided for dental and medical practitioners., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: The purpose of this study was to: (1) examine types of dental trauma presenting to a hospital emergency department (ED); (2) describe the medical services provided to these patients; and (3) quantify time spent during ED encounters for dental trauma emergencies., Methods: Records of 265 patients who presented to the ED with dental trauma over a three-year period were reviewed. Demographics, injury types, triage acuity, pain scores, and dental/medical treatment and times were analyzed., Results: Patient demographics and injury types were similar to previous studies. Eighty-two percent of patients received mid-level triage scores; 41 percent of patients had moderate to severe pain. The most frequently provided medical services were administration of analgesics and/or prescriptions (78 percent). The mean times were: 51 minutes waiting for a physician; 55 minutes with dentists; and 176 minutes total time. Higher triage acuity and pain levels resulted in significantly longer wait times for physician assessment. Dental evaluation, including treatment, averaged 32 percent of time spent at the hospital., Conclusions: A dental clinic is the most efficient venue for treating routine dental trauma. Patients in this study spent the majority of time waiting for physicians and receiving nondental services. Most patients required no medical intervention beyond prescriptions commonly used in dental practice.

Purpose: The purpose of this study was to compare the time interval between a child sustaining a dental injury and the rendering of treatment in a hospital setting and a private pediatric dental practice., Methods: Data were collected from the patient records of children treated for dental trauma at a children's hospital emergency department, a children's hospital dental clinic, and a private pediatric dental practice. Data included demographics and the time, date, type of injury, and its treatment., Results: Injuries were more severe, treatment was more complex, and the time interval between injury and treatment was longer for those children treated in the hospital setting versus private practice, regardless of distance traveled. Children treated at their dental home experienced fewer treatment delays. Insurance status, medical complexity, and associated injuries were not related to treatment delays., Conclusions: Children who seek emergency care for traumatic dental injuries in a hospital setting experience greater delays in treatment compared to those seeking care in a private practice setting. These findings might not be generalizable to other hospital settings or private practices due to the inherently unique characteristics of the sites used in this study.

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.

Purpose: The purpose of this study was to analyze and evaluate the correlation between dental injuries and the pattern of maxillofacial fractures. The correlation with age, gender, trauma mechanism and type of maxillofacial fracture was also investigated., Materials and Methods: From January 2000 to December 2009, 1131 patients with facial fractures were registered. Of these, 473 presented with associated dental trauma. The information and data collected and analyzed included: age, gender, mechanism of injury, type of facial fracture, type of dental injury, and the relationship between dental injury and facial fracture., Results: Dental injury was sustained by 473 patients (41.8%), with a total of 2215 injured teeth. Of the 2215 injured teeth, 1191 (53.8%) were in the maxilla and 1024 (46.2%) in the mandible. Fall from a height had the highest risk of dental injuries (OR = 4.145, P = 0.002). The central incisor was the most injured tooth for both the maxilla (388, 36.2%) and mandible (284, 27.7%). The most common type of dental injury was avulsion (1070, 47.4%). More anterior teeth in the maxilla were of crown fracture, avulsion, and intrusion than that in the mandible, whereas more anterior teeth in the mandible were of subluxation and concussion than that in the maxilla. Dental injuries were more prone to occur in patients who sustained only symphysis fractures (OR = 2.817, P < 0.001), only 0.236-fold risk in patients who sustained only mandible angle fracture (P < 0.001)., Conclusions: The occurrence of dental trauma is significantly related to the pattern and position of the maxillofacial fractures., (© 2012 John Wiley & Sons A/S.)

Purpose: The purposes of this study were to investigate the occurrence and patterns of dental trauma in patients with single mandibular fracture and to evaluate the relationships between dental injury and fracture site of mandible., Materials and Methods: From January 2000 to December 2009, 869 patients with mandibular fractures were registered. Only the patients with single mandibular fracture were included. The information and data collected included age, gender, mechanism of injury, type of mandibular fracture, and type of dental injury., Results: Single mandibular fractures were sustained in 294 (33.8%) patients. Of these, 43.5% (128 patients) presented with associated dental injuries (509 injured teeth). The patients' male/female ratio was 2.46:1 (91 males and 37 females). Patients in 30-39 year age group possessed the highest risk of suffering dental trauma (odds ratio = 2.004, P = 0.014). Road traffic accidents were the most common mechanism of injury (54, 42.2%). Lower-anterior teeth were more often injured in patients with symphysis fracture (P < 0.001), and patients with condylar fracture more frequently sustained upper-posterior teeth injury (P < 0.001). Lower-posterior teeth injury was mostly found in patients with mandibular body fracture (P < 0.001) or angle fracture (P < 0.001). Dental injuries were more prone to occur in patients who sustained only symphysis fractures (odds ratio = 3.283, P < 0.001), and the risk was only 0.193-fold in patients who sustained only mandible angle fractures (odds ratio = 0.193, P < 0.001)., Conclusions: The occurrence and type of dental injury were significantly related to the fracture site of mandible., (© 2012 John Wiley & Sons A/S.)

Background: Hospital emergency departments (ED) are confronted with triaging and managing dental emergencies of both traumatic and non-traumatic origin. However, the literature suggests that there exists inadequate knowledge of the management of traumatic dental injuries (TDI) among medical professionals who must be knowledgeable and have the appropriate resources needed to triage or treat patients presenting with TDI., Aim: The aims of this study were to (i) evaluate the resources of Massachusetts emergency departments (MEDs) for TDI, (ii) determine the knowledge of management of TDI among MED physicians, and (iii) investigate potential factors that affect their knowledge., Materials and Methods: Surveys were mailed to MED directors and their physicians. The director survey contained questions regarding institutional information for each emergency department (ED). The physician survey contained questions about physician characteristics and tested their knowledge of managing dental trauma., Results: A total of 72 surveys (16 MED directors and 56 physicians) were returned and included in the analysis. Only 50% of the MEDs had on-site dental coverage, 43.8% had 24-h off-site dental coverage, and none had a formal written dental trauma protocol. MED physician's knowledge of the appropriate management of luxations and avulsions was generally good, but poor for dental fractures. The MED physician's knowledge for the emergent nature of the various injuries was generally good with that of avulsions being the best. Physicians were more likely to have a better knowledge of managing dental trauma if they were specialists in pediatric emergency medicine (P = 0.001) or their hospitals had an academic affiliation (P = 0.05)., Conclusions: Based on the findings from this study, educational campaigns must be undertaken to improve both the resources available to the ED, and the knowledge of physicians regarding emergency management of TDI. In addition, efforts should be made by local dental organizations to provide ED with lists of dentists who are knowledgeable and willing to be available 24 h day⁻¹ to consult with and, if necessary, treat TDI. These efforts would enhance the long-term outcomes for patients sustaining dental trauma who present to hospital ED., (© 2012 John Wiley & Sons A/S.)

Background: Dental trauma at the workplace may have important clinical and occupational consequences, but little is known about its profile., Aims: To describe the frequency and characteristics of work-related dental injuries., Methods: For all patients with occupational dental trauma seen at the FREMAP Hospital of Barcelona (Spain) between January 2000 and December 2006, we recorded their characteristics, type of work and nature of the trauma, including cause of the accident, extent of trauma, reason for referral to a dentist, and days of sick leave., Results: The frequency of dental trauma was 1.71 per 1000 occupational accidents attended and was related to the worker's occupation. In security services, it was 7.37 per 1000 and 2.01 in transport services. The frequency was similar in both genders. The most common causal mechanisms were direct impact (38%), traffic accidents (29%) and falls at the same level (16%). Causal mechanisms differed according to gender and type of job. Most injuries consisted of dental fracture (54%), and 67% of the patients required referral to a dental surgery. Injuries were limited to the mouth in 52% of cases, 8% of which required sick leave, with a mean duration of 23.0±21.8 days., Conclusions: The frequency of dental trauma in this working population was low and was related to the worker's occupation. Causal mechanisms differed according to gender and type of job. Most dental injuries were severe and required referral to a dental surgery. Frequency of sick leave was low.

Sense of coherence (SOC) has been related to oral health behaviors and oral-health-related quality of life (OHRQoL) in observational studies. This cluster-randomized trial aimed to test the effect of an intervention to enhance SOC on OHRQoL in children. Twelve primary schools were randomly allocated to intervention and control groups. The intervention was comprised of 7 sessions over 2 mos, focusing on child participation and empowerment. The first 4 sessions were classroom activities, and the last 3 involved working on healthy school projects. Trained teachers who received a one-day course delivered the intervention. Socio-demographic and clinical data, together with self-reported measures of OHRQoL, SOC, and oral health beliefs, were obtained from 261 total 10- to 12-year-olds (133 in the intervention and 128 in the control groups). Data were collected at baseline, 2 wks after the intervention, and at three-month follow-up. Mixed-effects models indicated that the intervention increased SOC and improved OHRQoL, together with oral health beliefs and gingival health. The findings offer experimental evidence that OHRQoL can be influenced by SOC. SOC may also provide an avenue for oral health promotion (Australian New Zealand Clinical Trials Registry ACTRN12612000547842).

Objective:   (i) To assess the prevalence of traumatic dental injuries (TDI) in individuals with cerebral palsy and its possible relationship with type of palsy at Udaipur city, Rajasthan, India. (ii) To assess the prevalence of temporomandibular joint symptoms in cerebral palsy individuals., Materials and Methods:   The total sample comprised of 281 cerebral palsy individuals in the age group of 10-35 years. Clinical examination for dental trauma was performed on the basis of Andreasen & Andreasen classification (1994). Chi-square test, multiple logistic and stepwise linear regression analyses were carried out to find out the relationship between cerebral palsy individuals with different independent variables., Results:   Findings of the study indicated that there was highest prevalence of TDI in cerebral palsy patients with hemiplegia (40.6%) (P = 0.00). Stepwise and multiple logistic regression analyses showed that the best predictors for dental traumatic injuries was overjet and type of cerebral palsy., Conclusion:   It was concluded that hemiplegic cerebral palsy patients were most prone to TDI., (© 2011 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.)

This study aimed to assess the responsiveness of the Brazilian version of the Parental-Caregiver Perception Questionnaire (B-P-CPQ) to describe changes in quality of life (QoL) after treatment for traumatic dental injury (TDI). After eligibility criteria were applied, 42 of 255 patients who went to a dental trauma center for TDI treatment were included. QoL was evaluated in two different appointments: A1 (after TDI) and A2 (after TDI treatment). The B-P-CPQ scores were calculated using the additive method. Psychometric properties like internal consistency (Cronbach's Alpha), test-retest reliability, intraclass correlation coefficient (ICC), and construct validity (Spearman's correlations) were assessed, and, mainly, the responsiveness was analyzed by standardized response means (SRM). Mean B-P-CPQ scores were 30.05 (1.74 SD) and 2.67 (4.05 SD), while the median scores were 17.39 and 2.00 (P < 0.01), respectively in A1 and A2. Cronbach's Alpha was 0.87 in A1 and 0.66 in A2. ICC was 0.90. B-P-CPQ scores were correlated with overall well-being (P < 0.01; rho: 0.71). The B-P-CPQ responsiveness scores declined 27.38 points, and a perfect SRM of 1.76 was achieved. The B-P-CPQ scores indicated changes in QoL following TDI. The change was observed as an impact decrease after TDI treatment, demonstrating positive reduction and improvement on QoL. The responsiveness of the P-CPQ (Brazilian version) in detecting change on QoL after TDI treatment was confirmed by SRM assessment. The findings represent an evidence of the importance of professional care and treatment of TDI., (© 2011 John Wiley & Sons A/S.)

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.)

Purpose: This study was carried out to identify the occurrence, type, location, and severity of dental injuries (DIs), as well as predictors for DIs, in pediatric patients with facial fractures., Materials and Methods: This study examined the files of patients aged 16 years or less who had sustained facial fractures during a 12-year period. The outcome variable was DI. The explanatory variables included gender, age, trauma mechanism, and type of facial fracture. Data analysis was carried out with the χ(2) test and logistic regression analysis., Results: A total of 200 patients, 119 (59.5%) of whom were boys, met the inclusion criteria. The mean age was 12.6 years. A total of 45 patients (22.5%) had DIs. Crown fracture, the most common type of DI, occurred in 59.9% of all DIs. The most common location of crown fractures was in the premolars (37.4% of all crown fractures). Multiple DIs occurred in 71.1% of those with DIs and severe DI in 66.7%. DIs were significantly associated with motor vehicle collision (MVC) (P = .02) and mandibular fracture (P = .03)., Conclusions: DIs are common in pediatric patients with facial fracture, often being both multiple and severe. In association with pediatric facial fracture, facial surgeons should be especially alert for crown fractures in the lateral parts of the jaws., (Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Management of dental trauma in children can be a challenging problem in dental practices. Knowledge of current trauma guidelines is vital in effectively managing dental trauma so that favorable outcomes are achieved. The purpose of this paper is to review the current guidelines and management strategies of dental trauma in primary and permanent dentitions. When planning emergency treatment for a primary tooth, it is important to consider the lifespan of the tooth, the potential damage to the permanent dentition, and the behavior of the child. After injury to permanent teeth, the treatment strategy is dictated by the concern for vitality of the periodontal ligament and pulp of the injured tooth. The emergency nature of dental trauma requires that the dentist be knowledgeable and readily available during and after office hours to provide care.

The purpose of this study was to investigate the prevalence and types of traumatic dental injuries in situations of domestic violence. A coross-sectional study was conducted and data were collected from the police occurrence records to domestic physical aggression between 2001 and 2005. Of the 1,844 subjects who underwent medical evaluation, 15 had information pertaining to traumatic dental injuries. From the medical records, the forensic medical reports completed by the forensic medical experts who examined the victims after the aggression were reviewed and data of individuals with dental injuries (e.g., fractures, luxation and avulsion) were collected. In the selected sample, there was a predominance of individuals with injuries to the head and neck region (38.7%), and the frequency of traumatic dental injuries among all injuries to the head and neck region was 2.0%. The most frequently injured teeth were the maxillary incisors (31.8%), followed by the mandibular incisors (27.3%) and the maxillary canines (9.1%). In 31.8% of the injured teeth, the forensic experts did not specify the nomenclature. Of the dental trauma cases, 59.1% were fractures, 27.2% were luxations and 13.7% were avulsions. In conclusion, domestic violence was an important etiologic factor of traumatic dental injury. The aggression in all cases occurred in the form of punches and slaps. Fracture was the most common type of traumatic dental injury, and the most frequently injured teeth were the incisors.

The purpose of this article is to suggest important considerations for epidemiologic and clinical studies in the field of dental traumatology. The article is based on the authors' experiences from research in this field and editorial board work for the scientific journal Dental Traumatology. Examples are given of issues where development is important. The importance of planning ahead of the study and consulting with experts in other fields is emphasized., (© 2011 John Wiley & Sons A/S.)

The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5%. Trauma incidence was higher in boys (57.0%) and in children less than two years of age (40.3%). Falling while walking or running was the most predominant etiologic factor (37.7%), and the most prevalent type of injury was subluxation (32.6%). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0%). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

Background: Dental injuries occur commonly in childhood and may necessitate demanding courses of treatment. The aim of this study was to investigate a variety of clinical and demographic factors that may influence the quality of life impacts experienced by children after a dental injury., Method: A total of 244 children who attended a UK dental hospital, for management of traumatised permanent incisors, were invited to participate in the study. Clinical, demographic and psychosocial variables were collected at baseline, and outcome variables were assessed again at a 6-month follow up. Clinical variables included number of teeth injured; severity of the dental injury; visibility of the injury; time since injury; and number of dental appointments attended within the hospital. Psychosocial outcomes assessed included children's oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL)., Results: One hundred and eight children participated in the baseline study (44% response rate), and of this group of children, a total of 70 children completed follow-up questionnaires (65% response rate). The results indicated that the most affected areas of children's OHRQoL and HRQoL were functional limitations and school-related activities, respectively. Of all the demographic and clinical variables, which were investigated within the current study, the only variable that significantly predicted OHRQoL and HRQoL for children was gender. Boys were found to report fewer impacts on their OHRQoL and HRQoL than girls. Interestingly, over two-thirds of children reported fewer impacts at the 6-month follow up., Conclusions: The results revealed that girls were more likely to report higher level of impacts on their OHRQoL and HRQoL than boys following traumatic injury to their permanent incisors. Clinical variables were not significant predictors of child quality of life outcomes following dento-alveolar trauma at baseline or at the 6-month follow up., (© 2010 John Wiley & Sons A/S.)

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.

Aim: To audit key demographic and clinical factors relating to treatment of trauma to the permanent dentition at the Paediatric Dental Department, Cork University Dental School and Hospital, Ireland and to compare clinical management with guideline recommendations., Study Design: Clinical audit., Methods: Consecutive clinical records for children attending for treatment of dental trauma were audited with regard to age, gender and distance travelled. The number of teeth per patient, the cause, type and prevalence of injury were examined. Splinting of mobilisation injuries and the prevalence of pulp extirpation were compared with published guidelines., Results: Records were available for 94 children (65 male, 29 female) with a mean age at time of injury of 10.1 (SD±2.64) years. There were 82% of children living within 50 km of the Hospital. A total of 168 teeth were involved. Dental injuries comprised 39 uncomplicated crown fractures, 18 complicated crown fractures, 37 subluxations, 9 root fractures, 10 extrusions, 14 lateral luxations, 7 intrusions, 30 avulsions and 4 were unclassified. Sport injuries accounted for 23.2% of injuries to teeth, falls for 22.6%, bicycles were involved in 15.5%, other domestic accidents 6.5%, assault 4.2%, vehicles 3.0%, swimming 0.6%. and the remaining 24.4% were unclassified. In some instances of avulsion, lateral luxation, subluxation and extrusion injuries, a tendency to splint for durations longer than that recommended in guidelines was observed. Prevalence of pulpal extirpation for replanted teeth was in keeping with recommendations., Conclusion: General adherence to guidelines in respect of splinting and prevalence of pulp extirpation was demonstrated. Utilising a standardised recording system would facilitate the clinical audit process.

Introduction: The aim of this retrospective study was to examine the effect of orthodontic extrusion on the pulpal vitality of maxillary incisors with a history of trauma., Methods: Pulpal condition was examined clinically (rating of crown color and sensitivity testing with a cryogenic spray) and radiologically (periapical and panoramic radiographs) after orthodontic extrusion of previously traumatized (Orthodontics/Trauma group, n = 77) and nontraumatized teeth (Orthodontics group, n = 400) and after previous dental trauma without subsequent orthodontic treatment (Trauma group, n = 193). Dental traumata were divided into hard tissue injuries (fracture of enamel and enamel chipping, fracture of enamel-dentin without pulpal involvement, fracture of enamel-dentin with pulpal involvement, root fracture, crown-root fracture) and periodontal injuries (concussion, subluxation, intrusion, extrusion, lateral luxation, and avulsion)., Results: Teeth in the Orthodontics/Trauma group showed a significantly higher frequency of pulp necrosis than teeth in the Orthodontics group (P < .001) or teeth in the Trauma group (P < .009). In addition, teeth in the Orthodontics/Trauma group with periodontal injuries showed a significantly higher rate of pulp necrosis than teeth in the Orthodontics group (P < .001) or the corresponding teeth in the Trauma group (P = .004). No significant differences were observed between teeth in the Orthodontics/Trauma group with previous hard tissue injuries and teeth in the Orthodontics group or the corresponding teeth in the Trauma group. In addition, no statistically significant differences were determined between central and lateral incisors., Conclusions: The results indicated that maxillary incisors with a history of severe periodontal injury have a higher susceptibility to pulp necrosis during orthodontic extrusion than nontraumatized teeth., (Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Epidemiologic aspects of traumatic dental injuries (TDI) were evaluated in the permanent dentition in a sample of 847 patients treated at the Dental Urgency Service of the Dental School of the Federal University of Goiás, Brazil, between May 2000 and May 2008. The statistical treatment analyzed data from frequency distribution and chi-square test. The level of significance was set at 5% for all analyses. The results showed a higher incident among males (610; 72.01%) with mean age of 6-10 year-old. Uncomplicated crown fracture (without pulp exposure) (502; 26.95%), avulsion (341; 18.30%) and complicated crown fracture (with pulp exposure) (330; 17.71%) were the most prevalent TDI. The prevalence of trauma throughout the years showed proportionality, being observed a larger number of cases between July and September (249; 29.39%). The most affected teeth were the maxillary central incisors (65.65%), followed by the maxillary left lateral incisors (19.67%). In 311 participants (18.25%), only one tooth was involved, while in most patients (536; 81.75%), TDI occurred in more than one tooth. Significant proportion (82.27%) of traumatized teeth presented completely formed root apex. The main etiologic factors involved in TDI were falls (51.71%), traffic accidents (22.90%) and violence (5.67%). Based on the obtained data, it may be concluded that accurate policies of TDI prevention must be established, capable of stimulating the exposure of appropriate protocols for management of these lesions. The prevalence of TDI in Goiânia subpopulation is compared to the prevalence reported in epidemiological studies in others populations.

The old Boy Scout's motto, "Be Prepared," can be beneficially applied to the management of dental trauma. A large number of dental injuries occur every year, primarily in the 7- to 15-year age group. Preserving the natural dentition during that time period is critically important, because tooth loss at an early age presents significant lifelong dental problems. Being prepared to manage an emergency can make the difference between tooth loss and a successful outcome. Two factors contribute to achieving the better outcome: knowledge of the essentials of dental traumatology, and being prepared with the dental materials needed for appropriate treatment. It is the hope of the authors that these factors are clearly elucidated in this article.

Treatment of traumatized teeth generally occurs in two phases: short-term emergency treatment and stabilization followed by endodontic management and review. These authors recently reviewed the endodontic considerations in the treatment of traumatized permanent anterior teeth, and in this article review the early management of traumatized permanent teeth. Preoperative assessment and emergency management are emphasized, as is the treatment of immature teeth for which continued development of the root system must be encouraged. Factors influencing long-term prognosis are discussed and the influence of various management strategies evaluated.

A cross-sectional survey was carried out through clinical examination of anterior teeth among 4015, 6- to 13-year-old children enrolled in 20 public primary schools of Sulaimani city, northern Iraq. The prevalence and pattern of traumatized anterior teeth were studied in relation to age, gender, type of injury, dental treatment needs, place and cause of the trauma in addition to occlusal relation and upper lip position. The prevalence of children with traumatic dental injuries was found to be 6.1% (243 children) of the total sample. Age and gender were highly significantly associated with dental trauma (P < 0.001). Males were more affected than females and the prevalence increased with age. Simple enamel fracture was the most common type of injury followed by enamel-dentine fracture and concussion. The maxillary central incisors were found to be most affected by trauma followed by mandibular central incisors and the maxillary lateral incisors. The number of injured teeth per child was 1.38 (totally 336 anterior teeth were found with dental trauma) and single tooth trauma was the most common type (69.5%). Results showed that only 7% of the traumatized anterior teeth received treatment and about half (48.7%) of the remaining traumatized teeth did not need dental treatments, while the least treatment type needed was extraction (3.5%). The highest proportions of traumatized children were found with class II division 1 malocclusion and inadequate upper lip coverage. Falls and playing were the most common causes of dental injury, while home was the most common place of trauma occurrence. The present study revealed a relatively low prevalence of dental trauma, but still this figure represents a large number of children. Therefore, educational programs are to be initiated for the community regarding causes, prevention and treatments of traumatic dental injuries.

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 purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, type of tooth and trauma, from the records of traumatized children (0-3 years) referred to the Ondokuz Mayis University, Dental Faculty, Department of Pedodontics in middle Black Sea region of Turkey. A total of 563 boys and girls participated in the study. Traumatic dental injuries were recorded using the classification of the World Health Organization modified slightly by Andreasen & Andreasen. Traumatic dental injuries were identified in 17.4% of the children. The largest percentage of injuries were in the 13-18 months old children with no significant gender differences (P > 0.05). Periodontal tissue injuries were the most common (84.7%) with no statistical difference between different ages or gender (P > 0.05). The main etiological factor of traumatic dental injury was falls (73.5%) and it was not different between age and gender (P > 0.05). The maxillary central incisors were involved in a higher percentage of traumatic injuries (98%), with no differences between the right and the left sides (P > 0.05). Treatment was sought for 37.4% of children within 1-7 days. It is suggested that parents should be informed about prevention of traumatic injuries and to contact a dentist immediately.

Many articles have detailed local accidents and complications in dental implant treatment. Comparisons of the data they report are not always easy because different criteria have been followed in the various classifications and there is confusion between the terms accident and complication. The aim of this paper is to propose a classification that considers the timing of the events and makes a distinction between the two terms. Accidents are events that occur during surgery, and complications are any pathologic conditions that appear postoperatively. The proper diagnostic procedures and surgical techniques for their prevention and treatment are also described.

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.

Most epidemiologic studies of dental trauma are restricted to children and sports. The goal of the present study was to collect information on dental trauma in as many Swiss adults as possible. For that purpose data of the largest insurance company of Switzerland (SUVA) were evaluated and compared for the years 1992 and 2002. In these 2 years 23 000 dental injuries were reported to all insurance companies in Switzerland. Most often the upper central incisors were injured. However, in 20% posterior teeth were also affected. In 1992 most of the dental trauma was experienced by 30-39 year olds, in 2002 by 40-49 year olds. Regardless of the year, most of the injuries occurred at home; more than one-fifth of the injuries were sports related. Most common injuries were crown fractures without pulp involvement. In less than 10% of all cases more complicated injuries like avulsions or crown-root fractures occurred. Most traumatic injuries were treated by direct fillings and custom-made crowns; more involved treatments were required less often. Comparison of the years 1992 and 2002 showed that the numbers of and causes for injuries had hardly changed in these 10 years. However, the choice of therapy was related to the general development of dental medicine, which became especially apparent in the fields of adhesive dentistry and implantology.

The aim of this study was to assess the prevalence of dental trauma as compared to the prevalence of dental caries in children aged 3-59 months. A cross-sectional study was carried out during the National Immunization Day for Polio in Recife, northeast Brazil. The sample comprised 3489 children under the age of 5. The clinical examination was performed by 123 previously trained dental students. The inter-examiner agreement for crown fracture was 90.32% and for tooth discoloration it was 83.87%. The prevalence of dental caries was assessed using the dmf-t index. The statistical methods included descriptive analysis and the chi-square test with a margin of error of 5%. A total of 56 142 teeth were examined and the prevalence of dental trauma was 14.9%. Dental fracture was the most prevalent injury observed in 516 teeth (0.9%), followed by discoloration in 191 (0.9%), intrusion in 12 (0.02%) and extrusion in five (0.008%). The most affected teeth were the upper central incisors. The prevalence of dental trauma increased significantly with age and family income (P < 0.0001). Dental trauma was most prevalent from 2 to 5 years of age. The prevalence of dental caries was 14.3%. This prevalence increased significantly with age (P < 0.0001) and with the reduction in family income (P < 0.0001). The results showed that the prevalence of dental caries and dental trauma was similar, and that both caused the same amount of damage to dental health for the target population.

Traumatic dental injuries (TDI) are common in children. There are few data on prevalence of TDI in South African populations. We assessed the prevalence and causes of TDI to anterior teeth in 11- to 13-year-old South African schoolchildren through a cross-sectional study, using a random cluster sampling method. Oral examinations were performed by calibrated examiners following training for TDI to anterior permanent incisor teeth (eight teeth) using a modified version of Ellis's classification. Of the study population of 2610 children aged 11-13 years old from 26 primary schools, 1665 children participated. The response rate was 64%. More than two-thirds (64.4%) were 12 years old. One hundred and six children had a TDI (6.4%). After adjusting for the effect of age and socio-economic status, boys had an almost 2.5 (95% CI: 1.59, 3.69) times higher probability of having a traumatic dental injury than girls. The highest prevalence was in 12 year olds and in the high socio-economic status group. Most of the children had trauma to one tooth. Enamel fracture was the main type of TDI (69.1%). The majority of the TDIs were untreated (85.4%). Homes and schools were the most common places where TDIs occurred, while only 5.7% occurred on a street, road or pavement. Falls were the main cause of TDIs. Sport was the second most common cause and the third most common cause was collision with objects. The present study indicates that the prevalence of TDIs in schoolchildren is not as high as has been reported in other countries. The prevalence of TDIs in this population was relatively low.

The aims of this study were to assess the epidemiology of traumatic dental injuries (TDI) to primary teeth in infants and toddlers between 1 and 3 years of age and investigate whether TDI was related to biological and social factors. A representative sample of infants and toddlers in the city of Belo Horizonte, Minas Gerais, Brazil (n = 519) was examined during a vaccination campaign. The evaluation of clinical signs of previous dental trauma was performed by nine previously calibrated examiners (intra-examiner Kappa = 0.95%; inter-examiner Kappa = 0.88%). Data were analysed through descriptive analysis, the chi-squared test (P < 0.050) and logistic regression. The prevalence of dental trauma was 41.6%. Among the 519 children examined, 193 (37.2%) had enamel fractures, 30 (5.7%) had enamel-dentin fractures and only three (0.6%) had enamel-dentin fractures involving the pulp. Dental care had been performed within the first 24 h in 4.1% of the sample and after 36 h in 0.8% of the sample. There was no statistically significant difference between genders. The most reported aetiologies were falls (28.8%) and collisions (6.8%). There were no statistically significant associations between the prevalence of dental trauma and non-nutritive sucking habits, dental caries or lip incompetence (P > 0.050). Children of mothers with low levels of schooling (0-6 years of study) had a greater prevalence of TDI (P = 0.001). The results of the logistic regression also demonstrated a significant association between dental injury and the Social Vulnerability Index (P = 0.045). Children from families with high social vulnerability (worse living conditions) had a 1.51 (95% confidence interval 1.0-2.2) greater chance of exhibiting TDI. These results can help guide the implementation of health promotion policies.

The aim of this study was to determine the prevalence and risk factors of dental trauma in the permanent anterior teeth of schoolchildren in Campina Grande, Brazil. A sample of 448 schoolchildren, 228 boys and 220 girls, aged 7-12 years, were randomly selected from 17 public schools in an urban area. The sample selection was carried out in two stages: first, schools were selected by simple sampling and then children were chosen using a proportionality coefficient. Data were collected through clinical examinations and interviews, after examiner calibration. Overjet (OJ) was considered a risk factor when it presented values higher than 3 mm, while lip coverage was classified as adequate or inadequate. Yates' chi-squared test verified the association between the variables and odds ratio. Significance level was set at 5%. The prevalence of dental injuries was 21%. Boys experienced more injuries than girls, 21.9% and 20%, respectively (P > 0.05). Falls and collisions were the main causes of dental trauma, 63.8% and 24.5%, respectively. There was a statistically significant difference between traumatic dental injuries (TDI) and OJ (95% CI 0.22-0.63) (P < 0.001) and between TDI and inadequate lip coverage (95% CI 9.16-34.93) (P < 0.001). Data indicated that boys presenting an OJ size >3 mm and inadequate lip coverage were more likely to have TDI in Campina Grande, Brazil.

The objective of this study was to assess the incidence, characterizations and etiologies of traumatic dental injuries among Israeli army soldiers during basic combat training. Dental files of soldiers (n=11,053) from several combat military camps, who completed 8 months of basic training during 2006-2007, were analyzed for frequency, type and etiology of dental trauma. The study included 118 files. The incidence of dental trauma was 1.1% per 8 months (1.6% per year). The most frequently traumatized tooth was the right maxillary central incisor (46%), most prevalent type of injury was a noncomplicated crown fracture (45%), and most frequent etiology was the personal weapon (53%), with no statistical correlation toward a right-sided injury. The incidence of dental traumatic injuries during basic combat training was higher than among army personnel as found in other studies. A weapon impact can be a major risk factor for soldiers during basic training.

The purpose of this study was to assess the frequency, the effective factors and the applied treatments for dental trauma among children aged 1-15 years from Eastern Anatolia in a 6-year period. The total frequency of trauma in this study was calculated as 4.9% during a 6-year period. The males were found to have more traumatic injury than females (P < 0.05). Also, the permanent teeth were more vulnerable to dental trauma than the primary teeth (P < 0.05). The highest frequency of traumas in the primary teeth was observed at the age of 5, whereas the rate for the permanent teeth was at the age of 10. The teeth mostly influenced by the traumas were the upper central incisors in both primary and permanent teeth. It was in October that traumas were mostly seen for the permanent teeth and in June for the primary teeth. The most frequent source of trauma in both genders and in both primary and permanent teeth were falls. The most common type of trauma in the primary teeth was lateral luxation, while it was enamel-dentin crown fracture in the permanent ones. Soft tissue injuries were observed in 143 of 653 dental traumatized children. The most common method of treatment was examination and follow up for the primary teeth, and only direct restoration for the permanent teeth without any endodontic treatment. 15% of the patients applied for treatment 1 year after injury event. Therefore, it was concluded that the patients, parents and teachers living in Eastern Anatolia should be informed about the necessity of early treatment of dental traumas and the consequence of a delay.

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.

Dental trauma has been considered as a public health problem that affects mainly children and youngsters and due to its impact on the patient's quality of life. This study presents the results of a 6-year survey of the occurrence and characteristics of dental trauma in patients admitted to the Service of Surgery and Oral and Maxillofacial Traumatology of the School of Dentistry of Araçatuba (UNESP, Brazil) after emergency care in hospital facilities in the region of Araçatuba, SP, Brazil. For such purpose, the clinical files of patients treated at the Service between 1999 and 2005 were reviewed. Information regarding gender, age, number of traumatized teeth, etiology and diagnosis of the trauma was collected from the files of patients with tooth injuries and recorded in case report forms specifically designed for this purpose. The results showed that from a total of 4112 patients admitted to the Service within the surveyed period, 266 (6.5%) had tooth injuries (172 males - 64.7%; 94 females - 35.3%). The total number of traumatized teeth was 496. Most patients belonged to the 16-20 year-old age group (20.3%) and the most frequent causes of tooth injuries were bicycle accidents (28.6%), motorcycle accidents (19.2%) and falls (18.8%). Injuries to the periodontal tissues were the most frequent type of tooth injuries (408 teeth; 82.26%), occurring in 118 primary and 290 permanent teeth. Among the injuries to the periodontal tissues, avulsion was the most common (32.86%) (29.41% for primary and 34.0% for permanent teeth), followed by extrusive luxation (19.15%) (25.21% for primary and 17.24% for permanent teeth). In conclusion, in the surveyed population, cases of tooth injuries were more frequent in males aged 16-20 years old due to cyclist accidents with predominance of injuries to the periodontal tissues, in particular, avulsions.