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PubMed1995

A new concept of education and knowledge retrieval through network systems.

Recent epidemiological investigations reveal increasing figures of prevalence of dental traumatology; however, basic and clinical research is rather scarce in the scientific literature. The development of computer technologies and the advent of communication pathways through network systems offer increased opportunities to disseminate theoretical and practical data on dento-facial traumatisms. A new server launched on Internet, the global network system, is described and proposed to allow better recognition and information sharing through both practitioners and institutions in the field of dental traumatology.

Computer Communication Networks↗
PubMed1996

Root perforations: classification and treatment choices based on prognostic factors.

Root perforations are common complications of endodontic treatment or post preparation and often lead to tooth extraction. Successful treatment depends mainly on immediate sealing of the perforation and prevention of infection. Several factors affect the achievement of these goals, most important of which are: time of occurrence, size, and location of the perforation. A classification of root perforations, based on the above factors, is presented to assist the clinician in the choice of the treatment protocol which will give the best possible results when a perforation is diagnosed.

Dental Instruments↗
PubMed1997

Long-term follow-up of conservative treatment of severely traumatized maxillary incisors.

We present the case of a 26-year-old man who at the age of 9 suffered severe trauma to both maxillary central incisors. The underlying malocclusion was skeletal and classified as dental Class II/1 with severe crowding. Both the maxillary central incisors and the two lower first premolars were extracted and the patient was treated with an edgewise appliance for 2 years. Acceptable occlusal relationships were achieved following orthodontic and adjunctive treatment which consisted of reshaping the maxillary lateral incisors with composite materials and grinding the canines to resemble lateral incisors. A critical evaluation of the esthetic and functional results at the age of 26 years is presented.

Child↗
PubMed1999

Treatment of root perforation by intentional reimplantation: a case report.

Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. In this paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8-year follow-up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforation/instrument retrieval.

Adult↗
PubMed1999

Influence of several factors on the success or failure of removal of fractured instruments from the root canal.

The influence of several factors on the success rate of removal procedures of fractured endodontic instruments was evaluated postoperatively. In 105 teeth with 113 fragments removal attempts were undertaken using a wide range of techniques and instruments. All cases were analyzed with special regard to the following factors: type of tooth and root canal, site of fragment in relation to root canal curvature, length of fragment, and type of fractured instrument. Success of treatment was defined as removal or complete bypassing of the fragment. Of 82 instruments in molars (maxillary: 32, mandibular: 50), 56 were removed or bypassed (max.: 26, mand.: 30). Of 16 fragments in premolars (max.: 12, mand.: 4), 8 could be removed or bypassed (max.: 6, mand.: 2). Of 14 fragments in canines and incisors (max.: 7, mand.: 7), 13 could be removed completely (max.: 6, mand.: 7). When the fragment was localized before the curvature 2 of 18 cases failed, when localized inside the curvature 13 of 31 cases failed and when localized beyond the curvature 15 of 33 cases failed. Anatomical factors favorable for removal were: straight canals, incisors and canines, localization before the curvature, length of fragment more than 5 mm, localization in the coronal or mesial third of the root canal, reamer or lentulo spirales. In molars removal procedures were most successful in the palatal canals of maxillary molars.

Dental Instruments↗
PubMed1999

A comparison of laser Doppler flowmetry with other methods of assessing the vitality of traumatised anterior teeth.

Laser Doppler flowmetry is a non-invasive electrooptical technique which allows the semi-quantitative recording of pulpal blood flow. This study aimed to determine the reliability (measured as the sensitivity and specificity) of laser Doppler flowmetry as a method of assessing the vitality of traumatised anterior teeth, and to compare it with standard pulpal diagnostic tests. Recordings of pulpal blood flow were taken from 67 non-vital anterior teeth (55 patients), where the pulpal status was confirmed by pulpectomy. For comparison, recordings were also taken from 84 vital anterior teeth (84 patients). Analysis of the recordings allowed diagnostic criteria to be developed which gave the technique a sensitivity and specificity of 1.0 for this sample. None of the other standard pulpal diagnostic methods tested was as reliable. This was usually due to low sensitivities, which ranged between 0.92 for sensibility testing with ethyl chloride down to 0.36 for periapical radiolucency and 0.16 for a history of pain. Laser Doppler flowmetry was found to be a reliable method of assessing the pulpal status of traumatised anterior teeth, although it is technique-sensitive and time-consuming to use.

Adolescent↗
PubMed1999

Detection and measurement of endodontic root perforations using a newly designed apex-locating handpiece.

Access openings and lateral root perforations were prepared in 40 single-rooted extracted teeth. The distance to the perforations was measured visually and then with the Tri Auto ZX. The electronic device was used first in its apex-locating function and then in conjunction with its automatic reverse mechanism. On average, the electronically measured length was slightly shorter than the visually measured length (P < 0.05). When the automatic reverse mechanism was used, the values registered were either consistent with or slightly different (+/- 0.5 mm) from the electronically measured length (P > 0.05). The results of this study revealed that the Tri Auto ZX detected and measured endodontic root perforations within a range of clinically acceptable variations.

Dental High-Speed Equipment↗
PubMed2005

Prevalence of oral trauma in children with bilateral clefts.

The main object of this study is to analyze the prevalence of oral trauma in subjects with complete bilateral clefts, with anterior projection of the premaxilla. A total of 106 children aging 6 months to 9 years were analyzed. The caretakers answered a specific questionnaire, in order to report the presence or absence of trauma to the soft and/or hard tissues of the child's mouth. Whenever there was a history of trauma, the patients were submitted to clinical examination. The prevalence of oral trauma was 53%, being 91% of soft tissue lesions, 8.9% of avulsion, 7% of luxation and 1.8% of intrusion. For the males, the prevalence was 56% and for the females it was 47%, with no statistical significance. Regarding the following aspects:period of time spent with the parents and at school, and presence or absence of siblings, no statistical difference could be found. Among the traumatized individuals, 80% aged less than 3 years by the moment of the trauma, 89% suffered the trauma at home, 75% presented lesions in the soft tissue at the premaxilla, 16% in the maxillary incisors, and 8.9% presented lesions in both structures. It was noticed that 45% of the permanent incisors that succeeded the traumatized deciduous teeth presented alterations, being 48% of structure and 52% of structure and position. The prevalence of trauma in this sample was superior to that observed in the literature, without any positive associations between the evaluated aspects. These results suggest that the projection of the premaxilla brings about a higher risk of oral trauma around this area.

Brazil↗
PubMed2004

Federal University of Santa Catarina follow-up management routine for traumatized primary teeth -- part 1.

The objective of this study was to verify if the follow-up management routine of traumatized primary teeth set up by Federal University of Santa Catarina, which performs clinical and radiographic assessments (15 and 45 days; 4, 8 and 12 months) after the oral trauma, enabled an early diagnosis of sequelae which would indicate the need for endodontic intervention, as well as the influence a type of trauma and the child's age could have in the severity of the sequelae. In this study 52 sets of records were used of patients being seen in the last 6 months, with a total of 70 teeth that were receiving follow-up treatment. Patients returned for regular visits set up by the management routine, where clinical and radiographic examinations were performed to check for sequelae, which justified endodontic intervention. Mobility (51.2%) and crown discoloration (25.6%) were the most common sequelae found in the patient's first appointment. In the follow-up visits, replacement root resorption (22.5%) was the second most common sequela found, suggesting endodontic intervention. No significant association was found between severe sequelae, types of trauma and a child's age (chi(2) = 0.3, P = 0.8613). During the intervals of the follow-up visits, it was noticed that between 46 days and 8 months a higher number of sequelae were diagnosed (P < 0.05). The diagnosis of sequelae such inflammatory and replacement root resorption, which can lead to an early loss of a primary tooth, are frequent and that the interval between the follow-up visits has to be changed, suggesting the setting up of management routine 2. The study also concluded that the type of trauma and the child's age are not fundamental factors in the diagnosis of severe sequelae.

Child, Preschool↗
PubMed2004

Federal University of Santa Catarina endodontic treatment of traumatized primary teeth - part 2.

This research sought to evaluate periapical repair in 28 traumatized deciduous teeth that had suffered endodontic intervention due to the presence of internal or external inflammatory resorption or replacement root resorption. After obtaining endodontic access, work length and biomechanical preparation, the root canals were filled with calcium hydroxide and propylene glycol under the form of a dense slurry, during 12 months. Replacement of the intracanal dressing was performed when monthly radiographic examinations showed its absence. After 12 months the teeth were obturated with zinc oxide and eugenol cement. Halting of the inflammatory and replacement root resorption (64.3%; n = 28) occurred 9 months after the use of calcium hydroxide dressings, in a total of 18 successful cases. Fisher's test was applied to relate success with the type of trauma, work length time, child's age and pulpal condition. The test did not present statistical significance (P < 0.05). However, in the qualitative analysis, failure was observed in those cases (35.7%) where replacement resorption was already present at the moment of treatment (up to two-thirds) associated with severe trauma cases. The authors concluded that endodontic treatment must be initiated at an early stage, and must be coincident with the radiographic signs of resorption. Success of the treatment is directly related to the seriousness of the sequelae at the moment of the first examination or the endodontic treatment.

Child, Preschool↗
PubMed2006

Histological evaluation of dog permanent teeth after traumatic intrusion of their primary predecessors.

The aims of this study were to analyze the histomorphology of developing permanent teeth whose primary teeth had suffered traumatic intrusion, as well as to compare the influence of immediate extraction of the intruded tooth to passive re-eruption. Nine dogs from 45 to 50 days old were submitted to the intrusion of the maxillary central and lateral primary incisors using a force applicator adapted to the teeth incisal cuspids. The right side intruded teeth were kept in their sockets and the ones on the left side were extracted 30 min later. After a postoperatory periods of 30 and 60 days, four (group 1) and five (group 2) dogs, respectively, were killed by perfusion. The histological evaluations showed that, in group 1, alterations had occurred in the odontoblastic layer and deposition of the enamel matrix had taken place in some specimens while in group 2, a portion of non-mineralized matrix was observed. We concluded that the morphological changes were because of the immediate trauma of intrusion. No differences were found between the groups where the primary tooth was immediately extracted or left to passively re-erupt.

Ameloblasts↗
PubMed2006

Dental therapists' experience in the immediate management of traumatized teeth.

The optimal immediate management of traumatized teeth is known to be important for long-term success. One hundred and sixty-seven school dental therapists with General Certificate of Education 'Ordinary' (GCE 'O') level qualification were surveyed on their knowledge and experience on immediate management of dental trauma. The results showed only 41.2% felt comfortable with their present knowledge on the subject. A high proportion of the respondents (94.6%) indicated a need for more knowledge. All therapists concurred on the need to replant a permanent tooth and most (85.1%) agreed that this should be done within 30 min. More than half (54.8%) were not sure of the optimal storage medium for avulsed teeth. Their attitude towards acquiring knowledge in this aspect was good (80.5%) and all would take immediate action to settle appointments for trauma cases.

Appointments and Schedules↗
PubMed2006

Traumatic intrusion of permanent teeth. Part 3. A clinical study of the effect of treatment variables such as treatment delay, method of repositioning, type of splint, length of splinting and antibiotics on 140 teeth.

A prospective study of 140 intruded permanent teeth was examined for the following healing complications: pulp necrosis (PN), root resorption (RR; surface, inflammatory and replacement resorption), and defects in marginal periodontal bone healing (MA). The occurrence of these healing complications was related to various treatment factors such as treatment delay, method of repositioning (i.e. expecting re-eruption, orthodontic reposition and surgical reposition), type of splint (rigid, semirigid and flexible), length of splinting (days) and the use of antibiotics. Treatment delay, i.e. before and after 24 h, had no effect upon healing. Active repositioning in individuals with incomplete root formation (surgical or orthodontic) had a negative effect upon the three healing parameters compared with spontaneous eruption. In teeth with complete root formation and an age of 12-17 no repositioning was still the best treatment in regard to MA. In individuals older than 17 years of age, cases were not anticipated to spontaneously erupt and in these cases, the general choice of treatment was either active orthodontic or surgical repositioning. The former procedure appeared in this treatment scenario to slightly reduce the risk of MA complications. However, this treatment procedure was also found to be more time demanding (an average of 22 consultations for orthodontic repositioning compared with 17 consultations for surgical repositioning). If a surgical repositioning was performed, the type of splint (i.e. flexible, semirigid or rigid) appeared to have no significant effect on the type of healing. The same applied to the length of splinting time (shorter or longer than 6 weeks). No effect of dentin covering procedures for associated crown fractures (enamel-dentin fractures) could be demonstrated. Likewise, antibiotics had no apparent effect upon healing. In conclusion, in patients with intruded teeth with incomplete root formation, spontaneous eruption should be expected. In patients with completed root formation and with an age of 12-17 spontaneous eruption can still occur, but must be monitored very carefully. In older patients (i.e. >17 years) with completed root formation, either surgical or orthodontic extrusion should be attempted. The latter procedure appeared to lead to a slight reduction (not significant) in the risk of MA complications. The extent and direction of the intrusion may however favour surgical repositioning.

Adolescent↗
PubMed2006

Pattern of tooth loss in an elderly population from Ibadan, Nigeria.

OBJECTIVES: To determine tooth loss, edentulousness, causes of tooth loss and pattern of tooth loss in the elderly in South East Local Government area (SELGA) in Ibadan. BACKGROUND DATA: SELGA is one of the largest in Oyo State, Nigeria and has a population of 225,800. DESIGN: A cross-sectional survey. METHODOLOGY: A total of 690 elderly individuals who were 65 years and above living in various wards in SELGA were interviewed by two interviewers and examined by two trained and calibrated examiners whilst two record clerks recorded all the findings of the examination. RESULT: Forty-eight per cent of the subjects in the study had not lost any teeth. The mean tooth loss was 4.5+/-7.6. Percentage edentulousness was 1.3% and this was higher in males than in females. This difference was not statistically significant (chi(2)=0.07 p=0.7). The total number of teeth lost was 3,102, 14% of the total number of teeth examined. The study showed that caries was not a major cause of tooth loss. Only 22 (0.7%) teeth were lost as a result of caries, 19 (0.6%) were lost because of trauma and periodontal disease contributed to loss of 3,061 (98.7%) teeth. Mandibular teeth exhibited a higher rate of retention than maxillary teeth. The percentage of elderly individuals with tooth loss increased with age. CONCLUSION: The study highlights the high life expectancy of a tooth among the elderly in SELGA. Despite the different cause of tooth loss in this area, in comparison with developed countries, the pattern of tooth retention appeared similar.

Age Factors↗
PubMed2001

An in vitro comparative SEM study of marginal adaptation of IRM, light- and chemically-cured glass ionomer, and amalgam in furcation perforations.

The furcation regions of 30 human mandibular molars were perforated and sealed using four different materials: IRM, light- and chemically-cured glass ionomer cement (GIC), and amalgam. The materials were compared for marginal gaps in coronal, mid, and apical regions after routine SEM processing. While light-cured GIC showed the smallest gaps in the three regions, in mid and coronal regions chemically-cured GIC, and in apical regions amalgam, showed the largest gaps. IRM cases showed the highest rate of fillings with a good "fit", whereas the majority of amalgam cases and none of the chemically-cured GIC cases were overfilled.

Dental Amalgam↗
PubMedDate not supplied

Oral health status of homeless people in Hong Kong.

The authors report on an oral health survey among Hong Kong Chinese homeless people. A total of 140 homeless men underwent clinical examination and were interviewed with a structured questionnaire. More than 90% had evidence of caries experience; most (75%) were related to untreated caries. The mean DMFT score was 9.0 (DT = 3.2, MT = 5.2, FT = 0.6). Periodontal disease was highly prevalent, with 96% having periodontal pockets. The dental problems most frequently reported by the homeless were: bleeding gums or drifting teeth (62%), dental pain (52%) and tooth trauma (38%). More than 70% of the study's participants perceived a need for dental care. The population surveyed had poorer oral health compared to the general population. High levels of dental needs, both normative and perceived, were found. There is a need to provide more accessible and affordable oral health services to this group of people.

Adult↗