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PubMed1993

Dexamethasone treatment reduces sensory neuropeptides and nerve sprouting reactions in injured teeth.

Dental injuries have been shown to generate extensive structural and cytochemical changes in sensory fibers that contain neuropeptides such as calcitonin gene-related peptide (CGRP) or substance P (SP). The present study was designed to test whether the anti-inflammatory drug dexamethasone (DEX) can alter neural responses to dental injuries. DEX (20 micrograms/100 g body weight) was given to adult rats (n = 10) prior to dental surgery and daily thereafter for 4 days. Control animals received sterile saline vehicle (n = 6) or no injection (n = 1). Each rat was then anesthetized for dental surgery and a cavity was drilled partway through dentin on the anterior side of the right maxillary first molar. Pulp exposure injuries were also made on two right mandibular molars in 14 of 17 rats. After 4 days of daily drug treatment, the rats were anesthetized and fixed by perfusion with formaldehyde-picric acid, and their jaws were prepared for immunocytochemistry. Neural CGRP immunoreactivity near the maxillary cavity injury site of DEX-treated rats was reduced more than 50% compared to controls, as determined both qualitatively and by digital analysis. The SP immunoreactive (IR) fibers in molar pulp also had extensive inhibition of neural reactions to cavity injury. DEX also reduced the immunoreactivity for CGRP and SP in normal contralateral rat molars of all treated rats, and it caused a postoperative loss of weight. Pretreatment for 1-5 days prior to the 4 day injury gave the same results as pretreatment for 1 h. The mandibular pulp exposure injuries induced a chronic abscess and advancing pulpal necrosis but did not show differences in nerve reactions between DEX-treated rats and the controls. In conclusion, the synthetic steroid dexamethasone suppressed the CGRP and SP neuropeptide immunoreactivity in normal dental nerves and it reduced nerve-sprouting responses to dentin cavity injuries; however, sensory nerve reactions to pulpal exposure injuries were not affected by DEX in these experiments.

Animals↗
PubMed2006

Oral health issues for adolescent athletes.

Adolescent athletes are faced with a myriad of influences that can affect their oral health. During these formative years, the choices adolescents make regarding health could have repercussions throughout their lives. Health professionals can play an important role in educating their patients to make wise decisions. By becoming more aware of the health risks to which athletes are exposed,health professionals can learn to recognize these unhealthy behaviors and recommend appropriate prevention and cessation strategies to their patients who participate in sports.

Adolescent↗
PubMed2002

Dental trauma and level of information: mouthguard use in different contact sports.

The objective of the present work was to study the occurrence of dental trauma in different sports, as well as to check if athletes used mouthguard during sport activities, and knew the significance of its utilization. The professional and semi-professional athletes who practised contact sports were interviewed, and were analyzed to determine the occurrence of dental trauma during sport practice, as well as if the athletes used a mouthguard and knew its indication. Results showed a high rate of dental trauma in athletes compared to the general population. The majority of athletes also demonstrated little utilization of mouthguard, in spite of the information about usage during sports practices and a general knowledge of its uses.

Adolescent↗
PubMed2000

Prediction of sports-related dental traumatic injuries.

Predicting sports-related traumatic injuries is an important concern for dental health professionals. A predictive index has been developed that determines the likelihood of a sports-related traumatic dental injury in children and adolescents. This index can be used to aid in the prevention of injury by understanding who is most likely to be injured and what factors influence the chance of injury. The index has been designed for ease of use by dental health professionals, and has incorporated data collection and tracking features.

Adolescent↗
PubMed1992

Oro-facial trauma in children.

Dentoalveolar trauma is unfortunately a regular part of medical practice. The prompt management of such injuries is vital in re-establishing a healthy dentition. As well, the promotion of preventive equipment is paramount: from seat belts and bike helmets to mouthguards. The purchase of over the counter one-size-fits-all mouthguards is not only a waste of money but dangerous. Well made mouthguards fitted by a dentist are a sensible investment to reduce the frequency and severity of costly dental injury and to preserve the attractive aesthetics of natural teeth (Figures 21 and 22). They must be worn in competition and at practice.

Child↗
PubMed1979

[Dental injuries during general anaesthesia and their forensic consequences (author's transl)].

145 dental injuries in 83 patients occuring during general anaesthesia are classified on the basis of the material from a liability insurance company. These mainly affected the upper incisors. In childhood only luxations occured, in other ages no characteristic distribution of different types of damage could be found. Besides intubation, 20 per cent of injuries were caused by Guedel oral airways. Damage to teeth is the main cause of claims in tort from its total number. Damage of healthy teeth generally is due to carelessness, whereas an injury to teeth damaged by other reasons before administration of general anaesthesia causes liability of the anaesthesiologist because of inadequate examination and exploration.

Anesthesia, General↗
PubMed1994

[Dental and dentoalveolar injuries: their etiology, incidence and distribution in a specialized university service].

From 1987 to 1992, 520 patients presenting with traumatic injuries were referred to the Department of Orthodontics and Pedodontics at the University of Geneva. The sample consisted of 949 injuries, involving 556 primary and 393 permanent teeth. They concerned mostly upper primary (56%) or permanent (35%) incisors, and were more frequent in boys (60.6%) than girls (39.4%). Various epidemiological observations concerning etiology, age distribution and seasonal variations are discussed. Given the limits assigned by data derived from a selected sample, they are compared with other studies dealing with traumatic injuries.

Adolescent↗
PubMed2002

The relationship between problem behaviour and traumatic dental injury amongst children aged 7-15 years old.

AIM: The aim of this study was to test whether dental injuries are related to problem behaviour. In addition, it aimed to confirm the relationship between dental injuries and size of overjet and type of lip coverage. METHODS: A hospital-based matched (age and sex) case-control design was adopted. Data were collected through clinical examinations and interviews. The informant-rated version of the Strengths and Difficulties Questionnaire (SDQ) was used to identify problem behaviour. One parent of the child, most often the mother, was interviewed. Hierarchical modelling using conditional logistic regression was used to test the relationship between the five problem behaviours and traumatic dental injuries. RESULTS: The Odds ratio of having a dental injury increased 3.14 times if children have peer relationship problems (P = 0.032), whilst a prosocial behaviour showed a tendency to have a protective effect (OR = 0.25; P = 0.064). Emotional symptoms, conduct disorder and hyperactivity behaviours were not related to dental injury (P > 0.75). Results were adjusted by father's level of education, size of overjet and type of lip coverage, and these variables were significantly related to dental injury (P < 0.05). CONCLUSION: Problem behaviour may play an important role in the occurrence of traumatic dental injury.

Adolescent↗
PubMed1996

Traumatic injuries to anterior teeth in Italian schoolchildren: prevalence and risk factors.

In the present study, the prevalence of traumatic injuries to anterior teeth in 824, 6- to 11-year-old, schoolchildren from Rome (Italy) and the relationship between injuries and predisposing factors were evaluated. Prevalence value of the study-population was 20.26%. This value is higher than those reported in surveys performed in Italian emergency dental services, but it is similar to those of retrospective studies from other countries. The highest prevalence was found among 9-year-old boys (33.69%); the M/F ratio was 1.64. The percentage of injuries with unknown cause (21.46%) was higher than that of other studies. This may be because most of injuries were slight (64.39% of injuries were enamel fractures) and it is likely that children and their parents were not worried about them, when they happened, so that they did not seek urgent dental care-this helps to explain the prevalence values of this and other retrospective studies, which are higher than those from emergency services-and, when interviewed, they did not remember the circumstances of the traumatic event. Using the Mantel-Haenszel's Odds Ratios stratified for age and sex, injuries were related to individual predisposing factors (overjet larger than 3 mm: OR = 2.57, p = 0.0001, short upper lip: OR = 2.23, p = 0.0001 and upper medial incisor protrusion: OR = 3.95, p = n.s.), but not to children's trauma predisposing behaviour (OR = 0.92, p = n.s.). Serious injuries, however, happened to children without predisposing factors and were caused by strong impacts, suggesting that individual risk factors may not affect these type of injuries.

Age Distribution↗
PubMed1998

Traumatic dental injuries: current treatment concepts.

In an overview of traumatic injuries in the permanent dentition, the authors describe the classification of, assessment of and treatment strategies for managing such injuries. They explore pulpal and periodontal considerations, as well as methods of minimizing complications. In addition, they suggest preventive strategies and future directions for trauma management.

Humans↗
PubMed2003

[Effect of teeth protector on dental injuries during general anesthesia].

BACKGROUND: Dental injuries are the most common reason for complaints against anesthetists. The purpose of this study was to investigate the effect of teeth protector on dental injuries during general anesthesia. METHODS: Incidence of dental injuries was evaluated retrospectively in 5,946 consecutive patients between November 1998 and October 2001. All the patients were interviewed directly at a post-anesthetic clinic. RESULTS: Dental injuries were observed in 2.1% of the patients, and the injuries occurred more frequently in the patients undergoing difficult tracheal intubation. The teeth protector used in the present study was made of cellulose aceto-butylate and was produced using eruko-pressed disks molded from own teeth form. One hundred and eighty five patients (3.1%) requested teeth protectors, and none of them had their teeth injured during anesthesia. CONCLUSION: Our results showed that the teeth protector could protect the teeth from dental injuries and increased the satisfaction with anesthesia. Preoperatively anesthesiologists should know the characteristics of patients' teeth and inform the patients of the risk of injury. We conclude that the custom-made protector might be useful and necessary to preserve the teeth from dental injuries during anesthesia.

Adult↗
PubMed2002

Skatepark injuries and the influence of skatepark design: a one year consecutive case series.

Skateboarding and in-line skating are popular activities that attract millions of participants yearly and have spawned the development of skateparks (SPs). This study examined the types and distribution of injuries within a local commercial SP. Subjects were prospectively enrolled in a university Emergency Department (ED) after an injury at a local SP. One hundred subjects were enrolled over 1 year, representing 102 episodes and 106 injuries. Musculoskeletal injuries accounted for 80% of all injuries. Fractures and dislocations were the most frequent injuries (59%); six required operative management. One serious intra-abdominal injury occurred. Head and facial injuries occurred in 17% of subjects; none required operative repair. Admission rate was 9%. Safety equipment use was greater than 91%. Significantly more injuries occurred in the ramp/bars areas compared to the half-pipe and gully areas, suggesting that SP design may significantly influence injury patterns. A substantial number of injuries occurred at the SP, despite controlled conditions and equipment requirements.

Adolescent↗
PubMed2004

The cost of treating children and adolescents with injuries to their permanent incisors at a dental hospital in the United Kingdom.

The aim was to estimate the total cost, including the direct costs (outpatient costs) and indirect costs (missed working day) of treating children and adolescents with traumatic injuries to their incisors. Factors such as the number of treatment visits and the success of outcome were also investigated. The sample was taken from patients who attended the dental trauma clinic at a London teaching hospital between 1990 and 2001. Eighty-one patients, with 111 traumatized incisors were included in this study. The mean age was 9.9 (SD = 2.33) years and the male:female ratio was 3:2. The median number of visits and median treatment duration were eight visits and 21 months, respectively. Sixty-two per cent of the patients lived >5 miles and 25% lived >10 miles from the hospital; 44% of the patients had uncomplicated and 56% had complicated trauma to their incisors. Accidental falls, falls involving a second person, sport-related injuries and road accidents accounted for 30, 22, 22 and 17% of the total injuries. For uncomplicated trauma, 97% of the patients had a successful outcome but this was reduced to 58% for complicated trauma. The average total cost of treating a patient with one traumatic injury was 856 pounds. The best predictor for higher number of visits and unsuccessful outcome was complicated trauma with odd ratios of 4.5 and 24 (95% CI 1.5-13.7 and 2.9-194.2), respectively. It was concluded that the indirect cost was a considerably large proportion (39%) of the total cost. More specialists in paediatric dentistry are needed to improve access to care locally and thus reducing the indirect travelling cost.

Accidental Falls↗
PubMed2005

Transoral 2.0-mm locking miniplate fixation of mandibular fractures plus 1 week of maxillomandibular fixation: a prospective study.

PURPOSE: In this study, a 2.0-mm locking miniplate (LMP)/screw system was assessed in the treatment of mandibular fractures with a 1-week period of maxillomandibular fixation (MMF). PATIENTS AND METHODS: Fifty mandibular fractures in 34 patients with a mean of 6.97 days of MMF were included in the study. The 2.0-mm LMPs were adapted along Champy's line of ideal osteosynthesis and secured with four 8.0-mm locking monocortical screws. All patients were followed for a minimum of 6 weeks. The incidence of soft tissue infections, nonunion, malunion, malocclusion, osteomyelitis, nerve injury, and tooth damage was prospectively assessed. RESULTS: Primary bone healing was achieved in 98% of cases. Three complications (6%) were observed. Two minor complications of intraoral wound dehiscence and malocclusion were noted. A fibrous nonunion requiring 3 additional weeks of MMF was noted. No evidence of malunion, osteomyelitis, plate fracture, iatrogenic nerve injuries, or dental injuries was noted. CONCLUSIONS: A single 2.0-mm LMP placed along Champy's line of ideal osteosynthesis with four 8-mm monocortical locking screws plus 1 week of MMF fixation is a reliable and effective treatment modality for mandibular fractures.

Adolescent↗
PubMed1992

Traumatic dental injuries in normal and handicapped children in Nairobi, Kenya.

Two thousand, seven hundred and ninety one normal and handicapped children aged 5-15 years were examined for traumatic dental injuries. Twelve percent had traumatised teeth while three percent had soft tissue injuries. More handicapped children (18%) than normal children (11%) had injuries. This study indicates that children need to be educated on preventive measures regarding traumatic dental injuries.

Adolescent↗
PubMed1994

A nose stud retainer clip lost within the nasal cavity discovered on dental radiographs.

It is fairly common for a dental surgeon to come across patients with foreign bodies in the nasal cavity. In this paper we report an unusual case of a nose stud retainer clip being displaced into the nasal cavity by trauma, and its discovery on radiographs taken to assess dental injuries. We also present a review of the literature since 1982, and assess the possible sequelae to nasal foreign bodies.

Adolescent↗
PubMed2000

Causes and prevalence of traumatic injuries to the permanent incisors of school children aged 12 years in Jaragua do Sul, Brazil.

AIM: To assess the causes and the prevalence of traumatic injuries to the permanent incisors of 12-year-old schoolchildren in Jaragua do Sul, Brazil. DESIGN: Cross-sectional survey. SETTING: Public and private primary schools. PARTICIPANTS: 476 children of both sexes, selected by multistage sampling technique. METHODS: Clinical examination of upper and lower permanent incisors. MAIN OUTCOME MEASURES: Incisal overjet, lip coverage, traumatised anterior teeth, cause of trauma. Parents' levels of education and employment status and family income. RESULTS: Boys experienced double the percentage of injuries compared to girls. Children with incisal overjet greater than 5 mm (P = 0.077) and inadequate lip coverage (P = 0.667) were not more likely to have experienced dental injuries. The main causes of injuries to the permanent incisors were falls (26 per cent), traffic accidents (20.5 per cent), sports (19.2 per cent), violence (16.4 per cent) and collisions with people or inanimate objects (6.8 per cent). Socio-economic measures had no significant effect on prevalence of trauma. CONCLUSIONS: Policy makers must take the causes of trauma into account when developing a strategy for the prevention of dental injuries. The role of violence in causing traumatic dental injuries has been underestimated.

Accidental Falls↗
PubMed2003

Etiology of traumatic dental injuries in 11 to 13-year-old schoolchildren.

PURPOSE: To assess place, activities and human intention related to Traumatic Dental Injuries (TDI) events in 11 to 13-year-old schoolchildren in Biguaçu, Brazil. Also, to test the association between socio-economic status and TDI. MATERIALS AND METHODS: A cross-sectional survey (n = 2,260) was carried out. A trained and calibrated dentist collected the data through clinical examinations and interviews. Clinical examination included the type of TDI, the treatment required and provided, the size of incisal overjet and the type of lip coverage. RESULTS: The response rate was 90.6%. The prevalence of TDI was 10.7%. Boys experienced more TDI than girls, 13.6% and 7.6% respectively (P < 0.001). Fathers' and mothers' levels of education were not statistically associated with TDI (P > 0.05). Children who had an incisal overjet greater than 5 mm had more dental injuries than those whose incisal overjet was less than 5 mm (P = 0.003). There was no association between inadequate lip coverage and TDI (P > 0.05). Multiple logistic regression analysis showed that maleness and incisal overjet remained statistically associated with dental injuries, after adjusting for other risk factors. The main activities associated with TDI were physical leisure activities (28.9%), playing with other people (18.2%), collisions (9.1%), and falls (8.3%). Common places where the TDI event occurred were at home (42.6%), in the street (21.5%) and at school (9.5%). 29.2% of TDI were the result of the actions of another person. CONCLUSION: The most common TDI events were physical leisure activities, most TDI occurred at home, and the actions of another person were an important factor in relation to the occurrence of TDI.

Accidental Falls↗