The effect of traumatic injuries to primary teeth on their permanent successors

abstract – A material of 207 permanent teeth (including 90 cases collected from the literature), traumatized during'development by injuries to primary teeth, has been analyzed in a clinical, radiographic, histologic, microradiographic, and electron microscopic study. It appears from this examination that such developmental disturbances may be classified into distinct clinico-pathologic entities, i.e. — (1) white or yellow-brown discoloration of enamel, (2) white or yellow-brown discoloration of enamel and horizontal enamel hypoplasia, (3) crown dilaceration, (4) odontome-like malformation, (5) root duplication, (6) vestibular root angulation, (7) lateral root angulation or dilaceration, (8) partial or complete arrest of root formation, (9) sequestration of entire tooth germ, and (10) ectopic, premature, or delayed eruption or impaction.     

Retrospective study of traumatic dental injuries in primary teeth in a Brazilian specialized pediatric practice

Abstract – Objective: To determine the prevalence of traumatic dental injuries (TDI) in children younger than 7 years and the effect of predisposing clinical factors on their occurrence. Material and methods: Dental records of 2725 children younger than 7 years seen in a private pediatric dental clinic in Goiânia, Brazil, from February 1993 to December 2008 were analyzed. A group of 150 children without traumatic injuries and with similar characteristics to those of the trauma group were used to study predisposing clinical factors as follows: lip coverage (adequate/inadequate), overbite (normal/negative/deep), and overjet (less or greater than 3 mm). Frequency distribution and a chi‐square test were used for data analysis. The level of significance was set at 5%. Results: Clinical and radiographic data of 412 injured deciduous teeth were found in 383 records. TDI prevalence was 11.9%, with no significant difference between sexes. The maxillary central incisors were the teeth most frequently affected (83.3%), and the most frequent type of injury was subluxation (35.1%). TDI was most prevalent in the 13‐to‐36‐month age group (47.7%). Home (43.5%) was the main place of occurrence, followed by school (10.1%); falls (50.3%) were the most common cause, followed by collisions with objects (18.2%). The first examination or treatment occurred in the first 24 h in 46.5% of the cases. The analysis of the association of predisposing clinical factors with TDI revealed no differences in lip coverage; however, overjet >3 mm and deep and negative overbite were significantly associated with TDI. Conclusion: TDI in primary dentition should receive careful attention, particularly when it affects children younger than 3 years and in the presence of overjet, overbite, or both.     

Prevalence of traumatic injuries to maxillary permanent teeth in 9‐ to 14‐year‐old school children in Yazd,Iran

Abstract – Aim: Trauma to maxillary anterior teeth is a common reason for emergency room visits among children; therefore, the goal of this study was to evaluate the prevalence and related factors of such trauma among 9‐ to 14‐year‐old children in Yazd. Materials and methods: A sample of 1440 schoolchildren aged 9–14 years old, consisting of 720 boys and 720 girls, were randomly selected from 24 schools in Yazd. Ellis classification was used to record the dental injuries. Results: The prevalence found was 27.56%. The occurrence of trauma was significantly higher in male patients; furthermore, most of the dental trauma occurred in children between 9 and 10 years of age (47.38%). The most common type of injury was the ‘enamel only’ fracture; falls being the main cause of trauma. The most affected tooth was the maxillary central incisor Conclusions: The prevalence and most common causal factor of traumatic injuries to the maxillary anterior teeth in schoolchildren living in Yazd was approximately the same as that found in other countries.     

Prevalence of traumatic dental injuries in preschool children in Kuwait – a screening study

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

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牙外伤包括牙体硬组织损伤、牙髓组织损伤和牙周组织损伤。牙髓损伤常见于牙齿折断、牙齿移位和牙齿全脱出中,可见牙髓损伤几乎在所有的牙齿外伤中都存在。外伤后,牙髓组织的转归可分为牙髓存活、牙髓钙变和牙髓坏死3种。牙髓组织的转归与以下因素有关:(1)外伤冲击力对牙髓组织的损伤;(2)外伤后外界不良刺激;(3)牙齿发育程度、个体差异等。儿童恒牙外伤后牙齿尚处于生长发育中,其治疗和预后远比成人复杂。本文针对年轻恒牙的特点,提出外伤后牙髓损伤判断和处置的对策。     

Implants in fresh extraction sockets: a prospective 5‐year follow‐up clinical study

Objective: The aim of this prospective study was to evaluate the 5‐year clinical outcome of the ‘immediate implants.’ Material and methods: One week after the cementation of the prosthesis, a clinical baseline examination was carried out. Clinical measurements were performed of the following: plaque, mucositis, probing pocket depth, and soft tissue position. The height of the keratinized mucosa was measured at the buccal/lingual aspects. Standardized intra‐oral radiographs were taken. The marginal level of bone to implant contact [radiographic (Rx) bone level] was measured, and Rx bone level change over time was evaluated. The clinical/radiographic measurements were repeated on a yearly basis. The subjects were enrolled in a carefully supervised oral hygiene program. Results and conclusion: It was demonstrated that ‘immediate implants’ that were loaded after 5–7 months had a high success rate. During the 5‐year interval, no implant was lost, and the mean Rx bone level at the implants was maintained or even improved. The plaque and mucositis scores were low (<20%) at baseline and at all re‐examinations. Implant sites located adjacent to the teeth showed bone gain during the initial period while sites that were facing edentulous zones lost some bone.     

Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants

Objectives: The aim of the present study was to evaluate the long‐term results of dental implants using implant survival and implant success as outcome variables. Methods: Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990–1997, 55 patients with 131 implants were recalled 10–16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri‐implant lesions were analysed for each implant. Results: The long‐term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10–16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients. Conclusion: Despite a relatively high long‐term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri‐implant mucositis and peri‐implantitis. To cite this article :
Simonis P, Dufour T, Tenenbaum H. Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants.
Clin. Oral Impl. Res. 21 , 2010; 772–777
doi: 10.1111/j.1600‐0501.2010.01912.x     

Recent trends in the management of dentoalveolar traumatic injuries to primary and young permanent teeth

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