佛山市禅城区小学生家长对儿童牙外伤认知的调查

目的 了解佛山市禅城区小学生家长对儿童牙外伤的认知程度,为牙外伤健康教育提供依据.方法 采用随机抽样方法 ,对禅城区5所小学共320名小学生家长进行关于儿童前牙外伤处理方法 的问卷调查,并采用卡方检验对数据进行统计分析.结果 调查显示有40.6%的家长未能正确判断9岁儿童受外伤的门牙为恒牙;66.2%的家长不能正确回答对全脱位牙的处理方法 ;72.2%的家长不知道如何保存全脱位牙;95.6%的家长认为需要学习更多的牙外伤应急处理的知识.结论 佛山市禅城区小学生家长对儿童牙外伤(脱位)的认知程度低,相关的健康教育活动中需要注意提高人群对牙外伤(脱位)的认知能力和应急处理能力.     

公众对脱位牙应急处理知识的调查研究

再植牙的预后主要取决于迅速和正确的应急处理,如何使公众掌握外伤牙脱位后在事故现场的紧急处理措施是脱位牙再植有待解决的重要问题。本文就国外在学校老师、游泳教练及孩子的父母等人群中调查的脱位牙应急处理知识的普及情况作一阐述,以期提高国内对该领域相关知识普及的重视程度。     

外伤脱位牙再植的短期疗效观察

外伤脱位牙再植的短期疗效观察广东省口腔医院（５１０２６０）周会喜牙外伤脱位是口腔科急诊的常见病，多数脱位牙可以借助再植术得以保留，为了探讨影响脱位牙再植成功的因素，本文对２５例外伤脱位再植牙进行了临床观察与分析。资料与方法本文收集了从１９９２年至１９...     

脱位牙的临床处理

近来国外文献在脱位牙再植前处理，固定时间，牙髓治疗时机等方面对传统方法提出了较大改进，本文对此进行了综述。     

儿童外伤全脱位牙的应急处理与再植后的替代性吸收

目的:分析儿童外伤全脱位牙的应急处理与牙再植后替代性吸收间的关系,并比较校内、外儿童外伤全脱位牙应急处理的差异.方法:19例牙外伤全脱位病人,共计21个全脱位患牙纳入本实验.记录外伤发生地点,并记录患牙应急处理的情况,如保存状态(是否进行即刻再植)、保存的方法、外伤就诊时间等,通过2年的定期随访,观察再植牙发生替代性吸收的情况.用四格表的确切概率法进行检验,显著性水平设定为P<0.05.结果:失访全脱位牙3个,未进行统计.在统计的18个患牙中,校外发生11个,校内发生7个.校内发生者湿保存42.86%(3/7),高于校外发生的27.27%(3/11),二者有显著性差异(P<0.05);发生于校内者有42.86%(3/7)2 h内就诊,高于校外发生的18.18%(2/11),二者也有显著性差异(P<0.05).2 h内就诊的患牙产生替代性吸收的比例均显著低于2～24 h及24 h后就诊的患牙(P<0.05).湿保存的再植牙替代性吸收的比例比干燥保存的低,二者均有显著性差异(P<0.05).结论:学校老师相对比家长对全脱位牙的相关处理信息了解得更多,但二者均处于较低的水平,而患牙的保存和是否及时就诊均会影响再植牙替代性吸收的发生.     

外伤全脱位牙19小时后再植效果观察

牙齿全脱位,又称牙脱臼(complete avulsion),是指牙周膜完全断裂,牙齿与牙槽骨完全分离,患牙从牙槽窝中脱出[1].一般认为最好在脱臼后2小时内再植,文献报告再植成功的脱位牙最长的离体时间达15天[2].脱位的牙齿应立即冲洗后放入原位,或保存在口腔内舌下、牛奶内或生理盐水中并尽快就医[1].作者接诊一例离体19小时,干燥保存的切牙,再植后14个月临床效果满意,报告如下.     

上颌两中切牙外伤全脱位再植效果观察

牙受外力作用而脱离牙槽窝者称为牙脱位(dislocation of the teeth)[1]。一般认为如果牙在完全脱位2小时后再植,则因牙髓和牙周膜内细胞已坏死,不可能期望牙周膜重建,因而只能在体外完成根管治疗术,并经根面和牙槽窝刮治后,再植患牙并固定。作者接诊1例离体8小时,湿润保存的两个中切牙,再植后16个月临床观察效果满意,报告如下。     

上海五个区小学卫生教师对儿童牙外伤了解程度的调查与分析

目的调查上海五个区小学卫生教师对儿童牙外伤的了解程度,并分析其影响因素。方法采用随机抽样的方法,从上海所有19个区县中随机抽取5个区,对这5个区所有小学共306名卫生教师进行关于儿童牙外伤的问卷调查,用构成比及卡方检验对结果进行统计分析。结果在调查的5个区中一共收到了301份有效的卫生教师问卷。61.8%的教师表示接触过牙外伤;接受过专门关于牙外伤教育的教师人数比例为34.3%。3.7%的教师选择对全脱位牙齿进行即刻再植;对全脱位牙齿采用湿性保存媒介的教师有9.0%(含在口中)、45.5%(放在盐水中)1、8.3%(放在牛奶中);关于全脱位牙齿的就诊时间,认为应该在30 min内治疗的教师人数比例为46.8%。结论上海五个区小学卫生教师对儿童牙外伤的了解仍十分有限,今后需要加大对这类人群关于儿童牙外伤的宣传力度。     

公众对儿童牙外伤的了解情况

随着人们生活水平的不断提高,人们对儿童牙外伤的重视程度也在不断增加,但是由于人们对儿童牙外伤方面知识的匮乏,经常会采取不恰当的处理方式,进而导致延误治疗。本文就儿童牙外伤处理中常见的问题进行了阐述,并对这些问题进行了讨论。     

外伤全脱位牙自体再植术的临床观察研究

目的：分析６０个外伤全脱位前牙即期再植的随访结果总结经验。方法：详细记录牙离体时间、手术及术后处理情况,定期对患者进行随访。结果：６０个脱位牙再植后临床疗效优３７个（６１．７％）、良１８个（３０．０％）、差５个牙（８．３％）,３个牙１年内拔除。３年成功率８３．０％、５年成功率６１．７％。判断为牙周膜愈合２０个、骨性愈合３５个、纤维愈合５个牙。牙髓活力测定,活力阳性２３个、阴性３７个。术后对２０个牙施行了根管治疗。结论：细心保护脱位牙根面牙周膜、良好固定、预防感染、防止咬合创伤是再植成功的重要因素。术后定期复查,发现问题及时处理,有利于提高再植牙远期成功率。     

Characteristics,treatment outcomes and direct costs of tooth avulsion in children treated at a major hospital

Background/Aims

Avulsion of a permanent tooth is one of the most severe traumatic dental injuries, comprising an estimated 0.5%–16% of all dental injuries. The aim of this study was to estimate the direct financial costs of tooth avulsion in children based on stage of root maturity and the occurrence of ankylosis and to report patients' characteristics and outcomes of treatment.

Materials and Methods

A retrospective review of the dental records of children ages 6–18 who sustained a permanent tooth avulsion from 2010 to 2020 was completed. Relative Value Units (RVUs) were used to calculate the estimated cost of dental trauma care over the 2-year post-injury period for five different scenarios of avulsed teeth based on the stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted.

Results

There were 452 avulsed permanent teeth in 348 patients. Of those, 157 teeth were included in the cost analysis. Overall, the average direct dental cost of avulsion was 46.4 RVUs equal to $1619 USD based on the 2021 conversion rate ($34.89 per RVU). Direct costs ranged between 40 RVUs ($1396) and 52.8 RVUs ($1842) depending on the root maturation and ankylosis status or whether the tooth was replanted; however, ANOVA test did not show any statistically significant differences between the mean RVUs of different groups (p = .85). Patients returned 9.5 times on average over the 2-year study period for dental trauma care after avulsion.

Conclusion

The average direct cost of tooth avulsion within the limits of this study was $1619 USD. On average, patients returned for 9.5 follow-up visits after the avulsion. The stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted or not were not significantly associated with the direct cost of dental care.     

Knowledge of general practitioners dentists about the emergency management of dental avulsion in Curitiba, Brazil

Abstract –  The prognosis of traumatized teeth in general and of avulsed teeth in particular depends on prompt and appropriate treatment. Management of traumatic injuries may be a challenge to the non-specialized dentist, as they may occur when dentists are least prepared for it. The objective of this research was to investigate the knowledge of general practitioner dentists about the emergency management of dental avulsion in Curitiba, PR, Brazil. A group of 250 professionals were interviewed. The questions were related to knowledge of how to treat traumatic avulsion of teeth. The results suggest that the level of knowledge on the management of dental avulsion of the general practitioners dentists in Curitiba is adequate.     

Oral trauma and dental emergency management recommendations of first-aid textbooks and manuals

Abstract –  The recommendations of oral trauma and dental emergencies management of nine first-aid textbooks and manuals from the last two decades were evaluated. Only one book includes all the relevant topics: dental anatomy, management of tooth luxations and avulsion, tooth fracture, mandible dislocation, jaw fracture, intraoral bleeding and dental pain. Two books recommend self-replantation of an avulsed tooth, but four books detail the storage media and evaluate the importance of a quick referral to a dental surgery. In three first-aid books, the only mention of oral trauma is the hazard of choking from tooth fragments, and in one other book, only mandible dislocation is mentioned as oral trauma. The insufficient information of oral trauma management in these first-aid texts partly explains the previous reports of poor and inadequate knowledge in that topic among medics, teachers and the general public.     

上海市12岁儿童患龋状况调查分析

目的 了解上海市12岁儿童恒牙患龋状况,为龋病预防提供科学依据。方法 采取随机抽样方法 按照WHO口腔调查基本方法 中的龋病诊断标准对全市19个区县2 519名12岁学生进行口腔检查。结果 2 519名12岁儿童的患龋率和龋均分别为36.64%和0.61。其中97.14%的龋齿发生于窝沟。男女患龋率之间有显著性差异。显著性龋均指数为1.77,龋齿充填率为24.58%,窝沟封闭率为0.52。结论 上海12岁儿童龋患呈两极化分布,龋齿主要发生于第一恒磨牙的牙合面窝沟。     

Evaluation of the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil

Abstract –  Tooth avulsion is common in children, and emergency management in these cases is critical. This management can be made, not only by a dentist but by people who are present where the accident occurs. Consequently, knowledge of tooth avulsion is fundamental for school professionals working with children. The purpose of the present study was to evaluate the knowledge of tooth avulsion of school professionals from Adamantina, São Paulo, Brazil. For that purpose a questionnaire, including questions regarding emergency procedures for tooth avulsion, was answered by 117 teachers. The results demonstrated that 75.2% of school professionals knew the importance of emergency management and 60.6% would look for a dentist for treatment of the cases; 18.8% would reimplant the tooth and 7.6% would keep it in milk. This study showed the lack of knowledge of teachers on tooth avulsion; educational campaigns are necessary to improve the emergency management of tooth avulsion.     

Survival of avulsed permanent maxillary incisors in children following delayed replantation

Abstract The purpose of this study was to identify the variables that significantly influenced the survival of incisors replanted after extended extraalveolar duration at The Hospital for Sick Children, Toronto, Canada, between June 1988 and December 1993. Survival analysis was used to identify variables that significantly influence the retention of replanted incisor teeth. Survival was defined as the time that elapsed between the replantation of an avulsed incisor and the time it was finally lost. Information on 9 variables was collected for 3H patients (25 males; 13 females) and 52 replanted permanent maxillary incisors. The mean extraalveolar duration for the sample was 123 min. The mean follow-up interval was 942 days (range: 364–2126 days). Incisors replanted with open apices had a significantly decreased survival compared with teeth with mature apices (P=0.04; relative risk 4.2). There was also a significant association between increased survival and obturation of the root canal with gutta-percha and sealer P=0.006 relative risk 10.0). A trend towards improved survival of replanted incisors was found for children older than I 1 years old at the time of replantation (P= 0.09; relative risk 2.8). These results are consistent with previous studies and may assist clinicians and parents in the decision-making process associated with the management of avulsed teeth in children.     

Traumatic injury to maxillary incisor teeth in a group of South Wales school children

Abstract This study examines, from photographic records, the prevalence of accidental damage to maxillary incisor teeth in a group of 968 11/12-year-old South Wales school-children; 15.3% showed evidence of trauma ranging from enamel fractures or discolouration to actual loss of a tooth. Boys (19.4%) showed a higher prevalence of trauma than girls (11%). Maxillary central incisors were the most at risk from trauma, with coronal fractures being the most commonly sustained injury. Those subjects who showed evidence of trauma had an statistically (p< 0.001) but not clinically significantly greater overjet than did those who had none. The percentage of subjects suffering trauma increased significantly with increasing overjet, but lip incompetence did not affect the prevalence of accidental damage. Though statistically unsupported due to the small numbers involved in this cohort, it appeared that the rougher nature of boys activities and their more active participation in sports were of greater importance than the magnitude of their overjet in determining whether their teeth were at risk from trauma. In contrast, it was the magnitude of the overjet which was the dominant factor in girls. Despite the wide availability of relatively simple means of restoration and, in the majority of cases, regular dental examinations, only 14.8% of traumatised teeth had received treatment at this age.