International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth

Avulsion of permanent teeth is one of the most serious dental injuries. Prompt and correct emergency management is essential for attaining the best outcome after this injury. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. It represents the current best evidence and practice based on that literature search and expert opinions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on consensus opinions or majority decisions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. The purpose of these Guidelines is to provide clinicians with the most widely accepted and scientifically plausible approaches for the immediate or urgent care of avulsed permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.     

年轻恒牙嵌入性脱位的X线追踪观察分析

目的:通过对年轻恒牙嵌入性脱位的X线片进行回顾性研究,观察患牙复位、牙根发育和牙根吸收情况,并分析其影响因素。方法:收集2013年1月~2019年3月发生嵌入性脱位的年轻恒牙病例,分析其X线片,了解患牙复位、牙根发育及牙根吸收情况。结果:所有患牙基本复位,牙根继续发育占66.7%,发生替代性吸收占25%;嵌入程度较轻的患牙利于牙髓存活(P=0.008);自然再萌的患牙可减少替代性吸收(P=0.005);牙髓存活的患牙牙根可发育,且无替代性吸收(P<0.001)。结论:嵌入性脱位的年轻恒牙牙髓可存活,且牙根可继续发育。牙髓存活的患牙利于牙根发育、减少替代性吸收。重度嵌入的年轻恒牙可有萌出潜力。     

Development of a conceptual model of oral health for malocclusion patients

Objectives:To provide an empirical test of the applicability of Locker''s conceptual model of oral health for malocclusion patients, and to suggest alternative models of the effect of malocclusion on well-being.Materials and Methods:Data from a survey of 323 adolescents attending for orthodontic treatment were analyzed to develop a new oral health model for malocclusion patients. Oral health–related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile; malocclusion was measured using the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Using structural equation modeling, the relationship between conceptual domains in Locker''s model was explored and three models of their interrelationship tested for goodness of fit.Results:Fit indexes for Locker''s model indicated that it did not fit the data well. Therefore, a modified model was developed to incorporate additional paths between other levels to better fit the data. The best fit was provided by a model in which the direct effects of malocclusion on pain, discomfort, and handicapping—and the direct effect of pain on disability—were removed. A direct effect of functional limitation on disability was allowed. The modified Oral Health Impact Profile model proved to be a good fit to the data (root mean square error of approximation  =  0.069).Conclusion:The pathways identified in Locker''s (1988) conceptual model of oral health may not be appropriate for describing the relationships between OHRQoL constructs in individuals with malocclusion. An alternative model is proposed.