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Treatment by Preplanned Virtual Autotransplantation of a Microdont Immature Third Molar to a Maxillary Central Incisor Socket Using a 3D Printed Tooth Replica: A Case Report 使用3D打印牙齿复制品预先计划虚拟自体移植未成熟的第三磨牙至上颌中切牙槽:1例报告。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13044
Aurore Barraco, Clara Marcoux, Raphaël Richert, Romain Ligerot, Kerstin Gritsch, Arnaud Lafon

An 18-year-old female patient presented to emergency dental clinic for avulsion of maxillary left central incisor (#21) in a car accident. In the presence of an immature left maxillary microdontic third molar (#28), a preplanned virtual autotransplantation using an implant planification software was chosen to replace #21. A guided osteotomy using a 3D printed thermoplastic replica was performed to reduce the extra-oral time to < 1 min. Indirect restorations with lithium disilicate veneers were made for both central incisors. After 4 years, the esthetic integration remained satisfactory. The case presented, involving the replacement of an avulsed #21 with an immature microdontic third molar #28, illustrates the possibilities of extending the indications for autotransplantation using virtually planned surgery.

一位18岁的女性患者在一次车祸中上颌左中门牙撕脱(#21)到牙科急诊诊所就诊。在未成熟的左上颌小齿第三磨牙(#28)的存在下,选择使用种植体平面化软件进行预先计划的虚拟自体移植来代替#21。使用3D打印热塑性塑料复制品进行引导截骨,以减少口外时间至
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引用次数: 0
Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection: A Combined In Vitro and In Silico Analyses 用于颌面部创伤保护的定制护齿的强化定位:体外和计算机联合分析。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13060
Talita Suelen de Queiroz, João Paulo Mendes Tribst, Larissa Haddad e Borro, Guilherme da Rocha Scalzer Lopes, Alexandre Luiz Souto Borges, Tarcisio Jose de Arruda Paes Junior

Background/Aim

This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.

Material and Methods

Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm3 steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy.

Results

The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro–Wilk, Kruskal–Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10−5) but none between impact zones (p = 0.879), confirming uniform stress distribution.

Conclusions

Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.

背景/目的:本研究通过在三个不同位置使用聚酰胺网增强护齿(mg)来评估中切牙对上颌前牙外伤的牙槽反应。材料与方法:将40只4mm厚的mg按补片位置分为MG1 + 3组(补片距前庭极限1mm)、MG2 + 2组(补片距前庭极限2mm)、MG3 + 1组(补片距前庭极限3mm)和不补片的对照组。3D打印颅骨模型(Spin Red Resin, Quanton 3D)模拟牙槽复合体,使用Resilab Clear树脂(Wilcos)作为牙齿,添加固化硅树脂作为牙周韧带。该装置连接到一个定制的冲击装置,以确保力保持在材料的弹性极限内。采用放置在中切牙前庭面和上颌骨牙槽突上的4个应变计测量微应变。使用直径为35毫米的钢球,在平行于地面的Ep = 0.5496 J处施加冲击。对于硅测试,在CAD软件(Rhinoceros 7.0)中对装置进行建模,并在CAE软件(Ansys 2021 R1)中进行显式动态仿真分析。假定所有材料均质、各向同性和线弹性。使用7.8 g/cm3的钢球模拟1m /s的冲击。物理接触条件定义为摩擦和粘接,在10%收敛测试后使用四面体网格单元以确保精度。结果:通过比色图获得了牙齿和上颌骨的最大主应变和最大主应力。统计分析(Shapiro-Wilk, Kruskal-Wallis, and Dunn’s检验,5%显著性)显示非加固组有显著性差异(p = 6.8 × 10-5),但冲击区之间无显著性差异(p = 0.879),证实应力分布均匀。结论:强化系统可显著改善口腔组织的冲击吸收,增强保护作用。然而,加固位置对吸收没有显著影响。有限元分析验证了体外结果,为进一步研究和未来改进提供了理论和实践模型。
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引用次数: 0
Microbial Loads in Traumatized Immature Teeth and Their Impact on the Treatment Outcomes of Regenerative Endodontic Treatment: A Randomized Clinical Trial Comparing Chlorhexidine and Calcium Hydroxide 创伤性未成熟牙的微生物负荷及其对再生牙髓治疗效果的影响:氯己定和氢氧化钙的随机临床试验比较
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13062
Alina Wikström, Olena Rakhimova, Pavel Călin, Georgios Tsilingaridis, Malin Brundin, Nelly Romani Vestman

Introduction

Regenerative endodontic treatment (RET) aims to promote root maturation in necrotic immature teeth, where effective microbial disinfection is crucial for treatment success. This study evaluated the effect of calcium hydroxide (CH) and 2% chlorhexidine gluconate (CHD) as intracanal medicaments and their impact on bacterial loads and RET outcomes.

Methods

The material consisted of bacterial samples from 41 patients who participated in a previously conducted randomized controlled clinical trial comparing CH and CHD during RET. A total of 123 microbial samples were analyzed using real-time quantitative polymerase chain reaction (qPCR). Bacterial loads were assessed at three time points: before root canal disinfection (S1), after root canal disinfection (S2), and after intracanal dressing (S3). The microbial composition was evaluated at the kingdom (Eubacteria), phylum (Actinomycetota), and species (Enterococcus faecalis) levels.

Results

Significant reductions in bacterial loads were observed after root canal disinfection (S2) in both CH and CHD subgroups, regardless of treatment outcome. Further reductions after intracanal dressing (S3) occurred exclusively in the successful cases. Actinomycetota loads significantly decreased after root canal disinfection in the successful cases but remained unchanged after intracanal medication. The presence of E. faecalis after intracanal dressing was associated with failed RET (OR = 9.778; p = 0.0432), although no significant differences in the effectiveness of the intracanal medicaments were found.

Conclusion

Both CH and CHD effectively reduced bacterial loads, with greater reductions linked to successful outcomes. The association between E. faecalis and failed RET suggests that this species may play a role in treatment outcomes. Further research, including microbiome profiling, is desirable to identify potential prognostic markers for failed RET.

再生根管治疗(RET)旨在促进坏死未成熟牙齿的根成熟,其中有效的微生物消毒是治疗成功的关键。本研究评估了氢氧化钙(CH)和2%葡萄糖酸氯己定(CHD)作为肛管内药物的效果及其对细菌负荷和RET结果的影响。方法:材料包括41名患者的细菌样本,这些患者参加了一项比较RET期间CH和CHD的随机对照临床试验,共123份微生物样本采用实时定量聚合酶链反应(qPCR)进行分析。在三个时间点评估细菌负荷:根管消毒前(S1)、根管消毒后(S2)和管内敷料后(S3)。微生物组成在界(真细菌)、门(放线菌门)和种(粪肠球菌)水平上进行评估。结果:无论治疗结果如何,CHD和CHD亚组均在根管消毒(S2)后观察到细菌负荷显著减少。仅在成功的病例中,才会出现管内敷料(S3)后进一步复位。在根管消毒成功的病例中,放线菌负荷显著降低,但在管内给药后保持不变。肛管内敷料后粪肠球菌的存在与RET失败相关(OR = 9.778;P = 0.0432),尽管在肛管内药物的有效性方面没有发现显著差异。结论:CHD和CHD均能有效降低细菌负荷,且降低程度越大,治疗效果越好。粪肠球菌与失败的RET之间的关联表明,该物种可能在治疗结果中发挥作用。需要进一步的研究,包括微生物组分析,以确定RET失败的潜在预后标志物。
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引用次数: 0
Evaluation of the Knowledge and Experience of the Brazilian Orthodontists in the Handling of Traumatized Teeth: A Quantitative Study 巴西正畸医师处理创伤牙齿的知识和经验评估:一项定量研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-14 DOI: 10.1111/edt.13056
Livia Salgado, Davy de Melo Mendes, Fernanda Campos Machado, Flávia Almeida Ribeiro Scalioni, Camila Faria Carrada, Robert Willer Farinazzo Vitral, Marcio José da Silva Campos

Aim

This is the quantitative part of a study that aimed to evaluate the knowledge and experience of orthodontists in managing the orthodontic treatments of traumatized teeth.

Material and Method

The study was divided into 4 stages: first, a structured interview; second, face validity; third, test–retest; and fourth, administering the questionnaire. The first three stages aimed at developing the questionnaire, while the fourth consisted of the application of the instrument in a sample of 395 orthodontists properly licensed with the Regional Councils of Dentistry of Brazil. The questionnaire was sent to these orthodontists through the social media platform Instagram.

Results

It was found that the majority of participants had encountered this type of emergency in their offices, had moderate knowledge of the subject, and were successful in their orthodontic treatments. Furthermore, almost all professionals recognized the importance of additional training, and only a small portion of them were familiar with any care protocols for these cases.

Conclusion

It can be concluded that the orthodontists had limited experience and a moderate knowledge about the orthodontic management of traumatized teeth.

目的:这是一项研究的定量部分,旨在评估正畸医生在管理创伤牙齿正畸治疗方面的知识和经验。材料与方法:本研究分为4个阶段:第一阶段为结构化访谈;二是面孔效度;第三,两次试验法的;第四,管理问卷。前三个阶段的目的是编制调查表,而第四个阶段的工作是在巴西牙科区域委员会适当许可的395名正畸医生样本中应用该工具。调查问卷是通过社交媒体平台Instagram发送给这些正畸医生的。结果:研究发现,大多数参与者在他们的办公室遇到过这种类型的紧急情况,对这一主题有适度的了解,并且在正畸治疗中取得了成功。此外,几乎所有的专业人员都认识到额外培训的重要性,只有一小部分人熟悉这些病例的护理方案。结论:正畸医师对创伤牙的正畸治疗经验有限,知识水平不高。
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引用次数: 0
Emerging Insights in Dental Trauma: Exploring Potential Risk Factors, Innovations, and Preventive Strategies 牙科创伤的新见解:探索潜在的风险因素,创新和预防策略
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-14 DOI: 10.1111/edt.13053
Ana Beatriz Cantao, Liran Levin
<p>Several factors are associated with dental trauma (DT) occurrence, and these factors are well-established in the literature [<span>1, 2</span>]. However, new studies and hypotheses suggest that a lack of balance is positively associated with falls in children and older individuals [<span>3, 4</span>]. In this issue Lunardelli et al. investigated the relationship between orthostatic balance and the occurrence of DT in 6-year-old school children in Brazil [<span>5</span>]. The study emphasizes the connection between reduced orthostatic balance and an increased risk of falls, identifying it as a factor in the etiology of DT in children. This highlights the need for preventive measures focused on creating safer environments, particularly in schools, and involving a multidisciplinary team to support school-aged children in minimizing the risk of falls and dental trauma.</p><p>Traumatic dental injuries (TDI) are highly prevalent during childhood, particularly in the primary dentition [<span>6, 7</span>]. Although TDI is recognized as a common issue, the factors influencing its prevalence in preschool-aged children have been poorly understood [<span>8, 9</span>]. In this issue, Rivera López et al. investigated these factors through a cohort study involving 4-year-old children from South Brazil [<span>10</span>]. Using directed acyclic graphs (DAGs), the researchers developed a theoretical model to explore the complex relationships among potential risk factors, including demographic, behavioral, and environmental variables. This study provides insights into the multifactorial nature of TDI in young children, offering a foundation for targeted prevention and early intervention strategies. By applying advanced analytical techniques, Rivera López et al. contribute to a deeper understanding of dental trauma causes and its broader implications for pediatric oral health.</p><p>Autotransplanted teeth have demonstrated a remarkable survival rate of over 95% [<span>11-13</span>]. However, the lack of standardization and precision in quantifying root development results in inconsistent findings and impedes comparisons between studies. Traditional analysis methods based on two-dimensional radiographs shows significant limitations, such as image overlap, patient positioning challenges, and low measurement accuracy. Cone-beam computed tomography (CBCT) might provide a more accurate and detailed analysis, particularly in regions like the periapical areas [<span>14</span>]. In this issue, Beltrame et al. proposed a methodology for assessing root development and measuring root length using CBCT in 12 patients [<span>15</span>]. This study highlighted CBCT's superiority over conventional radiography for evaluating root development after autogenous tooth transplants. This method, as any radiographic tool, should be assessed in terms of radiation risks vs. the suggested benefits.</p><p>Advances in CBCT and 3D-printed replicas have demonstrated improvements in the effici
有几个因素与牙外伤(DT)的发生有关,这些因素在文献中得到了证实[1,2]。然而,新的研究和假设表明,缺乏平衡与儿童和老年人跌倒呈正相关[3,4]。在这一期Lunardelli等人调查了巴西6岁学龄儿童站立平衡与DT发生之间的关系。该研究强调了直立平衡能力下降与跌倒风险增加之间的联系,并将其确定为儿童DT病因学的一个因素。这突出表明需要采取预防措施,重点是创造更安全的环境,特别是在学校,并让一个多学科小组参与进来,以支持学龄儿童尽量减少跌倒和牙齿创伤的风险。创伤性牙损伤(TDI)在儿童时期非常普遍,特别是在初级牙列[6,7]。虽然TDI被认为是一个常见的问题,但影响其在学龄前儿童中流行的因素却知之甚少[8,9]。在本期中,Rivera López等人通过一项涉及巴西南部4岁儿童的队列研究调查了这些因素。利用有向无环图(dag),研究人员开发了一个理论模型来探索潜在风险因素之间的复杂关系,包括人口、行为和环境变量。本研究揭示了幼儿TDI的多因素性质,为有针对性的预防和早期干预策略提供了基础。通过应用先进的分析技术,Rivera López等人有助于更深入地了解牙齿创伤的原因及其对儿童口腔健康的更广泛影响。自体移植牙的成活率高达95%以上[11-13]。然而,在量化根系发育方面缺乏标准化和精确性,导致研究结果不一致,阻碍了研究之间的比较。传统的基于二维x线片的分析方法存在明显的局限性,如图像重叠、患者定位困难、测量精度低。锥形束计算机断层扫描(CBCT)可能提供更准确和详细的分析,特别是在像根尖周围区域b[14]这样的区域。在这一期中,Beltrame等人提出了一种使用CBCT评估12例患者牙根发育和测量牙根长度的方法。本研究强调了CBCT在评估自体牙移植后牙根发育方面的优越性。与任何放射照相工具一样,这种方法应根据辐射风险与建议的益处进行评估。CBCT和3d打印复制品的进步已经证明了牙科手术的效率和精度的提高,包括牙齿自体移植[16-18]。然而,大多数支持这些结果的证据来自观察性研究、病例报告和数量有限的病例对照研究。因此,评估生物功效(即长期临床和放射结果)的对照临床试验数据不足,限制了对这些技术影响的理解。在本期中,Lejnieks等人在一项对照临床试验中评估了CBCT和3D复制方案的联合疗效。目的是调查1年随访后的临床和影像学结果,为这些技术在磨牙自体移植中的益处提供更有力的证据。该研究强调了CBCT和3D复制协议在提高手术效率和作为有价值的培训工具方面的潜力,呼吁进一步研究以解决当前的局限性并探索其在临床实践中的更广泛应用。人工智能(AI)已经成为一种宝贵的资源,为寻求在线医疗保健知识的患者和临床医生提供信息,以支持医疗和牙科决策[20,21]。然而,在管理创伤恒牙的背景下,仍然缺乏对人工智能工具(如谷歌Gemini)提供的反应的准确性和一致性的严格评估。尽管这些技术具有改变医疗保健信息访问方式的巨大潜力,但人们对其可靠性和潜在偏差的担忧仍然存在。先前的研究表明,与ChatGPT等其他模型相比,谷歌Bard (Gemini的实验版本)等工具提供的信息一致性较差,尤其是在与牙髓学[22]相关的主题上。在这一期中,Portilla等人评估了谷歌Gemini提供的关于创伤恒牙管理的反应的准确性和一致性,并与经验丰富的学术牙髓专家进行了比较。他们使用一组预先确定的问题进行了全面的比较。 这项研究表明,双子座有可能成为牙科专业人员的一个可访问的支持工具。然而,改进其数据库和算法对于提高其在创伤恒牙相关主题中的准确性至关重要。推进培训和改进数据对于确保未来更可靠、更有力的响应至关重要。此外,在本期中,Johnson等人旨在评估人工智能聊天机器人(包括Bing、ChatGPT 3.5、谷歌Gemini和Claude AI)在解决与牙齿创伤相关的常见问题方面的有效性和可靠性。确保医疗信息的安全和准确传播,特别是在牙科创伤领域,需要当局制定明确的指导方针和法规来管理聊天机器人的使用。协作努力对于解决伦理问题并确保这些人工智能平台提供的信息的准确性和可靠性至关重要。公众对TDI管理的认识仍然不足[25,26]。然而,随着人工智能的进步,这些工具现在能够提供公共卫生支持和信息,帮助牙科专业人员和患者处理牙齿撕脱等问题。大型语言模型(llm)在牙科教育中提供了显著的好处,然而,由于这些工具是根据公众的人类反馈进行微调的,它们的数据可能有偏见或不正确,特别是关于牙齿撕脱伤bbb的问题的答案。在本期中,Tokgöz Kaplan和Cankar验证了ChatGPT和Gemini提供的关于牙齿撕脱的答案的准确性和全面性。四名儿科牙医审稿人根据IADT指南b[27]对这些回答进行了评估和评分。该评估显示,尽管这两种人工智能工具都有潜力,但需要进一步改进训练和数据质量,以确保其答案的可靠性和准确性。恒牙撕脱是最严重的牙外伤之一。治疗需要及时和正确的紧急管理,这取决于牙周韧带(PDL)细胞[29]的活力。撕脱会造成牙周韧带损伤,包括脱水和牙周纤维结构损伤。因此,将撕脱的牙齿储存在适当的介质中可以帮助保持牙周细胞的活力,防止它们脱水和分解。根据国际牙科创伤学协会(IADT)的指导方针,生理盐水、唾液和牛奶被认为是自然或生物溶液,有助于在再植bbb之前维持PDL的活力。在这一期中,Lee等人研究了六种实验培养基对牙周韧带成纤维细胞(PDLF)活力的影响。培养基包括汉克平衡盐溶液(HBSS)、补充抗坏血酸(维生素C)的HBSS、补充血小板衍生生长因子(PDGF)的HBSS、补充PDGF和抗坏血酸的组合的HBSS、补充血小板溶解液的HBSS和Dulbecco's Modified Eagle Medium[33]。评估了改良HBSS混合物支持ppdf活力的能力,并有助于再植手术的成功。本研究的结果有助于提高我们对撕脱牙合适的储存介质的整体认识和未来的考虑。中切牙经常受到牙外伤的影响[34,35],特别是在上颌前牙前倾的情况下。针对不同的活动和年龄组,可以采取不同的预防措施[37,38]。使用护齿器是预防运动时牙齿损伤最常见的方法。护齿器[39]有不同的制造方法;然而,定制的护齿器制作更专业,提供更好的契合度,根据一些报道,可以提高运动员的心肺能力。在这期杂志中,Bhadule等人通过对一名12岁男性患者[40]进行CBCT扫描,建立了三维有限元分析(FEA)模型。他们模拟了实际创伤对上颌前牙的影响,有和没有戴护齿。该研究强调了适当安装护齿器的重要性,通过减少压力大小来保护口腔和颌面损伤,特别是在有前倾上颌牙齿的牙列中。护齿器在运动和其他高风险活动中保护牙齿和软组织免受牙外伤也起着至关重要的作用[41,42]。最常用的类型包括stock mouthguard, mouth-formed models和定制选项,每种提供不同程度的舒适度和保护[41,43]。然而,尽管它们被广泛使用,一些护齿器所使用的材料可能不能提供足够的减震、耐用性或使用者舒适度[44,45]。 因此,越来越需要探索替代材料来开发增强性能,改善用户体验并促进更广泛采用的护齿器。在本期中,Nassani等人评估并比较了热成型乙烯醋酸乙烯酯(EVA)护齿器和3d打
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引用次数: 0
Histopathologic Features of Pulp Following Uncomplicated Crown Fracture of an Immature Tooth With Concomitant Subluxation Seven Days After the Injury. A Case Report 未成熟牙冠骨折伴半脱位7天后牙髓的组织病理学特征。一个病例报告。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-12 DOI: 10.1111/edt.13058
Giorgos N. Tzanetakis, Styliani Papanakou, Despina Koletsi, Nikolaos Katsoulas

Reports on the histopathologic features of pulp tissue following traumatic injuries are scarce. The aim of the present clinical and histological report was to provide some novel insights about the histological condition of the pulp tissue of an immature permanent tooth, shortly after a combined injury of uncomplicated crown fracture with concomitant subluxation. A seven-year-old male patient presented with a localized buccal swelling apically on tooth #21 and with a radiographic app. One week earlier, the patient had suffered an uncomplicated crown fracture, and the referral dentist had solely performed a permanent restoration by rebonding the fracture fragment of the crown. The diagnosis was pulp necrosis, and a regenerative endodontic procedure was decided due to the wide-open apex of the injured tooth. After access cavity preparation was performed, it was evident that no degeneration of the pulp had occurred, so the tissue was removed using a sterile barbed broach and processed for histopathologic examination. A whitish tissue specimen of soft consistency, 0.8 cm in length and 5 μm thick, was processed for histologic evaluation. An extensive coagulative necrosis of the pulp tissue was revealed with dense aggregates of neutrophils along with areas of abscess formation. Some scattered lymphocytes were observed as well, together with areas of dystrophic calcifications. Finally, no bacteria were observed in any section of the specimen. Pulp necrosis may occur shortly after a combined traumatic injury of uncomplicated crown fracture with subluxation. In such cases, pulpal inflammation and the arise of symptoms may not be necessarily associated with the presence of bacteria. The present histological observation demonstrates that some kinds of inflammatory processes, after traumatic dental injuries, may initiate and evolve potentially without the presence of bacteria at the inflammatory site.

关于外伤后牙髓组织病理特征的报道很少。本临床和组织学报告的目的是提供一些关于未成熟恒牙髓组织的组织学状况的新见解,在无并发症的冠骨折合并半脱位后不久。一名7岁的男性患者在21号牙齿的根尖出现局部颊肿胀,并进行了x线摄影。一周前,患者遭受了无并发症的冠骨折,转诊牙医仅通过将冠骨折碎片重新粘接进行了永久性修复。诊断为牙髓坏死,并决定再生根管手术,因为受伤的牙齿的顶端开放。在进行通道腔准备后,显然没有发生牙髓变性,因此使用无菌倒钩拉针去除组织并进行组织病理学检查。取长0.8 cm,厚5 μm的白色软稠度组织标本进行组织学评价。髓组织广泛凝固性坏死,中性粒细胞密集聚集,并伴有脓肿形成。可见一些分散的淋巴细胞,并伴有营养不良的钙化。最后,在标本的任何部分都没有观察到细菌。单纯冠状骨折合并半脱位的创伤性损伤后可发生髓质坏死。在这种情况下,牙髓炎和症状的出现不一定与细菌的存在有关。目前的组织学观察表明,创伤性牙齿损伤后,某些类型的炎症过程可能在炎症部位没有细菌存在的情况下启动和进化。
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引用次数: 0
Premolar Autotransplantation to the Anterior Maxilla Region—Aesthetic Outcome and Patient Satisfaction 上颌前区自体前磨牙移植-美学效果及患者满意度。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-12 DOI: 10.1111/edt.13057
Romy Doomen, Dick Barendregt, Liesbeth Temmerman, Noëmi De Roo, Guy De Pauw

Aim

The aim of this study was to assess the aesthetic results and patient satisfaction of premolars transplanted to the maxillary incisor region.

Material and Methods

In this multicenter study, 192 patients were included, with a minimum follow-up of 3 years.

The aesthetic evaluation comprised two parts:
  • Assessment of the PES/WES score using standardized intraoral photographs.
  • Patient's perspective (VAS questionnaire).

Results

The mean PES score was 6.94 (range, 2–10), and the mean WES score was 7.44 (range, 2–10). Most patients' aesthetic results were clinically acceptable (64.6%) to nearly perfect (9.4%). Significant correlations were found between PES and the orientation of the transplant at the receptor site (p = 0.038) and the level of oral hygiene (p < 0.001). A rotated orientation of the transplanted premolar at the receptor site and a poor/moderate level of oral hygiene are associated with lower PES scores. For the WES, there was a significant correlation with the restorative dentist (p < 0.001); if the restorative dentist was based at Center A instead of Center B, this is associated with higher WES scores. The response rate for the VAS questionnaire was 61.9%. 84.8% of the patients perceived the aesthetic outcome of the transplanted premolar the same as other teeth, 15.9% were not satisfied with the restorative treatment, and 12.6% were not satisfied with the surrounding tissues.

Discussion

Autotransplantation is a viable treatment option in cases with missing upper front teeth; PES/WES scores were at least comparable but mostly higher than those found in implant studies evaluating single-tooth replacement in the anterior maxilla. The VAS questionnaire showed that patients were satisfied with their transplanted tooth, which was consistent with the results of previous studies.

Conclusion

The aesthetic outcomes of premolars transplanted to the maxillary incisor region are predominantly favorable.

目的:本研究的目的是评估前磨牙移植到上颌切牙区的美学效果和患者满意度。材料和方法:在这项多中心研究中,纳入了192例患者,至少随访3年。美学评价包括两部分:使用标准化的口内照片评估PES/WES评分。患者视角(VAS问卷)。结果:PES评分平均为6.94分(范围2-10),WES评分平均为7.44分(范围2-10)。大多数患者的美容结果临床可接受(64.6%)至接近完美(9.4%)。PES与移植体在受体部位的朝向(p = 0.038)和口腔卫生水平之间存在显著相关性(p)。PES/WES评分至少与评估上颌前牙单牙置换术的种植体研究中发现的评分相当,但大多高于这些评分。VAS问卷调查显示患者对移植牙满意,这与以往的研究结果一致。结论:前磨牙移植至上颌切牙区美观效果良好。
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引用次数: 0
Custom-Made Mouthguard: Personalized Solution for Injury Prevention Secondary to Bruxism During Physical Activity 定制护齿器:在体育活动中预防磨牙损伤的个性化解决方案。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-10 DOI: 10.1111/edt.13052
Lívia Maria Sales Pinto Fiamengui, Luana Pinheiro Guerra Fontoura, João Felipe Barboza de Oliveira, Karina Miranda Lieuthier, Vinícius Rabelo Freire de Oliveira, Maria Laura Marreiro Mesquita, Carolina Ortigosa Cunha, Karina Matthes de Freitas Pontes

The natural dynamics of the jaw during physical activity and its physiological mechanisms are not fully understood. However, teeth clenching during certain sports activities may be associated with increased strength, power, flexibility, and performance. This behavior is termed awake bruxism (AB) and can lead to intraoral damage, highlighting the importance of patient education and management. This work describes the fabrication of a custom mouthguard (MG) idealized to prevent oral injuries secondary to AB during sports practice and discusses its indications, benefits, and guidelines for future research. A 3-mm Ethylene Vinyl Acetate (EVA) soft plate was selected as the material for MG fabrication, which was designed to fit the mandibular arch with an occlusal coverage thickness of 1.5–2 mm, vestibular and lingual extensions up to 3–4 mm away from the gingival margin, and an anterior connecting rod thickness of 3–5 mm. The proposed MG is intended to provide comfort, aesthetics, and protection against AB injuries for athletes who may experience neuromuscular benefits when clenching their teeth. For amateur and recreational athletes, promoting cognitive and behavioral changes for AB control is also suggested. Future in vitro and clinical studies are necessary to investigate the mechanical properties and clinical performance of the proposed MG.

下颌在身体活动中的自然动力学及其生理机制尚不完全清楚。然而,在某些体育活动中,咬牙可能会增加力量、力量、灵活性和表现。这种行为被称为清醒磨牙症(AB),可导致口腔内损伤,强调了患者教育和管理的重要性。这项工作描述了一种定制护齿器(MG)的制造,理想地用于预防运动练习中继发于AB的口腔损伤,并讨论了其适应症、益处和未来研究的指导方针。MG制作材料选用3mm的EVA软板,设计适合下颌弓,咬合覆盖厚度1.5-2 mm,前庭和舌部延伸距龈缘3-4 mm,前连接杆厚度3-5 mm。拟议的MG旨在为运动员提供舒适,美观和防止AB损伤,这些运动员在咬牙时可能会经历神经肌肉的益处。对于业余和休闲运动员,还建议通过促进认知和行为改变来控制AB。未来有必要进行体外和临床研究,以研究所提出的MG的力学特性和临床性能。
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引用次数: 0
A Retrospective Study of Dental Trauma in Israel Military Personnel 以色列军人牙齿创伤的回顾性研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-04 DOI: 10.1111/edt.13054
Yael Arbel, Yael Permut, Yehuda Zadik, Nir Tsur

Background

Traumatic dental injuries (TDIs) are a significant public health concern, especially prevalent among active populations like military personnel, where the causes and consequences of such injuries can be particularly severe due to the nature of their duties. This study aimed to investigate the patterns, associated injuries, and complications experienced by military personnel who sustained dental trauma.

Methods

This retrospective observational study utilized data from the Israel Defense Forces Trauma Registry, examining incidents from January 1997 through December 2018. The focus was on military personnel with injuries localized to the head, neck, and maxillofacial regions, analyzing the prevalence, types, and management of dental trauma.

Results

Out of 672 documented cases, 71 (10.5%) involved dental injuries. The most common injuries were tooth loss (5.2%), followed by tooth crown fractures (3.4%) and periodontal ligament (PDL) injuries (1.9%). Incisors were the most frequently injured teeth. Temporomandibular joint disorder (TMD) was identified in 10.2% of the subjects, with a notable 42.9% of TMD patients sustaining dental injuries as well.

Discussion

The study highlights the unique challenges of managing TDIs in military settings, emphasizing the need for early and effective treatment to prevent long-term consequences. Comparisons with civilian data reveal higher rates of severe injuries in military personnel, underscoring the importance of specialized training for military dentists in trauma management.

Conclusion

Dental injuries in the military require a focused approach due to the severe nature of the traumas involved. Effective management of these injuries is crucial to ensure the personnel's rapid recovery and continued operational readiness. The findings recommend implementing specialized training for military dentists and introducing mouthguard policies to mitigate dental injuries in combat scenarios.

背景:创伤性牙齿损伤是一个重大的公共卫生问题,在像军事人员这样的活跃人群中尤其普遍,由于他们的职责性质,这种损伤的原因和后果可能特别严重。本研究旨在探讨军事人员持续性牙外伤的模式、相关损伤和并发症。方法:这项回顾性观察性研究利用了以色列国防军创伤登记处的数据,调查了1997年1月至2018年12月的事件。重点是军事人员的损伤局限于头部,颈部和颌面区域,分析患病率,类型和管理的牙齿创伤。结果:672例病例中,71例(10.5%)涉及牙损伤。最常见的损伤是牙齿脱落(5.2%),其次是牙冠骨折(3.4%)和牙周韧带(PDL)损伤(1.9%)。门牙是最常受伤的牙齿。10.2%的患者存在颞下颌关节紊乱(Temporomandibular joint disorder, TMD),其中42.9%的患者存在牙损伤。讨论:该研究强调了在军事环境中管理tdi的独特挑战,强调了早期有效治疗以防止长期后果的必要性。与民用数据相比,军事人员的严重伤害率更高,强调了对军事牙医进行创伤管理专业培训的重要性。结论:由于所涉及的创伤的严重性,军队中的牙齿损伤需要一个集中的方法。有效管理这些伤害对于确保人员的快速恢复和持续的作战准备至关重要。研究结果建议对军队牙医进行专门培训,并引入护齿政策,以减轻战斗场景中的牙齿损伤。
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引用次数: 0
A Cross-Sectional Study Appraising the Reporting Quality of Abstracts of Systematic Reviews With Meta-Analyses on Traumatic Dental Injuries Using the PRISMA for Abstract Checklist 一项横断面研究评估创伤性牙齿损伤系统综述摘要的报告质量,并使用PRISMA作为摘要检查表。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-02-28 DOI: 10.1111/edt.13047
Venkateshbabu Nagendrababu, Vellore Kannan Gopinath, Giorgos N. Tzanetakis, Anand Suresh, Srinivasan Narasimhan, Clovis M. Faggion Jr, Paul V. Abbott, Paul M. H. Dummer

Aims

To evaluate the reporting quality of abstracts of systematic reviews (SRs) with meta-analyses (MA) related to traumatic dental injuries (TDI) using the PRISMA for Abstract (PRISMA-A) 2020 checklist and to determine potential predictive factors associated with the overall reporting quality.

Methods

SRs with MA identified in PubMed, SCOPUS, and EBSCOhost databases from inception to May 2024 within the scope of TDI were included. The abstracts were evaluated for reporting quality in accordance with the 12 items of the PRISMA-A checklist. Each item was awarded a score of “1” or “0” for adequate or inadequate responses, whereas items that were partially addressed were awarded a score of “0.5”. Utilizing multiple regression analysis, the association between six predictor variables (journal impact factor, publication year, number of authors, a priori protocol registration, word count of the abstract, and continent of the corresponding author) were examined in relation to the total PRISMA-A scores. The p-value was set at 5%.

Results

Abstracts from 53 SRs with MA were included. All adequately reported the “Title” and “General interpretation of the results and important implications”. However, none adequately addressed the “Source of funding”. A significant positive association was identified between the reporting quality of the abstract and both the year of publication (p = 0.032) and the word count of the abstracts (p = 0.002).

Conclusion

The adherence of abstracts of SRs with MA to the PRISMA–A checklist was deficient in several items. Authors should ensure their abstracts comply with the PRISMA–A checklist, as this will enhance their reporting quality and ultimately benefit patients, clinicians, and other stakeholders.

目的:采用 PRISMA for Abstract(PRISMA-A)2020 检查表,评估与牙外伤(TDI)相关的荟萃分析(MA)系统综述(SR)摘要的报告质量,并确定与总体报告质量相关的潜在预测因素:方法:纳入从 PubMed、SCOPUS 和 EBSCOhost 数据库开始到 2024 年 5 月期间在 TDI 范围内发现的涉及 MA 的 SR。根据 PRISMA-A 核对表的 12 个项目对摘要的报告质量进行评估。对每个项目的充分或不充分回答均给予 "1 "或 "0 "分,而对部分回答的项目则给予 "0.5 "分。利用多元回归分析,研究了六个预测变量(期刊影响因子、发表年份、作者人数、先验方案注册、摘要字数和相应作者所在大陆)与 PRISMA-A 总分之间的关联。P值设定为5%:结果:共纳入了 53 篇具有 MA 的 SR 摘要。所有摘要都充分报告了 "标题 "和 "结果的一般解释和重要意义"。但是,没有一篇论文充分阐述了 "资金来源"。摘要的报告质量与发表年份(p = 0.032)和摘要字数(p = 0.002)之间存在明显的正相关:结论:使用 MA 的 SR 摘要在多个项目上不符合 PRISMA-A 核对表的要求。作者应确保其摘要符合 PRISMA-A 核对表,因为这将提高其报告质量,并最终使患者、临床医生和其他利益相关者受益。
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引用次数: 0
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Dental Traumatology
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