Dental Traumatology最新文献

Background/aim: This study tests materials by additive manufacturing methods that will demonstrate impact resistance and structural stability comparable to conventional EVA.

Material and methods: Researchers tested ethylene-vinyl acetate copolymers, thermoplastic polyurethane via fused deposition modeling, and flexible photopolymer resins from liquid crystal display-based three-dimensional printing. Analyses included tensile strength, hardness, and impact resistance.

Results: Thermoplastic Polyurethane via fused deposition modeling showed the best combination of elasticity, energy dissipation, and durability. Ethylene-vinyl acetate exhibited lower resilience, and the resins failed prematurely. Increased thickness and structural reinforcement improved protection.

Conclusions: The material manufacturing method and design significantly influence a mouthguard's effectiveness. Thermoplastic Polyurethane made with additive manufacturing, especially with reinforced designs, offers superior resilience for high-impact sports, providing a path for customizable, effective, and accessible preventive dentistry.

Background/aim: Facial trauma is a major public health challenge due to its aesthetic, functional, psychological, and socioeconomic impacts. In Northern Brazil, particularly in the Amazon region, subsistence activities such as plant extraction, animal handling, and river transportation are essential to daily life and may contribute to an increased risk of facial injuries. These environmental and cultural factors are often underrepresented in the literature. This study aimed to investigate the epidemiological profile of facial fractures associated with etiologies specific to the Amazon region.

Materials and methods: This was a retrospective study conducted over an 8-year period (2013-2020) at a trauma referral center in Northern Brazil. Medical records of patients with facial fractures resulting from boat accidents, animal-related incidents, plant extraction, and hunting and fishing accidents were reviewed.

Results: A total of 97 patients met the inclusion criteria, with males accounting for 88.7% of cases and adults (20-64 years) being the most affected age group. Boat accidents were the most frequent cause of trauma (40.2%) and were associated with a higher median number of surgical fractures compared to animal-related trauma (p = 0.041) and hunting and fishing accidents (p < 0.001). The middle third of the face was most commonly affected (78%), and the mean FISS score was 4.4. The average length of hospital stay was 11 days, with a significant correlation between FISS and hospital stay (p = 0.0078). Hunting and fishing accidents were the leading cause of long-term sequelae.

Conclusion: Facial fractures related to the Amazon region are associated with distinct occupational and environmental risks, imposing not only a burden on public health but also resulting in specific morbidities within traditional populations. Although these injuries do not necessarily reflect the characteristics of the broader population, they highlight the need for public policies tailored to the regional context.

Background and aim: Physical strain is a potential contributing factor for bruxism, particularly among athletes, but limited research exists among weightlifters. The aim of this study was to assess the prevalence of awake bruxism among weightlifters in Chennai City and evaluate their knowledge and attitudes toward preventive measures.

Materials and methods: A cross-sectional study was conducted among 272 professional weightlifters aged 25-40 years using purposive sampling. Participants were evaluated using the Standardized Tool for the Assessment of Bruxism (STAB), which included self-reported behavior and clinical examination for signs such as linea alba, lip/tongue impressions, and tooth wear using the Tooth Wear Evaluation System. A validated 7-item questionnaire assessed knowledge and attitudes. Descriptive measures and Chi-square tests were used to analyze the data.

Results: Self-reported bruxism was observed in 68.01% of participants, while clinical signs included linea alba (61.02%), lip impression (48.16%), and tooth wear (63.97%). Though 66.9% had adequate knowledge of bruxism, only 29.04% exhibited a positive preventive attitude. Poor knowledge was significantly associated with the presence of all clinical signs (p < 0.001), while poor attitude correlated with a higher prevalence of self-reported bruxism and tooth wear (p < 0.001).

Conclusions: Awake bruxism is highly prevalent among weightlifters, with limited preventive attitudes despite moderate knowledge. These findings indicate the need for targeted education and screening strategies in fitness populations to reduce the prevalence of oral health disorders.

Background/aims: This evidence mapping (EM) and quality assessment of randomized controlled trials (RCTs) in Dental Traumatology (DT) aimed to identify the RCTs, distribute them in different domains and subdomains, analyze their methodological characteristics, and assess their quality.

Methods: A protocol was developed as per the principles of Global-Evidence-Mapping (EM) and registered in open-sciences-framework. A systematic electronic search was performed in the PubMed, SCOPUS, EMBASE, Web of Science, LILACS, and COCHRANE on September 30, 2025. Grey literature and reference searches were also performed. RCTs with intervention arms with/without a control group, having details of randomization related to any domain of DT, were included after screening of titles, abstracts, and full-text articles. Studies were distributed in domains and subdomains, and data related to demographic and methodological characteristics were extracted and analyzed. Risk of bias (ROB) was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB-2) and details were presented in the form of an abacus EM plot.

Results: The study identified 30 RCTs in four domains of DT, with the highest in the therapeutic domain and subdomain of treatment protocols in permanent dentition. Seven studies were published before 2010, nine between 2010 and 2019, and 14 others from 2020 to date. They represented 13 countries, with the highest from China, the United Kingdom, and India. A protocol was registered in 10 studies, and the majority of the studies had not followed Consolidated Standards of Reporting Trials (CONSORT) guidelines. Only three RCTs were found to have a low ROB.

Conclusion: The majority of studies exhibited a lack of methodological robustness in defining their hypothesis, sample size estimation, randomization, and statistical evaluation of outcomes. This was the reason for 27 of them being graded as having high ROB or some concerns. The results of this EM may help researchers in identifying the areas for future research and guide them to follow the best practices in the planning and conduct of RCTs.

Background/aims: To evaluate the prevalence and timing of post-operative complications following tooth autotransplantation, identify factors associated with earlier diagnosis, and report long-term survival and success rates.

Materials and methods: A single-centre retrospective cohort study was conducted at a Czech university dental clinic (2003-2024); no external funding. Donor teeth were grouped as premolars, molars and anterior (canines, incisors, one premaxillary supernumerary; predominantly single-rooted, single-canal). Root development was classified according to Moorrees: early (1-3), optimal (4-5), late (6-7). Survival/success were estimated with Kaplan-Meier; timing of first diagnosis with event-only cumulative incidence (1-Kaplan-Meier); and factors associated with earlier occurrence with Cox proportional hazards regression.

Results: The study included 134 teeth in 111 patients (74 premolars, 48 molars, 12 anterior). Half of the complications were diagnosed within 18 months (median time to first diagnosis: 11.7 months inflammatory resorption, 19.6 months apical pathology, 18.0 months cervical resorption, 21.4 months replacement resorption). Five-year survival: premolars 95.4%; molars 86.6%; anterior 75.8%. Five-year success: 75.3%, 76.8% and 66.0%, respectively. Age ≥ 30 years was associated with earlier tooth loss and apical pathology; male gender with earlier inflammatory resorption and loss of success. Anterior teeth and restorative indications (e.g., caries, previous root canal treatment failure) were associated with earlier apical pathology. A single preoperative dose of amoxicillin 1 g ~1 h before surgery or a 7-day post-operative amoxicillin course (500-1000 mg) was associated with delayed diagnosis of infection-related complications. Some treated complications recurred or transformed into another type, requiring additional intervention.

Conclusions: Early detection enables successful management of most complications. As half occurred within 18 months-the critical window-follow-up should include reviews at 1 week, 1 month, 3 months and every 3 months until 2 years post-transplantation, with continued long-term monitoring for recurrences and late complications.

Background: Intimate partner violence (IPV) is a global health concern, with over a quarter of women and girls worldwide experiencing IPV at least once in their lifetime. Previous research has indicated that dentists often lack the training and confidence to handle IPV-related concerns in clinical settings. The purpose of this study was to examine dental professionals' knowledge, attitudes, and solutions offered to victims regarding IPV-related concerns.

Methods: A cross-sectional study in a survey format was administered across Canada to collect responses from dentists, dental hygienists, dental therapists, and dental assistants. The questions in the survey were designed to evaluate professionals' knowledge of IPV, comfort levels addressing the topic with their patients, attitudes toward IPV, and knowledge of intervention resources.

Results: Overall, 327 dental professionals completed the survey, with 183 dentists, 77 dental assistants, 60 dental hygienists, and 5 dental therapists. Most dental professionals indicated that they have not received training related to IPV at any point either during their education (88%) or career (81%). Furthermore, most dental professionals reported that they did not feel comfortable speaking to patients about IPV-related concerns (51%) nor did they feel prepared to provide referrals or resources to victims. However, dental professionals generally feel that they do have a role in responding to IPV-related events (55%) and would like more training on this topic (61%).

Conclusions: Dental professionals largely believe that they are key responders to assist potential IPV victims and appear willing to take steps toward doing so. This study's findings also indicate that there is not currently widespread access to the tools, protocols, and educational resources that could facilitate this assistance.

Background: Use of artificial intelligence chatbots in dental traumatology has increased. However, concerns regarding their reliability are yet to be addressed. This study aims to evaluate the accuracy of a new AI chatbot Dental Trauma Evo in responding to queries on dental fractures and luxations.

Materials and methods: A total of 45 questions, including multiple-choice questions (MCQs), true/false, and yes/no types of questions were created and validated in accordance with the International Association of Dental Traumatology's position statement on fractures and luxations. Over the course of nine consecutive days in incognito mode, they were simultaneously exposed to four chatbots: ChatGPT-4o, DeepSeek R1, Google Gemini 2.5, and Dental Trauma Evo. The obtained answers were verified for accuracy and consistency. The Fisher's exact test was used for statistical analysis.

Results: The best overall accuracy was shown by Dental Trauma Evo (85.43%), which was followed by Google Gemini (81.72%), DeepSeek (80.24%), and ChatGPT-4o (79.75%). Regarding question type, ChatGPT-4o, Google Gemini, and Dental Trauma Evo recorded the best responses to Yes/No, True/False, and MCQs respectively. There was an insignificant difference between the question type and the different chatbots (p > 0.05).

Conclusion: The Dental Trauma Evo chatbot developed using the International Association of Dental Traumatology guidelines exhibited a favorable preliminary performance in the current study. Further research, clinical validation, and model enhancements are necessary to ensure the effective implementation of the same in practice.

Objective: This study aimed to compare the performance of artificial intelligence-based deep convolutional neural networks, YOLOv8, YOLOv11, and YOLOv12, in segmenting dental injuries using panoramic films of pediatric patients with traumatic dental injuries.

Methods and materials: Panoramic radiographs of pediatric patients aged 6-13 years with traumatic dental injuries presented to the Gaziantep University Faculty of Dentistry were input into an artificial intelligence model (CranioCatch, Eskisehir-Turkey) using YOLOv8, YOLOv11, and YOLOv12 as models to automatically detect and classify dental injuries.

Results: The AUC values of YOLOv8, YOLOv11, and YOLOv12 were 0.72, 0.69, and 0.73 for hard tissue injuries and 0.61, 0.67, and 0.69 for soft tissue injuries, respectively. Multiclass F1-scores are 0.592, 0.653, and 0.683, respectively. All models were able to better discriminate hard tissue injuries, and the most consistent results were obtained with YOLOv12.

Conclusion: The YOLOv12-based deep learning model demonstrated better performance in detecting dental trauma in pediatric panoramic radiographs compared to other models. Nevertheless, artificial intelligence has not yet achieved flawless performance in Dental Traumatology. Therefore, AI tools should be developed in collaboration with expert dentists to better support clinical decision-making in dental trauma cases.

Background/aim: Bi-colored mouthguards (MTG) are often sought by both professional and amateur athletes. Bi-colored MTG can be made in the dental office from premanufactured bi-colored EVA sheets or custom-designed in the dental office for greater color variety. This study aimed to evaluate the tensile strength of ethylene-vinyl acetate (EVA) plates from two commercial brands (BioArt and Polyshok), using different bonding methods and heat sources for producing bicolored MTG.

Materials and methods: EVA plates from BioArt and Polyshok (3 mm thickness) were bonded using six methods combining two bonding materials (metal angle and glass plate) and three heat sources (heat gun, mini-torch, and Hannau lamp). Bonded plates were sectioned into 30 standardized bar-shaped samples (70 × 10 × 3 mm) and subjected to tensile testing. Ultimate tensile strength was recorded, and statistical analyses were performed using One-Way ANOVA and Tukey's test (α = 0.05).

Results: Significant differences in ultimate tensile strength (MPa) were observed between bonding methods (p < 0.001) for each commercial brand. The metal angle and heat gun (MAH) method exhibited the highest tensile strength for both tested EVAs (BioArt: 146.5 ± 30 MPa; Polyshok: 87.8 ± 19.3 MPa). The Hannau lamp produced the lowest values for both tested EVAs (BioArt: 69.8 ± 43.1 MPa; Polyshok: 51.0 ± 14.4 MPa).

Conclusions: The bonding method significantly affects the tensile strength of EVA plates, with the MAH method and heat gun demonstrating superior performance. These findings highlight the importance of optimizing bonding techniques to ensure durability and protective performance in bi-colored MTG.

Objective: This in vitro study investigated whether the use of different intraorifice barrier materials (IOBMs) in combination with tricalcium silicate-based cements affects the vertical fracture resistance of simulated immature mandibular incisors treated with regenerative endodontic protocols.

Materials and methods: A total of 128 extracted mandibular incisor teeth were standardized by removing 3 mm of their root ends and randomly assigned to four controls (CG, n = 8) and eight experimental groups (EG, n = 12): CG1: Intact immature teeth, CG2: Simulated immature teeth (retrograde preparation only, without access cavity), CG3: Simulated immature teeth restored with resin-based composite (RBC) only, CG4: Simulated immature teeth left unrestored, EG1: White Angelus MTA + RBC, EG2: White MTA + Riva LC HV + RBC, EG3: White MTA + Cention Forte (Alkasit) + RBC, EG4: White MTA + Zirconomer Improved + RBC, EG5: Biodentine + RBC, EG6: Biodentine + Riva LC HV + RBC, EG7: Biodentine + Cention Forte + RBC, EG8: Biodentine + Zirconomer Improved + RBC. Following access cavity preparation, all groups (except CG1 and CG2) underwent the RET protocol. Then, specimens were subjected to vertical fracture testing. Data were analyzed using two-way ANOVA (p < 0.05). Fracture patterns were categorized as repairable or non-repairable.

Results: There was a significant difference in fracture resistance between CG1 and CG4 (p = 0.046). Samples restored with EG3 demonstrated significantly higher fracture resistance than the groups CG4 and EG7 (p = 0.044, p = 0.012, respectively). Across all groups, the majority of fractures were non-repairable.

Conclusion: Within the limits of this in vitro model, most coronal restoration protocols after RET showed comparable fracture resistance. Combinations with Zirconomer Improved showed favorable trends, but clinical recommendations should remain cautious pending further standardized studies. Material choice at the cervical level may help reduce the risk of root fracture in traumatized immature teeth treated with regenerative endodontic therapy, improving long-term outcomes.