Dental Traumatology最新文献

Background/aim: Women with lived experiences of intimate partner violence (IPV), especially physical trauma to the head, neck, and face, can experience oral health issues, leading to significant dental problems. Despite these severe dental outcomes, racialized women who have experienced IPV often find oral healthcare largely inaccessible. Yet access to oral care is a crucial, overlooked aspect of health and support for racialized women who have experienced IPV. The study aimed to explore the barriers and facilitators to accessing oral healthcare for racialized women who experience intimate partner violence.

Materials and methods: A qualitative research study using a critical, intersectional lens and principles of Community-Based Participatory Research (CBPR) was conducted using 14 interviews with women and five focus group discussions with dentists (n = 9) and shelter providers (n = 8) in Toronto, Canada. The resulting data were analyzed through reflexive thematic analysis guided by the McIntyre access framework.

Results: The research findings highlighted multiple barriers to oral healthcare. Financial difficulties and coverage restrictions make it challenging for participants to afford the high cost of needed treatment. There are intersectional power dynamics and structural barriers in service delivery that shape oral care experiences and can manifest as racial discrimination and misogyny. Additional barriers include long waitlists and minimal access to culturally responsive care.

Conclusions: This research underscores the urgent need for policies that expand dental care coverage and for further training of dental providers in trauma sensitivity and culturally competent care.

Background: In dental emergency situations, the knowledge and attitudes of primary school teachers, which may be influenced by their generational background, play a critical role in the success of initial management. The aim of this study was to investigate how generational differences affect primary school teachers' responses to oral and dental trauma.

Material and methods: This descriptive cross-sectional study was conducted between March and May 2025 with local ethical approval (2025-03/04). A 16-question survey, based on the IADT guidelines, was developed and piloted with 30 volunteer teachers. Following revisions, the final electronic questionnaire was distributed via email to primary school teachers from the same brand private schools across seven regions of Türkiye. Participation was voluntary, with reminders sent after 15 days. The survey included three parts: demographics, experience with dental trauma, and knowledge/attitudes toward avulsed tooth. Their knowledge about the Tooth SOS application was also investigated. Generational classification was based on birth years: Gen Z (after 1997), Gen Y (1981-1996), and Gen X (1965-1980). Data were statistically analyzed (p < 0.05).

Results: No statistically significant difference was found between Gen X and Y; however, individuals from Gen Z were more willing to replant an avulsed tooth within the first 12 h compared to other generations. Additionally, both Gen Y and Z participants were found to be more familiar with the Tooth SOS program.

Conclusion: Regardless of their generational affiliation, primary school teachers working in private schools across the seven regions of Türkiye were found to have insufficient knowledge regarding the management of emergency oral and dental injuries. Undergraduate teacher education curricula should be revised with consideration for generational differences, ensuring that essential topics such as dental emergency management are adequately covered.

Objective: Traumatic dental injury (TDI) is the world's fifth most common injury affecting children and adolescents. This study aimed to predict TDI based on ear problems and other factors among Australian children aged 4 years or over.

Methods: We used two longitudinal studies: the Longitudinal Study of Indigenous Children (LSIC) and the Longitudinal Study of Australian Children (LSAC). The outcome was the prevalence of TDI in children aged 14 years. We assessed 50 features, including demographic characteristics, health conditions (such as ear diseases) and health-related behaviours of the children, their parents, and other family members in children aged 4-6 years. The performance of machine learning algorithms was evaluated using the area under the receiver operating characteristic curve (AUC) with its 95% confidence interval, along with sensitivity (recall), specificity, precision (positive predictive value), F1 score (the harmonic mean of sensitivity and precision) and accuracy (the proportion of correct predictions). These metrics were evaluated for the full sample and separately for Indigenous and non-Indigenous subgroups, using both the full sample and stratified models. A sensitivity analysis was performed to compare model performance across the groups.

Results: This study included 1746 Indigenous and 8357 non-Indigenous children and their parents and family members. The prevalence of TDI among Australian children at age 14 was approximately 13%. The full sample model applied to the full sample and the non-Indigenous subpopulation demonstrated high predictive performance, with AUCs of 0.85 (95% CI: 0.82-0.88) and 0.86 (95% CI: 0.82-0.89), respectively. In contrast, the model applied to the Indigenous subpopulation demonstrated lower performance, with AUC values ranging from 0.76 (95% CI: 0.68-0.83) in the full sample model to 0.80 (95% CI: 0.70-0.83) in the stratified model.

Conclusions: Our findings indicated that early childhood ear problems were strong predictors of traumatic dental injuries in Australian children.

Aim: This study aims to assess the impact of visual case scenarios on parental awareness and urgency perception regarding enamel-dentin fractures in children.

Methods: This descriptive study included parents of children aged 4-14 who were receiving active dental care. Data were collected via a structured questionnaire, which consisted of two sections: demographic characteristics and general knowledge questions, and visual case-based scenarios to evaluate trauma perception. Statistical analysis was conducted using descriptive methods and chi-square testing. Internal consistency was assessed using Cronbach's alpha.

Results: A total of 317 participants participated in the study; 65.9% of the participants were mothers and 56.8% had female children. A history of dental trauma was reported by 11.7% of parents. Regarding information sources, 50% relied on dentists or healthcare professionals, and 30.1% used the Internet. After a traumatic event, 42% preferred consulting a pediatric dentist, while 25.2% would visit a general dentist. 62.1% of participants could distinguish between primary and permanent teeth, but only 45.1% believed that the tooth type (primary or permanent) influenced treatment decisions. Regarding trauma concerns, 62.8% prioritized treatment for anterior teeth due to the risk of future complications. 96.8% acknowledged that the time elapsed since the trauma could affect treatment outcomes, and 72.2% considered fracture size important in treatment decisions. Furthermore, 87.1% did not view posterior tooth fractures as concerning as anterior ones.

Conclusion: This study highlights significant gaps in parental knowledge about pediatric dental trauma, stressing the need for improved education on trauma severity, timely intervention, and the impact of fracture size and tooth type on treatment.

Objectives: The purpose of this study was to evaluate the impact of a case-based hands-on training session on dental students' self-perceived competence in managing traumatic dental injuries (TDI) using an innovative 3D-printed model.

Methods: Fifth-year undergraduate students were invited to voluntarily participate in a hands-on training on dental traumatology. Participants worked through a case-based multi-injury trauma using a specially designed 3D-printed model, allowing them to practice examination, diagnosis, and treatment procedures in a realistic clinical scenario. A questionnaire evaluating self-perceived competence in various TDI management domains was conducted immediately before, directly after, and 12 months after the training. Pre- and post-training scores were analyzed statistically.

Results: A total of 42 students participated in the training over two consecutive years. Thirty students participated in the evaluation 12 months after the training. Participants demonstrated a statistically significant increase in self-perceived competence for most assessed areas directly after the training, which kept true even after 12 months. The only exception was "worries about complications during clinical management," which showed no significant change.

Conclusion: Simulation-based hands-on training substantially enhanced dental students' self-perceived competence in managing TDI.

Background: Searching online for dental emergency treatment as a non-expert can lead to unreliable guidance. We tested the publicly available first multimodal large-language model, ChatGPT-4o, prospectively with real emergency-department avulsion cases to determine if it would deliver guideline-correct, time-critical directions within seconds.

Methods: Seventy-eight anonymized avulsion charts (42 permanent, 36 primary teeth; 39 dry, 39 moist; 40 immature roots) were rewritten as lay prompts. ChatGPT-4o created two single responses to each vignette, 14 days apart (156 responses). Three oral and maxillofacial surgeons (OMFS) scored diagnostic accuracy, immediate action, contraindication identification, and completeness. Three lay assessors scored clarity (0-15 composite rating). An additional time-critical safety flag required simultaneous accuracy in immediate action and contraindication advice. Statistical analysis was performed at a 95% confidence level.

Results: ChatGPT-4o demonstrated significant rates of accurate guidance. Inter-rater reproducibility was near perfect (ICC = 0.94; κ = 0.88-0.998). The median composite score was 13 (IQR 12-14); permanent dentition elevated the probability for perfect diagnostic, contraindication, and immediate-action scores (p ≤ 0.046), but extra-oral dry time lowered immediate-action (p = 0.003) and reduced completeness (p = 0.023). Root maturity had no effect. Clarity was rated at more than 93% in both sessions. The safety flag was present in 81% and 89% of cases (χ² = 6.73, p = 0.009), with one in eight potentially unsafe situations.

Conclusions: This first clinical validation of ChatGPT-4o demonstrates expert-level, reproducible triage for tooth avulsion and introduces the "time-critical safety" composite as a strict benchmark for emergency chatbots. There is still a need for guideline-linked retrieval before unsupervised deployment. Clinically, these findings show that while ChatGPT can offer quick and largely accurate advice, the remaining deficiencies highlight the risk of incomplete or unsafe guidance during emergencies.

Background: Dental erosion, the irreversible loss of enamel due to acid exposure, is increasingly observed among adolescents and athletes, primarily due to frequent consumption of acidic energy and sports drinks. These beverages, while marketed for performance enhancement, can lead to significant enamel demineralization, especially under reduced salivary flow during intense activity. This in vitro study evaluated the erosive potential of commercially available energy and sports drinks on human enamel and assessed the protective effects of three toothpaste formulations fluoride-based, herbal based and NovaMin-based.

Materials and methods: Forty extracted human premolars were randomly divided into four groups (n = 10): Group I (fluoridated toothpaste), Group II (Herbal toothpaste), Group III (NovaMin-based toothpaste), and Group IV (erosion control, no brushing). Baseline surface micro-hardness was measured using the Vickers hardness test. Following brushing simulation, specimens were exposed to Monster Energy and Gatorade for seven days. Post-treatment micro-hardness was assessed and data were analyzed statistically.

Results: All test groups showed significantly higher enamel micro-hardness compared to the control group. A significant increase in Mean Vickers Hardness Number was observed from baseline to post-treatment across all test groups. Pepsodent Germicheck (fluoridated toothpaste) showed the greatest protective effect, with mean post-treatment hardness values of 176.11 (Monster Energy) and 165.18 (Gatorade), with corresponding mean differences of 91.82 and 102.75 (p = 0.01).

Conclusion: Fluoride and NovaMin toothpastes significantly reduce enamel erosion from acidic drinks. Herbal dentifrices offered limited protection. Preventive strategies, including remineralizing toothpaste use and awareness of beverage acidity, are essential to combat dental erosion.