Dental Traumatology最新文献

Dental trauma is highly prevalent, involving 25% of school-age children and about 12.5% of the general population of the world. Due to the young age of the patients that are usually involved in dental trauma, there are tooth-related complicating factors, such as open apices, thin dentinal walls, and unfavorable crown-to-root ratio, as well as patient-related factors, such as anxiety and cooperation, and other challenges related to the complex diagnosis and treatment. Therefore, it is not surprising that the global status of knowledge for the prevention and emergency management of traumatic dental injuries among dental professionals was often reported as insufficient. Aiming to improve dental trauma education, one should consider that the contemporary educational settings have transitioned to a digital learning ecosystem and that the current students belong to a unique generational cohort. Therefore, this paper examines the challenges educators encounter in contemporary dental school classrooms and the defining characteristics of current generation Y and Z dental student cohorts. Finally, it outlines strategies to optimize dental trauma learning, considering the unique generational characteristics of the current dental students.

Background: This study aimed to analyse the relationships between injury variables, treatment variables and the status of the periodontium or pulp of luxated teeth.

Materials and methods: The electronic medical records and imaging data of patients who underwent treatment for luxation injuries of permanent teeth in the paediatric dentistry and dental emergency departments of the Stomatology Hospital, Zhejiang University School of Medicine between 1 January 2012 and 1 January 2022 were retrospectively analysed. First, the patients' records were reviewed to collect background and follow-up imaging data; then, all early clinical variables were reviewed and used to construct models to predict the periodontal and pulp status of the luxated teeth. The models included the significant factors identified in the univariate analysis, and multivariate analysis was performed to evaluate the relationships between the variables and the final status of the periodontium or dental pulp. The chi-square test and Fisher's exact test were employed to analyse the differences in the frequency of each variable. The variables were systematically screened based on their odds ratios, and significance levels were determined by Pearson's chi-square test.

Results: A total of 188 patients were initially identified and ultimately included. The age range of the patients was 7-56 years. Logistic regression models for periodontal and pulp prognosis of the luxated teeth were established. The models were refined by combining the results of feature selection, parameter testing and goodness-of-fit testing. The final model included four variables and accurately predicted the periodontal outcome in 65.79% of the cases. The prognostic model for the dental pulp included three significant factors and had an overall accuracy of 94.59%.

Conclusion: The prognostic models developed to predict the influence of various factors on the status of the periodontium and dental pulp of luxated teeth demonstrated notable accuracy and practical utility. Therefore, these models are potentially valuable tools for long-term prognostic assessments.

Trial registration: Approval no. ChiCTR2100044897.

Introduction: Maxillofacial injuries are usually associated with ophthalmic injuries that may be mild to severe, and may even result in loss of integrity of the orbital skeleton and impairment of the visual apparatus.

Aim: To evaluate the pattern of ophthalmic injuries associated with maxillofacial fractures in patients who reported to a tertiary care hospital, associated with a medical college in M.P, India.

Material and methods: The records of patients who sustained ophthalmic injuries with maxillofacial trauma from 1st January 2012 to 31st January 2024 and reported to the Department of Dentistry of a tertiary care hospital were evaluated. The data related to demographic characteristics, aetiology of trauma, type of maxillofacial fractures and pattern of ophthalmic injuries were gathered and analysed.

Results: A total of 1575 patients with maxillofacial trauma reported to the institute during the study duration. The study sample comprised 1046 (66.41%) maxillofacial trauma patients who sustained ophthalmic injuries. Males were more commonly involved (85.85%) than females (14.15%). The commonly involved age group was 21-30 years with 34.32% of patients belonging to the age group. The most common aetiology was road traffic accidents, reported in 71.89% of patients. Zygomaticomaxillary complex (ZMC) fractures were evident in 73.52%, mandibular fractures in 50.19%, naso-orbito-ethmoidal (NOE) fractures in 19.41% and frontal bone fractures in 18.74% patients. Subconjunctival haemorrhage was seen in 79.83%, periorbital ecchymosis in 72.94% and periorbital oedema in 60.32% of cases. Retrobulbar haemorrhage was seen in 2.58%, traumatic optic neuropathy in 2.01% and retinal detachment in 0.86% of cases.

Conclusion: Ophthalmic injuries were seen frequently in 66.41% of cases with maxillofacial trauma, particularly in zygomatic complex fractures (73.52%). The findings emphasise that the competency of maxillofacial surgeons plays a vital role in comprehending the severity and management of post-traumatic ophthalmic consequences in maxillofacial injuries. Also, ophthalmological evaluation in maxillofacial trauma, particularly involving the midface should be considered mandatory.

Traumatic dental injuries (TDIs) are a frequent challenge in pediatric dentistry, requiring a coordinated interdisciplinary approach for successful management. These injuries can affect various dental tissues and pose significant diagnostic and therapeutic challenges, particularly in young patients with developing dentition. This review aims to explore the complexities of managing TDIs in young permanent dentition, focusing on the role of orthodontics, endodontics, and other specialties in providing comprehensive care. We highlight the importance of interdisciplinary collaboration in achieving optimal functional and aesthetic outcomes, emphasizing the need for updated diagnostic tools and treatment protocols tailored to the growing child. Specific recommendations are provided for clinicians on integrating orthodontic and endodontic management in trauma cases, focusing on minimizing complications and ensuring long-term prognosis.

Sports-related traumatic dental injuries (TDIs) are a significant global concern, particularly in contact sports, where the risk of orofacial injuries is high. Custom-made sports mouthguards (CSMs) are recognized as the most effective means of preventing these injuries, providing both protection and comfort without impairing athletic performance. Despite their proven benefits, there is no globally standardized approach to mouthguard design, fabrication, or usage, primarily due to varying regulations, awareness levels, and cultural attitudes toward sports safety across different countries. This document from the European Association for Sports Dentistry (EA4SD) outlines the latest guidelines for selecting, constructing, clinical use, and maintaining CSMs. It emphasizes the need for mouthguards fabricated from FDA-approved materials, designed to absorb and distribute impact forces effectively, and customized to ensure optimal fit and comfort. The EA4SD also highlights the importance of education for dental professionals and athletes on the benefits of CSMs, advocating for their mandatory use in high-risk sports to reduce the prevalence of TDIs and related complications.

Management of traumatic dental injuries (TDI) is very complex, even under ideal circumstances. Children in the primary dentition have unique needs, and it is important that the diagnosis and treatment choices are offered to parents. The prevalence of TDI in the primary dentition is far greater than for any other age group. Education of parents and caregivers in prevention and emergency management of oral injuries is essential. When injuries occur, the dental professionals must also respond appropriately to establish correct diagnosis of the injuries and assist parents in making decisions for management while communicating realistic expectations for the future. Progress has been made in the diagnosis and management of dental injuries in the primary dentition based on the biological healing response of oral tissues following injury over time. Several factors influence critical decisions that must be made based on basic principles and guidelines to improve successful outcomes for the child. Managing co-operation must be balanced with the benefit of anticipated treatment need. The current evidence challenges previous dental interventions. The IADT guidelines updated the approach to management of TDI in children in the primary dentition. Encouraging a positive attitude to the dental setting early in the life course prepares the child to be a motivated dental attendee throughout their lifetime. This manuscript aimed to outline the critical issues and clinical choices for injuries to the primary dentition and to summarise recent guidance from the International Association of Dental Traumatology (IADT).

Background/aim: Artificial intelligence (AI) chatbots have become increasingly prevalent in recent years as potential sources of online healthcare information for patients when making medical/dental decisions. This study assessed the readability, quality, and accuracy of responses provided by three AI chatbots to questions related to traumatic dental injuries (TDIs), either retrieved from popular question-answer sites or manually created based on the hypothetical case scenarios.

Materials and methods: A total of 59 traumatic injury queries were directed at ChatGPT 3.5, ChatGPT 4.0, and Google Gemini. Readability was evaluated using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores. To assess response quality and accuracy, the DISCERN tool, Global Quality Score (GQS), and misinformation scores were used. The understandability and actionability of the responses were analyzed using the Patient Education Materials Assessment Tool for Printed Materials (PEMAT-P) tool. Statistical analysis included Kruskal-Wallis with Dunn's post hoc test for non-normal variables, and one-way ANOVA with Tukey's post hoc test for normal variables (p < 0.05).

Results: The mean FKGL and FRE scores for ChatGPT 3.5, ChatGPT 4.0, and Google Gemini were 11.2 and 49.25, 11.8 and 46.42, and 10.1 and 51.91, respectively, indicating that the responses were difficult to read and required a college-level reading ability. ChatGPT 3.5 had the lowest DISCERN and PEMAT-P understandability scores among the chatbots (p < 0.001). ChatGPT 4.0 and Google Gemini were rated higher for quality (GQS score of 5) compared to ChatGPT 3.5 (p < 0.001).

Conclusions: In this study, ChatGPT 3.5, although widely used, provided some misleading and inaccurate responses to questions about TDIs. In contrast, ChatGPT 4.0 and Google Gemini generated more accurate and comprehensive answers, making them more reliable as auxiliary information sources. However, for complex issues like TDIs, no chatbot can replace a dentist for diagnosis, treatment, and follow-up care.

Management of traumatic dental injuries is often challenging due to the complexity in diagnosis, concomitant injuries, and the interdisciplinary treatment planning. As a result, the clinicians are often confused and not confident over important treatment decisions. The guidelines of International Association of Dental Traumatology have improved the standard of dental trauma care globally and provide a roadmap for predictable prognosis. However, there are unique situations that require additional investigations such as the Cone Beam Computed Tomography and customized treatment and follow up protocol. An essential requisite for prevention of adverse late complications of dental injuries is clear understanding of their etiopathogenesis and the changes that occur after an injury. Additionally, it is prudent to understand the basic physiology behind the healing that is expected after a treatment protocol. This review presents the science behind the development of late complications of dental injuries and their management protocols in a simplified and clinical manner. An attempt has been made to highlight the clinical paradigms and decisions that reduce the chances of failures in traumatized teeth.

Fragment reattachment in traumatic injuries is notable for its excellent esthetic, morphological, and functional results. The aim of this study was to investigate the scientific history and trends in publications on dental fragment reattachment through a bibliometric and altmetric analysis. The search was conducted in October 2024 using Web of Science. Two researchers selected articles and extracted key study characteristics. Collaborative networks were generated using VOSviewer software. Dimensions was consulted to measure altmetric data. The Spearman correlation was used. A total of 129 articles were included. The most cited article received 160 citations. Studies were published between 1988 and 2024. The leading journal was Dental Traumatology (n = 55). Case reports (n = 63) were the most frequent study design. The majority of studies aimed at clinical case follow-up (n = 71), with coronal fractures being most commonly reported (n = 96). Young patients were most affected in the selected studies (n = 49). Tewari N stood out (n = 8). The All India Institute of Medical Sciences was prominent with seven articles. Brazil was the most prevalent country (n = 29), and Asia was the most frequent continent (n = 57). Vosviewer demonstrated collaborations among authors. According to Dimensions, significant mentions were identified on Mendeley, followed by X users. This bibliometric analysis provides a comprehensive description of the technique of fragments reattachment in traumatized teeth, which has been studied for over 36 years. Studies on this technique primarily rely on case reports describing follow-up in young patients. Intervention studies and systematic reviews are recommended. Additionally, more studies in Africa, Oceania, and North America are encouraged.