Dental Traumatology最新文献

Cemental tear (CeT) is a rare clinical finding characterized by a partial or complete detachment of a portion of the cementum from the root surface. CeT is a well-documented condition in the adult population, particularly among older individuals with periodontal disease, occlusal stress, or traumatic dental injuries (TDI). The prevalence of CeT in adults ranges from 0.9% to 2%. However, CeT has not been previously reported in the pediatric population. Approximately, one in three children experiences TDI, which subjects the teeth to a magnitude of force that can lead to cemental separation in both mature and immature anterior teeth. The clinical and radiographic features of CeT overlap with those of endodontic-periodontal lesions. Hence, it is assumed that CeT is seldom encountered in children, leading to missed or delayed diagnosis and treatment. This case series provides reports of a 13-year-old male and a 10-year-old female with CeT following TDI affecting maxillary central incisors. The clinical examination showed signs of TDI, while radiographs demonstrated a detached cemental fragment without pulpal involvement. The location of the finding warranted conservative management. This report reviews incidence, clinico-radiographic diagnosis, and management of CeT. This report also provides a novel radiographic classification of CeT secondary to TDI for early diagnosis and treatment to prevent sequelae and maintain long-term tooth function.

Background/aim: The aim of this study was to examine the timing of pulp necrosis, ankylosis, and tooth loss in intruded permanent teeth based on the stage of root development, degree of intrusion, and initial treatment.

Materials and methods: In this retrospective study of intruded permanent teeth between 2013 and 2021, data from 112 teeth in 77 patients were reviewed. Kaplan-Meier survival analyses and Cox Proportional Hazards Model were conducted to compare hazards and time to necrosis, ankylosis, and tooth loss (extraction or decoronation) in different groups.

Results: Majority of the patients (N=64, 84.4%) were 6-11 years old and male (N=46, 59.7%). The mean age was 8.8 years (Standard Deviation = 2.6) and the median age was 8 years old. Fifty-nine teeth (52.7%) were immature, and 53 teeth (47.3%) were mature. Two years post-injury, mature teeth, teeth with severe intrusion, and surgically repositioned teeth were more likely to experience necrosis (survival probabilities 11%, 17% and 13% respectively). The hazard of pulp necrosis in mature teeth was significantly higher than in immature teeth (HR = 4.30, p < 0.001). Two years post-injury, mature teeth, severely intruded teeth, and surgically repositioned teeth were more likely to experience ankylosis (survival probabilities 47%, 55% and 42% respectively), but the differences were not significant in Cox regression analysis. Two years post-injury, mature teeth, severely intruded, and surgically repositioned teeth were more likely to experience tooth loss (survival probabilities 55%, 57% and 55% respectively). The hazard of tooth loss was significantly higher in moderate and severe intrusions compared to mild intrusion (HR = 16.85, HR = 13.92, p = 0.01 respectively).

Conclusions: The results indicate that the risk of pulp necrosis, ankylosis, and tooth loss increased with mature apex, increasing degree of intrusion, and surgical repositioning. Cox proportional hazard models showed significant associations between pulp necrosis and mature root development, and between tooth loss and degree of intrusion.

Aim: To assess the eruption patterns and progression of external replacement root resorption of eight teeth that were avulsed and had delayed replantation treated by regenerative endodontic treatment (RET).

Methodology: In total, 102 traumatised anterior teeth were treated with regenerative endodontic treatment (RET) between December 2016 and December 2023. Of the 17 teeth that had avulsed, 8 that had been replanted after at least 30 min subsequently developed external inflammatory root resorption (EIRR). Patient ages ranged between 8 and 11 years. The RET followed the IADT 2020 guidelines and the protocol of the American Association of Endodontists guidelines. Under rubber dam, the teeth were accessed, the canals disinfected with 3% sodium hypochlorite, and dressed with a triple antibiotic paste consisting of metronidazole, cefuroxime, and ciprofloxacin. At the second visit, the canal was filled with plasma-rich fibrin (PRF) after ensuring bleeding from the periapical tissues. A resorbable collagen tape was placed above the PRF and covered with Biodentine, followed by a permanent restoration. The patients were followed up for 18-72 months.

Results: The eight avulsed teeth with delayed replantation diagnosed with pulp necrosis and EIRR were treated with RET, which arrested the EIRR. The teeth were subsequently diagnosed with external replacement root resorption (ERRR), which was generally progressive and classified as slow, moderate, or fast. The striking finding was that seven of the eight teeth did not develop infraposition, a showing favorable eruption patterns despite progressive and advancing ERRR. The remaining tooth developed only slight infraposition despite progressive ERRR. None of the teeth were lost, and in all cases, the alveolar ridge was preserved.

Conclusion: RET appeared to prevent the development of infraposition expected in teeth with delayed replantation following avulsion, due to its promotion of favorable eruption. RET may offer the most effective endodontic solution after avulsion and reimplantation, as it arrests EIRR and can preserve the alveolar ridge height and gingival line by preventing the occurrence of ankylosis, thereby eliminating the need for decoronation.

The current study aims to evaluate the quality, accuracy, and reliability of dental trauma videos posted on YouTube. A search was performed on YouTube using the keywords “dental trauma,” “tooth injury,” “dental injury,” and “traumatic dental injury.” For each search term, the first 100 videos were recorded, and a total of 400 videos were examined. After applying exclusion criteria, 158 videos were analyzed by two experts. In the current study, the quality, accuracy, and reliability of dental trauma videos on YouTube were evaluated using the m-DISCERN, JAMA, and GQS scales, respectively. In this study, which did not require approval from the ethics committee, a statistically significant positive correlation was found between the number of likes, number of dislikes, number of views, video power index, views rate and likes rate with the m-DİSCERN scores (p = 0.029, p = 0.025, p = 0.007, p = 0.021, p = 0.021, p = 0.025, respectively). There was a statistically significant positive correlation between the number of likes, video length, and interaction index with GQS scores (p = 0.048, p = 0.000, p = 0.005, respectively). A statistically significant positive correlation between the number of dislikes, number of views, video power index, and view rate with JAMA scores. The quality, accuracy, and reliability of YouTube videos on dental trauma are generally low, and healthcare professionals need to produce more video content on YouTube. Short videos receive more views and engagement during emergencies, indicating that YouTube video viewers prefer videos with easier-to-understand content. Viewers of videos can distinguish between high-quality and low-quality information.