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Evaluation of Parental Awareness on Emergency Management of Traumatic Dental Injuries: The Role of the ToothSOS Application 父母对创伤性牙损伤应急管理意识的评价:应用“牙齿sos”的作用。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-11 DOI: 10.1111/edt.13075
Gulden Barutcigil, Esra Oz

Background/Aim

Traumatic dental injuries (TDIs) are the most common cause of emergency dental treatment among children. This study aimed to evaluate the effectiveness of the ToothSOS application on the awareness regarding TDI emergency management among parents of children with a history of TDI.

Materials and Methods

The study was carried out by administering questionnaires to parents who visited the clinic between April 2023 and April 2024 due to TDIs in their children. The questionnaire was divided into five sections. The final section of the questionnaire was delivered at three different periods: before downloading the ToothSOS application (T0), after reviewing the application (T1), and 1-month post-download (T2). The data were analyzed using Friedman, Bonferroni, and multivariate linear regression tests.

Results

Over half of the participants (59.4%) were aged between 36 and 45 years, 60.9% were female, and 44.5% were high school graduates. At baseline, 96.1% of the participants had no prior knowledge about TDIs and were unaware of the ToothSOS application. Based on the participants' knowledge levels, at T0, 97.7% were deemed inadequate-low. At T1, 92.2% were adequate-high, and 7.8% acceptable-moderate. At T2, 39.8% were inadequate-low, 53.1% acceptable-moderate, and 7% adequate-high. Statistically significant differences were found between the median values of the scores at each period (p < 0.05). The score difference between T0 and T1 was significantly impacted by parents' having a high school education and having two children in the family (p < 0.05).

Conclusions

Using the ToothSOS application significantly improved parents' awareness of emergency management for TDIs.

背景/目的:创伤性牙损伤(TDIs)是儿童紧急牙科治疗的最常见原因。本研究旨在评估牙齿sos应用程序对有TDI病史儿童家长TDI应急管理意识的有效性。材料与方法:对2023年4月至2024年4月因儿童tdi就诊的家长进行问卷调查。问卷分为五个部分。问卷的最后一部分在三个不同的阶段进行:下载应用程序之前(T0)、审查应用程序之后(T1)和下载后1个月(T2)。采用Friedman、Bonferroni和多元线性回归检验对数据进行分析。结果:超过一半(59.4%)的参与者年龄在36 - 45岁之间,60.9%为女性,44.5%为高中毕业生。在基线时,96.1%的参与者没有关于tdi的先验知识,并且不知道牙齿sos的应用。根据参与者的知识水平,在T0时,97.7%的人被认为不够低。T1时,92.2%为足够高,7.8%为可接受中等。在T2时,39.8%为不充分-低,53.1%为可接受-中等,7%为充分-高。各时段得分中位数差异有统计学意义(p)。结论:使用ToothSOS应用程序可显著提高家长对tdi应急管理的认识。
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引用次数: 0
3D Printed Guides and Finite Element Analysis in Dental Autotransplantation: Biomechanical Efficiency and Clinical Workflow Optimization 3D打印指南和有限元分析在牙科自体移植:生物力学效率和临床工作流程优化。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-04 DOI: 10.1111/edt.13087
Junzhou Chi, Lu Yin, Shaozhen Ma, Xin Yang, Maoyuan Zhang, Xiaohua Ren, Kun Tian

Background

This study evaluates novel osteotomy guides, a morphology-adapted custom drill, and root-immersion containers to enhance the precision in dental autotransplantation through in vitro experiments and finite element analysis (FEA).

Methods

About 30 mandibular Cone Beam Computed Tomography (CBCT) datasets were reconstructed to design reverse-engineered osteotomy guides and a steel custom drill based on root morphology statistics. About 90 3D-printed models (30 cases × 3 groups: guide-assisted, custom drill, and freehand) underwent socket preparation, with operative time and cavity dimensions quantified via optical scanning. Extracorporeal root canal treatment compared between teeth in root-immersion containers (n=30) and handheld teeth (n=30). FEA simulated flexible/rigid fixation to assess the apical stress and displacement.

Results

(1) Osteotomy time was shortest with the custom drill (3.70 ± 0.42 min), followed by guided (5.33 ± 0.35 min) and freehand (12.18 ± 0.98 min; p < 0.001). (2) Root-socket distances were 0.58 ± 0.10 mm (custom drill) and 0.94 ± 0.12 mm (guided), outperforming freehand (1.75 ± 0.19 mm; p < 0.001). (3) Root canal duration was comparable between container (13.77 ± 0.78 min) and handheld (13.89 ± 1.12 min; p > 0.05), but procedural consistency favored the container (p < 0.001). (4) Rigid splinting reduced apical stress and limited displacement to 1.2 mm versus 3–5 mm with flexible methods.

Conclusion

The custom drill achieved efficient socket preparation with superior root adaptation, while the root-immersion container standardized therapy quality. Rigid fixation minimized biomechanical risks, collectively ensuring predictable autotransplantation outcomes.

背景:本研究通过体外实验和有限元分析(FEA),评估了新型截骨引导器、自适应形态的定制钻头和根浸泡容器对提高牙齿自体移植精度的作用。方法:对30余组下颌锥束ct (Cone Beam Computed Tomography, CBCT)数据进行重构,设计基于牙根形态统计的逆工程截骨导具和自定义钢钻。约90例3d打印模型(30例× 3组:引导辅助、定制钻头和徒手)进行了孔准备,通过光学扫描量化手术时间和腔尺寸。根管浸泡容器内牙(n=30)和手持牙(n=30)进行体外根管治疗的比较。FEA模拟柔性/刚性固定,评估顶端应力和位移。结果:(1)自定义钻孔截骨时间最短(3.70±0.42 min),其次为引导(5.33±0.35 min)和徒手(12.18±0.98 min);结论:自定义牙钻具有良好的根适应能力,实现了高效的牙槽准备,而根浸式牙槽则规范了治疗质量。刚性固定最大限度地降低了生物力学风险,共同确保了可预测的自体移植结果。
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引用次数: 0
Characteristics of Pediatric Traumatic Dental Injuries in Southwest China: A Single-Center Retrospective Study 中国西南地区儿童创伤性牙损伤的特点:一项单中心回顾性研究
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-07-04 DOI: 10.1111/edt.13091
Yanan Xu, Yudi Deng, Yuxin Chen, Jinlin Guo, Yumin Wang, Ruijie Huang

Background/Aim

Although pediatric traumatic dental injuries (TDIs) are widely reported, evidence regarding follow-up determinants remains limited. This study aimed to characterize TDI profiles and identify factors influencing subsequent dental visits.

Material and Methods

This retrospective study included all first-visit pediatric TDI patients between 2019 and 2020. Data were extracted from medical records. Statistical analyses were conducted using R Core Team software. The chi-square test, Fisher's exact test, and cumulative logistic regression were used to analyze the data.

Results

1362 children (66.23% boys and 33.77% girls) with a median age of 6 years were included, involving 1151 permanent and 1327 primary injured teeth. Central incisors were most frequently affected. Primary teeth were more prone to Class I and IV TDIs, while permanent teeth were more frequently associated with Class II and III TDIs (p < 0.001). Enamel-dentin fractures, subluxations, and contusions were the most prevalent TDIs in Class I, II, and IV, respectively. Tooth type distinction significantly affected the elapsed time between injury and arrival (p < 0.001), treatment plans (p < 0.001), and number of follow-ups (p < 0.001). More hard tissue alterations were observed during the follow-ups of permanent teeth (p = 0.003). In permanent teeth, predictors of increased follow-up visits included: older age (OR = 0.891, 95% CI: 0.824–0.964; p = 0.004), male sex (OR = 1.263, 95% CI: 1.015–1.574; p = 0.037), shorter elapsed time (< 2 h vs. > 7 days: OR = 0.211, 95% CI: 0.078–0.580; p = 0.002), and greater severity (severe vs. mild: OR = 7.324, 95% CI: 3.550–15.265; p < 0.001). For primary teeth, only severity was significant (severe vs. mild: OR = 0.496, 95% CI: 0.277–0.844; p = 0.013).

Conclusions

Permanent TDIs demand prolonged monitoring, particularly in older children with severe injuries who need prompt care.

背景/目的:虽然儿童创伤性牙损伤(TDIs)被广泛报道,但关于随访决定因素的证据仍然有限。本研究旨在描述TDI的特征,并确定影响后续牙科就诊的因素。材料和方法:本回顾性研究包括2019年至2020年期间所有首次就诊的儿科TDI患者。数据从医疗记录中提取。采用R Core Team软件进行统计分析。采用卡方检验、Fisher精确检验和累积逻辑回归对数据进行分析。结果:共纳入1362例儿童,其中男孩66.23%,女孩33.77%,中位年龄6岁,其中恒牙1151颗,乳牙1327颗。中门牙最常受影响。乳牙易发生I、IV类tdi,恒牙易发生II、III类tdi (p 7 d: OR = 0.211, 95% CI: 0.078 ~ 0.580;p = 0.002),更严重(重度vs轻度:OR = 7.324, 95% CI: 3.550-15.265;结论:永久性tdi需要长时间的监测,特别是对于需要及时护理的严重损伤的大龄儿童。
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引用次数: 0
Comparative Evaluation of Two Post-Bonding Reinforcement Protocols for Fragment Reattachment in Uncomplicated Crown Fracture-An In Vitro Study 单纯冠状骨折碎片再附着两种粘结后加固方案的比较评价-体外研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-27 DOI: 10.1111/edt.13084
Amna Afrin Kidwai, Komal Yadav, Nitesh Tewari, Farheen Sultan, Vijay Prakash Mathur, Ashish Dutt Upadhyaya, Morankar Rahul

Background/Aims

Re-bonding of a fractured fragment without any preparations or reinforcement has been recommended as the preferred treatment of uncomplicated crown fractures. A recent systematic review found that post-bonding reinforcements could reduce the risk of loss of attached fragments in teeth with uncomplicated and complicated crown fractures. Hence, this study aimed to compare various techniques of reinforcement in terms of the force required to fracture, using bovine incisor models with simulated uncomplicated crown fractures.

Methods

This in vitro study was initiated after obtaining approval from the Institutional Ethics Committee. The sample size was calculated as 20 teeth per group, and bovine mandibular incisors were carefully evaluated for size and absence of structural defects and randomly allocated to four groups (Group I- Simple Reattachment, Group II- External Chamfer, Group III- Over contouring, Group IV- Sound teeth). Those in experimental groups were subjected to a fracture protocol, kept dry at room temperature and atmospheric pressure for 24 h, rehydrated for 15 min, and bonded using simple reattachment. The post-bonding reinforcement protocols were followed for Groups II and III. Samples were stored in normal saline, and thermocycling was performed. A universal testing machine was used to assess the force required to fracture.

Results

The least magnitude of force required for fracture was seen in Group I, while the highest was seen in Group III (164.75 N). The force in Group I was significantly lower compared to all the protocols of post-bonding reinforcement and the control teeth (Group IV). A statistically significant difference was not seen between Groups II and III.

Conclusion

The force required to fracture the teeth subjected to post-bonding reinforcement was significantly more than that seen after simple reattachment. The maximum force was exhibited by the teeth reinforced by over-contouring, followed by an external chamfer.

背景/目的:无任何准备或加固的骨折碎片重粘接被推荐为非复杂性冠骨折的首选治疗方法。最近的一项系统综述发现,粘接后加固可以降低无并发症和复杂冠骨折牙齿附着碎片丢失的风险。因此,本研究的目的是比较不同的加固技术在断裂所需的力方面,使用牛切牙模型模拟简单的冠骨折。方法:本体外研究在获得机构伦理委员会批准后启动。按每组20颗牙齿计算样本量,仔细评估牛下颌切牙的大小和有无结构缺陷,并随机分为4组(I组-简单再附着,II组-外倒角,III组-过轮廓,IV组-健全牙齿)。实验组接受骨折治疗方案,在室温和常压下保持干燥24小时,再水合15分钟,并通过简单的再连接进行粘合。第二组和第三组采用粘接后加固方案。样品保存在生理盐水中,并进行热循环。使用万能试验机评估断裂所需的力。结果:I组骨折所需的力最小,III组骨折所需的力最大(164.75 N)。与所有粘结后加固方案和对照牙(IV组)相比,I组的受力明显降低。第二组和第三组之间没有统计学上的显著差异。结论:粘接后加固后的断牙力明显大于单纯再附着后的断牙力。最大的力是通过过度轮廓增强的牙齿,其次是外部倒角。
{"title":"Comparative Evaluation of Two Post-Bonding Reinforcement Protocols for Fragment Reattachment in Uncomplicated Crown Fracture-An In Vitro Study","authors":"Amna Afrin Kidwai,&nbsp;Komal Yadav,&nbsp;Nitesh Tewari,&nbsp;Farheen Sultan,&nbsp;Vijay Prakash Mathur,&nbsp;Ashish Dutt Upadhyaya,&nbsp;Morankar Rahul","doi":"10.1111/edt.13084","DOIUrl":"10.1111/edt.13084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Re-bonding of a fractured fragment without any preparations or reinforcement has been recommended as the preferred treatment of uncomplicated crown fractures. A recent systematic review found that post-bonding reinforcements could reduce the risk of loss of attached fragments in teeth with uncomplicated and complicated crown fractures. Hence, this study aimed to compare various techniques of reinforcement in terms of the force required to fracture, using bovine incisor models with simulated uncomplicated crown fractures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This in vitro study was initiated after obtaining approval from the Institutional Ethics Committee. The sample size was calculated as 20 teeth per group, and bovine mandibular incisors were carefully evaluated for size and absence of structural defects and randomly allocated to four groups (Group I- Simple Reattachment, Group II- External Chamfer, Group III- Over contouring, Group IV- Sound teeth). Those in experimental groups were subjected to a fracture protocol, kept dry at room temperature and atmospheric pressure for 24 h, rehydrated for 15 min, and bonded using simple reattachment. The post-bonding reinforcement protocols were followed for Groups II and III. Samples were stored in normal saline, and thermocycling was performed. A universal testing machine was used to assess the force required to fracture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The least magnitude of force required for fracture was seen in Group I, while the highest was seen in Group III (164.75 <i>N</i>). The force in Group I was significantly lower compared to all the protocols of post-bonding reinforcement and the control teeth (Group IV). A statistically significant difference was not seen between Groups II and III.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The force required to fracture the teeth subjected to post-bonding reinforcement was significantly more than that seen after simple reattachment. The maximum force was exhibited by the teeth reinforced by over-contouring, followed by an external chamfer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"42 1","pages":"89-95"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Knowledge and Attitude of the Care Staff Working in Children's Homes About Avulsed Teeth: Cross-Sectional Survey 儿童之家护理人员对牙齿脱落的知识和态度:横断面调查。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-27 DOI: 10.1111/edt.13083
Aysun Avsar, Aysuhan Ceyhan, Büşra Mutlu, Elif Buse Kaplan

Background

The knowledge and first-aid skills of care staff working in children's homes in cases of dental avulsion-defined as the complete displacement of a tooth from its alveolar socket- can significantly influence the prognosis of the affected tooth. This study aims to evaluate the knowledge and attitudes of care staff in children's homes regarding the management of avulsed teeth.

Material and Methods

The study included 118 participants, 62 women and 56 men, working as care staff in 3 different children's homes of Samsun Provincial Directorate of Social Services. The questionnaire was divided into three sections with a total of 18 questions: demographic information, knowledge and attitudes toward avulsion, and interventions for avulsion injuries. For the frequency data Chi-Square Independency test and Fisher's exact test for 2 × 2 tables were used. For the total score data, the Mann–Whitney U test and Kruskal–Wallis H test were used. The level of significance was set at p < 0.05 for all statistical tests. Hierarchical cluster analysis was applied to create a dendrogram using the nearest neighbor method and squared Euclidean distance.

Results

Majority of the participants stated that dental trauma is an emergency and they need to learn how to deal with it. Three quarters of the participants stated that they would be better able to help with dental trauma after receiving a short and relevant training. Unfortunately, only 3.4% correctly stated that a permanent tooth should be replaced in the event of an avulsion. Thirty-seven point 3% of the participants preferred to keep the avulsed tooth in a napkin, and 63.6% suggested keeping it in tap water while taking it to the dentist. The correct option, milk, was preferred by only 8.5%.

Conclusion

Care staff working in children's homes have insufficient knowledge about the management of permanent dental avulsion.

背景:儿童之家的护理人员在牙齿撕脱病例中的知识和急救技能-定义为牙齿从牙槽窝完全移位-可以显著影响受影响牙齿的预后。本研究旨在评估儿童之家护理人员对处理脱牙的知识和态度。材料和方法:该研究包括118名参与者,62名女性和56名男性,他们在三松省社会服务理事会的3个不同的儿童之家担任护理人员。问卷分为三个部分,共18个问题:人口统计信息、对撕脱伤的认识和态度、撕脱伤的干预措施。对于频率数据采用卡方独立性检验和Fisher精确检验2 × 2表。总分数据采用Mann-Whitney U检验和Kruskal-Wallis H检验。结果:大多数参与者表示,牙外伤是一个紧急情况,他们需要学习如何处理它。四分之三的参与者表示,在接受了简短的相关培训后,他们能够更好地帮助治疗牙齿创伤。不幸的是,只有3.4%的人正确地指出,在发生撕脱的情况下,应该更换恒牙。37.3%的人倾向于将被撕掉的牙齿放在餐巾纸里,63.6%的人建议在看牙医时将其放在自来水里。只有8.5%的人选择牛奶。结论:儿童之家的护理人员对永久性牙撕脱伤的处理知识不足。
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引用次数: 0
Integration of Child Abuse-Neglect in the Pediatric Dental Trauma Curriculum: A Mixed-Method Observational Cohort Study 儿童牙外伤课程中儿童虐待-忽视的整合:一项混合方法观察队列研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-27 DOI: 10.1111/edt.13085
Chaitanya P. Puranik, Shahbaz Katebzadeh, Samantha Bothwell, Tracy de Peralta

Background/Aim

There is a lack of a comprehensive dental curriculum for teaching child abuse-neglect (CAN) with traumatic dental injuries (TDIs). The integration of problem-based learning (PBL) to discuss CAN cases within a pediatric or dental trauma curriculum has never been investigated. The aim of this mixed-method, observational cohort study was to investigate the impact of PBL on student performance and self-perceived benefits in a pediatric dental trauma curriculum with training on CAN.

Material and Methods

The performance of two cohorts of students who received a comprehensive pediatric dental trauma curriculum with or without CAN case discussion in a PBL format was studied. A t-test compared scores and numbers of attempts on CAN and TDI examinations between cohorts with or without PBL case discussions on CAN. A voluntary three-question survey assessed students' perceived learning benefits. Differences in survey agreement were analyzed using the Mantel–Haenszel ordinal Chi-square test. Pearson's correlation assessed associations between scores (α = 0.05).

Results

CAN case discussion in the PBL format in a pediatric dental trauma curriculum significantly improved the students' scores on CAN (p = 0.02) and TDIs (p = 0.03) examinations. However, the first-time pass rates were improved for the CAN examination only (p = 0.003), with no correlation between the two examinations. A significantly higher proportion of students in the cohort with CAN case discussions in the PBL format reported the experience as beneficial (p = 0.04) and the discussed cases as appropriate for learning (p = 0.018).

Conclusion

Discussion of CAN cases in the PBL format significantly improved students' knowledge and self-perceived learning benefits. Students' knowledge about different domains of dental trauma should be independently evaluated.

背景/目的:目前缺乏一个综合性的牙科课程来教授创伤性牙损伤(TDIs)的儿童虐待-忽视(CAN)。整合基于问题的学习(PBL)来讨论小儿或牙外伤课程中的CAN病例从未被调查过。这项混合方法的观察性队列研究的目的是调查PBL对儿童牙外伤课程中具有CAN培训的学生表现和自我感知利益的影响。材料和方法:研究了两组接受综合儿科牙外伤课程的学生的表现,其中有或没有以PBL形式进行CAN病例讨论。t检验比较了有或没有PBL病例讨论CAN的队列之间的CAN和TDI检查的分数和尝试次数。一项由三个问题组成的自愿调查评估了学生对学习益处的感知。调查一致性差异采用Mantel-Haenszel序数卡方检验进行分析。Pearson相关评价评分之间的相关性(α = 0.05)。结果:在儿童牙外伤课程中进行PBL形式的CAN案例讨论,显著提高了学生在CAN (p = 0.02)和TDIs (p = 0.03)考试中的成绩。然而,只有CAN考试的首次通过率提高(p = 0.003),两种考试之间没有相关性。在以PBL形式进行CAN案例讨论的队列中,有更高比例的学生报告说这种经历是有益的(p = 0.04),所讨论的案例适合学习(p = 0.018)。结论:PBL形式的CAN案例讨论显著提高了学生的知识水平和自我感知的学习效益。学生对牙外伤不同领域的知识应进行独立评估。
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引用次数: 0
Investigation of the Mechanisms Involved in Periodontal Ligament Revascularization and Reinnervation Following Immediate Tooth Replantation in Rats 大鼠牙即刻再植后牙周韧带血管重建及神经再生机制的研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-20 DOI: 10.1111/edt.13082
Caroline Amaro da Silva, Luciano Aparecido de Almeida-Junior, Guido Artemio Marañon Vásquez, Alexandra Mussolino de Queiroz, Francisco Wanderley Garcia de Paula-Silva, Maya Fernanda Manfrin Arnez

Background/Aim

Tooth avulsion is characterized by the complete displacement of a tooth from its socket, and the recommended treatment is immediate replantation of the tooth. Despite this, the mechanisms involved in repairing the periodontal ligament following dental trauma remain unclear. Therefore, the objective of this research was to investigate the repair process of periodontal tissues after tooth avulsion and immediate replantation in Wistar rats.

Materials and Methods

Twenty-four rats underwent extraction of the upper right incisors, followed by immediate replantation. The left teeth were left intact as controls. The animals were euthanized after 15 and 60 days, and histopathological evaluation, immunohistochemical staining (neurotrophin-4—NT-4, and platelet endothelial cell adhesion molecule-1—PECAM-1), and TUNEL-based apoptosis quantification were performed. Image deconvolution was used to analyze slides, applying hematoxylin and DAB filters. The “integrated density” and “area” tools measured staining intensity, with data presented as arbitrary units per μm2. Data were analyzed using two-way ANOVA followed by Sidak's post-test at a significance level of 5%.

Results

Histopathological examination revealed an inflammatory response surrounding the replanted tooth, with mineralized tissue resorption occurring over time. After 15 days post-replantation, there was a significant increase in neurotrophin-4 (p = 0.0439) and platelet endothelial cell adhesion molecule-1 expression (p = 0.0389) compared with the control group (sound teeth). At 60 days, expression levels of these markers decreased and showed no significant difference compared to the control group (p > 0.05). Furthermore, replanted teeth showed a significantly higher amount of apoptotic cells compared with the control group, regardless of the period of investigation (p < 0.001).

Conclusions

This study indicate that proteins associated with angiogenesis and neurogenesis are present in the early stages of repair. Additionally, cell death was observed at both 15 and 60 days post-replantation.

背景/目的:牙齿撕脱的特点是牙齿从牙槽完全移位,推荐的治疗方法是立即重新种植牙齿。尽管如此,修复牙周韧带的机制仍不清楚。因此,本研究旨在探讨Wistar大鼠牙撕脱即刻再植后牙周组织的修复过程。材料与方法:24只大鼠拔除右上门牙后立即再植。作为对照,左牙保持完整。分别于15和60 d后安乐死,进行组织病理学评价、免疫组化染色(神经营养因子-4- nt -4、血小板内皮细胞粘附分子-1- pecam -1)和tunel细胞凋亡定量。使用苏木精和DAB滤波器对载玻片进行图像反卷积分析。“综合密度”和“面积”工具测量染色强度,数据以任意单位每μm2表示。数据分析采用双向方差分析,随后采用Sidak后验,显著性水平为5%。结果:组织病理学检查显示移植牙周围有炎症反应,随着时间的推移发生矿化组织吸收。术后15 d,与对照组(健全牙组)相比,神经营养因子-4 (p = 0.0439)和血小板内皮细胞粘附分子-1 (p = 0.0389)表达显著升高。60 d时,这些标志物的表达水平下降,与对照组相比无显著差异(p < 0.05)。此外,与对照组相比,再植牙的凋亡细胞数量明显增加,无论研究时间如何(p结论:本研究表明,与血管生成和神经发生相关的蛋白质存在于修复的早期阶段。此外,在移植后15天和60天均观察到细胞死亡。
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引用次数: 0
Psychomotor Development and Traumatic Dental Injuries in Preschool 学龄前儿童心理运动发育与创伤性牙损伤。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-19 DOI: 10.1111/edt.13072
Ednele Fabyene Primo-Miranda, Maria Letícia Ramos-Jorge, Rosane Luzia de Souza Morais, Paloma Christina Aguiar Silva, Débora Souto-Souza, Leandro Silva Marques

Background/Aim

Insufficient motor coordination can predispose children to falls and, consequently, the occurrence of traumatic dental injuries (TDIs). The present study investigated the association between psychomotor development and TDI in preschool children.

Materials and Methods

A cross-sectional study was conducted with 189 children aged three to six years in Diamantina, Brazil. Psychomotor development was assessed using the Test of Gross Motor Development—Second Edition (motor assessment) and a validated preschool version of the Mini-Mental State Examination (cognitive assessment). Parents/guardians answered a socioeconomic questionnaire. Anthropometric measures were determined using WHO growth curves to obtain the body mass index (BMI). Intraoral examinations were performed by a single examiner trained and calibrated for diagnosing TDI based on the criteria proposed by Andreasen, with radiographic evaluations conducted when necessary. Lip coverage, anterior open bite, arch shape, and overjet were also recorded. Descriptive statistics, the chi-square test, and Poisson regression (bivariate and multivariate) analyses were performed (95% CI, p < 0.05).

Results

The prevalence of TDI was 50.3%. Delayed motor development (PR = 1.66; 95% CI: 1.25–2.22) and obesity (PR = 1.64; 95% CI: 1.10–2.45) were significantly associated with TDI in the adjusted model.

Conclusion

Delayed motor development and obesity were associated with TDI in preschool children.

背景/目的:运动协调性不足会使儿童容易跌倒,从而导致创伤性牙损伤(TDIs)的发生。本研究旨在探讨学龄前儿童精神运动发展与TDI的关系。材料和方法:对巴西Diamantina的189名3 - 6岁儿童进行了一项横断面研究。使用大肌肉运动发展测试-第二版(运动评估)和经过验证的学前迷你精神状态检查(认知评估)来评估精神运动发展。家长/监护人回答了一份社会经济问卷。采用WHO生长曲线测定人体测量值,获得体重指数(BMI)。口腔内检查由一名经过培训并根据Andreasen提出的标准进行TDI诊断的检查者进行,必要时进行放射学评估。还记录了唇部覆盖、前牙合、弓形和上盖。描述性统计、卡方检验和泊松回归(双变量和多变量)分析(95% CI, p)结果:TDI患病率为50.3%。运动发育迟缓(PR = 1.66;95% CI: 1.25-2.22)和肥胖(PR = 1.64;95% CI: 1.10-2.45)与调整后模型中TDI显著相关。结论:学龄前儿童TDI与运动发育迟缓和肥胖有关。
{"title":"Psychomotor Development and Traumatic Dental Injuries in Preschool","authors":"Ednele Fabyene Primo-Miranda,&nbsp;Maria Letícia Ramos-Jorge,&nbsp;Rosane Luzia de Souza Morais,&nbsp;Paloma Christina Aguiar Silva,&nbsp;Débora Souto-Souza,&nbsp;Leandro Silva Marques","doi":"10.1111/edt.13072","DOIUrl":"10.1111/edt.13072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aim</h3>\u0000 \u0000 <p>Insufficient motor coordination can predispose children to falls and, consequently, the occurrence of traumatic dental injuries (TDIs). The present study investigated the association between psychomotor development and TDI in preschool children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted with 189 children aged three to six years in Diamantina, Brazil. Psychomotor development was assessed using the Test of Gross Motor Development—Second Edition (motor assessment) and a validated preschool version of the Mini-Mental State Examination (cognitive assessment). Parents/guardians answered a socioeconomic questionnaire. Anthropometric measures were determined using WHO growth curves to obtain the body mass index (BMI). Intraoral examinations were performed by a single examiner trained and calibrated for diagnosing TDI based on the criteria proposed by Andreasen, with radiographic evaluations conducted when necessary. Lip coverage, anterior open bite, arch shape, and overjet were also recorded. Descriptive statistics, the chi-square test, and Poisson regression (bivariate and multivariate) analyses were performed (95% CI, <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of TDI was 50.3%. Delayed motor development (PR = 1.66; 95% CI: 1.25–2.22) and obesity (PR = 1.64; 95% CI: 1.10–2.45) were significantly associated with TDI in the adjusted model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delayed motor development and obesity were associated with TDI in preschool children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"41 6","pages":"634-640"},"PeriodicalIF":3.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/edt.13072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Framework to Improve the Quality of Management of Traumatic Dental Injuries at a Tertiary Dental Hospital 提高三级牙科医院创伤性牙损伤管理质量的框架。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-19 DOI: 10.1111/edt.13080
Sarah Kho Xian Chua, Chee Weng Yong, Jeannette Ming Cheng Chua, Wataru Ode, Ren Jie Jacob Chew

Background/Aim

Appropriate early management, as well as early diagnosis and interceptive management of adverse outcomes, is essential in managing Traumatic Dental Injuries (TDIs) to minimize the incidence and impact of negative sequelae. Barriers to optimal management include inadequate clinician knowledge and experience, poor adherence to established guidelines, time constraints, and the complex nature of TDIs. These barriers can potentially be addressed by adopting a multipronged approach that integrates education and administrative support. The aim of this study was to evaluate the improvements in the quality of TDI management and review at the National University Centre for Oral Health Singapore after implementing a framework consisting of a series of targeted interventions.

Materials and Methods

Interventions included a refresher lecture, standardized recording templates, and improved access to resources such as international guidelines. Clinical records and radiographs of patients who had received acute management for TDI or received dental review as follow-up for TDIs between 1st May 2023 and 30th June 2024 were reviewed. The quality of baseline management and follow-up review was scored based on a scoring rubric, with a score of 100% deemed as “appropriate” management. The quality of baseline management and follow-up review of TDI in the pre- and post-implementation phases was compared using Chi-squared, Fisher's exact, and Mann–Whitney U tests.

Results

247 patients were seen for TDI baseline management or review. The quality of TDI baseline and review management improved significantly, with median (interquartile range) scores increasing from 62.5% (27.9%) and 100% (66.6%), respectively, to 100% (0%, p < 0.001). The proportion of cases deemed appropriately managed at both baseline and review significantly improved from 3.64% and 54.3% to 82.9% and 93.8%, respectively (p < 0.001).

Conclusion

A framework consisting of refresher lectures, standardized recording templates, and enhanced access to resources significantly improves the quality of TDI management and review.

背景/目的:适当的早期管理,以及早期诊断和不良后果的拦截管理,对于管理创伤性牙齿损伤(TDIs)至关重要,以尽量减少负面后遗症的发生率和影响。实现最佳管理的障碍包括临床医生知识和经验不足、对既定指南的遵守不力、时间限制以及tdi的复杂性。通过采取综合教育和行政支持的多管齐下的办法,这些障碍有可能得到解决。本研究的目的是评估新加坡国立大学口腔健康中心在实施由一系列有针对性的干预措施组成的框架后,TDI管理质量的改善和审查。材料和方法:干预措施包括复习讲座,标准化的录音模板,以及改善对资源的获取,如国际指导方针。回顾了2023年5月1日至2024年6月30日期间接受TDI急性治疗或作为TDI随访接受牙科检查的患者的临床记录和x线片。基线管理和后续审查的质量根据评分标准进行评分,得分为100%视为“适当”管理。采用卡方检验、Fisher精确检验和Mann-Whitney U检验比较实施前后阶段TDI基线管理和随访评价的质量。结果:247例患者接受TDI基线管理或复查。TDI基线和复习管理质量显著提高,中位数(四分位差)得分分别从62.5%(27.9%)和100%(66.6%)提高到100% (0%),p结论:复习讲座、标准化记录模板和加强资源获取的框架显著提高了TDI管理和复习质量。
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引用次数: 0
Epidemiology of Maxillofacial Injuries in the Swords of Iron War: Insights From a National Registry 铁之剑中颌面损伤的流行病学:来自国家登记处的见解。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-06-13 DOI: 10.1111/edt.13081
Nir Tsur, Dmitry Kotovich, Dean Dudkiewicz, Tomer Talmy, Irina Radomislensky, Adi Givon, Israel Trauma Group, Avi Benov, Yael Arbel, Mor Rittblat, Shachar Shapira

Background

Maxillofacial injuries (MFI) in warfare present significant challenges due to the concentration of vital structures in the facial region and the high-energy mechanisms of injury. This study analyzes the epidemiology, severity, and outcomes of MFI during the Swords of Iron conflict using data from the Israeli National Trauma Registry.

Methods

A retrospective analysis was conducted on casualties from October 7, 2023 to August 1, 2024. Injury characteristics, surgical interventions, intensive care unit (ICU) admissions, and mortality rates were assessed. Logistic regression identified predictors for severe head injury and surgical intervention.

Results

Of 1654 casualties, 324 (19.6%) sustained MFI, predominantly from explosions (85.2%). Fractures were associated with higher ICU admission rates (60.6% vs. 20.0%, p < 0.0001) and greater surgical intervention requirements (65.4% vs. 36.4%, p = 0.0001) than soft tissue injuries. Orbital fractures (59.6%) were the most common and strongly correlated with severe head injury (OR 9.33, CI 4.29–21.54, p < 0.001). Zygomatic (OR 8.47), maxillary (OR 5.81), and mandibular fractures (OR 12.61) significantly predicted the need for surgery, whereas orbital fractures often did not. Airway management was required in 26.5% of MFI cases, significantly higher than in other injuries (12.6%, p < 0.001). The overall mortality rate was low, with 7.7% in the fracture group and 0.9% in the soft tissue injury group.

Conclusion

MFI in combat settings demands specialized trauma care, particularly for fractures requiring surgical intervention and intensive care. The high prevalence of orbital fractures and their association with severe head injuries highlight the need for early recognition and intervention despite their being less prone to surgical correction. These findings can inform trauma care protocols to optimize management and outcomes in future conflicts.

背景:颌面部损伤(MFI)在战争中由于面部重要结构的集中和损伤的高能量机制而面临重大挑战。本研究使用来自以色列国家创伤登记处的数据,分析了铁剑冲突期间MFI的流行病学、严重程度和结果。方法:对2023年10月7日至2024年8月1日的伤亡者进行回顾性分析。评估损伤特征、手术干预、重症监护病房(ICU)入院率和死亡率。Logistic回归确定了严重颅脑损伤和手术干预的预测因素。结果:1654例伤亡者中,324例(19.6%)为MFI,主要为爆炸(85.2%)。结论:战斗环境中的MFI需要专门的创伤护理,特别是需要手术干预和重症监护的骨折。眶部骨折的高发病率及其与严重头部损伤的相关性突出了早期识别和干预的必要性,尽管它们不太容易进行手术矫正。这些发现可以为创伤护理方案提供信息,以优化未来冲突的管理和结果。
{"title":"Epidemiology of Maxillofacial Injuries in the Swords of Iron War: Insights From a National Registry","authors":"Nir Tsur,&nbsp;Dmitry Kotovich,&nbsp;Dean Dudkiewicz,&nbsp;Tomer Talmy,&nbsp;Irina Radomislensky,&nbsp;Adi Givon,&nbsp;Israel Trauma Group,&nbsp;Avi Benov,&nbsp;Yael Arbel,&nbsp;Mor Rittblat,&nbsp;Shachar Shapira","doi":"10.1111/edt.13081","DOIUrl":"10.1111/edt.13081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maxillofacial injuries (MFI) in warfare present significant challenges due to the concentration of vital structures in the facial region and the high-energy mechanisms of injury. This study analyzes the epidemiology, severity, and outcomes of MFI during the Swords of Iron conflict using data from the Israeli National Trauma Registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on casualties from October 7, 2023 to August 1, 2024. Injury characteristics, surgical interventions, intensive care unit (ICU) admissions, and mortality rates were assessed. Logistic regression identified predictors for severe head injury and surgical intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1654 casualties, 324 (19.6%) sustained MFI, predominantly from explosions (85.2%). Fractures were associated with higher ICU admission rates (60.6% vs. 20.0%, <i>p</i> &lt; 0.0001) and greater surgical intervention requirements (65.4% vs. 36.4%, <i>p</i> = 0.0001) than soft tissue injuries. Orbital fractures (59.6%) were the most common and strongly correlated with severe head injury (OR 9.33, CI 4.29–21.54, <i>p</i> &lt; 0.001). Zygomatic (OR 8.47), maxillary (OR 5.81), and mandibular fractures (OR 12.61) significantly predicted the need for surgery, whereas orbital fractures often did not. Airway management was required in 26.5% of MFI cases, significantly higher than in other injuries (12.6%, <i>p</i> &lt; 0.001). The overall mortality rate was low, with 7.7% in the fracture group and 0.9% in the soft tissue injury group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MFI in combat settings demands specialized trauma care, particularly for fractures requiring surgical intervention and intensive care. The high prevalence of orbital fractures and their association with severe head injuries highlight the need for early recognition and intervention despite their being less prone to surgical correction. These findings can inform trauma care protocols to optimize management and outcomes in future conflicts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"42 1","pages":"71-78"},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/edt.13081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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