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Soccer Coaches' Knowledge of Dental Trauma Management and Attitudes Toward Mouthguard Use: A Cross-Sectional Study 足球教练牙外伤管理知识与护齿器使用态度之横断面研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-04-15 DOI: 10.1111/edt.13066
Eman Behbehani, Mariam Alkheder, Lama Khraisha, Muawia A. Qudeimat

Background

Traumatic dental injuries represent a substantial concern in dental public health, often leading to functional, aesthetic, and psychological complications. Timely and appropriate management is essential to ensure favorable outcomes. This study aimed to assess the knowledge and attitudes of youth soccer team coaches regarding the management and prevention of traumatic dental injuries, as well as their awareness and promotion of protective mouthguard use.

Materials and Methods

A standardized three-part survey was distributed to youth soccer team coaches from all 14 professional football clubs in Kuwait. The survey instrument, adapted from validated tools in previous studies, gathered demographic data and assessed coaches' knowledge through hypothetical case scenarios and multiple-choice questions. Statistical analysis included descriptive methods and linear regression to assess factors influencing coaches' knowledge. Multicollinearity (VIF) and model fit (ANOVA) were evaluated.

Results

A total of 56 coaches completed the survey. Although 64% reported first aid training, only 9% had specific training in dental injury management. Case scenario analysis revealed significant knowledge gaps: only 29% correctly identified an injured tooth, and 9% recommended dental referral. In the avulsion scenario, 72% were unwilling to replant the tooth, and 90% were unaware of appropriate transport media. Although 59% acknowledged mouthguard importance, only 23% advised their use. Linear regression showed no significant predictors of knowledge score (mean = 1, SD = 0.88). The model explained only 9% of variance (R2 = 0.09), with no significant predictors (p > 0.05) or model fit (F = 0.446, p = 0.84).

Conclusion

There is a substantial gap in the recognition and management of traumatic dental injuries among Kuwaiti youth soccer coaches. The study highlights the importance of targeted educational programs to improve coaches' ability to recognize dental injuries, emergency response, and advocacy for the use of protective mouthguards.

背景:外伤性牙损伤是牙科公共卫生的一个重要问题,经常导致功能、美学和心理并发症。及时和适当的管理对于确保良好的结果至关重要。本研究旨在评估青少年足球队教练员对创伤性牙损伤管理与预防的知识与态度,以及对护齿器使用的认知与推广。材料和方法:向科威特所有14个职业足球俱乐部的青年足球队教练分发了标准化的三部分调查。该调查工具采用了先前研究中经过验证的工具,收集了人口统计数据,并通过假设的案例场景和多项选择题来评估教练的知识。统计分析采用描述性方法和线性回归方法评估影响教练员知识的因素。多重共线性(VIF)和模型拟合(ANOVA)进行评估。结果:共56名教练员完成调查。尽管64%的人报告接受过急救培训,但只有9%的人接受过牙齿损伤管理方面的专门培训。案例情景分析显示了显著的知识差距:只有29%的人正确识别出受伤的牙齿,9%的人建议转诊。在撕脱的情况下,72%的人不愿意再植牙齿,90%的人不知道合适的运输介质。虽然59%的人承认护齿器的重要性,但只有23%的人建议使用。线性回归显示知识得分无显著预测因子(mean = 1, SD = 0.88)。该模型仅解释了9%的方差(R2 = 0.09),没有显著的预测因子(p < 0.05)或模型拟合(F = 0.446, p = 0.84)。结论:科威特青少年足球教练员对创伤性牙损伤的认识和管理存在较大差距。该研究强调了有针对性的教育计划的重要性,以提高教练识别牙齿损伤、应急反应和倡导使用保护性护齿器的能力。
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引用次数: 0
Alveolar Bone Formation via Subperiosteal Storage of an Endodontically Treated Incisor for Periodontal Ligament Preservation Before Autotransplantation: A Case Report 牙髓治疗的切牙在自体移植前通过骨膜下储存形成牙槽骨以保存牙周韧带:1例报告。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-04-01 DOI: 10.1111/edt.13064
Dick Barendregt, Manfred Leunisse, Edwin Eggink

Background

When patients accidentally lose or miss one or more teeth due to agenesis, the dentoalveolar complex is either destroyed or not formed. Replacing these teeth typically presents significant challenges This case report offers proof of principle that the periodontal ligament (PDL) of an endodontically treated tooth can form new alveolar bone in a previously non-existent location, offering a potential breakthrough in treating such cases.

Case Description

A 15-year-old healthy Caucasian male presented for orthodontic treatment with lower right lateral incisor and canine transposition. To enable optimal canine positioning, extraction of the incisor was required. A decision was made to temporarily store the endodontically treated incisor in a subperiosteal pocket to preserve the viability of the PDL while the orthodontic repositioning of the canine was completed.

The incisor was thoroughly debrided, extracted, and placed in a subperiosteal pocket created via a small incision and tunnel preparation in the buccal corridor.

After 14 months, retrieval of the incisor revealed the formation of a nearly complete alveolus housing the incisor. The incisor was immediately transplanted into its final position. Favorable healing allowed functional loading with orthodontic extrusive force 3 weeks post-transplantation. Follow-up assessments were conducted at 3, 6, and 12 months, with annual evaluations extending up to 5 years.

Practical Implications

The regenerative potential of PDL to reconstruct the dentoalveolar complex, including alveolar bone, provides an optimal pathway for tooth replacement. This approach, employed within an interdisciplinary treatment framework, broadens the range of techniques available to dental specialists for managing complex clinical cases involving substantial alveolar bone loss.

背景:当患者因牙齿发育不全而意外丢失或缺失一颗或多颗牙齿时,牙槽牙综合体要么被破坏,要么未形成。替换这些牙齿通常会带来巨大的挑战,本病例报告提供了一个原理证明,即牙髓治疗后的牙周韧带(PDL)可以在以前不存在的位置形成新的牙槽骨,这为治疗此类病例提供了一个潜在的突破。病例描述:一个15岁的健康白人男性提出正畸治疗右下侧切牙和犬齿转位。为了实现最佳的犬齿定位,需要拔出门牙。在完成犬的正畸重新定位时,决定暂时将牙髓治疗后的切牙储存在骨膜下口袋中,以保持PDL的活力。切牙被彻底清除,取出,并放置在骨膜下口袋通过一个小切口和隧道准备在颊走廊。14个月后,恢复的门牙显示形成了一个几乎完整的牙槽容纳门牙。门牙立即移植到最终位置。移植后3周,良好的愈合允许使用正畸挤压力进行功能负荷。随访评估在第3、6和12个月进行,年度评估延长至5年。实际意义:PDL的再生潜力重建牙槽骨复合体,包括牙槽骨,为牙齿替代提供了最佳途径。这种方法在跨学科治疗框架内采用,拓宽了牙科专家处理涉及大量牙槽骨丢失的复杂临床病例的技术范围。
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引用次数: 0
Can Artificial Intelligence Language Models Effectively Address Dental Trauma Questions? 人工智能语言模型能有效解决牙外伤问题吗?
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-04-01 DOI: 10.1111/edt.13063
Hasibe Elif Kuru, Aslı Aşık, Doğukan Mert Demir

Background/Aim

Artificial intelligence (AI) chatbots, also known as large language models (LLMs), have become increasingly common educational tools in healthcare. Although the use of LLMs for emergency dental trauma is gaining popularity, it is crucial to assess their reliability. This study aimed to compare the reliabilities of different LLMs in response to multiple questions related to dental trauma.

Materials and Methods

In a cross-sectional observational study conducted in October 2024, 30 questions (10 multiple-choice, 10 fill-in-the-blank, and 10 dichotomous) based on the International Association of Dental Traumatology guidelines were posed to five LLMs: ChatGPT 4, ChatGPT 3.5, Copilot Free version (Copilot F), Copilot Pro (Copilot P), and Google Gemini over nine consecutive days. Responses of each model (1350 in total) were recorded in binary format and analyzed using Pearson's chi-square and Fisher's exact tests to assess correctness and consistency (p < 0.05).

Results

The answers provided by the LLMs to repeated questions on consecutive days showed a high degree of repeatability. Although there was no statistically significant difference in the success rate of providing correct answers among the LLMs (p > 0.05), the rankings based on the rate of successful answers were as follows: ChatGPT 3.5 (76.7%) > Copilot P (73.3%) > Copilot F (70%) > ChatGPT 4 (63.3%) > Gemini (46.7%). ChatGPT 3.5, ChatGPT 4, and Gemini showed a significantly higher correct response rate for multiple choice and fill in the blank questions compared to their performance on dichotomous (true/false) questions (p < 0.05). Conversely, The Copilot models did not exhibit significant differences across question types. Notably, the explanations provided by Copilot and Gemini were often inaccurate, and Copilot's cited references had low evidential value.

Conclusions

While LLMs show potential as adjunct educational tools in dental traumatology, their variable accuracy and inclusion of unreliable references call for careful integration strategies.

背景/目的:人工智能(AI)聊天机器人(也称为大型语言模型(LLM))已成为医疗保健领域越来越常见的教育工具。虽然在牙科创伤急救中使用 LLMs 的做法越来越受欢迎,但评估其可靠性至关重要。本研究旨在比较不同大型语言模型在回答与牙科创伤相关的多个问题时的可靠性:在 2024 年 10 月进行的一项横断面观察研究中,根据国际牙科创伤学会指南向五种 LLM 提出了 30 个问题(10 个选择题、10 个填空题和 10 个二分题):ChatGPT 4、ChatGPT 3.5、Copilot 免费版(Copilot F)、Copilot 专业版(Copilot P)和 Google Gemini 连续九天进行了测试。每个模型的答案(共 1350 个)均以二进制格式记录,并使用皮尔逊卡方检验和费雪精确检验进行分析,以评估正确性和一致性(P 结果):在连续几天的重复问题中,学习成绩优异者的答案具有很高的重复性。虽然在统计学上,各语言学家提供正确答案的成功率没有显著差异(p > 0.05),但根据成功率进行的排名如下:ChatGPT 3.5 (76.7%) > Copilot P (73.3%) > Copilot F (70%) > ChatGPT 4 (63.3%) > Gemini (46.7%)。ChatGPT 3.5、ChatGPT 4 和 Gemini 在多选题和填空题上的正确率明显高于它们在二分法(真/假)问题上的表现(p 结论:ChatGPT 3.5、ChatGPT 4 和 Gemini 在多选题和填空题上的正确率明显高于它们在二分法(真/假)问题上的表现:虽然 LLMs 显示出作为牙科创伤学辅助教学工具的潜力,但其不稳定的准确性和包含的不可靠参考资料要求采取谨慎的整合策略。
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引用次数: 0
The Effect of an Educational Intervention in Dental Traumatology on General Dentists' Knowledge: A Study in the Public Dental Service of Western Norway 牙科创伤学教育干预对普通牙医知识的影响:挪威西部公共牙科服务的研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13061
Andjelka Cvijic, Knut Helge Midtbø Jensen, Anne Åstrøm, Monika Kvernenes, Georgios Tsilingaridis, Athanasia Bletsa

Aim

To assess the effect of a dental traumatology educational intervention on general dentists' knowledge. The study was conducted at Vestland County's Public Dental Service (PDS) in Western Norway.

Materials and Methods

All PDS dental clinics of Vestland County (n = 52) were purposively assigned to a control group receiving no intervention (CC, n = 19), a webinar group (IC1, n = 17), and a combined webinar and in-person physical course group (IC2, n = 16). To examine the effect of the intervention, participants received a post-intervention online questionnaire (Q2) with clinical cases. A generalized linear mixed-effects model (GLMM) was used to compare the individual proportion of correct answers in Q2 between the three groups of educational intervention, where the clinic was set as a random effect factor. Additionally, a GLMM with a binary response variable was used to analyze the answers to individual cases. p < 0.05 was considered statistically significant.

Results

The response rate was 57% (n = 94). The overall proportion of correct answers was 67.7%, 71.0%, and 75.0% for the CC, IC1, and IC2 groups, respectively. There was no statistically significant difference in the overall proportion of correct answers between the groups when accounting for the dependency structure caused by clinics. However, for the individual cases, the IC2 group had a statistically significantly higher proportion of correct answers in complicated crown fracture of the immature tooth (p = 0.02) and first aid after avulsion (p = 0.02) compared to the CC group. Furthermore, the IC2 group had a trend of difference in complicated crown fracture of the mature tooth (p = 0.09) compared to the CC group and in emergency treatment of root fracture (p = 0.08) compared with IC1.

Conclusion

This study demonstrates that an educational intervention combining webinars with in-person interactive courses has a positive effect on general dentists' knowledge of dental trauma.

目的:评价口腔创伤学教育干预对全科牙医知识的影响。这项研究是在挪威西部韦斯特兰县的公共牙科服务(PDS)进行的。材料与方法:将Vestland县所有PDS牙科诊所(n = 52)随机分为无干预对照组(CC, n = 19)、网络研讨会组(IC1, n = 17)和网络研讨会与面对面物理课程联合组(IC2, n = 16)。为了检查干预的效果,参与者收到了一份包含临床病例的干预后在线问卷(Q2)。采用广义线性混合效应模型(GLMM)比较三组教育干预中Q2的个体正确答案比例,其中诊所设置为随机影响因素。此外,还使用了一个带有二元响应变量的GLMM来分析个别案例的答案。结果:有效率为57% (n = 94)。CC组、IC1组和IC2组的正确率分别为67.7%、71.0%和75.0%。当考虑到诊所导致的依赖结构时,两组之间的总体正确率没有统计学意义上的差异。但就个别病例而言,IC2组在未成熟牙复杂冠骨折(p = 0.02)和撕脱后急救的正确率比CC组高(p = 0.02),具有统计学意义。此外,IC2组在成熟牙复杂冠骨折方面与CC组相比有差异趋势(p = 0.09),在牙根骨折急诊治疗方面与IC1组相比有差异趋势(p = 0.08)。结论:本研究表明,将网络研讨会与面对面互动课程相结合的教育干预对普通牙医的牙外伤知识有积极的影响。
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引用次数: 0
Treatment by Preplanned Virtual Autotransplantation of a Microdont Immature Third Molar to a Maxillary Central Incisor Socket Using a 3D Printed Tooth Replica: A Case Report 使用3D打印牙齿复制品预先计划虚拟自体移植未成熟的第三磨牙至上颌中切牙槽:1例报告。
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13044
Aurore Barraco, Clara Marcoux, Raphaël Richert, Romain Ligerot, Kerstin Gritsch, Arnaud Lafon

An 18-year-old female patient presented to emergency dental clinic for avulsion of maxillary left central incisor (#21) in a car accident. In the presence of an immature left maxillary microdontic third molar (#28), a preplanned virtual autotransplantation using an implant planification software was chosen to replace #21. A guided osteotomy using a 3D printed thermoplastic replica was performed to reduce the extra-oral time to < 1 min. Indirect restorations with lithium disilicate veneers were made for both central incisors. After 4 years, the esthetic integration remained satisfactory. The case presented, involving the replacement of an avulsed #21 with an immature microdontic third molar #28, illustrates the possibilities of extending the indications for autotransplantation using virtually planned surgery.

一位18岁的女性患者在一次车祸中上颌左中门牙撕脱(#21)到牙科急诊诊所就诊。在未成熟的左上颌小齿第三磨牙(#28)的存在下,选择使用种植体平面化软件进行预先计划的虚拟自体移植来代替#21。使用3D打印热塑性塑料复制品进行引导截骨,以减少口外时间至
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引用次数: 0
Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection: A Combined In Vitro and In Silico Analyses 用于颌面部创伤保护的定制护齿的强化定位:体外和计算机联合分析。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13060
Talita Suelen de Queiroz, João Paulo Mendes Tribst, Larissa Haddad e Borro, Guilherme da Rocha Scalzer Lopes, Alexandre Luiz Souto Borges, Tarcisio Jose de Arruda Paes Junior

Background/Aim

This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.

Material and Methods

Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm3 steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy.

Results

The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro–Wilk, Kruskal–Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10−5) but none between impact zones (p = 0.879), confirming uniform stress distribution.

Conclusions

Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.

背景/目的:本研究通过在三个不同位置使用聚酰胺网增强护齿(mg)来评估中切牙对上颌前牙外伤的牙槽反应。材料与方法:将40只4mm厚的mg按补片位置分为MG1 + 3组(补片距前庭极限1mm)、MG2 + 2组(补片距前庭极限2mm)、MG3 + 1组(补片距前庭极限3mm)和不补片的对照组。3D打印颅骨模型(Spin Red Resin, Quanton 3D)模拟牙槽复合体,使用Resilab Clear树脂(Wilcos)作为牙齿,添加固化硅树脂作为牙周韧带。该装置连接到一个定制的冲击装置,以确保力保持在材料的弹性极限内。采用放置在中切牙前庭面和上颌骨牙槽突上的4个应变计测量微应变。使用直径为35毫米的钢球,在平行于地面的Ep = 0.5496 J处施加冲击。对于硅测试,在CAD软件(Rhinoceros 7.0)中对装置进行建模,并在CAE软件(Ansys 2021 R1)中进行显式动态仿真分析。假定所有材料均质、各向同性和线弹性。使用7.8 g/cm3的钢球模拟1m /s的冲击。物理接触条件定义为摩擦和粘接,在10%收敛测试后使用四面体网格单元以确保精度。结果:通过比色图获得了牙齿和上颌骨的最大主应变和最大主应力。统计分析(Shapiro-Wilk, Kruskal-Wallis, and Dunn’s检验,5%显著性)显示非加固组有显著性差异(p = 6.8 × 10-5),但冲击区之间无显著性差异(p = 0.879),证实应力分布均匀。结论:强化系统可显著改善口腔组织的冲击吸收,增强保护作用。然而,加固位置对吸收没有显著影响。有限元分析验证了体外结果,为进一步研究和未来改进提供了理论和实践模型。
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引用次数: 0
Microbial Loads in Traumatized Immature Teeth and Their Impact on the Treatment Outcomes of Regenerative Endodontic Treatment: A Randomized Clinical Trial Comparing Chlorhexidine and Calcium Hydroxide 创伤性未成熟牙的微生物负荷及其对再生牙髓治疗效果的影响:氯己定和氢氧化钙的随机临床试验比较
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-27 DOI: 10.1111/edt.13062
Alina Wikström, Olena Rakhimova, Pavel Călin, Georgios Tsilingaridis, Malin Brundin, Nelly Romani Vestman

Introduction

Regenerative endodontic treatment (RET) aims to promote root maturation in necrotic immature teeth, where effective microbial disinfection is crucial for treatment success. This study evaluated the effect of calcium hydroxide (CH) and 2% chlorhexidine gluconate (CHD) as intracanal medicaments and their impact on bacterial loads and RET outcomes.

Methods

The material consisted of bacterial samples from 41 patients who participated in a previously conducted randomized controlled clinical trial comparing CH and CHD during RET. A total of 123 microbial samples were analyzed using real-time quantitative polymerase chain reaction (qPCR). Bacterial loads were assessed at three time points: before root canal disinfection (S1), after root canal disinfection (S2), and after intracanal dressing (S3). The microbial composition was evaluated at the kingdom (Eubacteria), phylum (Actinomycetota), and species (Enterococcus faecalis) levels.

Results

Significant reductions in bacterial loads were observed after root canal disinfection (S2) in both CH and CHD subgroups, regardless of treatment outcome. Further reductions after intracanal dressing (S3) occurred exclusively in the successful cases. Actinomycetota loads significantly decreased after root canal disinfection in the successful cases but remained unchanged after intracanal medication. The presence of E. faecalis after intracanal dressing was associated with failed RET (OR = 9.778; p = 0.0432), although no significant differences in the effectiveness of the intracanal medicaments were found.

Conclusion

Both CH and CHD effectively reduced bacterial loads, with greater reductions linked to successful outcomes. The association between E. faecalis and failed RET suggests that this species may play a role in treatment outcomes. Further research, including microbiome profiling, is desirable to identify potential prognostic markers for failed RET.

再生根管治疗(RET)旨在促进坏死未成熟牙齿的根成熟,其中有效的微生物消毒是治疗成功的关键。本研究评估了氢氧化钙(CH)和2%葡萄糖酸氯己定(CHD)作为肛管内药物的效果及其对细菌负荷和RET结果的影响。方法:材料包括41名患者的细菌样本,这些患者参加了一项比较RET期间CH和CHD的随机对照临床试验,共123份微生物样本采用实时定量聚合酶链反应(qPCR)进行分析。在三个时间点评估细菌负荷:根管消毒前(S1)、根管消毒后(S2)和管内敷料后(S3)。微生物组成在界(真细菌)、门(放线菌门)和种(粪肠球菌)水平上进行评估。结果:无论治疗结果如何,CHD和CHD亚组均在根管消毒(S2)后观察到细菌负荷显著减少。仅在成功的病例中,才会出现管内敷料(S3)后进一步复位。在根管消毒成功的病例中,放线菌负荷显著降低,但在管内给药后保持不变。肛管内敷料后粪肠球菌的存在与RET失败相关(OR = 9.778;P = 0.0432),尽管在肛管内药物的有效性方面没有发现显著差异。结论:CHD和CHD均能有效降低细菌负荷,且降低程度越大,治疗效果越好。粪肠球菌与失败的RET之间的关联表明,该物种可能在治疗结果中发挥作用。需要进一步的研究,包括微生物组分析,以确定RET失败的潜在预后标志物。
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引用次数: 0
Evaluation of the Knowledge and Experience of the Brazilian Orthodontists in the Handling of Traumatized Teeth: A Quantitative Study 巴西正畸医师处理创伤牙齿的知识和经验评估:一项定量研究。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-14 DOI: 10.1111/edt.13056
Livia Salgado, Davy de Melo Mendes, Fernanda Campos Machado, Flávia Almeida Ribeiro Scalioni, Camila Faria Carrada, Robert Willer Farinazzo Vitral, Marcio José da Silva Campos

Aim

This is the quantitative part of a study that aimed to evaluate the knowledge and experience of orthodontists in managing the orthodontic treatments of traumatized teeth.

Material and Method

The study was divided into 4 stages: first, a structured interview; second, face validity; third, test–retest; and fourth, administering the questionnaire. The first three stages aimed at developing the questionnaire, while the fourth consisted of the application of the instrument in a sample of 395 orthodontists properly licensed with the Regional Councils of Dentistry of Brazil. The questionnaire was sent to these orthodontists through the social media platform Instagram.

Results

It was found that the majority of participants had encountered this type of emergency in their offices, had moderate knowledge of the subject, and were successful in their orthodontic treatments. Furthermore, almost all professionals recognized the importance of additional training, and only a small portion of them were familiar with any care protocols for these cases.

Conclusion

It can be concluded that the orthodontists had limited experience and a moderate knowledge about the orthodontic management of traumatized teeth.

目的:这是一项研究的定量部分,旨在评估正畸医生在管理创伤牙齿正畸治疗方面的知识和经验。材料与方法:本研究分为4个阶段:第一阶段为结构化访谈;二是面孔效度;第三,两次试验法的;第四,管理问卷。前三个阶段的目的是编制调查表,而第四个阶段的工作是在巴西牙科区域委员会适当许可的395名正畸医生样本中应用该工具。调查问卷是通过社交媒体平台Instagram发送给这些正畸医生的。结果:研究发现,大多数参与者在他们的办公室遇到过这种类型的紧急情况,对这一主题有适度的了解,并且在正畸治疗中取得了成功。此外,几乎所有的专业人员都认识到额外培训的重要性,只有一小部分人熟悉这些病例的护理方案。结论:正畸医师对创伤牙的正畸治疗经验有限,知识水平不高。
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引用次数: 0
Emerging Insights in Dental Trauma: Exploring Potential Risk Factors, Innovations, and Preventive Strategies 牙科创伤的新见解:探索潜在的风险因素,创新和预防策略
IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-14 DOI: 10.1111/edt.13053
Ana Beatriz Cantao, Liran Levin
<p>Several factors are associated with dental trauma (DT) occurrence, and these factors are well-established in the literature [<span>1, 2</span>]. However, new studies and hypotheses suggest that a lack of balance is positively associated with falls in children and older individuals [<span>3, 4</span>]. In this issue Lunardelli et al. investigated the relationship between orthostatic balance and the occurrence of DT in 6-year-old school children in Brazil [<span>5</span>]. The study emphasizes the connection between reduced orthostatic balance and an increased risk of falls, identifying it as a factor in the etiology of DT in children. This highlights the need for preventive measures focused on creating safer environments, particularly in schools, and involving a multidisciplinary team to support school-aged children in minimizing the risk of falls and dental trauma.</p><p>Traumatic dental injuries (TDI) are highly prevalent during childhood, particularly in the primary dentition [<span>6, 7</span>]. Although TDI is recognized as a common issue, the factors influencing its prevalence in preschool-aged children have been poorly understood [<span>8, 9</span>]. In this issue, Rivera López et al. investigated these factors through a cohort study involving 4-year-old children from South Brazil [<span>10</span>]. Using directed acyclic graphs (DAGs), the researchers developed a theoretical model to explore the complex relationships among potential risk factors, including demographic, behavioral, and environmental variables. This study provides insights into the multifactorial nature of TDI in young children, offering a foundation for targeted prevention and early intervention strategies. By applying advanced analytical techniques, Rivera López et al. contribute to a deeper understanding of dental trauma causes and its broader implications for pediatric oral health.</p><p>Autotransplanted teeth have demonstrated a remarkable survival rate of over 95% [<span>11-13</span>]. However, the lack of standardization and precision in quantifying root development results in inconsistent findings and impedes comparisons between studies. Traditional analysis methods based on two-dimensional radiographs shows significant limitations, such as image overlap, patient positioning challenges, and low measurement accuracy. Cone-beam computed tomography (CBCT) might provide a more accurate and detailed analysis, particularly in regions like the periapical areas [<span>14</span>]. In this issue, Beltrame et al. proposed a methodology for assessing root development and measuring root length using CBCT in 12 patients [<span>15</span>]. This study highlighted CBCT's superiority over conventional radiography for evaluating root development after autogenous tooth transplants. This method, as any radiographic tool, should be assessed in terms of radiation risks vs. the suggested benefits.</p><p>Advances in CBCT and 3D-printed replicas have demonstrated improvements in the effici
有几个因素与牙外伤(DT)的发生有关,这些因素在文献中得到了证实[1,2]。然而,新的研究和假设表明,缺乏平衡与儿童和老年人跌倒呈正相关[3,4]。在这一期Lunardelli等人调查了巴西6岁学龄儿童站立平衡与DT发生之间的关系。该研究强调了直立平衡能力下降与跌倒风险增加之间的联系,并将其确定为儿童DT病因学的一个因素。这突出表明需要采取预防措施,重点是创造更安全的环境,特别是在学校,并让一个多学科小组参与进来,以支持学龄儿童尽量减少跌倒和牙齿创伤的风险。创伤性牙损伤(TDI)在儿童时期非常普遍,特别是在初级牙列[6,7]。虽然TDI被认为是一个常见的问题,但影响其在学龄前儿童中流行的因素却知之甚少[8,9]。在本期中,Rivera López等人通过一项涉及巴西南部4岁儿童的队列研究调查了这些因素。利用有向无环图(dag),研究人员开发了一个理论模型来探索潜在风险因素之间的复杂关系,包括人口、行为和环境变量。本研究揭示了幼儿TDI的多因素性质,为有针对性的预防和早期干预策略提供了基础。通过应用先进的分析技术,Rivera López等人有助于更深入地了解牙齿创伤的原因及其对儿童口腔健康的更广泛影响。自体移植牙的成活率高达95%以上[11-13]。然而,在量化根系发育方面缺乏标准化和精确性,导致研究结果不一致,阻碍了研究之间的比较。传统的基于二维x线片的分析方法存在明显的局限性,如图像重叠、患者定位困难、测量精度低。锥形束计算机断层扫描(CBCT)可能提供更准确和详细的分析,特别是在像根尖周围区域b[14]这样的区域。在这一期中,Beltrame等人提出了一种使用CBCT评估12例患者牙根发育和测量牙根长度的方法。本研究强调了CBCT在评估自体牙移植后牙根发育方面的优越性。与任何放射照相工具一样,这种方法应根据辐射风险与建议的益处进行评估。CBCT和3d打印复制品的进步已经证明了牙科手术的效率和精度的提高,包括牙齿自体移植[16-18]。然而,大多数支持这些结果的证据来自观察性研究、病例报告和数量有限的病例对照研究。因此,评估生物功效(即长期临床和放射结果)的对照临床试验数据不足,限制了对这些技术影响的理解。在本期中,Lejnieks等人在一项对照临床试验中评估了CBCT和3D复制方案的联合疗效。目的是调查1年随访后的临床和影像学结果,为这些技术在磨牙自体移植中的益处提供更有力的证据。该研究强调了CBCT和3D复制协议在提高手术效率和作为有价值的培训工具方面的潜力,呼吁进一步研究以解决当前的局限性并探索其在临床实践中的更广泛应用。人工智能(AI)已经成为一种宝贵的资源,为寻求在线医疗保健知识的患者和临床医生提供信息,以支持医疗和牙科决策[20,21]。然而,在管理创伤恒牙的背景下,仍然缺乏对人工智能工具(如谷歌Gemini)提供的反应的准确性和一致性的严格评估。尽管这些技术具有改变医疗保健信息访问方式的巨大潜力,但人们对其可靠性和潜在偏差的担忧仍然存在。先前的研究表明,与ChatGPT等其他模型相比,谷歌Bard (Gemini的实验版本)等工具提供的信息一致性较差,尤其是在与牙髓学[22]相关的主题上。在这一期中,Portilla等人评估了谷歌Gemini提供的关于创伤恒牙管理的反应的准确性和一致性,并与经验丰富的学术牙髓专家进行了比较。他们使用一组预先确定的问题进行了全面的比较。 这项研究表明,双子座有可能成为牙科专业人员的一个可访问的支持工具。然而,改进其数据库和算法对于提高其在创伤恒牙相关主题中的准确性至关重要。推进培训和改进数据对于确保未来更可靠、更有力的响应至关重要。此外,在本期中,Johnson等人旨在评估人工智能聊天机器人(包括Bing、ChatGPT 3.5、谷歌Gemini和Claude AI)在解决与牙齿创伤相关的常见问题方面的有效性和可靠性。确保医疗信息的安全和准确传播,特别是在牙科创伤领域,需要当局制定明确的指导方针和法规来管理聊天机器人的使用。协作努力对于解决伦理问题并确保这些人工智能平台提供的信息的准确性和可靠性至关重要。公众对TDI管理的认识仍然不足[25,26]。然而,随着人工智能的进步,这些工具现在能够提供公共卫生支持和信息,帮助牙科专业人员和患者处理牙齿撕脱等问题。大型语言模型(llm)在牙科教育中提供了显著的好处,然而,由于这些工具是根据公众的人类反馈进行微调的,它们的数据可能有偏见或不正确,特别是关于牙齿撕脱伤bbb的问题的答案。在本期中,Tokgöz Kaplan和Cankar验证了ChatGPT和Gemini提供的关于牙齿撕脱的答案的准确性和全面性。四名儿科牙医审稿人根据IADT指南b[27]对这些回答进行了评估和评分。该评估显示,尽管这两种人工智能工具都有潜力,但需要进一步改进训练和数据质量,以确保其答案的可靠性和准确性。恒牙撕脱是最严重的牙外伤之一。治疗需要及时和正确的紧急管理,这取决于牙周韧带(PDL)细胞[29]的活力。撕脱会造成牙周韧带损伤,包括脱水和牙周纤维结构损伤。因此,将撕脱的牙齿储存在适当的介质中可以帮助保持牙周细胞的活力,防止它们脱水和分解。根据国际牙科创伤学协会(IADT)的指导方针,生理盐水、唾液和牛奶被认为是自然或生物溶液,有助于在再植bbb之前维持PDL的活力。在这一期中,Lee等人研究了六种实验培养基对牙周韧带成纤维细胞(PDLF)活力的影响。培养基包括汉克平衡盐溶液(HBSS)、补充抗坏血酸(维生素C)的HBSS、补充血小板衍生生长因子(PDGF)的HBSS、补充PDGF和抗坏血酸的组合的HBSS、补充血小板溶解液的HBSS和Dulbecco's Modified Eagle Medium[33]。评估了改良HBSS混合物支持ppdf活力的能力,并有助于再植手术的成功。本研究的结果有助于提高我们对撕脱牙合适的储存介质的整体认识和未来的考虑。中切牙经常受到牙外伤的影响[34,35],特别是在上颌前牙前倾的情况下。针对不同的活动和年龄组,可以采取不同的预防措施[37,38]。使用护齿器是预防运动时牙齿损伤最常见的方法。护齿器[39]有不同的制造方法;然而,定制的护齿器制作更专业,提供更好的契合度,根据一些报道,可以提高运动员的心肺能力。在这期杂志中,Bhadule等人通过对一名12岁男性患者[40]进行CBCT扫描,建立了三维有限元分析(FEA)模型。他们模拟了实际创伤对上颌前牙的影响,有和没有戴护齿。该研究强调了适当安装护齿器的重要性,通过减少压力大小来保护口腔和颌面损伤,特别是在有前倾上颌牙齿的牙列中。护齿器在运动和其他高风险活动中保护牙齿和软组织免受牙外伤也起着至关重要的作用[41,42]。最常用的类型包括stock mouthguard, mouth-formed models和定制选项,每种提供不同程度的舒适度和保护[41,43]。然而,尽管它们被广泛使用,一些护齿器所使用的材料可能不能提供足够的减震、耐用性或使用者舒适度[44,45]。 因此,越来越需要探索替代材料来开发增强性能,改善用户体验并促进更广泛采用的护齿器。在本期中,Nassani等人评估并比较了热成型乙烯醋酸乙烯酯(EVA)护齿器和3d打
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引用次数: 0
Histopathologic Features of Pulp Following Uncomplicated Crown Fracture of an Immature Tooth With Concomitant Subluxation Seven Days After the Injury. A Case Report 未成熟牙冠骨折伴半脱位7天后牙髓的组织病理学特征。一个病例报告。
IF 3.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-03-12 DOI: 10.1111/edt.13058
Giorgos N. Tzanetakis, Styliani Papanakou, Despina Koletsi, Nikolaos Katsoulas

Reports on the histopathologic features of pulp tissue following traumatic injuries are scarce. The aim of the present clinical and histological report was to provide some novel insights about the histological condition of the pulp tissue of an immature permanent tooth, shortly after a combined injury of uncomplicated crown fracture with concomitant subluxation. A seven-year-old male patient presented with a localized buccal swelling apically on tooth #21 and with a radiographic app. One week earlier, the patient had suffered an uncomplicated crown fracture, and the referral dentist had solely performed a permanent restoration by rebonding the fracture fragment of the crown. The diagnosis was pulp necrosis, and a regenerative endodontic procedure was decided due to the wide-open apex of the injured tooth. After access cavity preparation was performed, it was evident that no degeneration of the pulp had occurred, so the tissue was removed using a sterile barbed broach and processed for histopathologic examination. A whitish tissue specimen of soft consistency, 0.8 cm in length and 5 μm thick, was processed for histologic evaluation. An extensive coagulative necrosis of the pulp tissue was revealed with dense aggregates of neutrophils along with areas of abscess formation. Some scattered lymphocytes were observed as well, together with areas of dystrophic calcifications. Finally, no bacteria were observed in any section of the specimen. Pulp necrosis may occur shortly after a combined traumatic injury of uncomplicated crown fracture with subluxation. In such cases, pulpal inflammation and the arise of symptoms may not be necessarily associated with the presence of bacteria. The present histological observation demonstrates that some kinds of inflammatory processes, after traumatic dental injuries, may initiate and evolve potentially without the presence of bacteria at the inflammatory site.

关于外伤后牙髓组织病理特征的报道很少。本临床和组织学报告的目的是提供一些关于未成熟恒牙髓组织的组织学状况的新见解,在无并发症的冠骨折合并半脱位后不久。一名7岁的男性患者在21号牙齿的根尖出现局部颊肿胀,并进行了x线摄影。一周前,患者遭受了无并发症的冠骨折,转诊牙医仅通过将冠骨折碎片重新粘接进行了永久性修复。诊断为牙髓坏死,并决定再生根管手术,因为受伤的牙齿的顶端开放。在进行通道腔准备后,显然没有发生牙髓变性,因此使用无菌倒钩拉针去除组织并进行组织病理学检查。取长0.8 cm,厚5 μm的白色软稠度组织标本进行组织学评价。髓组织广泛凝固性坏死,中性粒细胞密集聚集,并伴有脓肿形成。可见一些分散的淋巴细胞,并伴有营养不良的钙化。最后,在标本的任何部分都没有观察到细菌。单纯冠状骨折合并半脱位的创伤性损伤后可发生髓质坏死。在这种情况下,牙髓炎和症状的出现不一定与细菌的存在有关。目前的组织学观察表明,创伤性牙齿损伤后,某些类型的炎症过程可能在炎症部位没有细菌存在的情况下启动和进化。
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Dental Traumatology
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