Preschool teachers' knowledge and attitudes about dental trauma in Rijeka, Croatia: a cross-sectional study.

Introduction: Traumatic tooth injuries often occur in childhood. They are not life-threatening, but they can cause a number of complications that can affect the quality of life. Proper first aid can significantly facilitate further dental treatment. The aim of this research was to evaluate preschool teachers’ knowledge and attitudes about dental trauma and their motivation for further education. Material and Methods: This cross-sectional study included 54 preschool teachers. It was carried out in the form of a questionnaire consisting of 23 questions regarding traumatic tooth injuries, experiences and knowledge and teachers’ interest in additional education.Results: Most of the preschool teachers, 68.51%, did not witness any dental traumas during their work experience. From the teachers who witnessed dental trauma, only 11.76% gave first aid and none of them called the dentist and followed their instructions. In case of dental avulsion 72.22% would keep the avulsed tooth in a dry gauze or tissue. Even though 81.49% consider themselves uninformed about dental, all of them are interested in additional education. Conclusion: Despite the insufficient knowledge about dental trauma, its management, and first aid it is encouraging that all of the preschool teachers included in this research are motivated to educate themselves more on this subject.

The Role of Dendritic Cells during Physiological and Pathological Dentinogenesis

The dental pulp is a soft connective tissue of ectomesenchymal origin that harbors distinct cell populations, capable of interacting with each other to maintain the vitality of the tooth. After tooth injuries, a sequence of complex biological events takes place in the pulpal tissue to restore its homeostasis. The pulpal response begins with establishing an inflammatory reaction that leads to the formation of a matrix of reactionary or reparative dentin, according to the nature of the exogenous stimuli. Using several in vivo designs, antigen-presenting cells, including macrophages and dendritic cells (DCs), are identified in the pulpal tissue before tertiary dentin deposition under the afflicted area. However, the precise nature of this phenomenon and its relationship to inherent pulp cells are not yet clarified. This literature review aims to discuss the role of pulpal DCs and their relationship to progenitor/stem cells, odontoblasts or odontoblast-like cells, and other immunocompetent cells during physiological and pathological dentinogenesis. The concept of “dentin-pulp immunology” is proposed for understanding the crosstalk among these cell types after tooth injuries, and the possibility of immune-based therapies is introduced to accelerate pulpal healing after exogenous stimuli.

Erosive Tooth Wear, Presence of Parafunctional Habits and Tooth Injuries–Occurrence in a Group of Children and Adolescents Exposed to Domestic Violence

Objectives: To compare the prevalence of parafunctional habits, erosive tooth wear and occurrence of tooth injuries among children being under the care of Social Welfare Centre and children treated in the Department of Children’s Dentistry of the Medical University of Warsaw. Study design: The study contains environmental and medical interviews, record-based analysis and clinical examination. Parafunctional habits were rated on the base of dental interviews and clinical examinations. The occlusal surfaces were evaluated by visual examination using modified tooth wear index (TWI). Tooth injuries were reported from a medical interview labeled using Andreasen classification. The consent of the bioethics committee and guardians of children participated in the study was obtained. Results: The study involved 782 patients, including 404 children from dysfunctional families (average age 11,4 ± 3,7) and 378 from ordinary families-control group (8,53 ± 3,92). In the study group we observed higher prevalence of erosive tooth wear (44,66% vs 18,02% p=0,000), dental trauma (9,4% vs 3,44% p=0,001) and a presence of parafunctional habits (67,8% vs 20,4 % p=0,000). Conclusion: The occurrence of parafunctional habits, erosive tooth wear and tooth injuries may be an indicator of domestic violence and a component of maltreated child syndrome.

PERIODONT TISSUES STATUS AND FEATURES OF CLINICAL COURSE OF APICAL PERIODONTITIS OF PERMANENT TEETH WITH DISORDERS OF ROOT FORMATION AS A RESULT OF INJURY

Relevance. In childhood, traumatic tooth injuries are often found. Pulp necrosis occurs in 34,2 % of injured teeth, this causes damage to the periapical tissues. The post-traumatic complications (odontogenic cysts, periodontitis) in teeth with incomplete root formation often lead to a halt in root development. Chronic nidus of infection can be the cause of the somatic pathology development. This makes the early clinical and radiological diagnosis of post-traumatic complications important. Objective of the work is to study the clinical features of the post-traumatic periodontitis of permanent teeth with incomplete root formation of the tooth and to assess the condition of periodontal tissues in permanent teeth with impaired root formation as a result of trauma based on data from clinical and radiological studies. Materials and methods. On follow-up there were 17 children 9-15 years old with post-traumatic periodontitis of permanent teeth with incomplete formation of the root of the tooth. When making the diagnosis, we relied on data from clinical and radiological studies. Results. Most children complained of an aesthetic defect. 9 children (52,9 %) after an acute tooth injury did not seek the help of a dentist, аfter treatment of 8 children, dynamic observation was not conducted. In 76 % (13 teeth) periodontitis is diagnosed in teeth with a crown fracture within the enamel, enamel and dentin. It has been established that chronic granulating periodontitis is the most common form among destructive forms of periodontitis (12 teeth – 70,6%). Exacerbation of chronic granulating periodontitis diagnosed in 5 teeth. We did not ascertain chronic granulomatous periodontitis in teeth with incomplete root formation. The prevalence of the granulating form of chronic periodontitis in children is due to the histomorphological features of periodontal disease in childhood. 8 children, among the examined had a bite pathology – protrusion of the teeth of the front of the jaw (5 children) and a distal deep bite (3 children). In 71% of lesions, destructive forms of periodontitis were most often diagnosed in the maxillary incisors. Conclusion. Untimely seeking help and the lack of dynamic monitoring of injured teeth are the main reasons for the development of post-traumatic periodontitis. The clinical course of periodontitis is peculiar – chronic granulating periodontitis predominates, the inflammatory process in periodontal tissues in childhood is characterized by rapidly progressive destruction of bone tissue. Malocclusion can be a risk factor for tooth injuries.

Fogászati sérülésekről készült látleletek komplex terminológiai, fogászati és igazságügyi orvosszakértői elemzése

Writing a constat is a professional skill required of every general physician and dentist. Constats are issued by healthcare providers on the investigating authority’s, court’s or injured person’s request. This document is an official judicial evidence, a record of medical examination, and it is also a medical opinion which can determine the outcome of the subsequent legal process. Incomplete and incorrect injury descriptions make it difficult for forensic experts to form accurate and appropriate opinions. The authors examined 147 dental and oral surgical constats from the Universities of Pécs and Debrecen using multidisciplinary approach (according to terminological, dental, surgical, forensic and criminal legal aspects). Several medical reports contained mistakes in terms of inaccuracies and self-contradictions, terminology and professional medical practice. The documents included 352 injuries (11.1% of which were tooth injuries, 47.7% bone injuries and 41.2% soft-tissue injuries). The low number of attributes per injury (0.64 on average) indicates insufficient documentation. As a result of the comparative analysis, significant differences were found between the documentation of dental injuries and that of other bone injuries pertaining to their information content. We can state that physicians are most consistent when describing bone injuries, while they are less articulate about tooth injuries. The authors provide an overview of the legal consequences of injuries as well as the legal practice regarding tooth injuries in Germany and Austria, and recommend the creation of a nationwide, unified terminology for both dental and trauma departments on nasal and dental injuries. Orv Hetil. 2018; 159(51): 2154–2161.

The assessment of teachers’ and medical professionals’ knowledge on first aid in tooth injuries

Introduction. Tooth injuries constitute a serious clinical problem in contemporary paediatric dentistry. Immediately delivered and correct first aid is particularly important in the case of dental trauma. Aim. The aim of the study was to assess the general knowledge of teachers and medical professionals on providing first aid to children in the case of dental trauma. Taking part in a first aid training course was also analysed. Material and methods. An anonymous, voluntary questionnaire was administered to 727 people. It was conducted in January and February 2017 in three Polish provinces. The respondents were divided into groups depending on their age, sex, educational level, number of children and profession related to medicine or school education. Behavioural patterns were analysed in the event of a complete tooth dislocation or crown fracture. Results. According to the study, 577 respondents (79.4%) have participated in a first aid training course at least once. Every third person: 223 (32%) has been a witness of a tooth injury. The most frequent type of encountered trauma was soft tissue injury and tooth crown fracture: 114 (35%) and 96 (29%) cases, respectively. The professionals who tried to provide first aid in dental trauma at a similar percentage were teachers: 56% of cases and people associated with medicine: 53%; the remaining professionals did so in 36% of cases. Conclusions. The issue of first aid in dental trauma is rarely raised during first aid training courses. Despite this, every second person participating in the study has tried to provide first aid. However, their actions were incorrect in most cases.

What Increases the Risk of Dental Traumatism in Patients with Developmental Disabilities?

This study investigated risk factors for tooth injuries in individuals from a dental clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 493 dental charts of individuals with or without tooth injuries at their first dental appointment. The dependent variable was the time of occurrence of new dental traumatic injuries and was measured in months. Gender, age, International Code of Diseases, mother’s education, mouth breathing, hyperkinesis, pacifier use, thumb sucking, psychotropic drug use, tooth injuries at the first dental examination, involuntary movements, open bite, having one or more siblings and reports of seizures were the covariates. The Cox proportional hazards regression model was used to estimate the unadjusted and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental traumatism was 170.78 months (95% CI, 157.89-183.66) with median of 216 months. The incidence of new events was 11.88%. The covariate associated with an increased risk of dental traumatism was a history of tooth injuries at the first dental appointment. The increase in dental trauma risk was 3.59 (95% CI, 1.94-6.65). A history of traumatic dental injury was the risk factor for the dental trauma found in this group of individuals with developmental disabilities.