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Dental Traumatology : Official... Aug 2020Traumatic dental injuries (TDIs) occur most frequently in children and young adults. Older adults also suffer TDIs but at significantly lower rates than individuals in... (Review)
Review
Traumatic dental injuries (TDIs) occur most frequently in children and young adults. Older adults also suffer TDIs but at significantly lower rates than individuals in the younger cohorts. Luxation injuries are the most common TDIs in the primary dentition, whereas crown fractures are more commonly reported for the permanent teeth. Proper diagnosis, treatment planning and follow up are very important to assure a favorable outcome. These updates of the International Association of Dental Traumatology's (IADT) Guidelines include a comprehensive review of the current dental literature using EMBASE, MEDLINE, PUBMED, Scopus, and Cochrane Databases for Systematic Reviews searches from 1996 to 2019 and a search of the journal Dental Traumatology from 2000 to 2019. The goal of these guidelines is to provide information for the immediate or urgent care of TDIs. It is understood that some follow-up treatment may require secondary and tertiary interventions involving dental and medical specialists with experience in dental trauma. As with previous guidelines, the current working group included experienced investigators and clinicians from various dental specialties and general practice. The current revision represents the best evidence based on the available literature and expert opinions. In cases where the published data were not conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. It is understood that guidelines are to be applied using careful evaluation of the specific clinical circumstances, the clinician's judgment, and the patient's characteristics, including the probability of compliance, finances and a clear understanding of the immediate and long-term outcomes of the various treatment options vs non-treatment. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.
Topics: Aged; Child; Dentition, Permanent; Humans; Tooth Avulsion; Tooth Fractures; Tooth Injuries; Tooth, Deciduous; Traumatology; Young Adult
PubMed: 32472740
DOI: 10.1111/edt.12574 -
Dental Traumatology : Official... Aug 2020Traumatic injuries to the primary dentition present special problems that often require far different management when compared to that used for the permanent dentition.... (Review)
Review
Traumatic injuries to the primary dentition present special problems that often require far different management when compared to that used for the permanent dentition. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions or majority decisions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. The primary goal of these Guidelines is to provide clinicians with an approach for the immediate or urgent care of primary teeth injuries based on the best evidence provided by the literature and expert opinions. The IADT cannot, and does not, guarantee favorable outcomes from strict adherence to the Guidelines; however, the IADT believes their application can maximize the probability of favorable outcomes.
Topics: Dentition, Permanent; Humans; Tooth Avulsion; Tooth Injuries; Tooth, Deciduous; Traumatology
PubMed: 32458553
DOI: 10.1111/edt.12576 -
European Journal of Paediatric Dentistry Jun 2020The aim of this review is to quantify the prevalence and type of malocclusion among children and adolescents during the different stages of dentition worldwide. (Meta-Analysis)
Meta-Analysis
AIM
The aim of this review is to quantify the prevalence and type of malocclusion among children and adolescents during the different stages of dentition worldwide.
MATERIALS AND METHODS
Recent studies (from 2009 to 2019), published in Medline, Web of Science and Embase and orthodontic text-books have been comprehensively reviewed herein. The methodological quality of the included studies was assessed using STROBE criteria.
RESULTS
After screening 450 records and analysing 284 relevant full-text publications, 77 studies were included in this review. A good degree of evidence was obtained due to the medium-high methodological quality level of included studies. The worldwide prevalence of malocclusion was 56% (95% CI: 11-99), without differences in gender. The highest prevalence was in Africa (81%) and Europe (72%), followed by America (53%) and Asia (48%). The malocclusion prevalence score did not change from primary to permanent dentition with a common score of 54%. Malocclusion traits such as Angle's classes, overjet, overbite, and asymmetrical midline shift essentially did not change their prevalence during different dentitions. Conversely, traits such as cross-bite and diastema reduced their prevalence during permanent dentition, while scissor-bite and dental crowding increased their scores.
CONCLUSION
The worldwide high prevalence of malocclusion and its early onset during childhood should induce policymakers as well as paediatric physicians and dentists to devise policies and adopt clinical strategies for preventing malocclusion since younger children's ages.
Topics: Adolescent; Child; Dentition; Europe; Humans; Malocclusion; Overbite; Prevalence
PubMed: 32567942
DOI: 10.23804/ejpd.2020.21.02.05 -
International Journal of Environmental... Jan 2022The objective was to determine whether trauma in primary dentition causes alterations in the development of permanent dentition. Searches were made in May 2020 using... (Review)
Review
The objective was to determine whether trauma in primary dentition causes alterations in the development of permanent dentition. Searches were made in May 2020 using PubMed, MEDLINE, MEDES, Scopus, Lilacs, and Embase. Papers in English, German, and Spanish, without restrictions in the year of publication, were included. The quality of the studies was analyzed using the NOS Scale. The search retrieved 537 references, and seven studies were included for a qualitative analysis. The results showed that trauma to a deciduous tooth can damage the bud of the permanent tooth. Enamel discoloration and/or hypoplasia were the most common sequelae in the permanent teeth after trauma to the primary predecessor. The type and severity of sequelae in the permanent tooth are associated with the development phase of the bud. Children with trauma of their primary teeth should receive checkups until the eruption of the permanent teeth for the early diagnosis and treatment of possible sequelae. Intrusion of the primary tooth was the trauma that caused the most damage and enamel alterations the most frequent sequelae.
Topics: Child; Humans; Dentition, Permanent; Tooth Avulsion; Tooth Eruption; Tooth, Deciduous; Spain; Tooth Injuries
PubMed: 35055575
DOI: 10.3390/ijerph19020754 -
Journal of Dental Research Apr 2022Previous studies on the global burden of caries primarily focused on simple descriptive statistics. We aimed to characterize the burden, trends, and inequalities of...
Previous studies on the global burden of caries primarily focused on simple descriptive statistics. We aimed to characterize the burden, trends, and inequalities of untreated caries of permanent and deciduous teeth from 1990 to 2019 at the global, regional, and national levels through an array of analytic approaches. Estimates of caries burden were extracted from the Global Burden of Disease Study 2019. Decomposition analysis was performed to examine the contribution of demographic and epidemiologic factors to the evolving number of prevalent caries cases. In portfolio analysis, the caries epidemiologic profile of each country was categorized by terciles of age-standardized prevalence in 2019 and average annual percentage change from 1990 to 2019. Sociodemographic attribution analysis was performed to reveal the scale of inequality in burden of caries. Age-standardized prevalence of caries in permanent and deciduous teeth decreased 3.6% (95% uncertainty interval, 2.6% to 4.5%) and 3.0% (1.3% to 4.9%), respectively. Population growth was the key driver of the changes in the number of caries cases, especially in sub-Saharan Africa (percentage contribution: 126.6%, permanent teeth; 103.0%, deciduous teeth). Caries prevalence in the permanent dentition was lower in more developed countries, whereas a reverse trend was noted in the deciduous dentition, except for the highest sociodemographic quintile where caries prevalence was the lowest. Globally, 64.6 million (95% CI, 64.4 to 64.9 million) and 62.9 million (62.8 to 63.1 million) prevalent cases of caries in permanent and deciduous teeth were attributable to sociodemographic inequality in 2019. This amounted to 3.2% (3.2% to 3.2%) and 12.1% (12.1% to 12.1%) of the global number of prevalent cases of caries in permanent and deciduous teeth. Burden of dental caries remains a global public health challenge. A systemwide reform of the global oral health care system is needed to tackle the causes of the burden and inequality of dental caries.
Topics: Dental Caries; Dentition, Permanent; Humans; Prevalence; Tooth, Deciduous
PubMed: 34852668
DOI: 10.1177/00220345211056247 -
Australian Endodontic Journal : the... Apr 2020The American Association of Endodontists (AAE) Consensus Conference Recommended Diagnostic Terminology states that mature permanent teeth clinically diagnosed with... (Review)
Review
The American Association of Endodontists (AAE) Consensus Conference Recommended Diagnostic Terminology states that mature permanent teeth clinically diagnosed with irreversible pulpitis are treated with pulpectomy and root canal filling because inflamed vital pulp is not capable of healing. Histological studies have demonstrated that clinically diagnosed irreversible pulpitis does not involve the entire pulp. A recent International Endodontic Journal Editorial suggested clinical diagnosis of pulp disease should be reassessed because of the poor correlation between clinical symptoms and pulp sensibility testing and the actual histological status of the pulp. This review identified studies in a PubMed search that provide evidence for vital pulp therapy (VPT) of mature permanent teeth with irreversible pulpitis is predictable if correctly diagnosed and properly treated. A narrative review was undertaken to outline the correlation between the clinical symptoms/signs and pulp sensibility testing and the histological findings of the pulp. Treatment procedures for permanent teeth are outlined.
Topics: Dental Pulp; Dentition, Permanent; Humans; Pulpitis
PubMed: 31865629
DOI: 10.1111/aej.12392 -
European Journal of Paediatric Dentistry Feb 2023It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of...
It is widely recognised by the scientific dental community that the correct development of the deciduous and mixed dentitions is paramount to the oral health of paediatric patients. In this respect, interceptive orthodontics plays a fundamental role in the process. Specifically, the paediatric dentist monitors the condition of the mouth from early childhood, distinguishing three age brackets for intervention, each defined by their own characteristics. It would also be desirable for other professionals who treat young patients and their mothers to various extents, such as paediatricians, gynaecologists, obstetricians and speech therapists to share valuable information with us. What follows is a brief summary of important conditions and key information regarding interceptive orthodontics. Age range 0-3 years: breastfeeding during the first months of life has been shown to have a positive effect on the development of the jaws. Later on, the transition to solid food, promoted by the eruption of the deciduous teeth, further stimulates their growth. During this phase, it is recommended to monitor and intercept any muscular hypotonia and low tongue postures. Additionally, it is essential to instruct parents on the proper dietary and lifestyle behaviours needed to ensure the physiological growth of the child, while protecting the health of their oral cavity. Age range 4-6 years: attention should be paid to the deciduous dentition and the development of the upper and lower maxillary bones, along with prompt interception and correction of bad habits such as the continued use of the pacifier, finger sucking, oral breathing and atypical swallowing. Age >6 years: within this phase, the careful monitoring of the space available in the arch, the natural exfoliation of milk teeth, the eruption of the permanent teeth and their occlusal relationship, as well as the maxillomandibular relationship are all important. If necessary, in addition to removing any risk factor, fixed or mobile orthodontic appliances can also be used during the above stages, especially stage 2 and 3, depending on the occlusal and skeletal status of the patient. Early diagnosis of malocclusion is crucial, as well as the sharing of information with other clinicians that deal with children and their parents, who need to be informed about the various therapies that their child may need. The paediatric dentist could, in fact, directly reach out to families to make them understand that malocclusion and other manifestations linked to conditions affecting oral functions such as breathing, sleeping, chewing and feeding often show the first signs as early as pre-school age, long before eruption of the first milk tooth, which is the time when the first dental visit is usually booked! We trust that awareness is the first form of prevention, and this is the message that must be conveyed to all of those involved in paediatric dentistry, patients and professionals alike: awareness and prevention is the first cure.
Topics: Humans; Child; Child, Preschool; Female; Infant, Newborn; Infant; Orthodontics, Interceptive; Malocclusion; Breast Feeding; Dentists; Dentition, Mixed
PubMed: 36853207
DOI: 10.23804/ejpd.2023.24.01.01 -
BMC Oral Health Dec 2022The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The...
INTRODUCTION
The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The objective of this study is to analyze the movement and stress of the whole dentition and further explore guidelines for the selection of traction methods.
METHODS
Three-dimensional (3D) finite element models are established to simulate the sequential molar distalization process, including the initial distalization of the 2 molar (Set I) and the initial distalization of the 1 molar (Set II). Each group set features three models: a control model without Class II elastics (model A), Class II elastics attached to the tooth by buttons (model B), and Class II elastics attached to the aligner by precision cutting (model C). The 3D displacements, proclination angles, periodontal ligament (PDL) hydrostatic stress and alveolar bone von Mises stress in the anterior area are recorded.
RESULTS
In all of the models, the maxillary anterior teeth are labial and mesial proclined, whereas the distal moving molars exhibit distal buccal inclination with an extrusion tendency. With the combination of Class II elastics, the anchorage was effectively reinforced; model C demonstrates superior anchorage reinforcement with lower stress distribution in comparison with model B. The upper canines in model B present an extrusion tendency. Meanwhile, the mandibular dentition in models B and C experience undesired movement tendencies with little discrepancy from each other.
CONCLUSIONS
Class II elastics are generally effective for anchorage reinforcement as the upper-molar distalization is performed with clear aligners. Class II elastics attached to an aligner by precision cutting is a superior alternative for maxillary anchorage control in cases that the proclination of upper incisors and extrusion of upper canines are unwanted.
Topics: Finite Element Analysis; Molar; Incisor; Periodontal Ligament; Orthodontic Appliances, Removable
PubMed: 36456944
DOI: 10.1186/s12903-022-02526-2 -
Scientific Reports Jun 2020To evaluate tooth behaviours under various maxillary incisor retraction protocols for clear aligner therapy. A three-dimensional finite element model of maxillary...
To evaluate tooth behaviours under various maxillary incisor retraction protocols for clear aligner therapy. A three-dimensional finite element model of maxillary dentition was constructed for first premolar extraction. A loading method was developed to mimic the mode of action of clear aligners for incisor en masse retraction. Three protocols with different amounts of retraction and intrusion on incisors were designed. Initial tooth displacements and stresses on periodontal ligaments were analysed with ANSYS software. The central (U) and lateral (U) incisors exhibited uncontrolled lingual tipping and extrusion upon 0.25 mm retraction. U1 exhibited translation movement, while U underwent less tipping during 0.2 mm retraction and 0.15 mm intrusion. Labial tipping and intrusion of U and bodily intrusion of U were observed during 0.1 mm of retraction and 0.23 mm of intrusion. With the additional intrusion on incisors, canine showed extrusion movement, and higher stresses on periodontal ligaments were shifted from U to canines. Incisors also exhibited different mesial-distal angulation in the three simulations, while posterior teeth all suffered mesial inclination. Incorporating intrusion displacement in clear aligners led to a tendency of lingual root movement during incisor retraction. The complexity of tooth movement should be recognized regarding clear aligner therapy.
Topics: Bicuspid; Biomechanical Phenomena; Dentition; Finite Element Analysis; Humans; Incisor; Maxilla; Orthodontic Appliances, Removable; Periodontal Ligament; Printing, Three-Dimensional; Software; Stress, Mechanical; Tooth Mobility; Tooth Movement Techniques
PubMed: 32576935
DOI: 10.1038/s41598-020-67273-2 -
The Journal of Clinical Pediatric... Jul 2021Premature loss of primary molars often leads to loss of arch circumference in the primary and mixed dentition. It can lead to malpositioning and even impaction of...
Premature loss of primary molars often leads to loss of arch circumference in the primary and mixed dentition. It can lead to malpositioning and even impaction of permanent tooth, if not prevented. Space maintainers in preventive orthodontics, are imperative in maintaining arch integrity. Band and loop space maintainers are indicated whenever there is premature loss of primary molar. The conventional band and loop space maintainer is most routinely fabricated, but poses certain limitations. Three-dimensional (3D) printing in digital dentistry is one of the major developments in dentistry. It replicates the dental cast in the most accurate forms. This allows for supreme precision and minimal human errors. Besides decreasing the laboratory procedures, it has the least chance of failure or breakage. The current case report discusses 3D printing technology for the fabrication of band and loop space maintainer, which can revolutionize preventive orthodontics for children.
Topics: Child; Dentition, Mixed; Humans; Molar; Orthodontics, Preventive; Printing, Three-Dimensional; Space Maintenance, Orthodontic; Tooth, Deciduous
PubMed: 34192758
DOI: 10.17796/1053-4625-45.3.1