Traumatic dental injuries (TDIs) account for a considerable proportion of bodily injuries. Nevertheless, global TDI frequency is unknown, probably because TDI diagnosis is not standardized. This study estimated world TDI frequency. A literature search (publication years 1996-2016) was aimed at covering as many countries, communities, ethnic groups as possible, thus achieving high generalizability. In particular, non-specific keywords, no language restrictions, and large databanks were used. Observational studies reporting proportions of individuals with at least one TDI (prevalence) and who developed TDI (incidence rate) were considered. Prevalence rates to permanent dentition, primary dentition and in 12-year-olds, incidence rate to any tooth for any age, male-to-female prevalence ratio (PR) in 12-year-olds, with 95% confidence intervals (95 CIs), were extracted/calculated. Study quality, Z-score distribution, funnel plot symmetry analysis, between-study heterogeneity, sensitivity, and subgroup analyses were performed. Selected primary studies were 102 (permanent dentition; 268 755 individuals; median age, 13.8 years), 46 (primary dentition; 59 436 individuals; median age, 3.4 years), 42 (12-year-olds; 33 829 individuals), 11 (incidence rate; 233 480 person-years; median age, 7.8 years), and 31 (PR; 16 003 males, 16 006 females). World TDI frequency resulted as follows: permanent dentition prevalence 15.2% (95 CI, 13.0%-17.4%); primary dentition prevalence 22.7% (95 CI, 17.3%-28.7%); 12-year-olds prevalence 18.1% (95 CI, 15.3%-21.0%); incidence rate, 2.82 (95 CI, 2.28%-3.42%) per 100 person-years; PR, 1.43 (95 CI, 1.34%-1.52%). Differences between WHO Regions were found. This study shows that more than one billion living people have had TDI. TDI is a neglected condition which could rank fifth if it was included in the list of the world's most frequent acute/chronic diseases and injuries.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/edt.12389

World traumatic dental injury prevalence and incidence, a meta-analysis-One billion living people have had traumatic dental injuries.

Dental trauma is a significant public health problem because of its frequency, impact on economic productivity and quality of life. It is not a disease and no individual is ever at zero risk of sustaining these potentially life-changing injuries. The aim of this article was to review the literature on the prevalence, incidence, aetiology, prognosis and outcomes of dental trauma. The importance of standardized reporting, oral health policy, adjunctive research methods, prevention and education will also be discussed. A search for relevant articles appearing in databases such as Medline, Cochrane and SSCI formed the basis of this review. Epidemiological studies indicate the annual incidence of dental trauma globally is at about 4.5%. Approximately one-third of children and toddlers (primary teeth) and one-fifth of adolescents and adults (permanent teeth) sustained a traumatic dental injury. The majority involved the maxillary central incisors, mainly from falls in toddlers at home and contact sport in adolescents. Despite these trends, there is considerable variation between studies within and across jurisdictions. There is a need to standardize research with a consistent approach to reporting, classification and methodology. This will improve research and form a greater basis for predicting prognosis. This research basis will assist in consent and clinical management.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/adj.12395

Epidemiology and outcomes of traumatic dental injuries: a review of the literature

OBJECTIVE: To assess trends in the prevalence of traumatic crown injuries (TCI) in children aged 1-4 years living in Diadema city (Brazil) and to investigate whether TCI were associated with socio-demographic and clinical variables. METHODS: Six cross-sectional surveys with representative samples were carried out from 2002 to 2012 following the same criteria and methodology. A total of 6389 children were evaluated and systematically selected on the National Children's Vaccination day. Calibrated examiners performed the children's oral examination for TCI according to Andreasen's criteria. Chi-square test for trends was used to perform comparative analysis. Poisson regression was used to associate TCI to socio-demographic and clinical variables. RESULTS: The prevalence of TCI in 2002 for preschool children aged 1, 2, 3 and 4 years was 4.5%, 11.4%, 14% and 13.9%, respectively, and the prevalence in 2012 for the same age groups was 10.4%, 15.9%, 25.7% and 28.1%, respectively. There was a significant increase in the prevalence of TCI for all age groups and for the total sample (P CONCLUSION: This study has shown an increase of TCI prevalence in Brazilian preschool children in the last 10 years and its association with children's age, male gender, presence of anterior open bite and inadequate lip coverage. However, this increase does not seem to be relevant to decisions on public policy. Language: en

Trends in the prevalence of traumatic crown injuries and associated factors in Brazilian preschool children: 10-year observational data.

AIM: The aims of this study were to determine the incidence of injuries to permanent incisors in 2011-2013 in children aged 8-10 years living in the county of Varmland, Sweden, and to compare it with the incidence rates in 1989/1990 in the county of Vastmanland, as well as to determine the cause of dental trauma in relation to time and place. METHOD: The study analysed the patient records from dental visits (2011-2013) of trauma to the permanent incisors in children aged 8-10 years. The incidence rates were the incidence per 1000 children at risk. Standardized incidence rates were calculated for the comparison between different years. Information about month, location where the trauma occurred as well as cause of trauma was recorded. RESULTS: A total of 2.2% of 21 721 children aged 8-10 years had experienced at least one trauma. The incidence rate in Varmland increased from 18.9 in 2011 to 21.3 in 2012 to 28.5 in 2013. The standardized incidence rate in Varmland in 2011 and 2012 was not significantly different than in Vastmanland in 1989/1990 (P > 0.05), but the standardized rates in 2013 were significantly higher than in 1989/90 (P CONCLUSION: The incidence rate for dental trauma has not decreased in the past 20 years, and there is an indication that parents and teachers should be more aware of the risks of dental trauma at leisure times and at school as well as during sports and exercise. Language: en

Incidence and causes of dental trauma in children living in the county of Värmland, Sweden.

Abstract Aim This prospective cohort study evaluates clinical and radiographical outcomes of endodontic pulp revitalization (PR) of traumatized necrotic incisors. Methodology Pulp revitalization was performed in 75 traumatized necrotic immature incisors from 71 patients. The radiographic outcome measures were continued root formation (width and length), root resorption, apex closure, periapical index, and root development stage. The clinical outcome measures were percussion pain, palpation pain, pathological tooth mobility, swelling, sinus tract, ankylosis, crown discolouration, response to pulp sensitivity test, and subjective pain. Treatment outcomes were categorized as a success based on the absence of clinical symptoms and when radiographic evidence was present for apical healing and continued root development. The performed statistical tests were repeated measures anova, pairwise comparisons of interactions (t‐test), McNemar's test, and linear regression model. Results In 45 of 75 teeth (60%), PR was successful with the resolution of clinical and radiographic signs and continued root development. PR failed due to the absence of bleeding (n = 19) and persistent infection (n = 11). PR showed statistically significant increases in root length (11%), and dentinal wall thickness (30%), root maturation (pre‐operative 3.38 [CI 1.88; 4.88]; post‐operative 4.04, [CI 2.56; 5.52]) apical closure (71.4%), healing of pre‐operative apical periodontitis (100%), and healing of pre‐operative inflammatory root resorptions (100%). Three predictive variables for continued root maturation were identified – root development stage at entry (p = .0001, β 0.649), [CI 0.431; 0.867], trauma to the soft tissues (p = .026, β −0.012), [CI −0.0225; −0.015], and pre‐operative dentinal wall thickness (p = .009, β −0.001); [CI −0.001; 0.0001]. Conclusions Our findings indicate that PR provides satisfactory clinical and radiographical outcomes in traumatized necrotic incisors. The failed cases were related to lack of bleeding and persistent infections, indicating that new techniques are needed to improve the predictability of PR.

/pdf/endodontic-pulp-revitalization-in-traumatized-necrotic-3gszwku9.pdf

Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long‐term outcomes—A longitudinal cohort study

BACKGROUND/AIM: To prevent traumatic dental injuries (TDI), there is a need for vital information. This information could be reached using certain specific variables. The aim of this study, therefore, was to investigate TDI in different age groups, their etiology, and differences by gender, in Swedish children aged 0-17 years. SUBJECTS AND METHODS: The study included 2363 children in four different age cohorts from 12 Public Dental Service clinics in Sweden. The design was a 5-year longitudinal study including yearly clinical examinations, retrospective and prospective data compiled from dental records and interviews regarding TDI. RESULTS: The prevalence for TDI was 37.6% (889) with no gender differences. Boys suffered more injuries during the spring and fall compared to girls. The incidence of 2.8% varied between the age groups where preschool children presented the highest incidence. No changes in prevalence for TDI were found for the years included in the study. The most common reason for TDI was Falling (42.1%). The frequencies for the etiological factors varied between the ages. CONCLUSIONS: The TDI prevalence showed to be stable at a high level in spite of great efforts in Sweden and worldwide to reduce it. Knowledge in why, where, and when TDI appears is therefore essential for dental personnel who will work to reduce TDI. Language: en

Traumatic dental injuries among children aged 0–17 years in the BITA study – A longitudinal Swedish multicenter study

AIM: The aim of the study was to identify individual risk factors for traumatic dental injuries (TDI) among Swedish children aged 0-17 years. The studied risk factors were temperamental reactivity of the child, family structure, parent's country of birth, and the socioeconomic status of the family represented by parental education and occupation. SUBJECTS AND METHODS: The study included 2363 children in four different age cohorts at 12 public dental service clinics in Sweden, representing different types of demographic areas, both rural and urban. Data were collected from parents and children through an interview and questionnaires. RESULTS: The more social and active children in the two older age cohorts showed less occasions of TDI. Having one parent/guardian protected the child from dental injury just as well as two parents/guardians. Parents born outside of the Nordic countries showed children with less TDI. Low parental education was related to more occasions of TDI among the children. CONCLUSIONS: This study has increased the knowledge on certain individual risk factors for TDI. To prevent dental injuries, information could be given to families and children at risk. Language: en

Temperamental and socioeconomic factors associated with traumatic dental injuries among children aged 0-17 years in the Swedish BITA study

AIM: To investigate general unintentional injuries (GUI) and traumatic dental injuries (TDI) in relation to behavioral and psychosocial strengths and difficulties among Swedish children aged 0-17 years, and to investigate general unintentional injuries in relation to temperament and socioeconomic status among the same children. SUBJECTS AND METHODS: The study included 2363 children in four different age cohorts aged 3, 7, 11, and 15 years at the study start. Twelve Public Dental Service clinics in Sweden participated, representing different types of demographic areas, both rural and urban. Data were collected from parents and children through an interview, questionnaires, and dental records. RESULTS: Twenty-four percentage (24%) of the children had experienced a serious general unintentional injury (GUI) at some point during their lifetime up until 3 months prior to the study start. Children who were regarded by their parents as being injured more often than other children also had occasions with general unintentional injuries to a greater extent. Most general unintentional injuries occurred at home. Children with incidents of general unintentional injuries had occasions with TDI to a greater extent than children without general unintentional injury. Children, whose mothers had 11 years of school/education or less, were involved in more general unintentional injuries during the 3-month period prior to the study start, compared to children of mothers with higher education level. CONCLUSIONS: Children with general unintentional injuries had more traumatic dental injuries. Children who were assessed by their parents as being injured more often than other children also had occasions with general unintentional injuries to a greater extent. Temperament, behavioral and psychosocial strengths and difficulties had different impacts at different ages for experiencing a general unintentional injury. Language: en

Individual risk factors associated with general unintentional injuries and the relationship to traumatic dental injuries among children aged 0-15 years in the Swedish BITA study.

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Traumatic dental injuries among children aged 0–17 years in the BITA study – A longitudinal Swedish multicenter study

Temperamental and socioeconomic factors associated with traumatic dental injuries among children aged 0-17 years in the Swedish BITA study

Individual risk factors associated with general unintentional injuries and the relationship to traumatic dental injuries among children aged 0-15 years in the Swedish BITA study.