Dental traumatology : official publication of International Association for Dental Traumatology
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Comparative Study
An ultrastructural study on indirect injury of dental pulp caused by high-speed missile projectile to mandible in dogs.
The aim of this study was to evaluate the characteristics of indirect injury of dental pulp caused by high-speed missile projectile to mandible in dogs. Eighteen dogs aged 12-13 months were divided equally into six groups (n = 3 in each group) with random allocation, then a high-speed missile projectile (a ball bearing of stainless steel, phi6.0 mm, 0.88 g) was shot at right mandible body (the wound tract was below the fourth premolar, 1 cm or so to the root tips) of each dog, but the teeth were not wounded directly. ⋯ On the wound side, dental pulp of the fourth mandibular premolar was injured seriously and irreversible necrosis happened in the end; yet, dental pulp of the second mandibular premolar was injured less seriously, reversibly; on the opposite side, dental pulp of the second mandibular premolar was injured slightly and temporarily. It may be concluded that there are several characteristics in indirect injury of dental pulp caused by high-speed missile projectile to dogs' mandible: the injured area is relatively extensive; traumatic degree decreases progressively and sharply with the distance to the wound tract increasing; ultrastructural change of nerval damage takes place in early stage after wound, etc.
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There is little epidemiological research regarding dental trauma in Australia. Previous research has largely focused on specific sub-populations with data not necessarily applicable to a general rural Australian population. Studies from other countries have presented variable data and the relevance of their findings to the Australian setting is questionable. The aim of this study was to investigate the prevalence, causes and presentation of dental trauma in a large rural centre in Australia. ⋯ The maxillary central incisors were the most commonly injured teeth in both the primary and permanent dentitions. Uncomplicated crown fractures were the most common injury followed by luxations and subluxations. No significant differences in frequency were reported for the different days of the week, the different months or seasons of the year. Only one-third of the patients presented for dental treatment within 24 h of the injury while the remainder delayed seeking treatment for varying times up to 1 year.
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In order to fill the discrepancy between the necessity of providing prompt and proper treatment to dental trauma patients, and the inadequate knowledge among medics and corpsmen, as well as the lack of instructions in first-aid textbook and manuals, and after reviewing the dental literature, a simple algorithm for non-professional first-aid management for various injuries to hard (teeth) and soft oral tissues, is presented. The recommended management of tooth avulsion, subluxation and luxation, crown fracture and lip, tongue or gingival laceration included in the algorithm. Along with a list of after-hour dental clinics, this symptoms- and clinical-appearance-based algorithm is suited to tuck easily into a pocket for quick utilization by medics/corpsmen in an emergency situation. Although the algorithm was developed for the usage of military non-dental health-care providers, this method could be adjusted and employed in the civilian environment as well.
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Children and adolescents who suffer traumatic injuries often seek emergency treatment at a Children's Hospital. Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. ⋯ Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint.
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School teachers can play an important role in improving the prognosis of avulsed permanent teeth of school children after they are informed about the immediate and proper dental first aid steps to be taken at the time of an accident. The aims of this study were: (i) to assess the knowledge level of emergency measures for tooth avulsion in Kuwaiti intermediate school teachers and (ii) to determine if a short lecture about tooth avulsion and replantation could improve teachers' knowledge on this topic. Eighty-five teachers at two intermediate schools (children 10-14 years old) in Kuwait were interviewed using a questionnaire about their first-aid knowledge with particular focus on the following five categories: General knowledge of teeth and avulsion, replantation of primary and permanent teeth, how to clean an avulsed tooth before replantation, extra-oral time and storage methods and media for an avulsed tooth. ⋯ The knowledge level on the importance of extra-alveolar time before replantation increased from 1% to 74% and knowledge of a suitable storage medium for the avulsed tooth improved from 4% to 86%. Many avulsed permanent teeth in school children can be saved by replantation if school teachers learn what to do when a tooth is avulsed. A lecture followed by discussion proved to be an effective and efficient method of intervention to enhance the knowledge level of teachers so that proper dental first-aid procedures can be achieved.