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Tooth Injuries (tooth + injury)
Selected AbstractsDirect and indirect time spent on care of dental trauma: a 2-year prospective study of children and adolescentsDENTAL TRAUMATOLOGY, Issue 1 2000U. Glendor Abstract , The aim was to account for the total time spent by professional care-givers (direct time) and by patients and companions engaged as support and help (indirect time) to treat and otherwise attend to children and adolescents with dental trauma to primary and permanent teeth. The study was based on a random sample of 192 children and adolescents with dental traumas reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years after the trauma episode. On average, direct time represented 16% of total time for all visits for dental trauma to permanent teeth and 11% for trauma to primary teeth. The most extensive type of indirect time was transport time, which took up 30% of the total time spent on injuries to permanent teeth and 36% for injuries to primary teeth. Multiple regression analysis of the impact of dental and demographic injury variables on the time variables showed that complicated trauma was associated with extended time, direct as well as indirect, for permanent and primary teeth injuries. Our estimate of the average relative increase in total time spent by patients and companions in cases of complicated injury to permanent teeth was 117% (95% confidence interval [CI], 52,211) for patients and 112% (95% CI, 42,217) for companions. For transport time a strong predictor was access to a dental clinic near the place of residence. Lack of access could extend the average transport time by 180% (95% CI, 80,335) for patients and 163% (95% CI, 67,317) for their companions in cases of injuries to primary teeth. [source] Dental trauma that require fixation in a children's hospitalDENTAL TRAUMATOLOGY, Issue 1 2008Timothy Bruns 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. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5,10 years) to early adolescence (11,15 years) and then decreased rapidly in late adolescence (16,19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). 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. [source] A multicentre investigation into the role of structured histories for patients with tooth avulsion at their initial visit to a dental hospitalDENTAL TRAUMATOLOGY, Issue 5 2003Peter F. Day Abstract ,,,A paper structured history (SH) is a sheet, which prompts or reminds the clinician to ask various important questions. The aim of this study was to examine avulsion cases with respect to the quality of clinical records. Hospitals studied used either a paper SH or had no specific structure in their recording of avulsion details, e.g. unstructured histories (USH). The most important prognostic items that should be recorded for avulsion cases at their first visit were identified by reviewing the literature. Clinical case records meeting strict inclusion criteria were retrospectively analyzed against 10 important prognostic items. Forty-seven patient records were identified in the SH group compared to 43 patient records in the USH group. Using chi-square and Fisher's exact tests, the SH group were significantly better at recording the following: accident details (P < 0.001), loss of consciousness (P < 0.001), other teeth or tooth injuries (P < 0.05), extra-alveolar mediums (P < 0.01), total extra-alveolar time (P < 0.001), antibiotics given at time of injury (P < 0.05) and apical maturity (P < 0.001). In all the dental hospitals selected, two-thirds of the case records were completed by junior dentists not in specialist training and the improvement in history when using an SH form was most pronounced in these groups. It is concluded, therefore, that an SH should be taken for cases of avulsion as it was significantly better at collecting essential prognostic information. [source] Therapeutic and economic implications of traumatic dental injuries in Denmark: an estimate based on 7549 patients treated at a major trauma centreINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2001Mette Kit Borum Aim. To analyse the type and extent of injuries presented by patients seeking treatment for traumatic dental injuries at a major trauma centre. Furthermore, to analyse acute and subsequent treatment demands and treatment costs. Methods. A therapeutic and economic analysis was performed of 7549 patients treated for traumatic dental injuries in a major trauma centre located at the University Hospital in Copenhagen, Denmark. Cases were divided into uncomplicated (concussion, subluxation, enamel and enamel-dentine fractures) and complicated cases (crown fractures with exposed pulps and crown-root fractures, luxation injuries with displacement of the tooth and bone fractures). Results. Primary tooth injuries were found in 2874 patients, involving 5443 teeth, among which 62·8% had complicated injuries. Permanent tooth injuries were found in 4525 patients, involving 10673 teeth, among which 40·4% had complicated injuries. The cost of treatment (including acute trauma service, follow-up and subsequent restoration) was estimated to be 0·6,1 mill USD a year for the patients treated in this trauma centre. If this figure is transferred to the estimated trauma population in Denmark, a yearly cost of traumatic dental injuries appears to range from 2 to 5 mill USD per 1 mill inhabitants per year according to the treatment scenario. Conclusion. Thus, treatment of traumatic dental injuries comprises an expensive part of the health services in Denmark. [source] Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries , a review articleDENTAL TRAUMATOLOGY, Issue 3 2002J.O. Andreasen Abstract,,,Based on an analysis of the literature concerning parameters influencing the prognosis of traumatic dental injuries, few studies were found to have examined possible relationships between treatment delay and pulpal and periodontal ligament healing complications. It has been commonly accepted that all injuries should be treated on an emergency basis, for the comfort of the patient and also to reduce wound healing complications. For practical and especially economic reasons, various approaches can be selected to fulfill such a demand, such as acute treatment (i.e. within a few hours), subacute (i.e. within the first 24 h), and delayed (i.e. after the first 24 h). In this survey the consequences of treatment delay on pulpal and periodontal healing have been analyzed for the various dental trauma groups. Applying such a treatment approach to the various types of injuries, the following treatment guidelines can be recommended, based on our present rather limited knowledge of the effect of treatment delay upon wound healing. Crown and crown/root fractures: Subacute or delayed approach. Root fractures: Acute or subacute approach. Alveolar fractures: Acute approach (evidence however questionable). Concussion and subluxation: Subacute approach. Extrusion and lateral luxation: Acute or subacute approach (evidence however questionable). Intrusion: Subacute approach (evidence however questionable). Avulsion: If the tooth is not replanted at the time of injury, acute approach; otherwise subacute. Primary tooth injury: Subacute approach, unless the primary tooth is displaced into the follicle of the permanent tooth or occlusal problems are present; in the latter instances, an acute approach should be chosen. These treatment guidelines are based on very limited evidence from the literature and should be revised as soon as more evidence about the effect of treatment delay becomes available. [source] A retrospective study of traumatic dental injuries in a Brazilian dental trauma clinicDENTAL TRAUMATOLOGY, Issue 6 2001Arnaldo De França Caldas Jr Abstract , The purpose of this retrospective study was to analyse data from the records of patients seen in the dental trauma emergency clinic in a general hospital in the city of Recife, Brazil, during the years 1997,1999, according to sex, age, cause, number of injured teeth, type of tooth and type of trauma. The records of all patients seen by dentists were collected. Altogether, 250 patients from 1 to 59 years of age presenting 403 dental injuries were examined and/or treated. The causes of dento-alveolar trauma were classified in five categories: home injuries, street injuries, school injuries, sports activities, violence. The type of trauma was classified by dentists working at the dental trauma clinic on the basis of Andreasen's classification. The gender difference in the number of cases of trauma was statistically significant (males 63.2% vs females 36.8) (P<0.0001). Fracture in enamel only (51.6%) and fractures in dentine (40.8%) were the most commonly occurring types of injury. Injuries were most frequently diagnosed as serious among the youngest patients (up to 15 years of age); 82.4% of intrusive luxation cases were diagnosed in the 1,5 years age group. The main causes of tooth injury were falls (72.4%), collisions with objects (9.2%), violence (8.0%), traffic accidents (6.8%) and sports (3.6%). Trauma caused by violence was found to be statistically significant in the 6,15 years age group (P<0.0005). [source] Assessment of Intraoperative Safety in Transoral Robotic Surgery,THE LARYNGOSCOPE, Issue 2 2006Neil G. Hockstein MD Abstract Introduction: Robotic technology has been safely integrated into thoracic and abdominopelvic surgery, and the early experience has been very promising with very rare complications related to robotic device failure. Recently, several reports have documented the technical feasibility of transoral robotic surgery (TORS) with the daVinci Surgical System. Proposed pharyngeal and laryngeal applications include radical tonsillectomy, base-of-tongue resection, supraglottic laryngectomy, and phonomicrosurgery. The safety of transoral placement of the robotic endoscope and instruments has not been established. Potential risks specific to the transoral use of the surgical robot include facial skin laceration, tooth injury, mucosal laceration, mandible fracture, cervical spine fracture, and ocular injury. We hypothesize that these particular risks of transoral surgery are similar with robotic assistance compared with conventional transoral surgery. Methods: To test this hypothesis, we attempted to intentionally injure a human cadaver with the daVinci Surgical System by impaling the facial skin and pharyngeal and laryngeal mucosa with the robotic instruments and endoscope. We also attempted to extract or fracture teeth and fracture the cadaver's mandible and cervical spine by applying maximal pressure and torque with the robotic arms. Experiments were documented with still and video photography. Results: Impaling the cadaver's skin and mucosa resulted in only superficial lacerations. Tooth, mandible, and cervical spine fracture could not be achieved. Conclusions: Initial experiments performing TORS on a human cadaver with the daVinci Surgical System demonstrate a safety profile similar to conventional transoral surgery. Additionally, we discuss several strategies to increase patient safety in TORS. [source] | ||||||||||