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International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition

Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Dental Traumatology (Impact Factor: 1.21). 06/2012; 28(3):174-82. DOI: 10.1111/j.1600-9657.2012.01146.x
Source: PubMed

ABSTRACT Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome.

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    • "Os dentes decíduos podem sofrer diversos tipos de lesões traumáticas, em graus de severidade e demanda de tratamento distintos. Malmgren et al. (2012) 11 descrevem uma relação em forma crescente da complexidade dos traumatismos envolvendo ou não a fratura do elemento dentário. Nos casos onde há fratura, esta pode envolver somente esmalte, esmalte e dentina, fratura coronária e exposição pulpar, fraturas corono-radiculares e fratura da tábua óssea. "
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    ABSTRACT: In the last decade, the alveolar-dental trauma been recognized as public health problems. The trauma of the primary dentition can provide both loss of deciduous tooth, as damage to the permanent dentition. Children are more susceptible to the alveolar-dental trauma, and the most affected teeth are the maxillary central incisors. Thus, the aim of this study was to report a clinical case of dental trauma, where a male patient, 3 years and 6 months old, has undergone trauma of deciduous maxillary central incisors. Were evaluated soon after the trauma, the teeth presented a slight mobility and marginal bleeding, there is still swelling and lip lacerations. Clinical and radiographic follow-up of the case and after nine months of control been established, despite the darkening of dental crowns, endodontic treatment was discarded, and the patient will continue to be monitored until the exfoliation of the teeth that have suffered trauma occurs, and that the eruption of the respective permanent successors can be observed. Through a correct diagnosis is possible to keep the traumatized tooth in the oral cavity without invasive interventions, facilitating psychological recovery of patients and parents after the trauma, and preserving the deciduous teeth with its function and aesthetics.
  • Dental Traumatology 06/2012; 28(3):173. DOI:10.1111/j.1600-9657.2012.01147.x · 1.21 Impact Factor
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    ABSTRACT: BACKGROUND: Hospital emergency departments (ED) are confronted with triaging and managing dental emergencies of both traumatic and non-traumatic origin. However, the literature suggests that there exists inadequate knowledge of the management of traumatic dental injuries (TDI) among medical professionals who must be knowledgeable and have the appropriate resources needed to triage or treat patients presenting with TDI. AIM: The aims of this study were to (i) evaluate the resources of Massachusetts emergency departments (MEDs) for TDI, (ii) determine the knowledge of management of TDI among MED physicians, and (iii) investigate potential factors that affect their knowledge. MATERIALS AND METHODS: Surveys were mailed to MED directors and their physicians. The director survey contained questions regarding institutional information for each emergency department (ED). The physician survey contained questions about physician characteristics and tested their knowledge of managing dental trauma. RESULTS: A total of 72 surveys (16 MED directors and 56 physicians) were returned and included in the analysis. Only 50% of the MEDs had on-site dental coverage, 43.8% had 24-h off-site dental coverage, and none had a formal written dental trauma protocol. MED physician's knowledge of the appropriate management of luxations and avulsions was generally good, but poor for dental fractures. The MED physician's knowledge for the emergent nature of the various injuries was generally good with that of avulsions being the best. Physicians were more likely to have a better knowledge of managing dental trauma if they were specialists in pediatric emergency medicine (P = 0.001) or their hospitals had an academic affiliation (P = 0.05). CONCLUSIONS: Based on the findings from this study, educational campaigns must be undertaken to improve both the resources available to the ED, and the knowledge of physicians regarding emergency management of TDI. In addition, efforts should be made by local dental organizations to provide ED with lists of dentists who are knowledgeable and willing to be available 24 h day(-1) to consult with and, if necessary, treat TDI. These efforts would enhance the long-term outcomes for patients sustaining dental trauma who present to hospital ED.
    Dental Traumatology 07/2012; 29(4). DOI:10.1111/j.1600-9657.2012.01170.x · 1.21 Impact Factor
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