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13 pages, 3428 KiB

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Biomechanical Behavior Evaluation of a Novel Hybrid Occlusal Splint-Mouthguard for Contact Sports: 3D-FEA

by Les Kalman, Amanda Maria de Oliveira Dal Piva, Talita Suelen de Queiroz and João Paulo Mendes Tribst

Dent. J. 2022, 10(1), 3; https://doi.org/10.3390/dj10010003 - 30 Dec 2021

Cited by 9 | Viewed by 3875

Abstract

Background: Orofacial injuries are common occurrences during contact sports activities. However, there is an absence of data regarding the performance of hybrid occlusal splint mouthguards (HMG), especially during compressive loading. This study amid to evaluate the biomechanical effects of wearing a conventional custom [...] Read more.

Background: Orofacial injuries are common occurrences during contact sports activities. However, there is an absence of data regarding the performance of hybrid occlusal splint mouthguards (HMG), especially during compressive loading. This study amid to evaluate the biomechanical effects of wearing a conventional custom mouthguard (MG) or the HMG on the teeth, bone, and the device itself. Methods: To evaluate the total deformation and stress concentration, a skull model was selected and duplicated to receive two different designs of mouthguard device: one model received a MG with 4-mm thickness and the other received a novel HMG with the same thickness. Both models were subdivided into finite elements. The frictionless contacts were used, and a nonlinear analysis was performed simulating the compressive loading in occlusion. Results: The results were presented in von-Mises stress maps (MPa) and total deformation (mm). A higher stress concentration in teeth was observed for the model with the conventional MG, while the HMG design displayed a promising mechanical response with lower stress magnitude. The HMG design displayed a higher magnitude of stress on its occlusal portion (7.05 MPa) than the MG design (6.19 MPa). Conclusion: The hybrid mouthguard (HMG) reduced (1) jaw displacement during chewing and (2) the generated stresses in maxillary and mandibular teeth. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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11 pages, 1843 KiB

Open AccessArticle

Dental Trauma at a University Dental Clinic in Milan including the SARS-CoV-2 Period

by Sara Pederielli, Cristina Mirelli, Federico Pozzi, Aldo Bruno Giannì and Roberto Biagi

Dent. J. 2021, 9(12), 145; https://doi.org/10.3390/dj9120145 - 2 Dec 2021

Cited by 5 | Viewed by 3192

Abstract

The aim of this study i.e., is to present the distribution of traumatic dental injuries (TDI) in 306 patients registered at the Unit of Dental Emergencies at a University Dental Clinic in Milan, Italy, between June 2019 and May 2021. This time frame [...] Read more.

The aim of this study i.e., is to present the distribution of traumatic dental injuries (TDI) in 306 patients registered at the Unit of Dental Emergencies at a University Dental Clinic in Milan, Italy, between June 2019 and May 2021. This time frame includes the beginning of the SARS-CoV-2 pandemic. Information regarding age, gender, number and type of injured teeth, type of traumatic injury, and data on where or how the injury happened were recorded. Seventy-nine percent of patients can be classified as pediatric (under 14 years old), and in all age groups, male patients were found to be more susceptible (1.6:1). A total of 480 teeth were involved, 59% of which were deciduous, and 41% permanent. The most affected teeth in both dentitions were upper central incisors. In deciduous teeth, periodontal lesions were more common, whereas in permanent dentitions, dental fractures were diagnosed more often. Most data found in this study confirms the results found in the literature. The biggest difference, due to changes in daily routine during the SARS-CoV-2 pandemic, can be found by analyzing the incidence and etiology. As a matter of fact, there was a decrease in school accidents, whereas domestic falls remained constant. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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6 pages, 899 KiB

Open AccessArticle

Direct versus Indirect Techniques to Menage Uncomplicated Crown Fractures of Anterior Teeth Following Dentoalveolar Trauma

by Roberto Apponi, Alberto Murri dello Diago, Vittorio Colombini and Giorgia Melis

Dent. J. 2021, 9(2), 13; https://doi.org/10.3390/dj9020013 - 20 Jan 2021

Cited by 5 | Viewed by 6290

Abstract

Dental trauma are the most common reasons for dental fractures in the anterior area, they have an incidence of 5% in the population, and in permanent teeth, they are mainly caused by sports. The most involved teeth are the maxillary anterior teeth. Direct [...] Read more.

Dental trauma are the most common reasons for dental fractures in the anterior area, they have an incidence of 5% in the population, and in permanent teeth, they are mainly caused by sports. The most involved teeth are the maxillary anterior teeth. Direct composite restorations and indirect ceramic restorations are the therapy of choice for restoring anterior teeth after fracture when is not possible to reattach the tooth fragment. The treatment options in uncomplicated coronal fractures depend on various factors such as the amount of residual dentinal enamel tissue, the relationship with the gingival profiles, and the age of the patient. The purpose of this article is to discuss the option of using direct or indirect restorative techniques in the treatment of traumatically fractured anterior teeth and to analyze the advantages and disadvantages of the two methods. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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19 pages, 1515 KiB

Open AccessArticle

Extrusive Luxation Injuries in Young Patients: A Retrospective Study with 5-Year Follow-Up

by Enrico Spinas, Laura Pipi and Claudia Dettori

Dent. J. 2020, 8(4), 136; https://doi.org/10.3390/dj8040136 - 16 Dec 2020

Cited by 12 | Viewed by 9317

Abstract

(1) Background: The purpose of this study was to analyze the influence of the chosen diagnostic and therapeutic approach (repositioning and splinting methods) on the risk, frequency and timing of the onset of pulp canal obliteration and pulp necrosis following extrusive luxation in [...] Read more.

(1) Background: The purpose of this study was to analyze the influence of the chosen diagnostic and therapeutic approach (repositioning and splinting methods) on the risk, frequency and timing of the onset of pulp canal obliteration and pulp necrosis following extrusive luxation in young patients with permanent dentition. (2) Methods: From an initial sample of 50 subjects affected by extrusive luxation, were selected the clinical data of 13 patients presenting extrusive luxation but no other type of injury to the dental hard tissue. All teeth were examined according to a standardized protocol. Follow-up examinations were performed at regular intervals for 5 years. Statistical associations between pulp consequences and several covariates were assessed using the Mann–Whitney test and Fisher’s exact test. (3) Results: Among the 13 studied teeth, only 1 healed completely, whereas 9 showed pulp obliteration and 3 developed pulp necrosis. No tooth with obliteration developed pulp necrosis. The average time to treatment was 11.9 h. The treatment approaches used were manual repositioning, orthodontic repositioning and stabilization splinting. “Time to treatment” was the only covariate that showed a weak statistical association with the onset of pulp consequences. (4) Conclusions: There is still uncertainty over the most appropriate therapeutic approach to adopt in young patients with extrusive luxation injuries, particularly for repositioning of the injured tooth. Extruded teeth should be treated as soon as possible after the traumatic event. This study highlighted the value of orthodontic repositioning of the extruded tooth, which does not seem to aggravate the conditions of the dental pulp. In addition, the study confirmed that prophylactic endodontic treatment is not appropriate for immature teeth affected by extrusive luxation injuries, given the extreme rarity of pulp necrosis in teeth already affected by pulp obliteration. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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Review

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12 pages, 3377 KiB

Open AccessReview

The Impact of Sport Training on Oral Health in Athletes

by Domenico Tripodi, Alessia Cosi, Domenico Fulco and Simonetta D’Ercole

Dent. J. 2021, 9(5), 51; https://doi.org/10.3390/dj9050051 - 3 May 2021

Cited by 23 | Viewed by 7831

Abstract

Athletes’ oral health appears to be poor in numerous sport activities and different diseases can limit athletic skills, both during training and during competitions. Sport activities can be considered a risk factor, among athletes from different sports, for the onset of oral diseases, [...] Read more.

Athletes’ oral health appears to be poor in numerous sport activities and different diseases can limit athletic skills, both during training and during competitions. Sport activities can be considered a risk factor, among athletes from different sports, for the onset of oral diseases, such as caries with an incidence between 15% and 70%, dental trauma 14–70%, dental erosion 36%, pericoronitis 5–39% and periodontal disease up to 15%. The numerous diseases are related to the variations that involve the ecological factors of the oral cavity such as salivary pH, flow rate, buffering capability, total bacterial count, cariogenic bacterial load and values of secretory Immunoglobulin A. The decrease in the production of S-IgA and the association with an important intraoral growth of pathogenic bacteria leads us to consider the training an “open window” for exposure to oral cavity diseases. Sports dentistry focuses attention on the prevention and treatment of oral pathologies and injuries. Oral health promotion strategies are needed in the sports environment. To prevent the onset of oral diseases, the sports dentist can recommend the use of a custom-made mouthguard, an oral device with a triple function that improves the health and performance of athletes. During training, the sports dentist must monitor the athletes and the sports examination protocol must be implemented with the inclusion of the clinical examination, quantitative and qualitative analysis of saliva and instructions on the use, cleansing and storage of the mouthguard. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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22 pages, 2851 KiB

Open AccessReview

Sport and Dental Traumatology: Surgical Solutions and Prevention

by Lorenzo Mordini, Po Lee, Ricardo Lazaro, Roberto Biagi and Luca Giannetti

Dent. J. 2021, 9(3), 33; https://doi.org/10.3390/dj9030033 - 23 Mar 2021

Cited by 9 | Viewed by 5319

Abstract

Trauma is a worldwide cause of millions of deaths and severe injuries every year, all over the world. Despite the limited extension of the oral region compared to the whole body, dental and oral injuries account for a fairly high percentage of all [...] Read more.

Trauma is a worldwide cause of millions of deaths and severe injuries every year, all over the world. Despite the limited extension of the oral region compared to the whole body, dental and oral injuries account for a fairly high percentage of all body traumas. Among head and neck traumas, dental and facial injuries are highly correlated to sport activities, and their management can be a real challenge for practitioners of any specialty. In case of trauma directed to periodontal structures, restorative and endodontic solutions may not be sufficient to achieve a definitive and long-lasting treatment. This article aims to illustrate surgical options and appliances to prevent dental injuries that may be available to the clinicians treating dental trauma involving oral soft and hard tissues. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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15 pages, 786 KiB

Open AccessReview

Use of Orthodontic Methods in the Treatment of Dental Luxations: A Scoping Review

by Enrico Spinas, Laura Pipi, Silvia Mezzena and Luca Giannetti

Dent. J. 2021, 9(2), 18; https://doi.org/10.3390/dj9020018 - 4 Feb 2021

Cited by 10 | Viewed by 5369

Abstract

(1) Background: Treating dental luxation injuries is challenging for the clinician. Dental luxations account for 18–33% of injuries to permanent teeth and can be addressed using different therapeutic approaches. The present work was conducted with two aims: (i) to evaluate, through a scoping [...] Read more.

(1) Background: Treating dental luxation injuries is challenging for the clinician. Dental luxations account for 18–33% of injuries to permanent teeth and can be addressed using different therapeutic approaches. The present work was conducted with two aims: (i) to evaluate, through a scoping review, current knowledge of the orthodontic methods (repositioning and stabilization splinting) that can be used at the time of the trauma, and (ii) to investigate the frequency and type of pulp consequences arising after these traumatic injuries. (2) Methods: The literature search was conducted in the period June 2020–December 2020 using the PubMed/MEDLINE, SCOPUS and Web of Science databases. The research questions were formulated according to the PICO (Population, Intervention, Comparison, Outcomes) method and considered the following aspects: type of luxation injury and stage of root development; use of orthodontic repositioning and splinting techniques; frequency and type of pulp consequences; and compliance of treatments with international guidelines. (3) Results: The initial screening of the databases, using the selected search keywords, yielded a total of 587 articles, just 8 fully met the inclusion criteria. Closer analysis of these 8 publications revealed that they would not produce clear meta-analytical data. This made it necessary to limit the data collected to the following six items: number and type of injuries, initial therapeutic intervention, duration of follow-up, number, and type of different pulp consequences. (4) Conclusions: While orthodontic techniques are commonly used to treat dental intrusions, in the case of extrusive and lateral luxation injuries, they are less frequently used and the orthodontic approach is generally confined to the stabilization phase. Among the various possible pulp consequences, many authors consider only pulp canal obliteration (PCO) and pulp necrosis (PN), often tending to overlook physiological healing (pulp survival) and the possible development of PN after PCO. There is therefore a clear need for new, high-quality clinical studies of this topic based on systematic and standardized data collection. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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Other

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9 pages, 2980 KiB

Open AccessCase Report

Root Fracture and Extrusive Luxation in Primary Teeth and Their Management: A Case Report

by Gianni Di Giorgio, Giulia Zumbo, Matteo Saccucci, Valeria Luzzi, Gaetano Ierardo, Roberto Biagi and Maurizio Bossù

Dent. J. 2021, 9(9), 107; https://doi.org/10.3390/dj9090107 - 11 Sep 2021

Cited by 5 | Viewed by 6443

Abstract

Background: Extrusion, lateral luxation, and intrusion are among the most serious types of dental trauma. Only a few studies have specifically focused on extrusion; the present one was aimed at reporting a case of domestic traumatic dental injury to primary tooth and describing [...] Read more.

Background: Extrusion, lateral luxation, and intrusion are among the most serious types of dental trauma. Only a few studies have specifically focused on extrusion; the present one was aimed at reporting a case of domestic traumatic dental injury to primary tooth and describing the measures taken in managing the trauma in order to avoid future consequences to the underlying permanent tooth germ. Case report: A 3.5-year-old boy reported a dental injury with extrusion and root fracture of deciduous tooth 5.1. After intraoral and radiographic evaluation, the element was repositioned and stabilized by an orthodontic flexible splint attached to the adjacent teeth. Several follow-up checkups were made and showed good healing of the tissues and physiological exfoliation of the tooth, with a healthy and unaffected corresponding central permanent incisor. Conclusion: This case report strengthens the importance of well-timed diagnosis and treatment and of regular follow-up of traumatized teeth as they may affect both dentitions with a negative impact on Oral Health-Related Quality of Life. Conservative treatment should be taken into consideration when possible, being in some cases more appropriate. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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9 pages, 2968 KiB

Open AccessCase Report

External Root Resorption Management of an Avulsed and Reimplanted Central Incisor: A Case Report

by Gianni Di Giorgio, Alessandro Salucci, Gian Luca Sfasciotti, Flavia Iaculli and Maurizio Bossù

Dent. J. 2021, 9(6), 72; https://doi.org/10.3390/dj9060072 - 16 Jun 2021

Cited by 5 | Viewed by 4743

Abstract

Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy [...] Read more.

Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy reported an uncomplicated crown fracture and avulsion of tooth 11 and complicated crown fracture of tooth 21 due to trauma. Reimplantation of element 11 was obtained within 30 min post-trauma and 3 days after both elements were diagnosed with necrotic pulp. In addition, tooth 11 showed early external root resorption. Both elements underwent endodontic treatment and root closure with apical plug using calcium-silicate-based cement. At 6-month follow-up root resorption appeared to be arrested. Twenty-four months after trauma the clinical results were stable, although signs and symptoms of ankylosis were observed. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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5 pages, 1444 KiB

Open AccessCase Report

Conservative Non-Surgical Management of Horizontal Root-Fractured Maxillary Incisors in a Young Male with Angle Class II, Division 2, Malocclusion

by Roberto Biagi, Giulia Bardini, Giuseppe Guidazzi and Enrico Spinas

Dent. J. 2021, 9(5), 55; https://doi.org/10.3390/dj9050055 - 12 May 2021

Cited by 1 | Viewed by 2393

Abstract

Horizontal root fractures are a rare emergency in a dental office. The injury involves periodontal ligament, cementum, dentine and pulp. The healing is influenced by the location of the root fracture, the displacement of the fragments and the status of the pulp. This [...] Read more.

Horizontal root fractures are a rare emergency in a dental office. The injury involves periodontal ligament, cementum, dentine and pulp. The healing is influenced by the location of the root fracture, the displacement of the fragments and the status of the pulp. This report presents a clinical case of horizontal fractures to both maxillary central incisors due to an act of violence. The type of occlusion has avoided a severe diastasis of the coronal parts with a subsequent damage to the pulp and periodontum. The fractures were treated with an orthodontic splint without any further therapy and hard tissue healing was observed. A careful diagnosis and well-timed treatment planning usually allow a cost-efficient and biologically-oriented therapy with a favorable outcome. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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7 pages, 1411 KiB

Open AccessCase Report

Combined Management of Apical Root Fracture and Avulsion of Two Maxillary Permanent Central Incisors: A Case Report

by Giulia Bardini, Davide Musu, Silvia Mezzena, Claudia Dettori and Elisabetta Cotti

Dent. J. 2021, 9(4), 39; https://doi.org/10.3390/dj9040039 - 1 Apr 2021

Cited by 4 | Viewed by 3888

Abstract

As a result of a skiing accident, a ten-year-old girl suffered combined injuries to both maxillary central incisor teeth (#1.1 and #2.1). The injuries were uncomplicated crown fractures, apical horizontal root fractures, and a severe extrusive luxation of the coronal segments of the [...] Read more.

As a result of a skiing accident, a ten-year-old girl suffered combined injuries to both maxillary central incisor teeth (#1.1 and #2.1). The injuries were uncomplicated crown fractures, apical horizontal root fractures, and a severe extrusive luxation of the coronal segments of the teeth. Her mother repositioned the teeth immediately, resulting in good initial healing. Nine months later, the patient was referred to a specialist to manage the endodontic consequences of the trauma. The apexification treatment of the fractured roots, using a preformed apical barrier technique with bioactive cement, was the treatment of choice, administered to both the avulsed roots at two separate recall visits. The best option for managing the fractured apical segments was to continue with the follow-up, which was conducted to assess the overall case at 30 months. The fractured apexes remained normally positioned inside the socket and were asymptomatic (as they presumably maintained a physiological vascular-nerve supply and, consequently, their vitality), while the apexification treatment led to the healing of the periodontal tissues and to hard tissue formation in the area of the interrupted roots in the avulsed portion of the teeth. The management of traumatic injuries in teeth often requires multiple treatment approaches, because these injuries rarely represent one single type of trauma. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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9 pages, 3101 KiB

Open AccessCase Report

Management of the Sequelae of a Sport-Related Traumatic Dental Injury Using Ultrasound Examination in the Diagnosis and Follow-Up

by Davide Musu, Giulia Bardini, Francesca Ideo, Silvia Mezzena and Elisabetta Cotti

Dent. J. 2021, 9(3), 27; https://doi.org/10.3390/dj9030027 - 2 Mar 2021

Cited by 1 | Viewed by 3784

Abstract

About a quarter of all oral pathologies involving the oral cavity and dental apparatus are traumatic injuries, and a substantial number of these cases are the result of sports injuries affecting adolescents and young adults. Here, we report the case of a 25-year-old [...] Read more.

About a quarter of all oral pathologies involving the oral cavity and dental apparatus are traumatic injuries, and a substantial number of these cases are the result of sports injuries affecting adolescents and young adults. Here, we report the case of a 25-year-old healthy female referred to the department of Endodontics for the evaluation and management of teeth 1.2 and 1.1 because of a chronic apical abscess in an area involved in a sport-related dental trauma in the past. A multi-modular diagnostic assessment, comprising conventional periapical radiographs, CBCT imaging, ultrasound, and histopathologic examination, led to a final diagnosis of an apical granulomatous lesion connected to both teeth, and an associated sinus tract. During the follow-up period of three years, the patient was reviewed twice a year and showed progressive healing of the bone and absence of the sinus tract. The present report shows the challenges of diagnosing complications arising from past dental trauma. Furthermore, it is the first documented traumatic case where ultrasound examination was fruitfully used. Emphasis should be put on introducing diagnostic ultrasound for the management of both apical periodontitis and the related sinus tract. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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7 pages, 1200 KiB

Open AccessCase Report

Complex Implant-Prosthetic Rehabilitation Following Sports Trauma with 14 Years of Follow-Up: Case Report

by Alberto Murri dello Diago, Roberto Apponi, Vittorio Colombini, Lorenzo Mordini and Francesca Ideo

Dent. J. 2021, 9(1), 6; https://doi.org/10.3390/dj9010006 - 9 Jan 2021

Cited by 3 | Viewed by 3252

Abstract

Tooth loss after traumatic dental injuries (TDI) often requires rehabilitation with a multidisciplinary treatment plan. In growing patients, the therapeutic approach may be different than in adults; the scientific literature offers alternative solutions even if they involve long, complex and uncomfortable treatments. Among [...] Read more.

Tooth loss after traumatic dental injuries (TDI) often requires rehabilitation with a multidisciplinary treatment plan. In growing patients, the therapeutic approach may be different than in adults; the scientific literature offers alternative solutions even if they involve long, complex and uncomfortable treatments. Among the possible therapeutic options, implant-prosthetic treatment through the use of mini-implants is presented in this complex case report with a 14-year follow-up. Full article

(This article belongs to the Special Issue Sport and Dental Traumatology)

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