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BACKGROUND/AIM: Crown fractures are common traumatic dental injuries and tooth fragment reattachment is a viable option for restoring a fractured tooth. The aim of this study was to assess the knowledge and experience of dentists in the Federal District regarding the tooth fragment reattachment technique for enamel and dentin fractures. MATERIALS AND METHODS: For the cross-sectional observational study, an electronic form was designed with objective and self-report questions for dentists. The data were analyzed using descriptive statistics, with their absolute and relative frequencies. For the analysis of categorical variables, the nonparametric chi-squared or Fisher exact association tests were used in the statistical software R (version 4.2.1). RESULTS: A total of 416 dentists participated in the study (58.9% female and 41.1% male). Of these, 70% declared they knew about fragment reattachment, but only 42.3% reported previous experience with this procedure. The most common storage medium used for the fractured fragment was milk (78.1%), and the bonding material used for reattachment was light-cured composite resin (86.3%). A majority (66.3%) reported that for a patient with enamel and dentin fracture, with the crown fragment in good condition, they would choose to do the reattachment. CONCLUSION: Dentists demonstrated that they had adequate knowledge about the tooth fragment technique, although many did not have previous experience with this procedure.

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OBJECTIVE: Analyse factors associated with dental trauma in 12-year-old adolescents. METHODS: An epidemiological survey was carried out in the five largest cities in the state of Mato Grosso do Sul, Brazil. Data on traumatic dental injuries (TDI) based on the World Health Organization (WHO), sociodemographic characteristics and individual clinical and behavioural characteristics in 615 adolescents were collected. Univariate and adjusted multilevel logistic regressions were performed to test the association of dental trauma with behavioural and sociodemographic factors. The study was approved by the Ethics Committee (CAAE number 85647518.4.0000.0021). RESULTS: The prevalence of TDI at 12 years was 3.4% (95% CI 1.8; 6.4). In the adjusted models, clinical characteristics of adolescents such as overjet >3 mm (OR = 1.51 [95% CI 1.00; 2.41]) were associated with trauma. Sociodemographic characteristics such as female sex (OR = 0.13 [95% CI 0.07; 0.25]), income above the poverty level (OR = 0.34 [95% CI 0.15; 0.78]), who declared themselves white (OR = 0.23 [95% CI 0.11; 0.47]) and with sedentary behaviour (OR = 0.69 [95% CI 0.59; 0.80]) were associated with trauma, as protective factors. CONCLUSION: Sociodemographic, behavioural and individual clinical characteristics were associated with TDI in adolescents. Oral health teams should focus on the most vulnerable groups, encouraging the use of mouthguards and access to treatment services.

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La fractura coronaria es el traumatismo dentoalveolar (TDA) más frecuente en la dentición permanente. Cuando existe exposición pulpar, se conoce como fractura coronaria complicada (FCC). Actualmente, en estos casos, se recomienda realizar terapias que permitan preservar la vitalidad del tejido pulpar, tanto en dientes maduros como inmaduros. El presente reporte describe el caso de un paciente de 9 años con FCC en diente 2.1, donde se realizó tratamiento con terapia pulpar vital (pulpotomía de Cvek), y adhesión de fragmento dentario. En los controles posteriores al TDA (1 semana, 4 meses, 1 y 2 años) el diente estaba asintomático, se observó formación de puente dentinario y continuación de desarrollo radicular con cierre apical, indicios de que el tejido pulpar se mantuvo vital. En este caso se destaca la importancia del diagnóstico, tratamiento adecuado, junto al seguimiento de un diente con desarrollo radicular incompleto.

Crown fracture is the most frequent dental traumatic injury (DTI) in permanent dentition. When there is pulp exposure, it is known as a complicated crown fracture. Currently, in these cases, it is recommended to carry out therapies that allow preserving the vitality of the pulp tissue, both in mature and immature teeth. This report describes the case of a 9-year-old patient with a complicated crown fracture in tooth 2.1, who underwent treatment with vital pulp therapy (Cvek pulpotomy), and adhesion of the dental fragment. In follow-up sessions (after 1 week, 4 months, 1 and 2 years), the tooth was asymptomatic. It was observed dentin bridge formation and the continuation of root development with apical closure, indications that the pulp tissue has remained vital. In this case, the importance of proper diagnosis and treatment is highlighted, together with the follow-up of a tooth with incomplete root development.

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BACKGROUND/AIMS: Following coronal tooth fracture, keeping the fragment hydrated is of the utmost importance in the tooth fragment bonding technique. The aim of this study was to evaluate the effects of different immersion times in different storage media on multimode adhesive bonding between reattached fragments and teeth. MATERIALS AND METHODS: A total of 195 bovine incisors were fractured and randomized into the following storage groups (n = 15): G0-control group (sound tooth); GA-saline solution: for 1 hour (A1) or 24 hours (A2); GB-artificial saliva: for 1 hour (B1) or 24 hours (B2); GC-coconut water: for 1 hour (C1) or 24 hours (C2); GD-tap water: for 1 hour (D1) or 24 hours (D2); GE-milk: for 1 hour (E1) or 24 hours (E2); GF-dry (dehydration): for 1 hour (F1) or 24 hours (F2). Tooth fragments were then reattached using a multimode adhesive in a self-mode technique with a flowable resin composite. Fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min). The data were submitted to two-way analysis of variance and the post hoc Tukey test (5%). RESULTS: The group submitted to the dehydration factor (GF) exhibited a mean value of 599.1 ± 144.2 N, while those submitted to all hydration protocols (GA, GB, GC, GD, GE) exhibited a mean value of 751.8 ± 285.4 N. Dehydration significantly affected the fracture strength values (P = .005). No significant interaction between the rewetting solutions was observed (P > .05). CONCLUSIONS: Hydration of the tooth fragment increased fracture resistance, regardless of the storage solution and/or immersion time.

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OBJECTIVE: To investigate the effect of dental trauma educational intervention among undergraduate students of a Federal University in Brazil. MATERIALS AND METHODS: Students (n = 125) enrolled in the dentistry (n = 70), nursing (n = 33), and speech therapy (n = 22) courses were invited to attend a dental trauma lecture and also to answer a questionnaire about their confidence in managing crown fracture and tooth avulsion, before (T0) and immediately after (T1) the lecture. McNemar's test (P < 0.05) with logistic regression compared the answers between the courses. RESULTS: Female gender (78.4%) aged from 18 to 22 years (73.6%) predominated among all the participants. Dentistry students scored higher correct answers (54.3%) in T0 when compared to nursing (12%) and speech therapy (9%) students, concerning the storage medium for tooth fragment transportation. Likewise, few dentistry students (22.9%) and no nursing and speech therapy students knew about the ideal storage medium for an avulsed tooth when immediate replantation was unviable. After educational intervention, a significant improvement was found between T0 and T1 (P < 0.001) for all courses, mainly regarding tooth avulsion with almost 100% of correct answers. Furthermore, logistic regression demonstrated that dentistry students had three times more knowledge absorption than nursing and speech therapy ones. CONCLUSIONS: The educational intervention demonstrated a significant positive impact regarding the knowledge of dental trauma emergency management among health students. Accordingly, it is essential to spread this information among health professionals to save teeth, especially in cases of avulsion.

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Dental fractures comprise the most frequent form of traumatic dental injury and often require an immediate procedure for their treatment. The repositioning of fractured crown fragments using the bonding fragment technique offers several advantages, including the reestablishment of function, esthetics, shape, shine, and surface texture, in addition to the maintenance of the original contour and alignment of the teeth. The aim of this article is to describe a therapeutic approach used with a patient who suffered varying degrees of crown fractures in three teeth that were treated with adhesive fragment reattachment. The natural crown bonding technique, using tooth fragments and a direct composite resin, successfully restored all of the fractured anterior teeth. The clinical examinations showed good esthetics and periodontal health after a 14-month follow-up, proving that the technique is a good option for tooth fractures.

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BACKGROUND/AIMS: Fragment reattachment is a procedure that offers advantages, such as preservation of tooth structure and maintenance of color, shape, and translucency of the original tooth. The aim of this study was to analyze the reattachment techniques used to restore anterior teeth fractured by trauma. MATERIALS AND METHODS: The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were evaluated to identify additional studies. Two authors assessed studies for inclusion and extracted the data. In vitro studies that evaluated permanent human teeth fractured by trauma were included. RESULTS: Twenty-one studies remained after screening. The bond strength between the fragment and the crown was evaluated in 119 experimental groups. Ten different techniques were evaluated as follows: no preparation, chamfer, bevel, anchors, overcontour, internal groove, no preparation associated with chamfer after reattachment, fragment dentin removal associated with chamfer after reattachment, bevel associated with overcontour, and groove associated with shoulder. Five different materials were used to reattach the fragment: bonding system, luting composite resin, flowable composite, microhybrid composite, and nanocomposite. CONCLUSION: Fragment reattachment using a technique with no preparation and an adhesive system associated with an intermediate composite with good mechanical properties can restore part of the resistance of the fractured tooth.

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BACKGROUND/AIM: Several strategies have been developed for tooth fragment reattachment following fracture. Although many techniques have been reported, there is no consensus on which one has the best results in terms of the bond strength between the fragment and the dentin over time. The aim of this study was to assess the currently reported tooth fragment reattachment techniques for fractured crowns of anterior teeth. MATERIALS AND METHODS: The PubMed, LILACS, Web of Science, Cochrane, and Scopus databases were searched in October 2016, and the search was updated in February 2017. A search of the gray literature was performed in Google Scholar and OpenGrey. Reference lists of eligible studies were cross-checked to identify additional studies; gray literature and ongoing trials were investigated. Two authors assessed studies to determine inclusion and undertook data extraction. Case reports/series of three or more cases, cross-sectional studies, cohort studies, and in vivo clinical trials in all languages were included. RESULTS: Five articles remained after screening. These studies predominantly reported on fragment reattachment with composite resin and resin cement. There was little consistency among the studies in regard to the technique used for tooth fragment reattachment and length of the follow-up period. CONCLUSIONS: According to the evidence found in the studies included in this review, simple tooth fragment reattachment was the preferred reattachment technique. An increase in the bond strength between tooth fragment and dentin was observed when an intermediate material was used. Further investigation is needed, using standard follow-up periods and larger samples.

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Introducción: los traumatismos dento-alveolares son lesiones producidas en dientes, huesos y demás tejidos de sostén, por un impacto físico en su contra. Deben considerarse, siempre, urgencias estomatológicas. Objetivo: caracterizar los traumatismos dentales en estudiantes de la Escuela Primaria William Aguilera, San Andrés, en el año 2016. Método: se realizó un estudio descriptivo, de corte transversal, de un universo de 391 estudiantes, con una muestra intencionada de 46 alumnos con traumatismos dentales, en edades de 6 a 11 años. Se les efectuó examen clínico e interrogatorio. Se recogió información de interés en formulario. Un grupo de variables fueron estudiadas y procesadas, a través del análisis porcentual, resultados que fueron presentados en tablas. Resultados: los traumatismos dentarios tuvieron una frecuencia de 39,13%, en el rango de 6 a 7 años, donde predominó el sexo masculino con 69,57%. El traumatismo dentario más frecuente fue la fractura no complicada de corona con 54,34%. El 45,65% nunca recibió tratamiento postrauma, y el 23,80% presentó discromía, como secuela del traumatismo. Conclusiones: los traumatismos dentarios y las fracturas no complicadas de corona, aparecieron, con frecuencia, en escolares del sexo masculino. La discromia resultó el hallazgo clínico más detectado en estos pacientes. La mayoría de los pacientes no recibieron tratamiento después del trauma dental.

Introduction: dental traumatisms appear in teeth, bones, and other support tissues, as a result of physical impact. They must be always treated like stomatologic emergencies. Objective: to characterize dental trauma in students from William Aguilera elementary school. San Andrés, Holguín, 2016. Methods: a cross-sectional descriptive study was carried out with a universe of 391 students, of the elementary school William Aguilera, San Andres, Holguin, 2016. From 6 to 11 years old, forty-six students showed some dental trauma. Oral examination and medical search was performed. Data collecting was developed by the authors. The group of variables were studied and processed by percentage analysis. The results were showed in tables. Results: dentals traumas were frequent on ages 6 to 7, at 39.13%. Males prevailed with 69.57%. The most common traumatic lesion was the non-complicated crown fracture, with 54.34%. A 23.80 showed dental discromia. The 45.65 % were not treated after trauma. Conclusions: dental trauma was higher in males. Non-complicated crown fracture was prevalent. Most of patients with dental trauma were not under treatment after lesion, and the most detected not treated clinic sing, was discromia.

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Coronal fractures of the anterior teeth are common sequelae of traumatic dental injuries. Reattachment of fractured tooth fragments using dental adhesive techniques offers some advantages, including restoration of the function, esthetics, shape, texture, and brightness of the surface. The present report describes a clinical case of reattachment with a 4-year clinical and radiographic follow up in a permanent maxillary central incisor with an uncomplicated crown fracture. Fragment reattachment is a conservative procedure, preserving esthetics and functionality, and it can provide an immediate positive emotional response from the patient.

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ABSTRACT: Dento-alveolar traumas are one of the most frequent injuries to teeth, mainly affecting the upper incisors due to their exposed position in the dental arch. In such cases, esthetics, function and phonetics of anterior teeth may be compromised. Furthermore, when there is involvement of the biological width, there is often a poor prognosis. This case report describes the multidisciplinary approach to tooth fragment re-attachment in a fracture with biological width violation. The patient presented with an oblique crown fracture in the maxillary right lateral incisor, extending from the buccal to palatal side, as well as a biological width invasion. The re-establishment of the biological width was obtained by periodontal surgery to achieve clinical-crown lengthening and tooth fragment re-attachment with a glass fiber post to increase retention. After 3 years of follow-up, the rehabilitated lateral incisor remains in good condition, with satisfactory esthetic and periodontal health.

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BACKGROUND/AIMS: The tooth fragment bonding technique, frequently used to restore traumatized teeth, may be affected by dehydration/rehydration periods. The aim of this study was to evaluate the effects of different dry and wet storage intervals on multimode adhesive bonding between reattached fragments and teeth. MATERIALS AND METHODS: Eighty-four bovine incisors were fractured and randomized into groups (n=12). After teeth fracturing, each specimen was assigned to one of the following groups: G0: control group (sound tooth); GA1 and GA2: 1-h dehydration and a 15-min or 24-hours rewetting period, respectively; GB1 and GB2: 24-hours dehydration and a 15-minutes or 24-hours rewetting period, respectively; and GC: 1-hour (GC1) or 24-hours (GC2) dehydration period only. Tooth fragments were then reattached using a multimode adhesive in a self-mode technique with a flowable resin composite. The fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min-1 ). Data were submitted to two-way analysis of variance and post hoc Tukey test (5%). RESULTS: No significant interaction between dehydration and rehydration intervals was observed (P>.05). Only the step of rehydration significantly affected the reattachment strength when compared to the groups submitted only to dehydration, regardless of the interval (15 minutes or 24 hours). CONCLUSION: Rehydrating a tooth fragment for 15 minutes before bonding with a multimode adhesive maintained sufficient moisture to increase reattachment strength.

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Introdução: a odontologia prioriza a manutenção e integridade dos dentes na boca e a ocorrência de traumatismos dentais vem dificultando o cumprimento desta meta, uma vez que suas consequências envolvem danos funcionais, estéticos, psicológicos, sociais e terapêuticos, além dos altos custos para a reabilitação e acompanhamento por longos períodos de tempo. Objetivo: avaliar o conhecimento dos cirurgiões dentistas da região metropolitana de Juazeiro do Norte sobre as condutas clínicas baseadas nos planos de tratamentos propostos por estes profissionais sobre fraturas coronárias com ou sem exposição pulpar. Método: a partir de um questionário descritivo, foram abordadas questões referentes ao perfil dos profissionais entrevistados e procedimentos empregados na conduta frente a fraturas coronárias. Setenta e cinco questionários foram devidamente preenchidos, sendo 34 mulheres e 41 homens. Resultados: dos entrevistados 13 relataram nunca terem atendido casos de trauma dental, 26% relataram serem incapazes de tratar todos os casos de traumatismo dentário. E mesmo a maioria tendo formação especializada, grandes dificuldades foram encontradas nos planos de tratamento propostos em relação a fraturas mais complicadas. Discussão: as lesões dentais traumáticas envolvendo tecidos duros e de sustentação podem representar padrões de cicatrização bastante complexos. As lesões traumáticas do tipo fraturas coronárias apresentam um prognóstico favorável para a manutenção da vitalidade pulpar em relação às fraturas coronárias complicadas. As fraturas corono-radiculares com ou sem envolvimento pulpar, foram as que apresentaram mais indicações inadequadas de tratamento, provavelmente por necessitarem de uma abordagem multidisciplinar. Conclusão: considera-se primordial a multidisciplinaridade durante a formação acadêmica do clinico geral, bem como o aperfeiçoamento ao atendimento a pacientes com trauma dental. (AU)

Introduction: Dentistry prioritizes the maintenance and integrity of teeth in the mouth and the occurrence of dental trauma is hampering the achievement of this goal, since its consequences involve functional, aesthetic, psychological, social and therapeutic damage, in addition to high costs for rehabilitation and monitoring for extended periods of time. Objective: The objective of this study was to assess the knowledge of dentists in the metropolitan region of Juazeiro do Norte on the clinical management based on treatment plans proposed by these professionals on crown fractures with or without pulp exposure. Methods: For that, starting from a descriptive questionnaire, some questions regarding the profile of inquired professionals and procedures used in the performance of treatment of crown fractures. Results: Seventy-five questionnaires were fully completed, 34 women and 41 men. Only 13 reported ever having met cases of dental trauma, 26% reported being unable to deal with all cases of dental trauma. And even most having specialized training, great difficulties were encountered in the proposed treatment plans for the most complicated fractures. Discussion: Traumatic injuries involving pulp and periapical tissues can represent very complex healing patterns. The crown fractures have a favorable prognosis for the maintenance of pulpal vitality in relation to coronary complicated fractures. The corono-root fractures with or without pulp involvement, were the ones that had more inadequate treatment, probably because they require a multidisciplinary approach. Conclusion: it is essential for multidisciplinary academic training of general practitioner as well as improving service to patients with dental trauma. (AU)

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Introducción: entre las principales urgencias estomatológicas se encuentran los traumatismos dentarios, por la presencia de dolor, molestia y alteración funcional repentina hacen que el paciente acuda al estomatólogo. Objetivo: determinar el comportamiento de los traumatismos dentarios en adolescentes de la Secundaria Básica José Martí. Métodos: se realizó un estudio observacional, descriptivo, transversal en el municipio Cárdenas de 2011 a 2012. El universo de trabajo estuvo conformado por 79 pacientes entre 12 y 14 años de edad, que sufrieron traumatismos dentarios en dientes incisivos permanentes, tanto superiores como inferiores. Se tuvo en cuenta el consentimiento informado de los padres. Se analizaron las variables: edad, sexo, dientes afectados, tipo de fractura dentaria, causa que lo produjo, tiempo transcurrido para recibir tratamiento después de ocurrido la lesión traumática. Se realizó un examen clínico e interrogatorio, a fin de constatar los signos presentes. Los datos obtenidos fueron procesados estadísticamente, se usó el porcentaje como medida de resumen. Resultados: el sexo masculino resultó el más afectado con 12,5 % y el 13,4 % a la edad de 14 años. La principal causa fue la caída con 44,3 %, el 58,2 % de los pacientes que sufrieron traumatismos dentarios acudieron a consulta después de las 24 horas de ocurrido la lesión traumática. El 72,2 % de los padres no recibieron información sobre el seguimiento en consulta. Conclusiones: los traumatismos dentarios fueron más frecuentes en la edad de 14 años y en el sexo masculino. Predominó la fractura no complicada de la corona en los incisivos centrales, la mayoría de los pacientes con traumatismos dentarios acudieron a consulta a recibir tratamiento después de las 24 horas de ocurrida la lesión.

Background: dental trauma is among the main stomatologic urgencies. Because of the presence of pain, discomfort and functional disturbance they make the patient assisting the dentist. Aim: determining dental trauma behavior in teenagers of the Basic High School Jose Martí. Methods: we carried out a cross-sectional descriptive observational study in the municipality of Cardenas from 2011 to 2012. The universe of work was formed by 79 patients aged 12-14 years who suffered dental trauma in permanent incisors, both lower and upper. We obtained their parents informed consent. The analyzed variables were: age, gender, affected teeth; kind of dental fracture, cause, time passed from the moment the lesion occurred and the moment the patient was treated. A clinical examination and interview were performed to assess the signs. Obtained data were statistically processed; the percente was used as measure Outcomes: the most affected age group was the one grouping children aged 14 years, 13,4 %, and the highest percent corresponded to the male gender, 12,5 %. The main cause was fall, 44,3 %. 58,2 % of the patients who suffered dental trauma assisted the consultation 24 hours after the trauma lesion has occurred. 72,2 % of the patients’ parents were not informed about the consultation follow up. Conclusions: dental traumas were more frequent at the age of 14 and in male gender. There it was a predominance of the non-complicated crown fracture in central incisors. Most of the patients with dental trauma assisted the consultation 24 hours after the lesion occurrence.

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Objetivo: a reabsorção radicular inflamatória é uma das consequências do traumatismo dentário, sendo a detecção e o tratamento precoces determinantes na limitação de seus danos. Assim, o objetivo deste estudo foi investigar, em dentes anteriores permanentes traumatizados, a prevalência de reabsorção radicular inflamatória, relacionando-a com os diferentes tipos de traumatismos nos tecidos de sustentação e dentários. Sujeitos e método: os dados relativos à reabsorção inflamatória foram coletados a partir de 111 dentes, nos prontuários de 74 pacientes de um serviço de tratamento de trauma dental da FO/UFPel, no período de 2005 a 2011. Foram registrados, ainda, o sexo e a idade dos pacientes, os dentes envolvidos no trauma, a presença de rizogênese completa ou não e o tempo inicial para o aparecimento da reabsorção. A avaliação dos dados foi realizada por estatística descritiva e teste qui-quadrado, com correção de Yates, ao nível de significância de 5%. Resultados: a reabsorção radicular inflamatória foi mais frequente em pacientes do sexo masculino, em incisivos superiores, em dentes com rizogênese completa e nas lesões de menor gravidade nos tecidos dentários e de sustentação. Ainda, as lesões nos tecidos de sustentação, quando não combinadas às fraturas dentárias, apresentaram maior frequência de reabsorção. O tempo inicial para o aparecimento da patologia foi dentro dos primeiros trinta dias após o trauma. Conclusão: é importante diagnosticar detalhadamente os traumas nos tecidos dentários, a fim de verificar o comprometimento dos tecidos de sustentação, devendo a proservação desses casos ser sistemática e contínua para interceptar a reabsorção radicular.

Objective: inflammatory root resorption is one of the consequences of dental trauma so its early detection and treatment are crucial in limiting their damage. Thus, this study aimed to investigate the prevalence of inflammatory root resorption in traumatized permanent anterior teeth, relating it to the different types of trauma in support and dental tissues. Subjects and method: data concerning inflammatory resorption were collected from 111 teeth, in medical records of 74 patients of a dental trauma care in UFPel’s Dentistry School, from 2005 to 2011. Gender and age of patients, teeth involved in the trauma, presence or absence of full rooting, and the initial time of root resorption emergence were also registered. Data assessment was performed by descriptive statistics and chi-square test with Yate’s correction, at significance level of 5%. Results: inflammatory root resorption was most frequent in male patients, in upper incisors, in teeth with complete root formation, and in minor injuries of dental and support tissues. Also, the supporting tissues injury presented higher resorption frequency when not combined with dental fractures. The starting time for pathology emergence was within the first thirty days after the trauma. Conclusion: it is important to thoroughly diagnose the trauma in dental tissues to verify the impairment of support tissues, since the proservation of these cases should be systematic and continuous to intercept root resorption.

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Among injuries that affect permanent teeth, the most prevalent is an uncomplicated crown fracture. Currently, autogenous bonding of the fragments is still the procedure of choice to restore fractured anterior teeth if the fragments are recovered by the patient and taken to a dental office within a reasonable time in an appropriate storage medium. There is no study or case report in the literature regarding autogenous bonding of lower incisors. This study presents a case with a 17-year follow-up for a 9-year-old patient who underwent uncomplicated crown fractures of the permanent mandibular central incisors and was treated by autogenous bonding of the tooth fragments. After 17 years, clinical and radiographic dental elements present vitality, and the restorations remain without major cosmetic changes. This case shows that autogenous bonding can be considered as a treatment option in the management of fractured lower incisors.

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AIM: To assess clinical characteristics and other factors associated with the occurrence of pulp polyp in traumatized primary teeth as well to evaluate the impact of pulp polyp occurrence on clinical decision-making after traumatic injuries. MATERIAL AND METHODS: This study was divided into three phases. First, occurrence and clinical characteristics of pulp polyp were assessed followed by a descriptive analysis and categorical tests of association. Secondly, a case-control design was used, and the occurrence of pulp polyp was set as the outcome. In third phase, the occurrence of pulp polyp after fracture with pulp exposure was investigated as a variable possibly associated with clinical decision-making (dental extraction/endodontic treatment). Logistic regression analyses were used, and odds ratios and 95% confidence interval (OR; 95% CI) were calculated in second and third phases. RESULTS: Occurrence of pulp polyp in traumatized primary teeth was of 2.3%. Hyperplastic tissue color and proliferation size were not associated with the time to seek treatment after injury (P > 0.05). Children up to 2 years of age had more chance of having pulp polyp in comparison with older children (3.15; 1.15-8.64). Teeth with crown-root fracture had more chance of dental extraction in the therapeutic approach than the teeth with only crown fracture (4.36; 1.10-17.32). Presence of pulp polyp was not associated with the treatment carried out. CONCLUSIONS: Occurrence of pulp polyp in traumatized primary teeth is not frequent and is associated with the age when traumatic dental injury occurs but does not interfere directly with the therapeutic approach.

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In cases of trauma, dental fragments occasionally penetrate into the soft-tissues and may cause severe complications, if neglected. Clinical and radiographic examinations can provide a diagnosis and help in the surgical removal of any dental fragment embedded in soft-tissue. This case report concerns an 8-year-old boy who was diagnosed with a fragment of a fractured permanent central incisor crown located in the lower lip. The patient was seen initially at a general hospital, where the dental fragment went unnoticed. After 2 days, the patient was seen at the pediatric dentistry clinic, where a fragment embedded in the lower lip, causing a large swelling, was diagnosed. The fragment was removed surgically and bonded to the fractured tooth. A mouth guard was prescribed for sports. The importance of soft-tissue exploration even post-trauma was highlighted in this paper.

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OBJECTIVE: To describe the treatment of two patients who had horizontal crown fractured maxillary incisors a few years after endodontic treatment. METHOD: The 23 and 19-year-old male patients presented to Atatürk University Dentistry Faculty with complex crown fractures. The treatment includeda glass fiber reinforced root canal post, a fiber ribbon core and restoration with a universal resin composite. RESULTS AND CONCLUSION: The one-year follow-up examinations showed thatthe restorations were still in place and successful.

OBJETIVO: Descrever o tratamento de dois pacientes com fraturas horizontais de coroas de incisivos superiores, alguns anos após tratamento endodôntico. MÉTODO: Os pacientes, ambos do sexo masculino, com 23 e 19 anos de idade, apresentaram-se na Faculdade de Odontologia da Universidade Ataturk com fraturas coronárias complexas de incisivos superiores. O tratamento consistiu de utilização de pinos intracanais reforçados com fibra de vidro, tiras de fibra de vidro e restauração com uma resina composta universal. RESULTADOS E CONCLUSÃO: Oacompanhamento do paciente por um ano mostrou o sucesso do tratamento.

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Los traumatismos dentales son la segunda causa de atención odontopediátrica tras la caries dental y dentro de ellos, la fracturas no complicadas son las que más frecuentemente se presentan. Esta investigación se desarrolló en Clínica Estomatológica Docente "Antonio Briones Montoto" del municipio Pinar del Río, en el periodo enero 2006 - noviembre 2007. Para ello se examinó una muestra de 40 pacientes divididos en dos grupos, un grupo control y uno estudio que se trataran convencionalmente y con terapia láser respectivamente. Esta muestra se seleccionó entre los pacientes que asistieron a consulta de urgencias, con el diagnóstico de fractura no complicada de corona y cumplían con los criterios de inclusión. Los datos fueron recogidos en tablas y tabulados por el método estadístico Chi cuadrado con un nivel de significación previamente fijado á= 0.05; esta investigación clasificó como un estudio de tipo experimental, aleatorio, longitudinal y prospectivo. Se encontró que a los 3 días de tratamiento el mayor porciento de pacientes tratados con láser presentaba alivio y remisión del dolor. El número de complicaciones al año evolución fue mucho menor en los pacientes tratados con láser que en los pacientes tratados convencionalmente.

Dental traumas are the second cause of odonto-paedriatic assistance after dental caries and among them the non-complicated fractures are the most frequent. This research was conducted at "Antonio Briones Montoto" Dental University Clinic in Pinar del Rio Municipality, during January 2006-November 2007. To carry it out a sample of 40 patients was taken dividing them into two groups, a control group and a study group, treating them with the conventional and laser therapies respectively. This sample was chosen among patients attending to emergency room having the diagnosis of non-complicated fracture of the dental crown and presenting the characteristics to be included. Data were collected in tables and tabulated using the statistical method of chi-squared with a level of significance previously fixed á=0.05, this research classified as an experimental, randomized, longitudinal and prospective study, finding in three days of treatment that the great percent of patients treated with laser presented relief and pain remission. Te number of complications at one-year evolution was minor in patients treated with laser than in those patients treated conventionally.