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Abstract This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p <0.05) in the extra-alveolar time (< one hour), but without difference between the guidelines in late replantation (p > 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket.

Resumo Este estudo teve como objetivo comparar a sobrevida, por cinco anos, de dentes reimplantados que seguiram as diretrizes de 2012 ou 2020 da International Association of Dental Traumatology (IADT). Sessenta e dois dentes permanentes reimplantados foram avaliados retrospectivamente (IADT 2012, n = 45; IADT 2020, n = 17). Cinco anos após o reimplante, foram realizados exames clínicos e radiográficos. Foi considerado um nível de significância de 95% para avaliar os desfechos. Trinta e um dentes (50,0%) permaneceram em seus alvéolos e 31 (50,0%) foram perdidos por reabsorção radicular externa. Dos 25 (40,3%) dentes reimplantados em uma hora, 16 (64,0%) permaneceram em seus alvéolos e 9 (36,0%) foram perdidos. Vinte e dois (71,0%) de todos os 31 dentes perdidos tiveram um tempo extra-alveolar superior a uma hora. Doze dentes permaneceram em seus alvéolos sem reabsorção: 8 (66,7%) foram reimplantados em uma hora, 2 (16,7%) seguiram a IADT de 2012 e 2 (16,7%) as diretrizes da IADT de 2020 para reimplante tardio. Houve diferença significativa (p<0,05) no tempo extra-alveolar (< uma hora), mas sem diferença entre as diretrizes no reimplante tardio (p > 0,05). Dentes reimplantados seguindo as diretrizes de 2012 ou 2020 da IADT, tiveram taxas de sucesso semelhantes. O tempo extra-alveolar inferior a uma hora demonstrou ser importante para manter o dente permanente em seu alvéolo.

RESUMO

Resumen Introducción: Los traumatismos dentoalveolares (TDA) son eventos que ocurren frecuentemente, llegando a comprometer órganos dentarios, sus tejidos de soporte, los maxilares y los tejidos blandos de la cara. Las estadísticas revelan cifras significativas en cuanto a la incidencia y prevalencia de estos accidentes, por lo que son considerados como un problema de salud pública global. Objetivo: Determinar la prevalencia de trauma dentoalveolar (TDA) en la parroquia urbana Hermano Miguel del cantón Cuenca- Ecuador en el año 2019. Materiales y Métodos: La investigación forma parte del proyecto "Macro estudio epidemiológico del trauma dentoalveolar en niños, adolescentes y adultos, del Cantón Cuenca, 2019" de la Universidad Católica de Cuenca. El diseño de investigación fue descriptivo/analítico y retrospectivo. Se utilizó un cuestionario validado por expertos, obteniendo información de 320 personas en 78 viviendas de entre 2 y 11 habitantes (M=4; DE=2) en 11 cuadras escogidas de forma aleatoria. Resultados: La prevalencia de trauma en la muestra fue del 8.1% (n=26); en el 28.2% (n=22) de viviendas visitadas se registraron una (23.1%) o dos (5.1%) personas con golpes en los dientes. Conclusión: El traumatismo dentoalveolar, por la frecuencia con que se presenta, se considera una urgencia odontológica de suma importancia para mantener en boca la pieza dentaria afectada y los tejidos involucrados; se considera que la arcada superior recibe más traumatismos y las causas más frecuentes suelen ser las caídas.

Abstract Introduction: Dentoalveolar trauma (DTA) are events that occur frequently, compromising dental organs, their supporting tissues, the jaws and the soft tissues of the face. Statistics reveal significant figures regarding the incidence and prevalence of these accidents, which is why they are considered a global public health problem. Objective: To determine the prevalence of Dentoalveolar Trauma (TDA) in the urban parish of Hermano Miguel in the canton of Cuenca- Ecuador in 2019. Materials and Methods: The research is part of the "Macro epidemiological study of dentoalveolar trauma in children, adolescents and adults in Cuenca Canton, 2019" of the Catholic University of Cuenca. The research design is descriptive/analytical and retrospective. A questionnaire validated by experts was used, obtaining information from 320 people in 78 dwellings of between 2 and 11 inhabitants (M=4; SD=2) from 11 randomly selected blocks. Results: The prevalence of trauma in the sample was 8.1% (n=26); in 28.2% (n=22) of the dwellings visited, one (23.1%) or two (5.1%) persons were recorded with blows to the teeth. Conclusion: Dentoalveolar trauma, due to the frequency with which it occurs, is considered a dental emergency of utmost importance to keep the affected tooth and the tissues involved in the mouth; it is considered that the upper arch received more trauma and the most frequent causes were falls.

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BACKGROUND/AIM: An adequate storage medium can help preserve the viability of periodontal ligament cells, favoring the periodontal ligament repair process. The aim of this study was to evaluate the repair process following the delayed replantation of teeth stored in soy milk and whole milk. MATERIAL AND METHODS: The maxillary right incisors of 27 rats were divided into three equally sized groups: Group SM (delayed replantation with storage in soy milk), whose teeth were immersed in 50 mL of soy milk for 60 minutes; Group WM (delayed replantation with whole milk), teeth were kept for 60 minutes in 50 mL of whole milk; and Group D (delayed replantation with dry storage), teeth were kept in dry conditions for the same period (negative control). Next, the teeth of the animals of all groups were replanted into their sockets. Systemic antibiotics were given to all the animals, and then, they were euthanized after 60 days. Sections were obtained and stained with hematoxylin and eosin for histomorphometric study. The presence and location of acute and chronic inflammatory processes in the epithelial insertion of the protective and insertion periodontium were evaluated, as well as the presence, extension, depth, and repair of root resorption, and the resorption and ankylosis with bone. Statistical differences between groups were analyzed using the Dunn test. RESULTS: Groups SM and WM showed similar patterns in the repair of the periodontal ligament following delayed replantation, in relation to the inflammatory process in the proximities of the epithelial insertion, inflammation and organization of the periodontal ligament, plus root and bone resorption. However, in group WM, more ankylosis was observed than in group SM. CONCLUSION: The teeth stored in soy milk and whole milk had similar periodontal repair, which shows the potential of soy milk as a storage medium before tooth replantation.

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Quando o reimplante imediato não é possível, os meios de conservação têm papel fundamental para a manutenção da integridade do ligamento periodontal do dente avulsionado, para que um tratamento adequado seja alcançado. A clara do ovo apresentou resultados favoráveis para esse fim e a albumina constitui seu principal componente. Assim o propósito desse estudo foi analisar se a albumina pasteurizada em pó possui o mesmo potencial que a sua forma natural, como meio de conservação. Para isso foram utilizados 40 ratos divididos em 4 grupos de 10 animais. Após a extração do incisivo superior direito, os dentes do grupo IM foram reimplantados em seus respectivos alvéolos após 5 minutos (controle positivo grupo AP os dentes serão imersos em 40 ml de clara de ); No ovo pasteurizada em pó, reconstituída em água (10 gramas de pó em 30ml de água); No grupo CO dentes foram imersos em 40 ml de clara de ovo in natura; No grupo SE - os dentes serão mantidos em meio seco (controle negativo ). Com exceção do grupo IM, os demais dentes foram mantidos em seus respectivos meios por 60 minutos em temperatura ambiente para serem então reimplantados em seus respectivos alvéolos. Os animais receberam em dose única, antibiótico e analgésico. Na análise histológica da inserção epitelial e ligamento periodontal, foram consideradas a ocorrência de inflamação e a localização. Na superfície radicular foi analisada a ocorrência de reabsorção inflamatória, reabsorção por substituição, total de reabsorção, áreas reparadas por ligamento periodontal, anquilose. Os dados foram submetidos à análise estatística a um nível de significância de 5%. Os resultados demonstraram que a intensidade da inflamação aguda no tecido conjuntivo da inserção epitelial, foi maior no grupo SE em relação ao grupo IM. O grupo SE foi o mais comprometido que os demais grupos em relação à reabsorção total, reabsorção inflamatória e reabsorção por substituição. O grupo SE apresentou a menor extensão de ligamento periodontal que os demais grupos. Para o ligamento periodontal reinserido, o grupo SE apresentou menor extensão do que os grupo IM e AP. Pode-se concluir que a albumina em pó apresentou resultado histológico semelhante ao da clara de ovo in natura e do reimplante imediato, constituindo uma opção como meio de conservação de dentes avulsionados(AU)

When immediate replantation is not possible, preservatives play a fundamental role in maintaining the integrity of the periodontal ligament of the avulsed tooth so that proper treatment is achieved. Egg white showed favorable results for this purpose and a lbumin is its main component. Thus the purpose of this study was to analyze whether pasteurized albumin powder has the same potential as its natural form as a preservative medium. Forty rats were divided into 4 groups of 10 animals. After extraction of the right upper incisor, the teeth of the IM group were reimplanted in their respective alveoli after 5 minutes ( group AP positive control); In the teeth will be immersed in 40 ml of pasteurized egg white powder, reconstituted in water (10 grams of powder i n 30ml of water); In group CO were immersed in 40 ml of fresh egg white; In the SE group -- the teeth the teeth will be kept in a dry environment ( negative control). With the exception of the IM group, the remaining teeth were kept in their respective mea ns for 60 minutes at room temperature and then reimplanted in their respective alveoli. The animals received a single dose, antibiotic and analgesic. Histological analysis of epithelial insertion and periodontal ligament considered the occurrence of inflam mation and location. The root surface was analyzed for inflammatory resorption, replacement resorption, total resorption, areas repaired by periodontal ligament, ankylosis. Data were subjected to statistical analysis at a significance level of 5%. The resu lts showed that the intensity of acute inflammation in the connective tissue of the epithelial insertion was higher in the SE group than in the IM group. The SE group was the most compromised than the other groups in terms of total resorption, inflammatory resorption and replacement resorption. The SE group had the smallest periodontal ligament extension than the other groups. For the reinserted periodontal ligament, the SE group presented smaller extension than the IM and AP groups. It can be concluded tha t albumin powder presented histological results similar to that of fresh egg white and immediate replantation, constituting an option as a means of preserving avulsed teeth(AU)

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Objetivo: avaliar o efeito da educação continuada na aquisição e consolidação de conhecimento sobre avulsão dentária dos Orientadores Educacionais do Ensino Fundamental de escolas públicas do município de Maringá-PR, em relação aos corretos procedimentos a serem adotados imediatamente após a ocorrência de uma avulsão dentária. Material e Métodos: Trata-se de um estudo de campo, descritivo-exploratório, de abordagem quantitativa desenvolvido com os Orientadores Educacionais do Ensino Fundamental da rede pública do Município de Maringá, PR. Consideraram-se dois grupos de profissionais entrevistados: submetido à intervenção oral e visual e submetido à intervenção oral e visual, reforçada por outros meios visuais, e o grupo controle, anterior à intervenção. Aplicou-se um questionário dividido em três partes: dados demográficos, conhecimento/domínio sobre traumatismos dentários em geral e a avulsão, em especial, sendo a terceira o conhecimento/domínio sobre as atitudes a serem adotadas em relação ao manejo imediato dos dentes avulsionados .No questionário,utilizou-se uma escala indireta para medir as atitudes dos participantes, a escala de Likert e para interpretação das respostas aplicou-se uma escala de escores de 0 a 4. A intervenção propriamente dita foi a instituição de um Programa de Educação Continuada para capacitação dos envolvidos. A consistência interna do instrumento foi medida por meio do coeficiente Alfa de Cronbach. Para medir a diferença entre os escores atribuídos, utilizou-se o teste de Kruskal-Wallis, seguido do teste de comparações múltiplas de Dunn. Resultados: Foram observadas diferenças estatisticamente significativas para ambos os domínios, Conhecimento e Atitude, quando se comparou o conhecimento prévio e após a realização da capacitação, seja por meio da comunicação oral e visual ou quando houve reforço visual. No entanto, não houve diferenças entre o conhecimento adquirido entre esses dois grupos. Conclusão: A educação continuada, por meio da comunicação oral e visual foi eficaz na aquisição e consolidação de conhecimento dos Orientadores Educacionais do Ensino Fundamental de escolas públicas do município de Maringá-PR sobre avulsão dentária e os corretos procedimentos a serem adotados imediatamente após a sua ocorrência(AU)

Aim: To evaluate the effect of continuing education on the acquisition and consolidation of knowledge about dental avulsion of Primary School Education Mentors of public schools in the city of Maringá-PR, in relation to the correct procedures to be adopted immediately after the occurrence of a dental avulsion. Materials and methods: This is a field-based, descriptive-exploratory, quantitative approach developed with the Educational Mentors of Elementary School of the public network of the city of Maringá, PR. Two groups of professionals were interviewed: submitted to oral and visual intervention; and submitted to oral and visual intervention, reinforced by other visual means, and the control group, prior to the intervention. A questionnaire was applied divided into three parts: demographic data, knowledge / domain on dental trauma in general, and avulsion in particular; and the third, knowledge / domain about the attitudes to be adopted in relation to the immediate management of avulsed teeth. In the questionnaire, an indirect scale was used to measure the participants' attitudes, the Likert scale and for the interpretation of the answers a score scale of 0 to 4 was used. The intervention it self was the institution of a Continuing Education Program to empower those involved. The internal consistency of the instrument was measured by Cronbach's alpha coefficient. To measure the difference between the assigned scores, the KruskalWallis test was used, followed by Dunn's multiple comparison test. Results: Statistically significant differences were observed for both domains, Knowledge and Attitude, when comparing the previous knowledge and after the realization of the training, either through oral and visual communication or when there was visual reinforcement. However, there was no difference between the knowledge acquired between these two groups Conclusion: Continuing education through oral and visual communication was effective in acquiring and consolidating the knowledge of Primary School Education Advisors of public schools in the municipality of Maringá-PR on dental avulsion and the correct procedures to be adopted immediately after its occurrence(AU)

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BACKGROUND/AIMS: Dental root cell proliferation following tooth avulsion has not been well researched. Understanding the effects of dry time and dentin treatment influences on cell proliferation is essential to provide evidence-based guidelines for tooth replantation. The study evaluated the viability of periodontal ligament fibroblasts (PLF) in contact with roots, submitted to surface treatments with ethylenediaminetetraacetic acid (EDTA) and hyaluronic acid (HA) at different times, including to quantify inflammatory cytokines interleukin (IL)-6, IL-8, IL-1ß and TNF-α expressed by PLF. The adhesion of fibroblasts to treated root surfaces was also evaluated. MATERIAL AND METHODS: One hundred and eight cementum discs from bovine teeth were randomly divided into groups according to time periods of being dry (n = 12) as follows: (i) fresh discs that were not kept dry, (WD); (ii) dry for 1 hour (1 hd); and (iii) dry for 24 hours (24 hd). The discs were subdivided into 3 subgroups (n = 12) according to surface treatments: (iv) no treatment, (v) treatment with EDTA, (vi) treatment with HA. The discs were placed in 96-well plates, and PLF were seeded and kept in contact with the discs for 48 hours. Cell viability on the surface of the discs was assessed by XTT, and PLF adhesion was evaluated using scanning electron microscopy (SEM). Quantification of cytokines was performed using enzyme-linked immunosorbent assay (ELISA). Data were submitted to ANOVA and Tukey's test (α = .05). RESULTS: Surface treatment had a statistically significant effect on the cell viability in groups WD (P = .03), 1 hd (P = .01) and 24 hd (P = .048). PLF in contact with dried root surfaces expressed more cytokines without treatment with IL-6 decreasing the expression when treated with HA for 24 hours. SEM also showed adhesion of PLF to the surface of all discs at all time periods. CONCLUSION: EDTA + HA is an alternative treatment for cases of avulsed teeth as it promoted adhesion and increased viability of PLF.

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INTRODUCTION: Sports' practitioners are vulnerable to dental trauma; if this occurs, the emergency treatment should be fast and efficient. This may be performed by any person at the site of the accident, not only by dental professionals. Physical educators may face dental trauma and should be able to provide proper care. This study had the objective evaluated the knowledge of physical education graduates on dental trauma. MATERIALS AND METHODS: A questionnaire containing questions on dental trauma was applied to 199 physical education students; after collection of the questionnaires, data were tabulated and processed on the software Epi Info 2000 (Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA). As a result, only 36.7% of participants would take the individual suffering trauma to the dental professional, 56.8% believe that the avulsed tooth should be replanted, and 42.2% would replant it. Only 7.5% would store the avulsed tooth in an ideal storage medium for transportation. CONCLUSION: It was concluded that there is a lack of knowledge on dental trauma among physical education graduates, evidencing the need of public policies to allow education on this issue.

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Introducción: Los traumatismos dentoalveolares (TDA) son eventos que ocurren frecuentemente, llegando a comprometer órganos dentarios, sus tejidos de soporte, los maxilares y los tejidos blandos de la cara. Las estadísticas revelan cifras significativas en cuanto a la incidencia y prevalencia de estos accidentes, por lo que son considerados como un problema de salud pública global. Objetivo: Determinar la prevalencia de trauma dentoalveolar (TDA) en la parroquia urbana Hermano Miguel del cantón Cuenca- Ecuador en el año 2019. Materiales y Métodos: La investigación forma parte del proyecto "Macro estudio epidemiológico del trauma dentoalveolar en niños, adolescentes y adultos, del Cantón Cuenca, 2019" de la Universidad Católica de Cuenca. El diseño de investigación fue descriptivo/analítico y retrospectivo. Se utilizó un cuestionario validado por expertos, obteniendo información de 320 personas en 78 viviendas de entre 2 y 11 habitantes (M=4; DE=2) en 11 cuadras escogidas de forma aleatoria. Resultados: La prevalencia de trauma en la muestra fue del 8.1% (n=26); en el 28.2% (n=22) de viviendas visitadas se registraron una (23.1%) o dos (5.1%) personas con golpes en los dientes. Conclusión: El traumatismo dentoalveolar, por la frecuencia con que se presenta, se considera una urgencia odontológica de suma importancia para mantener en boca la pieza dentaria afectada y los tejidos involucrados; se considera que la arcada superior recibe más traumatismos y las causas más frecuentes suelen ser las caídas.

Introduction: Dentoalveolar trauma (DTA) are events that occur frequently, compromising dental organs, their supporting tissues, the jaws and the soft tissues of the face. Statistics reveal significant figures regarding the incidence and prevalence of these accidents, which is why they are considered a global public health problem. Objective: To determine the prevalence of Dentoalveolar Trauma (TDA) in the urban parish of Hermano Miguel in the canton of Cuenca- Ecuador in 2019. Materials and Methods: The research is part of the "Macro epidemiological study of dentoalveolar trauma in children, adolescents and adults in Cuenca Canton, 2019" of the Catholic University of Cuenca. The research design is descriptive/analytical and retrospective. A questionnaire validated by experts was used, obtaining information from 320 people in 78 dwellings of between 2 and 11 inhabitants (M=4; SD=2) from 11 randomly selected blocks. Results: The prevalence of trauma in the sample was 8.1% (n=26); in 28.2% (n=22) of the dwellings visited, one (23.1%) or two (5.1%) persons were recorded with blows to the teeth. Conclusion: Dentoalveolar trauma, due to the frequency with which it occurs, is considered a dental emergency of utmost importance to keep the affected tooth and the tissues involved in the mouth; it is considered that the upper arch received more trauma and the most frequent causes were falls.

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Objetivo ­ Avaliar o conhecimento dos estudantes de graduação em Educação Física do Centro Universitário Doutor Leão Sampaio (UnilLeão), Juazeiro do Norte-CE sobre o atendimento emergencial ao trauma dental. Métodos ­ Foi realizada uma pesquisa transversal junto aos estudantes de graduação de Educação Física, mediante aplicação de um questionário, contendo perguntas sobre idade, gênero, conhecimento sobre primeiros socorros ao traumatismo dental e simulação de casos clínicos de fratura coronária e avulsão e reimplante. Resultados ­ Participaram 120 estudantes, sendo 62% homens e 38% mulheres, dos quais 86% responderam que o tratamento deve ser imediato, 56% reimplantariam o dente no alvéolo, apenas 44% sabiam o que era reimplante dental. Em relação ao acondicionamento do dente, 36% o manteriam em água, 29% em guardanapo, 14% soro fisiológico e 7,5% lavaria no leite. Dos participantes 39% afirmaram não saber o que fazer com o dente avulsionado coberto de sujeira, 20% o escovaria com escova de dente, e 17,5% lavaria em água corrente. Em relação à fratura coronária, 19% procuraria o pedaço do dente e o acondicionaria corretamente. Em relação ao reimplante dental 46% escolheram o reimplante imediato. Conclusão ­ Verificou-se um conhecimento insuficiente sobre o manuseio dos dentes traumatizados, indicando a necessidade de promover campanhas educativas além da inclusão deste tema durante a formação dos profissionais.

Objective ­ To assess the knowledge of Physical Education students of the Centro Universitário Doutor Leão Sampaio (UniLeão), Juazeiro do Norte-CE on emergency care to dental trauma. Methods ­ A cross-sectional survey was conducted among students, by applying a questionnaire containing questions about age, gender, knowledge of first aid to dental trauma and simulation of clinical cases of coronary fracture and avulsion and replantation. Results ­ Participants were 120 students, 62% men and 38% women, of which 86% responded that treatment should be immediately, 56% reimplant the tooth in the dental alveolus, only 44% knew about the technique to dental reimplant. Regarding the preparation of the tooth, 36% responded put on water, 29% put on napkin, 14% put on the saline solution and 7.5% put on milk. Of the participants 39% said they did not know what to do with the tooth avulsed covered in dirt, 20% would use the toothbrush, and 17,5% would use the wash in running water. Regarding coronary fracture, 19% seek for the piece of tooth and kept it properly. Regarding to dental reimplant, 46% chose the immediate reimplantation. Conclusions ­ There was insufficient knowledge about the handling of traumatized teeth, indicating the need to promote educational campaigns and training of professionals about this issue.

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Introduction : Dental trauma care emergency is very important issue, especially in cases of avulsion and it is crucial for the prognosis. A preventive-educational approach had not been effective and there are many failures in handling dental trauma, mainly by lack of knowledge by health professionals, teachers and lay people. Objective: The aim of this study was to assess the knowledge of 89 teachers about dental trauma. Material and methods: A questionnaire divided into three parts containing questions about the emergency procedures in cases of dental trauma was applied. Results: Only 13% of teachers would replant the tooth in the socket, and only 7% said they would put the tooth in some liquid and 58% would store in a piece of paper, cloth or clean container. In relation to replantation, 75% reported that they would hold the tooth by the crown, 79% reported that first they would refer to the dentist, and 80% thought that the treatment had to be immediate. With regard to tooth preparation, 46% would keep it in saline, 24% in water, and only 11% in milk. Concerning to the avulsed tooth, only 15% correctly answered that they would replant the avulsed tooth and then referred to the dentist. Conclusion: It was concluded that the knowledge of teachers must be improved by educational and preventive campaigns on management of traumatized teeth.