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  • 1.
    Albertsson, Josefin
    et al.
    Malmö University, Faculty of Odontology (OD).
    Lauridsen, Eva
    University Hospital, Copenhagen, Denmark.
    Andreasen, Jens O.
    University Hospital, Copenhagen, Denmark.
    Gerds, Thomas A.
    University of Copenhagen, Denmark.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    The risks of ankylosis of 89 avulsed human teeth stored in saliva prior to replantation-A re-evaluation of a long-term clinical study2021In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 37, no 4, p. 537-545Article in journal (Refereed)
    Abstract [en]

    Background/Aim: The survival of an avulsed tooth highly depends on the emergency management. The aim of this study was to evaluate the risk of ankylosis for avulsed human teeth stored in saliva preceded by various dry storage conditions prior to replantation. Material and methods: Data include 74 patients (54 male and 20 female) with 89 avulsed and replanted teeth (16 immature teeth, 73 mature teeth). Patient ages ranged from 6 to 36 years (median: 13.0 years). All teeth were stored in saliva before replantation. Treatment and follow-up were performed according to a standardized procedure. Follow-up periods ranged from 7 months to 20 years (mean 5.3 years). The risk of ankylosis over time was estimated by the Aalen-Johansen method in relation to the length of dry storage and the stage of root development. The effect of risk factors (root development and length of dry time) on the risk of ankylosis was analysed by Cox regression analysis. Results: For mature teeth, dry storage for 5 min or less before saliva storage resulted in a 47.4% (95% confidence interval (CI): 32.8-60.7) ankylosis rate. When dry storage was >5 min and <20 min, the risk of ankylosis was 76.8% (95% CI: 45.7-91.5). When dry storage exceeded 20 min prior to saliva storage, ankylosis increased to 89.3% (95% CI: 68.0-96.7). Ankylosis also increased with increasing saliva storage time. Specifically, one additional minute of wet time increased the ankylosis hazard rate (HR) by approximately 1% (CI = [0%, 2%], p = .052). Teeth with mature root development were significantly more frequently affected by ankylosis than teeth with immature root development (HR: 2.4 (95% CI: 1.0-5.5), p = .04). Conclusion: Temporary storage in saliva should be encouraged if an avulsed permanent tooth cannot be immediately replanted or a suitable storage medium such as milk or saline is not immediately available at the place of the accident.

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  • 2.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Andreasen, Jens Ove
    Copenhagen Univ Hosp, Oral & Maxillofacial Surg, Copenhagen, Denmark..
    Dr Ulf Glendor has left us at age 71 OBITUARY2020In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 36, no 3, p. 217-217Article in journal (Other academic)
  • 3.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bakland, Leif K
    Loma Linda University, Loma Linda, CA, USA.
    Heithersay, Geoffrey S
    The University of Adelaide, Adelaide, SA, Australia.
    Lauridsen, Eva
    University Hospital Copenhagen, Copenhagen, Denmark.
    Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology.2021In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 37, no 1, p. 4-16Article in journal (Refereed)
    Abstract [en]

    The life and professional contributions to dental traumatology of Dr. Jens Ove Andreasen are described in terms of his research, writing, teaching, and leadership.

  • 4. Cvek, Miomir
    et al.
    Mejàre, Ingegerd
    Malmö högskola, Faculty of Odontology (OD).
    Andreasen, Jens Ove
    Conservative Endodontic Treatment of Teeth Fractured in the Middle or Apical Part of the Root2004In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 20, no 5, p. 261-269Article in journal (Other academic)
    Abstract [en]

    According to treatment type, root-fractured teeth with pulp necrosis or exposed pulps were divided into five groups, group 1: 17 teeth in which the root canal of the coronal fragment only was filled with gutta-percha (GP); group 2: seven teeth in which the root canals of the coronal and apical fragments were both filled with GP; group 3: 19 teeth in which the coronal fragment was filled with GP and the apical fragment was surgically removed; group 4: 68 teeth where the root canal of the coronal fragment was treated with calcium hydroxide and subsequently filled with GP; and group 5: five vital teeth with root and concomitant crown fractures in which the exposed pulps were treated by partial pulpotomy. The frequency of periodontal healing was 76% in group 1, zero in group 2, 68% in group 3 and 86% in group 4. Compared with groups 1 and 2 combined, healing in group 4 was significantly more frequent. In groups 1, 2 and 4, failures occurred sig-nificantly more often in teeth showing overfilling, i.e. protrusion of GP into the space between the fragments, compared with teeth without overfilling. All five teeth in group 5 showed healing. It was concluded that root canal filling with GP of the coronal fragment only, with or without surgical removal of the apical fragment, can be successful in selected cases. Treatment of the root canal with calcium hydroxide followed by GP filling appears to be the treatment of choice in root-fractured non-vital teeth. Partial pulpotomy of exposed pulps in five teeth showed results similar to root-unfractured teeth with pulp exposure treated with this technique.

  • 5.
    Eden, Ece
    et al.
    Department of Pedodontics, School of Dentistry, Ege University, İzmir, Turkey;.
    Baysal, Mehmet
    School of Dentistry, Ege University, Izmir, Turkey.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Eden Baysal Dental Trauma Index: Face and content validation2020In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 36, no 2, p. 117-123Article in journal (Refereed)
    Abstract [en]

    Recording of traumatic dental injuries in the emergency situation with a simple and easily recordable index that will also enable computer registration is advantageous. The aim of this paper is to present a new index to facilitate recording traumatic dental injuries and assess its face and content validity. Materials and methods The index included information on the type of injury related to the affected structures (enamel, dentin, cement, pulp, periodontal ligament, and alveolar bone) in accordance with Andreasen's classification. In addition, injuries to the alveolar bone and the maturity of the root were included. Fifteen dental trauma experts from 11 different countries rated the codes and content of the “Eden Baysal Dental Trauma Index” using the RAND modified e‐Delphi consensus method. A statement was considered valid after reaching 75% consensus among panel members. Two rounds were necessary for reaching consensus on seven statements and the definition. The last version of the index was then presented online to a feedback group that included 10 experts from five countries to determine the external validity by representative cases. Results The wording of the definition showed 92.8% agreement in the first round. Statements 1 and 2 gave information about the structure of the index and both reached 90% agreement in the first round. Definition and statements from 1 to 7 reached agreement as 93.3%, 93.3%, 100%, 93.3%, 80%, 93.3%, 80%, and 93.3%, respectively, in the second round. Most of the experts in the feedback group reported that the index was useful and user‐friendly. Conclusion After a total of two rounds with the panel members and one round with the feedback group, the “Eden Baysal Dental Trauma Index” was approved for face and content validity and external validity was obtained.

  • 6.
    Gul, Abdulaziz
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia.
    Lauridsen, Eva
    Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark.
    Gerds, Thomas A
    Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation: A long-term clinical study2024In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 40, no 2, p. 137-143Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIM: There are few long-term clinical follow-up studies on human teeth replanted immediately or after storage in a suitable storage medium prior to replantation. This study aimed to assess the risk of ankylosis in avulsed human teeth replanted immediately or after storage in physiological media for a short time.

    MATERIAL: Data from 116 patients with 145 replanted avulsed permanent teeth were selected from a comprehensive dental trauma database in Copenhagen University Hospital. The following teeth were selected: Group 1 comprised 36 teeth replanted immediately (dry time <6 min; wet time <6 min). Group 2 comprised 61 teeth replanted after physiologic storage media (saliva and saline) (dry time <6 min; wet time >5 min; wet time ranged from 7 to 170 min, and mean wet time was 59 min). Group 3 (control) included 48 teeth replanted after dry storage (dry time > 60 min).

    METHOD: Clinical and radiographic registrations were carried out according to a standardized protocol; follow-up ranged from 7 months to 23 years. Ankylosis was diagnosed by percussion test and radiographs and related to the conditions prior to replantation and stage of root development.

    RESULTS: The overall risk of ankylosis was 17.2% [95% CI: 4.61; 29.79] for immediately replanted teeth, 55.3% [95% CI: 42.54; 68.00] for teeth stored in physiologic media before replantation, and 85.7% [95% CI: 75.70; 95.73] for teeth stored dry more than 1 h. Mature teeth showed a significantly higher risk of ankylosis than immature teeth.

    CONCLUSION: This clinical long-term study has verified earlier experimental studies showing that immediate reimplantation has the lowest risk of ankylosis. Physiologic storage media are good alternatives that also reduce the risk of ankylosis compared to dry storage, where ankylosis is more likely although not always seen. Mature teeth are significantly more likely to develop ankylosis.

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  • 7.
    Kenny, Kate P
    et al.
    Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK.
    Day, Peter F
    Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK.
    Sharif, Mohammad O
    Departments of Orthodontics, Eastman Dental Hospital and Croydon University Hospital, London, UK.
    Parashos, Peter
    Department of Restorative Dentistry, Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia.
    Lauridsen, Eva
    Resource Center for Rare Oral Disease, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark.
    Feldens, Carlos Alberto
    Department of Paediatric Dentistry, School of Dentistry, Universidade Luterna do Brasil, Porto Alegre, Brazil.
    Cohenca, Nestor
    Lakeside Endodontics, University of Washington and Seattle Children's, Seattle, WA, USA.
    Skapetis, Tony
    Faculty of Dentistry, Oral Health, Western Sydney LHD, University of Sydney, Sydney, NSW, Australia.
    Levin, Liran
    Division of Periodontology, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada.
    Kenny, David J
    Department of Dentistry, The Hospital for Sick Children and School of Graduate Studies, University of Toronto, Toronto, ON, Canada.
    Djemal, Serpil
    Department of Restorative Dentistry, King's College Dental Hospital, Denmark Hill, London, UK.
    Malmgren, Olle
    Orthodontic Clinic, Tandregleringen, Huddinge, Stockholm, Sweden.
    Chen, Yong-Jin
    State Key Laboratory of Military Stomatology, Department of General Dentistry and Emergency, School of Stomatology, The Fourth Military Medical University, Xian, China.
    Tsukisboshi, Misuhiro
    Tsukiboshi Dental Clinic, Aichi, Japan.
    Andersson, Lars
    Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait, Kuwait.
    What are the important outcomes in traumatic dental injuries? An international approach to the development of a core outcome set.2018In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 34, no 1, p. 4-11Article in journal (Refereed)
    Abstract [en]

    Background/Aims: There are numerous treatment options following traumatic dental injury (TDI). Systematic reviews of different treatments are challenging owing to the diversity of outcomes reported between clinical studies. This issue could be addressed through the development and implementation of a agreed and standardized collection of outcomes known as a core outcome set (COS). The aim of this study was to develop a COS for TDI in children and adults. The secondary aim was to establish what, how, when and by whom these outcomes should be measured. Materials and Method: The project was registered with Core Outcomes Measures in Effectiveness Trials (COMET). A web‐based survey was developed to capture the opinions of dentists globally as to which outcomes should be recorded. A list of outcomes was entered into a Delphi Survey and scored by an Expert Working Group (EWG). The scoring was repeated, followed by conference calls to discuss, refine and finalize the COS. The EWG split into small groups of subject‐specific experts to determine how, when and by whom each outcome would be measured. Results: The questionnaire was completed by 1476 dentists. The EWG identified 13 core outcomes to be recorded for all TDI's. An additional 10 injury‐specific outcomes were identified. A table has been produced for each outcome detailing what, when, and how each outcome should be recorded. Conclusions: A robust consensus process was used to develop an international COS for TDI in children and adults. This includes both generic and injury‐specific outcomes across all identified domains.

  • 8.
    Kevci, Mir
    et al.
    Malmö University, Faculty of Odontology (OD).
    Gerds, Thomas Alexander
    Univ Copenhagen, Dept Biostat, Copenhagen, Denmark..
    Lauridsen, Eva
    Copenhagen Univ Hosp, Resource Ctr Rare Oral Dis, Dept Oral & Maxillo Facial Surg, Copenhagen, Denmark.;Copenhagen Univ Hosp, Resource Ctr Rare Oral Dis, Dept Oral & Maxillo Facial Surg, Rigshosp, Copenhagen, Denmark..
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    The risk of healing complications in primary teeth with root fractures: A retrospective cohort study2023In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 39, no 5, p. 455-461Article in journal (Refereed)
    Abstract [en]

    Background/aim: Primary teeth are frequently affected by traumatic dental injuries. Root fractures are rare and have a reported incidence of 2% in the primary dentition. Hence, there is limited evidence on this topic. This study aims to evaluate the risk of healing complications in primary teeth with root fracture and to identify possible sequelae in the permanent dentition following root fracture in the primary dentition.

    Materials and methods: A retrospective analysis of a cohort of 53 patients with 74 root fractured primary teeth. The standard follow-up program included clinical and radiographic examination after 4 weeks, 8 weeks, 6 months, and 1 year after the trauma and when the patient was 6 years of age. The following complications were registered: pulp necrosis (PN), pulp canal obliteration (PCO), ankylosis with replacement root resorption (ARR), infection-related root resorption (IRR), premature tooth loss (PTL), and repair-related resorption (RRR).

    Statistics: The Kaplan-Meier and Aalen-Johansen estimators were employed. The level of significance was 5%.

    Results: A total of 74 teeth were included. 42 teeth were extracted at the initial examination. Risks estimated after 3 years: PTL 45.9% [95% CI: 28.8-63.0], PCO 12.9% [95% CI: 2.3-23.4], PN 14.9% [95% CI: 3.9-25.9], RRR 2.6% [95% CI: 0.0-7.5]. No teeth showed ARR or IRR. All complications were diagnosed within the first year. Most common sequelae in the permanent dentition was demarcated opacities, with an estimated risk of 20% [95% CI: 8.2-41.3].

    Conclusions: There is a low risk of healing complications following a root fracture in the primary dentition. Root fractures often result in early extraction of the coronal fragment. The remaining apical fragment will undergo a physiological resorption. Aside from opacities, there is a low risk of sequelae in the permanent dentition.

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  • 9.
    Kevci, Mir
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Oral and Maxillofacial Surgery Gävle County Hospital Gävle Sweden.
    Lauridsen, Eva
    Department of Oral and Maxillo‐Facial Surgery, Resource Centre for Rare Oral Diseases Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Risk of Healing Complications Following Alveolar Process Fractures in the Primary Dentition: A Retrospective Clinical Cohort Study2024In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657Article in journal (Refereed)
    Abstract [en]

    Background/aim: Alveolar bone process fractures in preschool children are not well documented in the literature. Alveolar process fractures are located very close to primary teeth and permanent tooth germs. This study investigates the risk of healing complications following alveolar process fractures in the primary dentition and potential sequelae in the permanent dentition.

    Materials and methods: A retrospective cohort study was conducted involving 21 patients with 49 primary teeth involved in an alveolar fracture. The follow-up protocol included clinical and radiographic examinations at specified intervals up to the age of 6 years. Healing complications in the primary teeth such as pulp necrosis, pulp canal obliteration, ankylosis, infection-related resorption and premature tooth loss were examined. Sequelae in the permanent dentition was also registered when the permanent incisors had erupted.

    Results: Over a 3-year follow-up, the incidence of premature tooth loss was 51.2% [95% CI: 34.1%-68.4%], pulp canal obliteration was 42.5% [95% CI: 27.1%-57.8%], and pulp necrosis was 8.9% [95% CI: 0.6%-17.3%] following an alveolar process fracture. No cases of ankylosis were observed. Sequelae in the permanent dentition primarily included demarcated opacities and hypoplasia with a risk estimated at 24% [95% CI: 13%-39%] and 9% [95% CI: 2%-21%] respectively.

    Conclusion: Alveolar process fractures in primary dentition are associated with several healing complications in the primary teeth. Although the likelihood of severe complications in the permanent dentition is low, young children are still susceptible to developing sequelae in their permanent teeth. These results highlight the importance of awareness of dental injuries following alveolar process bone fractures in the primary dentition.

  • 10.
    Lauridsen, Eva
    et al.
    Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark.
    Andreasen, Jens O
    Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark.
    Bouaziz, Oliver
    Laboratoire MAP5, Université Paris Descartes and CNRS, Sorbonne Paris Cité, France.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD). Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark.
    Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage: A re-evaluation of a long-term clinical study2020In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 36, no 2, p. 108-116Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIMS: Ankylosis and subsequent tooth loss is a serious complication following tooth avulsion and replantation. The aim of the study was to evaluate the risk of ankylosis of human teeth replanted after various periods of dry storage prior to replantation. The material originates from a previously reported clinical study of 400 replanted teeth. METHODS: Initial treatment, clinical and radiological examination and follow-up were conducted according to a standardized protocol. PDL was not removed. Follow-up periods ranged from 0.2 to 20 years (mean 5.1 years). The risk of ankylosis was analysed using the Cox regression model including stage of root development, length of dry time and age > 20 years. RESULTS: The risk of ankylosis significantly increased with increasing length of dry time (hazard ratio: 1.22, P = .002) and was significantly higher for teeth with mature root development than for teeth with immature root development (hazard ratio: 2.1 P < .0001). The estimated risks of ankylosis after 900 days for teeth with immature root development were: dry time < 20 minutes: 33.9% (95% confidence interval (CI): 25.4-42.7), dry time 20-40 minutes: 49.6% (95% CI: 37.5-64.8), dry time 40-60 minutes: 54.4% (95% CI: 37.1-71.3) and dry time > 60 minutes: 60.0% (95% CI: 45.0-75.8). The risks for teeth with mature root development were: dry time < 20 minutes: 59.4% (95% CI: 51.6-66.5), dry time 20-40 minutes: 78.3% (95% CI: 69.5-86.2), dry time 40-60 minutes: 81.9% (95% CI: 67.2-92.4) and dry time > 60 minutes: 86.4% (95% CI: 79.7; 92.9). CONCLUSION: The risk of ankylosis rose with increasing length of dry time. However, some teeth may heal without ankylosis even after 60 minutes of dry time. Immature teeth have a lower risk of developing ankylosis. Replantation should therefore always be considered for avulsed teeth.

  • 11.
    Maslamani, Manal
    et al.
    Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait.
    Joseph, Bobby
    Department of Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Kuwait, Kuwait.
    Gabato, Severino
    Kuwait Animal Resources Center - Health Sciences Center, Kuwait University, Kuwait, Kuwait.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Effect of periodontal ligament removal with gauze prior to delayed replantation in rabbit incisors on rate of replacement resorption2018In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 34, no 3, p. 182-187Article in journal (Refereed)
    Abstract [en]

    Background/AimDelayed (dry storage > 60minutes) replantation results in ankylosis and replacement resorption. It has been suggested to remove the non-viable periodontal ligament before replantation to possibly reduce the rate of replacement resorption. However there has been no study on the rate of replacement resorption after such measures. The aim of this study was to investigate if there was any difference in the rate of replacement resorption by either removing the periodontal ligament (PDL) with gauze or not removing PDL in teeth subjected to delayed replantation followed by healing for 2 or 6weeks. Materials and MethodsMaxillary central incisors were extracted in 8 rabbits. In the right central incisors, the necrotic PDL was removed by dry gauze over the root surface. In the left eight extracted teeth PDL was left on the root surface. All extracted teeth were left to dry for 60minutes. Extra-oral root canal treatment was performed before replantation. The rabbits were sacrificed after 2weeks and 6weeks respectively. Histologic processing and evaluation was done. ResultsIn the 2weeks group, all teeth showed ankylosis. The cementum was intact, and fusion of the bone and root was generally seen without resorption of the root, whereas in the 6weeks group regardless of whether PDL had been kept or not, ankylosis and osseous replacement of the dentin was seen. There was no evidence of inflammatory infiltrate in the sections examined. ConclusionRemoval of PDL prior to delayed replantation may result in some initial protection of the cementum during the first few weeks. However, over longer times there seems to be neither protection of the dentin from ankylosis and osseous replacement, nor any influence on the rate of replacement resorption.

  • 12. Mordenfeld, Arne
    et al.
    Hallman, Mats
    Lindskog, Sven
    Tissue reactions to subperiosteal onlays of demineralized xenogenous dentin blocks in rats.2011In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 27, no 6, p. 446-51Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study was undertaken to examine the influence of partial demineralization of xenogenous dentin on bone formation in an osteoconductive environment.

    MATERIALS AND METHODS: Sixty dentin blocks, 2-3 mm thick and 4 mm in diameter, were prepared from developing teeth of young pigs. Forty blocks were demineralized in 24% ethylenediaminetetraacetic acid (pH 7.0) for 1, 2, 6 or 12 h. Forty adult rats divided into eight groups with five rats in each group were used. A sagittal midcranial incision was made from the occipital to the frontal region. Through a subperiostal dissection, a pocket was created on each side of the skull. One demineralized block was placed on one side, and a non-demineralized block was placed on the contralateral side, or the pocket was left empty as controls. Thus, eight experimental groups with five rats in each were formed.

    RESULTS: Resorption increased significantly with increasing degree of demineralization while bone formation increased significantly with increasing degree of demineralization, provided inflammation was compensated for. This suggests an important role for inflammation or infection control during the healing period of osteogenic implants to optimize osseous integration in an osteoconductive environment.

    CONCLUSION: Partial demineralization of xenogenous dentin blocks may provide a method for optimizing the integration of dentin onlays in an osteoconductive environment, thus stabilizing the implant and slowing down replacement resorption.

  • 13.
    Petti, Stefano
    et al.
    Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
    Andreasen, Jens Ove
    Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
    Glendor, Ulf
    Malmö University, Faculty of Odontology (OD).
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    NA0D - The new Traumatic Dental Injury classification of the World Health Organization.2022In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 38, no 3, p. 170-174Article in journal (Refereed)
    Abstract [en]

    An accurate, clear, and easy-to-use traumatic dental injury (TDI) classification and definition system is a prerequisite for proper diagnosis, study, and treatment. However, more than 50 classifications have been used in the past. The ideal solution would be that TDIs are adequately classified within the International Classification of Diseases (ICD), endorsed by the World Health Organization (WHO). TDI classification provided by the 11th Revision of the ICD (ICD-11), released in 2018, and previous Revisions, failed to classify TDIs satisfactorily. Therefore, in December 2018, a proposal was submitted by Dr's Stefano Petti, Jens Ove Andreasen, Ulf Glendor, and Lars Andersson, to the ICD-11, asking for a change of the existing TDI classification. Proposal #2130 highlighted the TDI paradox, the fifth most frequent disease/condition neglected by most public health agencies in the world, and the limits of ICD-11 classification. Namely, injuries of teeth and periodontal tissues were located in two separate blocks that did not mention dental/periodontal tissues; infraction, concussion, and subluxation were not coded; most TDIs lacked description; and tooth fractures were described through bone fracture descriptions (e.g., comminuted, compression, and fissured fractures). These limitations led to TDI mis-reporting, under-reporting, and non-specific reporting by untrained non-dental healthcare providers. In addition, no scientific articles on TDIs, present in PubMed, Scopus, and Web-of-Science, used the ICD classification. Proposal #2130 suggested to adopt the Andreasen classification, the most widely acknowledged classification used in dental traumatology. The Proposal was reviewed by two WHO teams, two scientific Committees, one WHO Collaborating Center, and the Department of Non-Communicable Disease Prevention at WHO headquarters, and it underwent two voting sessions. In March 2022, the Andreasen classification was accepted integrally. A new entity was generated, called NA0D, "Injury of teeth or supporting structures" (https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1413338122). Hopefully, this will contribute to increasing the public awareness, and the dental profession's management, of TDIs.

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  • 14.
    Petti, Stefano
    et al.
    Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
    Glendor, Ulf
    Malmö University, Faculty of Odontology (OD).
    Andersson, Lars
    Department of Surgical Sciences, Faculty of Dentistry, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
    World traumatic dental injury prevalence and incidence, a meta-analysis: One billion living people have had traumatic dental injuries2018In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 34, no 2, p. 71-86Article, review/survey (Refereed)
    Abstract [en]

    Traumatic dental injuries (TDIs) account for a considerable proportion of bodily injuries. Nevertheless, global TDI frequency is unknown, probably because TDI diagnosis is not standardized. This study estimated world TDI frequency. A literature search (publication years 1996-2016) was aimed at covering as many countries, communities, ethnic groups as possible, thus achieving high generalizability. In particular, non-specific keywords, no language restrictions, and large databanks were used. Observational studies reporting proportions of individuals with at least one TDI (prevalence) and who developed TDI (incidence rate) were considered. Prevalence rates to permanent dentition, primary dentition and in 12-year-olds, incidence rate to any tooth for any age, male-to-female prevalence ratio (PR) in 12-year-olds, with 95% confidence intervals (95 CIs), were extracted/calculated. Study quality, Z-score distribution, funnel plot symmetry analysis, between-study heterogeneity, sensitivity, and subgroup analyses were performed. Selected primary studies were 102 (permanent dentition; 268755 individuals; median age, 13.8years), 46 (primary dentition; 59436 individuals; median age, 3.4years), 42 (12-year-olds; 33829 individuals), 11 (incidence rate; 233480 person-years; median age, 7.8years), and 31 (PR; 16003 males, 16006 females). World TDI frequency resulted as follows: permanent dentition prevalence 15.2% (95 CI, 13.0%-17.4%); primary dentition prevalence 22.7% (95 CI, 17.3%-28.7%); 12-year-olds prevalence 18.1% (95 CI, 15.3%-21.0%); incidence rate, 2.82 (95 CI, 2.28%-3.42%) per 100 person-years; PR, 1.43 (95 CI, 1.34%-1.52%). Differences between WHO Regions were found. This study shows that more than one billion living people have had TDI. TDI is a neglected condition which could rank fifth if it was included in the list of the world's most frequent acute/chronic diseases and injuries.

  • 15.
    Qudeimat, Muawia A
    et al.
    Department of Developmental and Preventive Sciences, Kuwait University, Safat, Kuwait.
    AlHasan, Abdulaziz A
    Asnan Private Dental Centre, Salmiyah, Kuwait.
    AlHasan, Mohammad A
    Asnan Private Dental Centre, Salmiyah, Kuwait.
    Al-Khayat, Khaled
    Asnan Private Dental Centre, Salmiyah, Kuwait.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Prevalence and severity of traumatic dental injuries among young amateur soccer players: A screening investigation2019In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 35, no 4-5, p. 268-275Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/AIMS: Traumatic dental injuries (TDI) are prevalent among soccer players. In Kuwait, no studies of TDI among soccer players have been carried out. The aim of this study was to investigate the prevalence, type and causes of soccer-related traumatic dental injuries among 7-18-year-old amateur soccer players. METHODS: All amateur soccer players who were registered in the 14 sports clubs in the country were invited to participate in this screening study. Players who were present in the club on the assigned examination day were included. The players were examined by two trained and calibrated paediatric dentists for signs of injury to the oral tissues. Injury diagnosis was made according to the Andreasen (2007) epidemiological dental injury classification. The history of any dental injury present at the time of examination was recorded. The timing and nature of any dental advice or treatment sought was also noted. RESULTS: Six hundred sixty-seven (48% inclusion rate) male players were included (mean age of 13.4 +/- 2.6 years). In total, 213 injured teeth were observed among 169 (25%) players. The prevalence of soccer-related injuries was 11%, and a greater number of injuries were observed in older players. Maxillary central incisors were the most frequently injured teeth (91%), and enamel-only fractures represented 60% of all injured teeth. Slightly more TDIs were soccer-related (44%) compared to non-soccer-related injuries (39%), and a large number of TDIs (39%) occurred inside the sports clubs. The prevalence of reported soft-tissue injuries was 18%. The majority of the players (75%) did not receive dental care for their injuries. CONCLUSIONS: A significant number of young Kuwaiti amateur soccer players suffered TDIs. In addition, a high percentage of traumatic injuries were not treated, and there was a lack of the use of protective mouthguards.

  • 16.
    Tewari, Nitesh
    et al.
    All India Inst Med Sci, Ctr Dent Educ & Res, Div Pediat & Prevent Dent, New Delhi, India; All India Inst Med Sci, Ctr Dent Educ & Res, Div Pediat & Prevent Dent, New Delhi, India.
    Lauridsen, Eva
    Rigshosp, Dent Trauma Guide Teamet Kaebekirurg Afdeling, Copenhagen, Denmark.
    Atif, Mohammad
    Aligarh Muslim Univ, ZA Ahmed Dent Coll, Dept Pediat Dent, Aligarh, India.
    Srivastav, Sukeshana
    Aarhus Univ, Dept Dent & Oral Hlth, Sect Orthodont, Aarhus, Denmark.
    Tsilingaridis, Georgios
    Karolinska Inst, Dept Dent Med, Div Orthodont & Paediat Dent, Stockholm, Sweden; Ctr Pediat Oral Hlth, Stockholm, Sweden.
    Haldar, Partha
    All India Inst Med Sci, Ctr Community Med, New Delhi, India.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation: A systematic review and meta-analysis2024In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 40, no 5, p. 482-498Article, review/survey (Refereed)
    Abstract [en]

    This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.

  • 17.
    Wimalarathna, A. A. A. K.
    et al.
    Univ Peradeniya, Fac Dent Sci, Dept Prosthet Dent, Peradeniya, Sri Lanka..
    Herath, E. M. U. C. K.
    Univ Peradeniya, Fac Dent Sci, Div Paedodont, Peradeniya, Sri Lanka..
    Senarath, N. H.
    Univ Peradeniya, Fac Dent Sci, Div Paedodont, Peradeniya, Sri Lanka..
    Fonseka, M. C. N.
    Univ Peradeniya, Fac Dent Sci, Dept Restorat Dent, Peradeniya, Sri Lanka..
    Manathunga, M. M. K. M.
    Univ Peradeniya, Fac Dent Sci, Peradeniya, Sri Lanka..
    Nawarathna, L. S.
    Univ Peradeniya, Fac Sci, Dept Stat & Comp Sci, Peradeniya, Sri Lanka..
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Introduction of an interactive tool (the Dental Trauma Guide) in the undergraduate dental teaching to manage traumatic dental injuries2021In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 37, no 5, p. 717-724Article in journal (Refereed)
    Abstract [en]

    Background/Aims Traumatic dental injuries (TDI) are complex problems where lack of proper care may result in serious complications. The need to improve the management of TDI is a frequently addressed concern. Methods of improvement in their diagnosis and management are continuously evolving. The interactive Internet tool, the Dental Trauma Guide (DTG), helps to simplify diagnostic and management dilemmas. However, it is not a freely available tool. The aim of the current study was to assess the knowledge and diagnostic skills of undergraduate dental students with access to the DTG compared with students without such access, in order to validate and promote this tool in dental education. Materials and Methods Two groups of students were randomly selected where one group of final year dental undergraduate students were exposed to lectures, demonstrations, discussions and tutorials on the management of TDI according to the standard undergraduate curriculum in Sri Lanka. Another test group of 21 students were provided with access to DTG during their training in paediatric dentistry. At the end of the study period, students were assessed on their knowledge of TDI using MCQs (Multiple Choice Questions) and OSCEs (Objective Structured Clinical Examination), based on the DTG. Results The students with access to the DTG were more knowledgeable in providing the correct answers to three out of the seven OSCE questions. Evaluation based on the MCQs did not reveal a significant difference (p = .913). However, users of the DTG showed a statistically significant difference with better overall knowledge based on their answers (p = .028). Following this period of evaluation, all of the students were provided with access to the DTG to supplement their learning experience. Conclusion The Dental Trauma Guide is a useful supplementary tool for undergraduate students to arrive at a correct diagnosis and treatment plan for TDI.

  • 18.
    Wolf, Eva
    et al.
    Malmö University, Faculty of Odontology (OD). Malmö University, Centre for Sexology and Sexuality Studies (CSS).
    Priebe, Gisela
    Karlstad Univ, Dept Social & Psychol Studies, Karlstad, Sweden.
    The self-perceived impact of sexual abuse on daily life and general health - an issue to consider in dental care2024In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657, Vol. 40, no S2, p. 43-52Article in journal (Refereed)
    Abstract [en]

    Background/Aim: To analyse, from the perspective of adults with a history of sexual abuse, the impact of the experience on their general health and well-being.Material and Methods: The participants comprised 12 strategically selected informants (10 women), aged 19-56; all sexually abused during child- and/or adulthood. They were interviewed in-depth and encouraged to describe the impact of the sexual abuse on their daily lives. The consequences of sexual abuse on oral health have previously been reported. The interviews were recorded digitally, transcribed verbatim and analysed according to qualitative content analysis with an inductive approach.Results: The overall theme illustrating the latent content was Sexual abuse experience-limiting long-term consequences, always present in body and mind. The first category covering the manifest content was 'A lost foothold', with two subcategories: (i) emotional repercussions and (ii) physical health repercussions. The second category was 'The significance of distance to trauma', with two subcategories (i) keeping a distance and tending to escape and (ii) processing the trauma experience-a struggle towards balance.Conclusions: A history of sexual abuse cannot be understood in isolation: the long-term repercussions pervade daily life. However, after disclosure of the abuse and processing the trauma, it is possible to ameliorate some of the negative effects. In this context, the dental setting emerges as a potentially important venue for disclosure as almost every person, sooner or later, visits the dentist.

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