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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.
    Al-Melh, M. A.
    et al.
    Department of Developmental and Preventive Sciences, Kuwait University, Faculty of Dentistry, Kuwait.
    Badr, H.
    Department of Community Medicine, Kuwait University, Faculty of Medicine, Kuwait.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study2021In: Journal of Contemporary Dental Practice, E-ISSN 1526-3711, Vol. 22, no 6, p. 637-643Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: The aims of this study were to compare the anesthetic effect of a lidocaine/prilocaine (L/P) topical anesthetic with placebo on pain from needle sticks and to compare the anesthetic effect of the L/P topical anesthetic with an infiltrative anesthetic on pain from orthodontic miniscrew placement. Materials and methods: Pain elimination was analyzed from two interventions: (a) needle stick and (b) miniscrew insertion. When assessing pain from needle stick, one side of the mandible received 2.5% lidocaine/2.5% prilocaine topical anesthetic, and the other side received placebo. When evaluating pain from miniscrew placement, one side of the mandible received L/P topical anesthetic and the other side received infiltrative anesthetic. The findings were recorded on a Visual Analogue Scale after needle stick and after miniscrew placement. Subjective assessment was analyzed by a questionnaire. Results: The L/P topical anesthetic significantly eliminated the pain from needle stick (Mann–Whitney test of medians, 29.0 vs 0.0, respectively, p<0.001). However, the injection anesthetic eliminated the pain from the miniscrew placement better than the L/P topical anesthetic (Mann–Whitney test of medians, 0.0 vs 5.5, respectively, p<0.001). Eighty percent of the subjects felt more comfortable with L/P topical anesthetic than injection anesthetic. Pain from needle stick pain was reported to be the most uncomfortable part of the study. Conclusion: The L/P topical anesthetic efficiently eliminated pain from needle stick. The L/P topical anesthetic did not completely eliminate pain from miniscrew placement as the injection anesthesia, but it did reduce pain to tolerable levels. Clinical significance: L/P topical anesthetics can significantly eliminate pain from needle stick injections, and L/P topical anesthetics can reduce pain from orthodontic miniscrew placement to tolerable levels. © Jaypee Brothers Medical Publishers. 2021 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

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  • 3.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Andreasen, Jens O
    Soft Tissue Injuries2018In: Textbook and Color Atlas of Traumatic Injuries to the Teeth / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 626-647Chapter in book (Other academic)
  • 4.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Andreasen, Jens O
    Moule, Alex
    International Association of Dental Traumatology2018In: Textbook and Color Atlas of Traumatic Injuries to the Teeth / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 1015-1019Chapter in book (Other academic)
  • 5.
    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)
  • 6.
    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.

  • 7.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bakland, Leif K
    Loma Linda University, Loma Linda, California.
    Heithersay, Geoffrey S
    University of Adelaide, Adelaide, South Australia, Australia.
    Lauridsen, Eva
    University Hospital Copenhagen, Copenhagen, Denmark.
    Reprint of: Jens Ove Andreasen, 1935-2020 Father of Dental Traumatology2021In: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 47, no 6, p. 852-861, article id S0099-2399(21)00237-5Article in journal (Other academic)
    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.

  • 8.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Malmgen, Barbro
    Malmgen, Olle
    Storgård Jensen, Simon
    Strategies for treatment of Tooth Loss after Trauma in the Anterior region of young patients.2018In: Textbook and Color Atlas of Traumatic Injuries to the Teeth / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 878-887Chapter in book (Other academic)
  • 9.
    Andersson, Lars
    et al.
    Malmö University, Faculty of Odontology (OD).
    Petti, Stefano
    Day, Peter
    Kenny, Kate
    Glendor, Ulf
    Andreasen, Jens O
    Classification,Epidemiolofy and Etiology2018In: Textbook and Color Atlas of Traumatic Injuries to the Teeth / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell, 2018, p. 252-294Chapter in book (Other academic)
  • 10. Andreasen, Jens O
    et al.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Tsukiboshi, Mitsuhiro
    Autotransplantation of teeth to the anterior region2018In: Textbook and Color Atlas of Traumatic Injuries to the Teeth / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 853-877Chapter in book (Other academic)
  • 11. Andreasen, Jens O
    et al.
    Andreasen, Frances MAndersson, LarsMalmö University, Faculty of Odontology (OD).
    Textbook and Color Atlas of Traumatic Injuries of the Teeth, 5th Edition2018Collection (editor) (Other academic)
  • 12. Eden, Ece
    et al.
    Baysal, Mehmet
    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.

  • 13.
    Farzad, Payam
    et al.
    University of Gothenburg; Karolinska University Hospital.
    Lundgren, Ted
    University of Gothenburg.
    Al-Asfour, Adel
    Kuwait University, Kuwait.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Dahlin, Christer
    University of Gothenburg; NU Hospital Organization, Trollhättan.
    Integration of Dental Implants in Conjunction with EDTA-Conditioned Dentin Grafts: An Experimental Study2021In: Dentistry Journal, ISSN 2304-6767, Vol. 9, no 6, article id 63Article in journal (Refereed)
    Abstract [en]

    This study was undertaken to investigate the integration of titanium micro-implants installed in conjunction with previously dentin-grafted areas and to study the morphological appearance, mineral content, and healing pattern of xenogenic EDTA-conditioned dentin blocks and granules grafted to cavities in the tibial bone of rabbits. Demineralized and non-demineralized dentin blocks and granules from human premolars were implanted into cavities prepared on the lateral aspects of the tibias of rabbits. After a healing period of six months, micro-implants were installed at each surgical site. Histological examinations were carried out after 24 weeks. Characterization of the EDTA-conditioned dentin blocks was performed by means of light microscopy, dental X-rays, scanning electron microscopy, and energy dispersive X-ray analysis (EDX). No implants were found to be integrated in direct contact with the dentin particles or blocks. On the EDTA-conditioned dentin surface, the organic marker elements C and N dominated, as revealed by EDX. The hydroxyapatite constituents Ca and P were almost absent on the dentin surface. No statistically significant difference was observed between the EDTA-conditioned and non-demineralized dentin, as revealed by BIC and BA. The bone-inductive capacity of the dentin material seemed limited, although demineralization by means of EDTA indicated higher BIC and BA values in conjunction with the installed implants in the area. A 12 h EDTA treatment did not fully decalcify the grafts, as revealed by X-ray analysis.

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  • 14. Flores, Marie Therese
    et al.
    Al Sane, Mona
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Information to the public, Patients and Emergency Services on Traumatic Dental Injuries.2018In: Textbook and Color Atlas of Traumatic Injuries of the Teeth, 5th Edition / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 992-1008Chapter in book (Other academic)
  • 15. Glendor, Ulf
    et al.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Andreasen, Jens O
    Economic Aspects of Traumatic Dental Injuries2018In: Textbook and Color Atlas of Traumatic Injuries to the Teeth / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 982-991Chapter in book (Other academic)
  • 16.
    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 study2023In: Dental Traumatology, ISSN 1600-4469, E-ISSN 1600-9657Article 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.

  • 17. Kenny, Kate P
    et al.
    Day, Peter F
    Sharif, Mohammad O
    Parashos, Peter
    Lauridsen, Eva
    Feldens, Carlos Alberto
    Cohenca, Nestor
    Skapetis, Tony
    Levin, Liran
    Kenny, David J
    Djemal, Serpil
    Malmgren, Olle
    Chen, Yong-Jin
    Tsukisboshi, Misuhiro
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    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.

  • 18.
    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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  • 19.
    Klinge, Anna
    et al.
    Malmö University, Faculty of Odontology (OD).
    Ahmad, Marianne
    Malmö University, Faculty of Odontology (OD).
    Eldh, Peter
    Malmö University, Faculty of Odontology (OD).
    Ulvan, Rasmus
    Malmö University, Faculty of Odontology (OD).
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Becktor, Jonas P
    Malmö University, Faculty of Odontology (OD).
    Craniofacial Height in Relation to Cross-Sectional Morphology of the Anterior Maxilla: An Anatomica Considers ion in Implant Therapy2020In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, no 2, p. 386-394Article in journal (Refereed)
    Abstract [en]

    Purpose: Patients who have a vertical growth pattern are more prone to complete alveolar bone growth later and run a higher risk for inhibition of growth and infraposition after implants have been placed. Moreover, it has been suggested for the same category of patients that craniofacial height may influence the alveolar bone morphology of the anterior maxilla during growth. Hence, it is important to identify such patients early when considering implant treatment in young patients. The purpose of this study was to investigate the height and width of the alveolar bone in the anterior maxilla in subjects with different craniofacial heights to assess if there is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Materials and Methods: Measurements on cephalograms and cone beam computed tomography (CBCT) images of the maxilla from 180 fully dentate subjects were analyzed and categorized into three angle groups based on the craniofacial height: low-, normal-, and high-angle groups. Measurements of the alveolar bone were taken interradicular, at six reference points distributed between the first premolar regions in the maxilla. The height and width of the alveolar bone were measured with a standardized technique at 3, 6, 9, and 12 mm from the top of the alveolar process. Results: Significant differences were found regarding the height of the alveolar bone in all the subgroups and regarding the width in the 9- and 12-mm subgroups, and between low-/normal- and low-/high-angle groups, where the high-angle group represented the thinnest alveolar bone. A significant difference was found between male and female patients concerning all dimensions of the alveolar bone. Conclusion: There is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Craniofacial height is an important factor to analyze when implant treatment is considered in the maxillary anterior region. This identification can preferably be carried out early in young patients who are still growing when various treatment options can still be considered.

  • 20.
    Lauridsen, Eva
    et al.
    Dental Trauma Guide Competence Center, Copenhagen University Hospital, Rigshospitalet, Denmark.
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Suresh, Nandini
    The Dental Trauma Guide: An evidence-based treatment guide2023In: Endodontology, ISSN 0970-7212, Vol. 35, no 2, p. 79-84Article, review/survey (Refereed)
    Abstract [en]

    Dental trauma is complex, as it includes a wide range of different injury types with each type requiring specific considerations. It constitutes the fifth-most prevalent disease, and nearly 900 million individuals from 7 to 65 years of age are affected. The Dental Trauma Guide (DTG) project was initiated by Dr. Jens Andreasen in 2008 with the intention that all dentists around the world should be able to get access to the best available evidence regarding diagnosis, treatment, and prognosis for a patient with dental trauma within a few minutes. The DTG has been a global success, and today, 40,000 colleagues visit the DTG website every year. The website displays the treatment guidelines developed by the International Association of Dental Traumatology as well as visualized with film animations to make it easy and appealing for the users. The dentist can connect to the DTG Copenhagen database to compare his/her case with similar cases from the database, providing guidance to emergency treatment. Furthermore, DTG provides prognosis estimates for each individual injury type, as well as prognosis estimates for teeth with combinations of fracture and luxation injuries. Today, the DTG is a nonprofit organization with the aim of improving the level of care for dental trauma patients worldwide. Therefore, the DTG team has decided to offer free access for students at all dental schools in India.

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  • 21. Lauridsen, Eva
    et al.
    Andreasen, Jens O
    Bouaziz, Oliver
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    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.

  • 22. Malmgen, Barbro
    et al.
    Malmgren, Olle
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    Dentoalveolar ankylosis, Decoronation and Alveolar Bone preservation2018In: Textbook and Color Atlas of Traumatic Injuries of the Teeth, 5th Edition / [ed] Jens O Andreasen, Frances M Andreasen, Lars Andersson, Wiley-Blackwell Publishing Inc., 2018, p. 834-852Chapter in book (Other academic)
  • 23. Maslamani, Manal
    et al.
    Joseph, Bobby
    Gabato, Severino
    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.

  • 24.
    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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  • 25. Petti, Stefano
    et al.
    Andreasen, Jens Ove
    Glendor, Ulf
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    The fifth most prevalent disease is being neglected by public health organisations2018In: The Lancet Global Health, E-ISSN 2214-109X, Vol. 6, no 10, p. E1070-E1071Article in journal (Refereed)
  • 26. Petti, Stefano
    et al.
    Glendor, Ulf
    Andersson, Lars
    Malmö University, Faculty of Odontology (OD).
    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.

  • 27.
    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.

  • 28.
    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.

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