Background/Aims: Understanding the risk factors for dental injuries is essential to develop prevention strategies. The aim of this study was to perform a systematic review and meta-analysis to determine whether people with special needs (SN) have a higher incidence of traumatic dental injury (TDI). Materials and methods:Electronic searches were performed with no language or date restrictions in the following databases: PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library and Open Gray. According to the PECOS strategy, observational studies that investigated subjects with and without SN and its association with TDI episodes were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies according to the type of SN, with the odds ratio (OR) also being calculated (P ≤ .05). The evidence was quality tested using the GRADE approach.Results: After titles and abstracts were examined, and full texts were read, 28 studies were included in the qualitative synthesis and 27 in the meta-analysis. Three studies were classified with high methodological quality and the others had methodological problems. No associations were determined between TDI and autism spectrum disorder, epilepsy and mental disability (OR 1.12 [0.70, 1.78], OR 1.28 [0.13, 12.27] and OR 1.04 [0.20, 5.35], respectively, P > .05). A positive association (P < .05) was found between TDI and hyperactivity disorder, cerebral palsy, 21 trisomy, various conditions of SN and in pooled results (OR 2.67 [1.22, 5.87], OR 1.89 [1.06, 3.37], OR 6.18 [2.24, 17.05], OR 1.69 [1.18, 2.41], OR 1.61 [1.16; 2.22], respectively).The certainty of evidence ranged from very low to low. Conclusions: In general, people with SN had a higher chance of having TDI with very low certainty of evidence. People with ADHD and cerebral palsy had a higher chance of TDI. K E Y W O R D S disabled persons, systematic review, tooth injuries | 219 SILVEIRA Et AL.
-Background/aim: The association between trauma and caries is still controversial in the literature. The aim of this study was to evaluate the possible association between caries and dental trauma through a systematic review with meta-analysis. Design: A systematic literature search was performed in PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library, and Open Grey databases. The MeSH terms used were 'Tooth injuries', 'Tooth fractures', 'Tooth avulsion', 'Tooth movement'; 'Dental caries'; 'DMF index'; and 'Tooth demineralization'. MeSH synonyms, related terms, and free terms were included. The inclusion criteria comprised clinical investigations of subjects with and without caries that had suffered dental trauma. Quality assessment and bias control were carried out. Meta-analysis was performed using the COMPREHENSIVE META-ANA-LYSIS software (version 3.2). Heterogeneity was assessed using the I 2 index, and the odds ratio was also calculated (P < 0.05). Results: From 1290 abstracts, seven met the inclusion criteria. All studies had high methodological quality and five were included in the meta-analysis. The results demonstrated a positive association (P < 0.001) between dental trauma and dental caries in permanent teeth [OR: 1.490, 95%, CI: 1.209-1.835]. However, for children with primary teeth, the results showed a negative association (P = 0.006) between dental trauma and caries [OR: 0.706, 95%, CI: 0.550-0.906]. Conclusions: The results demonstrated positive and negative association between the presence of caries and dental trauma in permanent and primary teeth, respectively.Oral health status is characterized by the health of oral tissues and the development of functions, which allow an individual to perform daily activities such as to eat, speak, and socialize without discomfort and embarrassment, contributing to the general well-being of the individual (1, 2). Dental caries and traumatic injuries are considered the main problems that affect the oral health of children and adolescents (3-5).Dental caries is a multifactorial disease caused by the demineralization of tooth enamel surface by oral bacteria, thus weakening its structure (6). Dental traumatic injuries are caused by an external impact on a tooth and its surrounding tissues (7). Studies have shown that social, economic, and behavioral factors are determinants for both caries and dental trauma (6-9). More recently, the relationship between dental trauma and caries experience has been studied; however, the results from those studies have been contradictory (10)(11)(12)(13)(14)(15)(16).If an association between these two conditions could be proved, children at risk could benefit from a common approach for the prevention of dental trauma and caries (10). Furthermore, dentists could help to implement health promotion measures targeting patients and their parents.The absence of a comprehensive study comparing all evidence from existing studies to reach clear conclusions, based on scientific evidence, about a specific object of interest ...
Introdução: É dever do cirurgião-dentista ser capaz de identificar lesões provenientes de abuso sexual infantil, uma vez que grande parte das mesmas ocorrem nos campos de trabalho deste profissional. Objetivos: O presente trabalho visa, por meio de revisão da literatura, apontar o papel do dentista ao se deparar com lesões provenientes de abuso sexual infantil. Material e método: Informações provenientes de legislação e literatura especializada nacional, relativas ao tema, foram compiladas. Visto que, em sua graduação, os cirurgiões-dentistas recebem pouca ou nenhuma base referente às principais manifestações físicas e psicológicas em situações de abuso sexual, muitos acabam por não conseguirem diagnosticar e, consequentemente, não cumprem seu papel de notificar casos suspeitos, seja por medo ou por desconhecer sua obrigação diante deste tipo de violência. Resultados e conclusão: É necessário que profissionais da Odontologia sejam conscientizados durante sua graduação, para que, depois de formados, não sejam omissos. Portanto, é de extrema importância que o tema passe a compor o plano de ensino de todas as instituições, especialmente nas disciplinas de Odontologia Legal e Odontopediatria.
The risk factors for TDI in the Brazilian population are similar to those found worldwide. However, some differences can be observed, such as gender and socioeconomic indicators as predisposing factors.
Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.
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