Prevalence of dental fractures at the emergency clinic of a Dentistry School
Keywords:
Tooth fractures, Root canal therapy, Dentistry, Dental careAbstract
Tooth fractures are common, and patients commonly seek out emergency clinics to be immediately cared for regarding aesthetics and pain. This retrospective study analyzed patient medical records from a dental school clinic aimed at verifying the prevalence of tooth fractures so as to identify the causes of the fractures and immediate clinical conduct. The inclusion criteria were: the fracture itself as the main complaint and the respective, duly filled-out and signed, medical records. The following data were collected: gender, age, fractured tooth, cause of fracture, and clinical procedure. Among the 3.783 patients who sought out the emergency service between January 2004 and June 2008, 5% (188) reported a “tooth fracture” as the main complaint. One hundred forty five medical records fit the inclusion criteria and presented 170 fractured permanent teeth, most of which were maxillary incisors (49%), followed by mandibular molars (17.6%), maxillary molars (13.5%), maxillary
premolars (8.8%), mandibular premolars (4.7%), mandibular incisors (3.5%), maxillary canines (1.8%), and mandibular canines (0.6%). The mean age was 31.2 ± 13.3 years, and 54% of the patients were male. The main causes included weakening of the tooth structure by caries (47.7%) and multiple restorations, endodontic treatment, or traumas (14%). The most frequent immediate treatment was temporary restoration (54%). A small portion of the emergency dental care was due to dental fractures, which were mostly caused by the weakening of the tooth structure by caries, multiple restorations, endodontic treatment, or traumas. The teeth that were most affected by fractures were the maxillary incisors, and the most common immediate treatment was temporary restoration.
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Sakai VT, Magalhães AC, Pessan JP, Silva SMB, Machado MAAM. Urgency treatment profile of 0 to 15 year-old children assisted at urgency dental service from Bauru Dental School, University of São Paulo. J Appl Oral Sci. 2005;13:340-4.
Mani SP, Cleaton-Jones PE, Lownie JF. Demographic profile of patients who present for emergency treatment at Wits’ Dental School. J Dent Assoc S Afr. 1997;52:69-72.
Agostini FG, Flaitz CM, Hicks MJ. Dental emergencies in a university based pediatric dentistry postgraduate outpatient clinic: a retrospective study. ASDC J Dent Child. 2001;68:316-21.
Esberard RM, Silva FPM, Gabrielli F. Fratura coronária em dente anterior. Rev Assoc Paul Cir Dent.1978;32:130-4.
Moosavi H, Maleknejad F, Kimyai S. Fracture resistance of endodontically-treated teeth restored using three root-reinforcement methods. J Contemp Dent Pract. 2008;1:30-7.
Gonçalves PMJ, Machado MP, Vaz RR, Rosa RM, Freire JMV. Fratura radicular dos incisivo s centrais superiors: relato de caso clínico. Arq Centro Estud Curso Odontol. 1996;32:9-19.
Forte FDS, Bittencourt HCR, Almeida RB. Fratura dentária na dentição permamente em crianças / Dental fracture in permanent teeth in children. Pesq Bras Odontoped Clin Integr. 2002;2:16-9.
Sandalli N, Cildir S, Guler N. Clinical investigation of traumatic injuries in Yeditepe University, Turkey during the last 3 years. Dent Traumatol. 2005;21:188-94.
Andreasen JO, Andreasen FM. Texto e atlas colorido de traumatismo dental. 3ªed. Porto Alegre: Artmed; 2001.
Barbosa SH, Miranda CB, Rauscher FC, Gonçalves SEP, Rodrigues JR, Nicoló R. Prevalência de fratura dental coronária anterior em escolares de 6 a 18 anos da cidade de São José dos Campos, São Paulo. JBP Rev Ibero- am odontopediatr odontol bebê. 2004;7:291-5.
Hunter AR, Treasure ET, Hunter AJ. Increases in cavity volume associated with the removal of class 2 amalgam and composite restorations. Oper Dent.1995;20:2–6.
Larson TD, Douglas WH, Geistfeld RE. Effect of prepared cavities on the strength of teeth. Oper Dent. 1981;6:2–5.
Millar BJ, Robinson PB, Davies BR. Effects of the removal of composite resin restorations on class II cavities. Br Dent J. 1992;173:210–2.
Mondelli J, Sene F, Ramos RP, Benutti AR. Tooth structure and fracture strength of cavities. Braz Dent J. 2007;18:134-8.
Mondelli J, Steagall L, Ishikiriama A, Lima Navarro MF, Soares FB. Fracture strength of human teeth with cavity preparations. J Prosthet Dent. 1980;43:419–22.
Mondelli RF, Barbosa WF, Mondelli J, Franco EB, Carvalho RM. Fracture strength of weakened human premolars restored with amalgam with and without cusp coverage. Am J Dent. 1998;11:181–4.
Bell JG, Smith MC, de Pont JJ. Cuspal failures of MOD restored teeth. Aust Dent J. 1982;27:283-7.
Goel VK, Khera SC, Singh K. Clinical implications of the response of enamel and dentin to masticatory loads. J Prosthet Dent. 1990;64:446-54.
Spears IR, Van Noort R, Crompton RH, Cardew GE, Howard IC. The effects of enamel anisotropy on the distribution of stress in a tooth. J Dent Res. 1993;72:1526-31.
Nishiyama CK, Godoy LF, Pedroso JA, Kuga MC, Brosco HB, Ramos RHA. Análise crítica das principais causas de exodontia de dentes tratados endodonticamente em pacientes portadores de fissuras lábio-palatais / Extration of endodontically treated teeth in cleft lip and palate patients. Rev Fac Odontol Lins.1993;6:15- 9.
Cardoso M, Carvalho Rocha MJ. Traumatized permanent teeth in Brazilian children assisted at the Federal University of Santa Catarina, Brazil. Dent Traumatol. 2001;17:245-9.
Cunha RF, Pugliesi DMC, Vieira AE. Oral trauma in Brazilian patients aged 0-3 years. Dent Traumatol. 2001;17:206-11.
Andreasen JO. Traumatic injuries of teeth. 2ªed. Copenhagen: Munksgaard; 1981.
Glendor U, Halling A, Andersson L, Andreasen JO, Klitz I. Type of treatment and estimation of time spent on dental trauma: a longitudinal and retrospective study. Swed Dent J. 1998;22:47- 60.
Schwartz S. A one-year statistical analysis of dental emergencies in a pediatric hospital. J Can Dent Assoc. 1994;60:959-62,966-8.
Morales MOCC, Fraiz FC, Menezes JVNB, Gugisch RC. Prevalence and characteristics of crown fractures in permanent upper incisors from schoolchildren in a southern brazilian city. Arq Odontol. 2007;43:4-8.
Sousa DL, Moreira Neto JJS, Gondim JO, Bezerra Filho JG. Prevalência de trauma dental em crianças atendidas na Universidade Federal do Ceará / Prevalence of dental trauma in children attending the Federal University of Ceará. Rev Odonto Ciênc. 2008;23:355-9.
Saroglu I, Sönmez H. The prevalence of traumatic injuries treated in the pedodontic clinic of Ankara University, Turkey, during 18 months. Dent Traumatol. 2002;18:299-303.
Kargul B, Çaglar E, Tanboga I. Dental trauma in Turkish children, Ýstanbul. Dent Traumatol. 2003;19:72-5.
Bengtson AL, Bengtson NG, Avessa RMF. Fraturas coronárias de incisivos permanentes em crianças e adolescentes / Coronal fractures of permanent incisors in children and adolescents. RGO. 1997;45:127-30.
Otuyemi OD. Traumatic anterior dental injuries related to incisor overjet and lip competence in 12 year old Nigerian children. Int J Paediatr Dent. 1994;4:81-5.
Cardoso M, Carvalho Rocha MJ. Traumatized primary teeth in children assisted at the Federal University of Santa Catarina, Brazil. Dent Traumatol. 2002;18:129-33.
Bastone EB, Freer TJ, McNamara JR. Epidemiology of dental trauma: a review of the literature. Aust Dent J. 2000;45:2-9.
Baratieri LN. Odontologia restauradora fundamentos e possibilidades. São Paulo: Santos; 2001.
Santos FDS, Bampa JU, Bampa ATTB. Colagem autógena mediata na solução de fratura radicular de incisivos central superior. Rev Assoc Paul Cir Dent. 2003; 57:195-7.
Campos MIC, Henriques KAM, Campos CN. Nível de informação sobre a conduta de urgência frente ao traumatismo / Level of information about the urgent procedures in dental traumatism with avulsion. Pesqui BrasOdontopediatria Clín Integr. 2006;6:155-9.
