Dental Traumatology最新文献

{"title":"Reinforcement Positioning in Custom-Made Mouthguards for Maxillofacial Trauma Protection: A Combined In Vitro and In Silico Analyses.","authors":"Talita Suelen de Queiroz, João Paulo Mendes Tribst, Larissa Haddad E Borro, Guilherme da Rocha Scalzer Lopes, Alexandre Luiz Souto Borges, Tarcisio Jose de Arruda Paes Junior","doi":"10.1111/edt.13060","DOIUrl":"https://doi.org/10.1111/edt.13060","url":null,"abstract":"<p><strong>Background/aim: </strong>This study evaluated the dentoalveolar responses of central incisors to anterior maxillary trauma in vitro and in silico using mouthguards (MGs) reinforced with polyamide mesh at three distinct positions.</p><p><strong>Material and methods: </strong>Forty 4-mm thick MGs were categorized based on mesh location: Group MG1 + 3 (reinforcement 1 mm from the vestibular limit), Group MG2 + 2 (2 mm), Group MG3 + 1 (3 mm), and a control group without reinforcement. A 3D-printed skull model (Spin Red Resin, Quanton 3D) simulated the dentoalveolar complex, with Resilab Clear resin (Wilcos) for teeth and addition-cured silicone for the periodontal ligament. This setup was connected to a custom impact device to ensure forces remained within the materials' elastic limits. Microstrains were measured using four strain gauges placed on the vestibular surfaces of the central incisors and the alveolar process of the maxilla. The impact was applied at Ep = 0.5496 J, parallel to the ground, using a 35-mm diameter steel sphere. For the in silico test, the setup was modeled in CAD software (Rhinoceros 7.0) and analyzed in CAE software (Ansys 2021 R1) through explicit dynamic simulation. All materials were assumed homogeneous, isotropic and linearly elastic. A 1 m/s impact was simulated using a 7.8 g/cm³ steel sphere. Physical contact conditions were defined as frictional and glued, with tetrahedral mesh elements applied after a 10% convergence test to ensure accuracy.</p><p><strong>Results: </strong>The maximum principal strains and stresses in teeth and maxilla were presented through colorimetric graphs. Statistical analysis (Shapiro-Wilk, Kruskal-Wallis, and Dunn's tests, 5% significance) revealed significant differences for the non-reinforced group (p = 6.8 × 10^-5) but none between impact zones (p = 0.879), confirming uniform stress distribution.</p><p><strong>Conclusions: </strong>Reinforcement systems significantly improved impact absorption in oral tissues, enhancing protection. However, the reinforcement location did not significantly affect absorption. Finite element analysis validated the in vitro results supporting both theoretical and practical models for further study and future improvements.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Insights in Dental Trauma: Exploring Potential Risk Factors, Innovations, and Preventive Strategies","authors":"Ana Beatriz Cantao,&nbsp;Liran Levin","doi":"10.1111/edt.13053","DOIUrl":"https://doi.org/10.1111/edt.13053","url":null,"abstract":"&lt;p&gt;Several factors are associated with dental trauma (DT) occurrence, and these factors are well-established in the literature [&lt;span&gt;1, 2&lt;/span&gt;]. However, new studies and hypotheses suggest that a lack of balance is positively associated with falls in children and older individuals [&lt;span&gt;3, 4&lt;/span&gt;]. In this issue Lunardelli et al. investigated the relationship between orthostatic balance and the occurrence of DT in 6-year-old school children in Brazil [&lt;span&gt;5&lt;/span&gt;]. The study emphasizes the connection between reduced orthostatic balance and an increased risk of falls, identifying it as a factor in the etiology of DT in children. This highlights the need for preventive measures focused on creating safer environments, particularly in schools, and involving a multidisciplinary team to support school-aged children in minimizing the risk of falls and dental trauma.&lt;/p&gt;&lt;p&gt;Traumatic dental injuries (TDI) are highly prevalent during childhood, particularly in the primary dentition [&lt;span&gt;6, 7&lt;/span&gt;]. Although TDI is recognized as a common issue, the factors influencing its prevalence in preschool-aged children have been poorly understood [&lt;span&gt;8, 9&lt;/span&gt;]. In this issue, Rivera López et al. investigated these factors through a cohort study involving 4-year-old children from South Brazil [&lt;span&gt;10&lt;/span&gt;]. Using directed acyclic graphs (DAGs), the researchers developed a theoretical model to explore the complex relationships among potential risk factors, including demographic, behavioral, and environmental variables. This study provides insights into the multifactorial nature of TDI in young children, offering a foundation for targeted prevention and early intervention strategies. By applying advanced analytical techniques, Rivera López et al. contribute to a deeper understanding of dental trauma causes and its broader implications for pediatric oral health.&lt;/p&gt;&lt;p&gt;Autotransplanted teeth have demonstrated a remarkable survival rate of over 95% [&lt;span&gt;11-13&lt;/span&gt;]. However, the lack of standardization and precision in quantifying root development results in inconsistent findings and impedes comparisons between studies. Traditional analysis methods based on two-dimensional radiographs shows significant limitations, such as image overlap, patient positioning challenges, and low measurement accuracy. Cone-beam computed tomography (CBCT) might provide a more accurate and detailed analysis, particularly in regions like the periapical areas [&lt;span&gt;14&lt;/span&gt;]. In this issue, Beltrame et al. proposed a methodology for assessing root development and measuring root length using CBCT in 12 patients [&lt;span&gt;15&lt;/span&gt;]. This study highlighted CBCT's superiority over conventional radiography for evaluating root development after autogenous tooth transplants. This method, as any radiographic tool, should be assessed in terms of radiation risks vs. the suggested benefits.&lt;/p&gt;&lt;p&gt;Advances in CBCT and 3D-printed replicas have demonstrated improvements in the effici","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"41 2","pages":"129-132"},"PeriodicalIF":2.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/edt.13053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathologic Features of Pulp Following Uncomplicated Crown Fracture of an Immature Tooth With Concomitant Subluxation Seven Days After the Injury. A Case Report.","authors":"Giorgos N Tzanetakis, Styliani Papanakou, Despina Koletsi, Nikolaos Katsoulas","doi":"10.1111/edt.13058","DOIUrl":"https://doi.org/10.1111/edt.13058","url":null,"abstract":"<p><p>Reports on the histopathologic features of pulp tissue following traumatic injuries are scarce. The aim of the present clinical and histological report was to provide some novel insights about the histological condition of the pulp tissue of an immature permanent tooth, shortly after a combined injury of uncomplicated crown fracture with concomitant subluxation. A seven-year-old male patient presented with a localized buccal swelling apically on tooth #21 and with a radiographic app. One week earlier, the patient had suffered an uncomplicated crown fracture, and the referral dentist had solely performed a permanent restoration by rebonding the fracture fragment of the crown. The diagnosis was pulp necrosis, and a regenerative endodontic procedure was decided due to the wide-open apex of the injured tooth. After access cavity preparation was performed, it was evident that no degeneration of the pulp had occurred, so the tissue was removed using a sterile barbed broach and processed for histopathologic examination. A whitish tissue specimen of soft consistency, 0.8 cm in length and 5 μm thick, was processed for histologic evaluation. An extensive coagulative necrosis of the pulp tissue was revealed with dense aggregates of neutrophils along with areas of abscess formation. Some scattered lymphocytes were observed as well, together with areas of dystrophic calcifications. Finally, no bacteria were observed in any section of the specimen. Pulp necrosis may occur shortly after a combined traumatic injury of uncomplicated crown fracture with subluxation. In such cases, pulpal inflammation and the arise of symptoms may not be necessarily associated with the presence of bacteria. The present histological observation demonstrates that some kinds of inflammatory processes, after traumatic dental injuries, may initiate and evolve potentially without the presence of bacteria at the inflammatory site.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premolar Autotransplantation to the Anterior Maxilla Region-Aesthetic Outcome and Patient Satisfaction.","authors":"Romy Doomen, Dick Barendregt, Liesbeth Temmerman, Noëmi De Roo, Guy De Pauw","doi":"10.1111/edt.13057","DOIUrl":"https://doi.org/10.1111/edt.13057","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to assess the aesthetic results and patient satisfaction of premolars transplanted to the maxillary incisor region.</p><p><strong>Material and methods: </strong>In this multicenter study, 192 patients were included, with a minimum follow-up of 3 years. The aesthetic evaluation comprised two parts: Assessment of the PES/WES score using standardized intraoral photographs. Patient's perspective (VAS questionnaire).</p><p><strong>Results: </strong>The mean PES score was 6.94 (range, 2-10), and the mean WES score was 7.44 (range, 2-10). Most patients' aesthetic results were clinically acceptable (64.6%) to nearly perfect (9.4%). Significant correlations were found between PES and the orientation of the transplant at the receptor site (p = 0.038) and the level of oral hygiene (p < 0.001). A rotated orientation of the transplanted premolar at the receptor site and a poor/moderate level of oral hygiene are associated with lower PES scores. For the WES, there was a significant correlation with the restorative dentist (p < 0.001); if the restorative dentist was based at Center A instead of Center B, this is associated with higher WES scores. The response rate for the VAS questionnaire was 61.9%. 84.8% of the patients perceived the aesthetic outcome of the transplanted premolar the same as other teeth, 15.9% were not satisfied with the restorative treatment, and 12.6% were not satisfied with the surrounding tissues.</p><p><strong>Discussion: </strong>Autotransplantation is a viable treatment option in cases with missing upper front teeth; PES/WES scores were at least comparable but mostly higher than those found in implant studies evaluating single-tooth replacement in the anterior maxilla. The VAS questionnaire showed that patients were satisfied with their transplanted tooth, which was consistent with the results of previous studies.</p><p><strong>Conclusion: </strong>The aesthetic outcomes of premolars transplanted to the maxillary incisor region are predominantly favorable.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Custom-Made Mouthguard: Personalized Solution for Injury Prevention Secondary to Bruxism During Physical Activity.","authors":"Lívia Maria Sales Pinto Fiamengui, Luana Pinheiro Guerra Fontoura, João Felipe Barboza de Oliveira, Karina Miranda Lieuthier, Vinícius Rabelo Freire de Oliveira, Maria Laura Marreiro Mesquita, Carolina Ortigosa Cunha, Karina Matthes de Freitas Pontes","doi":"10.1111/edt.13052","DOIUrl":"https://doi.org/10.1111/edt.13052","url":null,"abstract":"<p><p>The natural dynamics of the jaw during physical activity and its physiological mechanisms are not fully understood. However, teeth clenching during certain sports activities may be associated with increased strength, power, flexibility, and performance. This behavior is termed awake bruxism (AB) and can lead to intraoral damage, highlighting the importance of patient education and management. This work describes the fabrication of a custom mouthguard (MG) idealized to prevent oral injuries secondary to AB during sports practice and discusses its indications, benefits, and guidelines for future research. A 3-mm Ethylene Vinyl Acetate (EVA) soft plate was selected as the material for MG fabrication, which was designed to fit the mandibular arch with an occlusal coverage thickness of 1.5-2 mm, vestibular and lingual extensions up to 3-4 mm away from the gingival margin, and an anterior connecting rod thickness of 3-5 mm. The proposed MG is intended to provide comfort, aesthetics, and protection against AB injuries for athletes who may experience neuromuscular benefits when clenching their teeth. For amateur and recreational athletes, promoting cognitive and behavioral changes for AB control is also suggested. Future in vitro and clinical studies are necessary to investigate the mechanical properties and clinical performance of the proposed MG.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Study of Dental Trauma in Israel Military Personnel.","authors":"Yael Arbel, Yael Permut, Yehuda Zadik, Nir Tsur","doi":"10.1111/edt.13054","DOIUrl":"https://doi.org/10.1111/edt.13054","url":null,"abstract":"<p><strong>Background: </strong>Traumatic dental injuries (TDIs) are a significant public health concern, especially prevalent among active populations like military personnel, where the causes and consequences of such injuries can be particularly severe due to the nature of their duties. This study aimed to investigate the patterns, associated injuries, and complications experienced by military personnel who sustained dental trauma.</p><p><strong>Methods: </strong>This retrospective observational study utilized data from the Israel Defense Forces Trauma Registry, examining incidents from January 1997 through December 2018. The focus was on military personnel with injuries localized to the head, neck, and maxillofacial regions, analyzing the prevalence, types, and management of dental trauma.</p><p><strong>Results: </strong>Out of 672 documented cases, 71 (10.5%) involved dental injuries. The most common injuries were tooth loss (5.2%), followed by tooth crown fractures (3.4%) and periodontal ligament (PDL) injuries (1.9%). Incisors were the most frequently injured teeth. Temporomandibular joint disorder (TMD) was identified in 10.2% of the subjects, with a notable 42.9% of TMD patients sustaining dental injuries as well.</p><p><strong>Discussion: </strong>The study highlights the unique challenges of managing TDIs in military settings, emphasizing the need for early and effective treatment to prevent long-term consequences. Comparisons with civilian data reveal higher rates of severe injuries in military personnel, underscoring the importance of specialized training for military dentists in trauma management.</p><p><strong>Conclusion: </strong>Dental injuries in the military require a focused approach due to the severe nature of the traumas involved. Effective management of these injuries is crucial to ensure the personnel's rapid recovery and continued operational readiness. The findings recommend implementing specialized training for military dentists and introducing mouthguard policies to mitigate dental injuries in combat scenarios.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Workflow for the Fabrication of a Carbon Fiber Face Guard to Prevent Orofacial Trauma: An overview and Case Report","authors":"Airin Karelys Avendaño Rondon,&nbsp;Maribí Isomar Terán Lozada,&nbsp;Izabela Batista Cordeiro,&nbsp;Maryuri del Carmen Macias Bautista,&nbsp;Thiago Leite Beaini,&nbsp;Priscilla Barbosa Ferreira Soares,&nbsp;Carlos José Soares","doi":"10.1111/edt.13050","DOIUrl":"10.1111/edt.13050","url":null,"abstract":"<p>Face guards effectively reduce the risk of facial injuries in athletes. This study aimed to present a case report and discuss the scientific literature on facial trauma in sports and innovations in the fabrication of face guards. Global regulatory disparities and the importance of education in promoting the use of protective equipment are key factors for injury prevention. Conventionally, alginate impressions have been widely used in manufacturing processes. However, the implementation of digital workflows involving photogrammetry and three-dimensional printing offers a promising alternative for fabricating customized face guards. Various materials have been used for fabricating the outer layer of face guards, with carbon fibers standing out for their ability to enhance both protection and comfort. These findings suggest that digital innovations and custom designs can improve athlete safety and increase comfort and confidence, thereby contributing to a safer sports environment.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"41 4","pages":"377-386"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/edt.13050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrasting Responses Following Transverse Root Fractures in Two Maxillary Central Incisors: (a) Marginal Breakdown With Superimposed Infection and (b) Transient Internal Surface and Tunnelling Resorption. A Case Report of Management With a 34-Year 9-Month Follow-Up","authors":"Geoffrey S. Heithersay,&nbsp;Lawrence Alvino","doi":"10.1111/edt.13049","DOIUrl":"10.1111/edt.13049","url":null,"abstract":"<p>An example of contrasting responses in two root fractured teeth in a 16-year-old male seriously injured in a hit-and-run motor accident is documented over a 34-year 9-month period. Extended non-surgical endodontic management was necessary for one of the root-fractured central incisors that had developed an infective marginal breakdown, and by contrast, the contralateral incisor with a diagnosis of internal surface resorption and internal tunneling resorption was carefully monitored to ultimate resolution.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"41 4","pages":"476-483"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/edt.13049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth F.I.R.S.T Aid: An Acronym-Based Awareness Tool Aligned With Updated Guidelines for Emergency Management of Tooth Avulsion.","authors":"Mebin George Mathew, Joe Mathew Cherian, Kevin George Varghese, Nebu Philip, Nirmal Kurian","doi":"10.1111/edt.13051","DOIUrl":"https://doi.org/10.1111/edt.13051","url":null,"abstract":"<p><p>Tooth avulsion is among the most severe dental traumas, with prognosis heavily dependent on prompt and appropriate management at the accident scene. Despite existing educational resources, a significant knowledge gap persists among laypersons regarding emergency response to tooth avulsion. The TOOTH F.I.R.S.T Aid acronym is introduced as an effective educational tool aligned with the 2020 International Association of Dental Traumatology (IADT) Guidelines to simplify and promote correct immediate actions. This short communication presents the acronym, emphasizes its importance, discusses strategies for its implementation, addresses potential limitations, and encourages its promotion to improve outcomes in dental avulsion cases.</p>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Physical Activity on the Occurrence of Traumatic Dental Injuries in Primary Dentition: A Cohort Study in Southern Brazil","authors":"Muriel Denisse Rivera López,&nbsp;Mariana Gonzalez Cademartori,&nbsp;Marília Leão Goettems,&nbsp;Flávio Fernando Demarco,&nbsp;Pedro Curi Hallal,&nbsp;Vanessa Polina Pereira da Costa","doi":"10.1111/edt.13045","DOIUrl":"10.1111/edt.13045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To verify the association between physical activity (PA) and prevalence and severity of traumatic dental injuries (TDIs) in 4-year-old children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort study was conducted involving all children born in 2015 in Pelotas, Brazil. During the 4-year follow-up period, mothers answered a questionnaire regarding their child's health and demographic characteristics. All children underwent a clinical examination to assess their oral health, including TDIs, classified as per the United Kingdom Children's Dental Health Survey criteria and Glendor's classification for injury severity. PA levels were measured using an accelerometer and maternal perceptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of TDI was 14.5% and 85.5% for complicated and uncomplicated TDIs, respectively. The cohort comprised 50.5% boys and 49.5% girls, with a higher TDI prevalence observed in boys (22.4%) than in girls (17.9%) (<i>p</i> = 0.001). Furthermore, boys exhibited more severe TDIs (<i>p</i> &lt; 0.001). No association was observed between PA and the prevalence of TDIs in the overall cohort. However, a trend toward an increase in the severity of complicated trauma (TDI) with higher levels of PA was observed. In particular, children in the higher tertile had a higher proportion of severe TDIs compared to those in the lower PA tertile (relative risk [RR]: 2.42; 95% confidence interval [CI]: 1.34–4.36). Moreover, children whose mothers considered them more active than their counterparts were more likely to have complicated TDIs (RR: 1.52; 95% CI: 1.06–2.20).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found an association between the severity of TDIs and increased PA. To avoid TDIs, a safer environment for PA should be provided.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55180,"journal":{"name":"Dental Traumatology","volume":"41 4","pages":"419-426"},"PeriodicalIF":2.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}