Background. Traumatic dental injuries represent nearly 5% of children and adolescents’ injuries leading to serious medical and psychological issues. This current study aims to evaluate the prevalence of dental trauma and its potential association with different predisposing factors among 12-and 15-year-old schoolchildren in Lebanon. Materials and Methods. 7902 schoolchildren, 3806 male and 4096 female aged 12 years (n = 3985) and 15 years (n = 3917), were recruited by a stratified multistaged randomized cluster sampling method from public and private schools and were clinically examined in a national cross-sectional study. WHO criteria were used to assess anterior permanent teeth; the nature of trauma, the tooth involved, the size of the incisal overjet, and the type of the lip coverage were furthermore assessed. Data regarding age, sex, and causes of TDI were recorded through a structured questionnaire. Results. The prevalence of dental trauma to anterior teeth was 10.9%. Maxillary central incisors (83.7%) were commonly affected. The most common type of injury was enamel fracture (68.3%), falls being the main reason (52.5%). Increased overjet (OR = 2.32, p  = 0.034), deficient lip coverage (OR = 5.73, p  = 0.019), and gender (OR = 5.36, p  ≤ 0.001) were significant predisposing factors for dental trauma. Conclusion. This research highlighted many predisposing factors for dental trauma that affect commonly the anterior teeth. Based on these results, the implementation of strategic preventive measurements targeting especially the identified risk groups remains crucial.

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Introduction: Implant esthetics can be compromised with a lack of hard and/or soft tissue in the anterior maxilla. Soft‐tissue augmentation is often a crucial step in optimizing esthetic outcomes. Palatal pedicle soft‐tissue grafts present a versatile option and have a high survival potential. This case series presents a pedicle connective tissue graft technique with novel palatal tunneling as an additional tool for implant site development. It has multiple indications, including complete socket closure, augmentation of soft‐tissue volume, enhancement of gingival papillae, and treatment of peri‐implant defects. Case Series: In the first case, the pedicle graft was performed to achieve soft‐tissue closure over a socket preservation site that was fully dehisced on the facial aspect. This procedure allowed for protecting the bone graft and developing the soft tissue for implant placement 4 months later. The second case was more challenging because of an ankylosed maxillary central incisor presenting with a severe gingival discrepancy. After tooth extraction and hard‐tissue reconstruction, a pedicle graft was used at the time of implant placement to augment the soft tissue over the facial dehiscence of the implant in combination with a bone graft. Conclusions: The novel palatal tunneling in this technique improved the positioning of the pedicle graft at the recipient site. It also preserved the integrity of the mucosa palatal to the defect site by minimizing the protuberance that resulted at the site of pedicle rotation. Soft‐tissue height and volume were found to be increased.

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Focused Clinical Question: How can the soft tissue be managed with autogenous options after tooth extraction in the anterior maxilla? Summary: Esthetic concerns are of unique importance in the anterior maxilla. Tooth loss usually leads to significant alterations of the soft‐ and hard‐tissue components of the ridge. These alterations may be prevented or minimized by a variety of tissue augmentation methods at different time points, ranging from tooth extraction to the placement of a restoration. Autogenous soft‐tissue options are available to achieve complete closure of socket grafting and immediate implant sites. They comprise free gingival grafts, free connective tissue grafts, pedicle palatal tissue grafts, and coronally advanced flaps. A decision tree is presented for the different hard‐ and soft‐tissue management options after tooth extraction in the anterior maxilla. Conclusions: The literature lacks comparative studies among the different soft‐tissue grafting techniques designed for soft‐tissue closure of extraction sockets. Nonetheless, full closure is recognized as an important hallmark for improved healing outcomes. Soft‐tissue augmentation and volume increase were clinically evident with the various techniques. The minimal adverse healing events and improved survival reported with the pedicle grafts tend to favor these options in socket preservation cases, whereas coronally advanced flaps are preferred in severe cases involving multiple sockets.

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Background: Studies addressing the oral health status among Lebanese school children are scarce. Aims: To assess the oral health status of Lebanese school children, and to provide epidemiological data for planning and evaluation of oral health care programmes. Methods: We selected 7902 schoolchildren aged 12–15 years from the 6 governorates of Lebanon, using a multistage probability sampling method. Data were obtained by self-administered structured questionnaires and clinical examinations (World Health Organization methodology and criteria). Dental caries was recorded using the Decayed, Missing, and Filled Teeth (DMFT) index. Periodontal status was evaluated using the Community Periodontal Index (CPI). Results: The mean (standard deviation) number of decayed, missing and filled teeth was 3.01 (2.927), 0.05 (0.245) and 2.14 (2.071), respectively, and the mean DMFT score was 5.20 (3.549). Among the whole tested population, the prevalence of caries was 89.5% and only 10.5% of the children were completely free of caries. Age, geographic location and school sector were the most significant risk factors for caries prevalence. Periodontal disease (CPI score > 0) was seen in 7633 participants (96.6%). In contrast to the shallow periodontal pockets that showed a low prevalence, calculus was the most frequently detected periodontal condition in both ages (50.9% at 12 years old and 50.2% at 15 years old). Age, sex, school sector and smoking status were significantly associated with occurrence of periodontal disease. Conclusion: Preventive and restorative public health campaigns are highly recommended to improve oral health status among Lebanese schoolchildren.