Over two hundred million injuries to anterior teeth attributable to large overjet: a meta‐analysis

Background/Aims Traumatic dental injuries are one of the most prevalent diseases globally, impacting people of different ages and socio‐economic statuses. As disease prevention is preferable to management, understanding when an individual's overjet is prone to dental trauma helps identify at‐risk patients, so to institute preventive strategies. The aim of this study was to identify the different overjet sizes that present an increased risk for developing dental trauma across different ages and dentition stages. Methods The title and protocol were registered and published a priori with the Joanna Briggs Institute (JBI) and PROSPERO (CRD42017060907) and followed the JBI methodology of systematic reviews of association (etiology). A three‐step search strategy was performed, including electronic searches of gray literature and four databases. Studies of healthy human participants of any age and in any dental dentition stage were considered for inclusion. Only high methodological quality studies with low risk of bias were included. Where possible, meta‐analyses were performed using the random‐effects model, supplemented with the fixed‐effects model in situations where statistical heterogeneity was ≤50%, assessed using the I2 statistic. Results The study identified 3718 articles, 41 were included. An increased overjet was significantly associated with higher odds of developing trauma in all dentition stages and age groups. Children 0‐6 years with an overjet ≥3mm have an odds of 3.37 (95%CI, 1.36‐8.38, P = 0.009) for trauma. Children in the mixed and secondary dentition with an overjet >5mm have an odds of 2.43 (95%CI, 1.34‐4.42, P = 0.004). Twelve‐year‐old children with an overjet >5mm have an odds of 1.81 (95%CI, 1.44‐2.27, P < 0.0001). Conclusions The results confirm the association between increased overjet and dental trauma. A child in the primary dentition could be considered as having an overjet at risk for trauma when it is ≥3mm. In the early secondary dentition, the threshold for trauma is an overjet ≥5mm.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The association of overjet size and traumatic dental injuries—A systematic review and meta‐analysis

Arraj

Rossi‐Fedele

Doğramacı

2019

“…The remaining respondents reported asking about dental trauma only with evidence of increased overjet or clinical evidence of previous dental trauma. Although an increased overjet of 3 mm or more has been shown to be associated with a twofold increase in the risk of dental trauma, such an approach carries the risk of overlooking patients with history of dental trauma.…”

Section: Discussionmentioning

confidence: 99%

Orthodontic management of traumatized teeth: A national survey of UK orthodontists

Sandler¹,

Barry

Littlewood

et al. 2019

Background/Aim There is a lack of research into orthodontic movement and management strategies of traumatized teeth. The aim of this survey was to assess the knowledge of UK‐based orthodontists in the orthodontic management of traumatized teeth. Materials/Methods A 24‐item questionnaire survey was electronically distributed to all members of the British Orthodontic Society. Results A total of 213 respondents completed the survey with the majority of these being UK registered specialists in orthodontics. Three responses were excluded as one was not based within the UK and two were orthodontic trainees with <1 year of experience, leaving a total of 210 respondents. The majority had orthodontically treated up to three patients with a history of dental trauma in the preceding 3 months. Obtaining a trauma history was done by the majority of respondents. A wide variation in times waited by respondents before orthodontically treating teeth with different types of traumatic injuries was observed. Similarly, the preferred orthodontic management strategies of traumatized teeth differed substantially among respondents. Almost all respondents were interested in further training in the management of dental trauma. Conclusions The study showed a wide variation in the orthodontic management of traumatized teeth among UK‐based orthodontists. Further training and national guideline establishment are indicated for orthodontic management of traumatized teeth in the UK.

“…Accentuated overjet stands out among the few variables consistently demonstrated as risk factors for the occurrence of TDI in both the primary and permanent dentitions. A recent systematic review including children, adolescents, and adults concluded that accentuated overjet accounts for 22% of TDIs worldwide . Indeed, accentuated overjet is the most commonly identified risk/associated factor in the primary dentition ().…”

Section: Factors Associated With Tdi In the Primary Dentitionmentioning

confidence: 99%

Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence

Feldens

Borges

Vargas‐Ferreira

et al. 2016

The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.