Avulsão dental: desempenho de serviço público de trauma, conhecimento profissional e fatores determinantes de sucesso

Abstract

Dental avulsions are serious injuries that affect children and adolescents. Its prognosis is dependent on measures taken by lay people who have assisted the victim after the accident. This study aims to investigate the epidemiological characteristics and management details of avulsion cases, the level of knowledge presented by lay people directly involved with the risk group and to evaluate the factors that impact treatment prognosis of this type of lesion. Therefore, three specific objectives were presented. Objective 1: To access, through the analysis of patient’s records, the epidemiology and teeth management details of avulsion cases attended at a specialized dental trauma service. Objective 2: To investigate the factors related to the level of knowledge about dental avulsion presented by parents, elementary school teachers, physical educators and undergraduate Linguistics, Pedagogy and Physical Education students, by means of a questionnaire-based survey. Objective 3: To investigate the influence of factors related to the patient and to the management of the avulsed tooth on the prognosis of replantation, using case reports as examples of scientific-based clinical conducts. Regarding objective 1, it was found that the majority of avulsion victims belong to 6-10 (31,2%) e 11-15yrs (26,9%) age groups. Male individuals (58%) were more affected than females (42%). The main etiological factor was bicycle falls (31.2%). Patients sought treatment on the same day of the accident in 88.2% of the cases, however, 36.7% of the teeth were not replanted. Only one tooth was immediately reinserted into the alveolus. Most of teeth were kept in dry medium (30.2%) while 8.6% were stored in milk. In relation to objective 2, it was found that the level of knowledge presented by the participants was independently associated with their age and with the interviewed group that they belonged to. Ages above 45 years were related to the highest levels of knowledge (65.2%). Primary school teachers presented the highest level of knowledge (65.1%) while undergraduates in Letters, the lowest one (10.3%). Regarding objective 3 it has been observed that root resorptions are a common outcome in avulsion cases. The patient's age and the extralveolar time, especially the period in which the tooth was kept in a dry medium, have a great influence on the prognosis of avulsion. The youngest the patient, the faster the progression of root resorptions and the more serious is the manifestation of their sequelae. According to the present study, it was possible to conclude that the great majority of avulsed teeth are incorrectly handled and that the people who are directly related to the risk group do not have sufficient information in order to proper to handle avulsion cases. Thus, the risk group composed of children and adolescents is exposed to serious sequelae derived from avulsion, since their age and the inadequate handling of their teeth are directly related to the development of root resorptions.