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Exceptionally high rates of tooth fracture in large Pleistocene carnivorans imply intensified interspecific competition, given that tooth fracture rises with increased bone consumption, a behavior that likely occurs when prey are difficult to acquire. To assess the link between prey availability and dental attrition, we documented dental fracture rates over decades among three well-studied populations of extant gray wolves that differed in prey:predator ratio and levels of carcass utilization. When prey:predator ratios declined, kills were more fully consumed, and rates of tooth fracture more than doubled. This supports tooth fracture frequency as a relative measure of the difficulty of acquiring prey, and reveals a rapid response to diminished food levels in large carnivores despite risks of infection and reduced fitness due to dental injuries. More broadly, large carnivore tooth fracture frequency likely reflects energetic stress, an aspect of predator success that is challenging to quantify in wild populations. Gray wolves roam many European and American landscapes, where they prey on large animals such as elk and moose. A healthy dentition is essential for these predators to kill, eat and defend themselves. As a result, they tend to avoid biting down on tough body parts, such as bones, so that their teeth do not break. If food becomes scarce however, the wolves may resort to consuming these hard elements, eating more of the carcasses and leading to more damaged teeth. It could therefore be possible to assess the food levels available to existing (or even extinct) wolf populations based on how many broken teeth the animals have. However, older individuals are also more likely to have more damaged teeth, so age would need to be taken into consideration. Van Valkenburgh et al. decided to evaluate whether it was indeed possible to deduce how much food was available to groups of wolves based on teeth damage. Tooth wear and fracture were quantified in three current populations of gray wolves whose skulls had been collected and preserved in natural history collections. For each group, there were data available about the variations of number of moose per wolf over time, and how much of the carcasses the wolves were consuming. The analyses showed that indeed, when prey became less abundant, the wolves ate more of the remains – including the bones – and therefore broke more teeth. These conclusions can be applied to other large predators and even to extinct species such as dire wolves or sabertooth cats. Tapping into the potential of museum specimens could help to retrace environmental conditions and the history of animals now long gone.

Introduction This survey reports the incidence of traumatic dental injuries in an adult population attending an adult dental trauma clinic in a London teaching hospital. Materials and methods Retrospective data were collected from patients attending an adult dental trauma clinic between 2012 and 2018. Results In total, 1,769 patients attended, with more men seen (1,030; 58.2%) compared to women (739; 41.8%) and this was statistically significant (p <0.05). The most common aetiological factor was an accidental fall (728; 41.15%), followed by assaults (413; 23.35%), bicycle accidents (253; 14.3%), sports injuries (132; 7.46%) and road traffic accidents (84; 4.75%). Lateral luxation (833) was the most common traumatic injury and this was followed by avulsions (362; 17%). Enamel-dentine fractures were the most common type of fracture injury (1,273; 64%). Discussion This retrospective survey attempts to report on the incidence of traumatic dental injuries in a London-based cohort of patients attending a specialised dental trauma clinic. In line with other reports, there were more men than women affected, which is probably attributed to behavioural activities. Conclusion(s) Accidental falls are the most common cause of a traumatic dental injury, lateral luxation was the most common type of displacement injury and enamel-dentine fractures were the most common type of fracture injury. Key points Reports incidence of dental trauma in adults in the UK. Outlines the aetiology of dental trauma. Describes the differences between men and women in sustaining dental trauma. Lists the types and incidence of fracture injuries presenting to an adult dental trauma service.

Objectives The aim of this study was to investigate the prevalence, by gender, of vertical root fracture (VRF) as the main reason for the extraction of permanent teeth in dental clinics in Tokyo. Materials and methods Participating dentists were requested to provide information about extractions of permanent teeth they had performed from 1 January 2013 to 30 June 2013. The main reasons for extraction were categorized as follows: VRF, caries (horizontal root fracture included), periodontal disease and others. Results At a total of 24 clinics, 736 teeth were extracted from 626 patients during the 6-month period. A total of 233 teeth were extracted by VRF (31.7 %), and 93.6 % of these were endodontically treated teeth. Among non-vital extracted teeth, 82.1 % (179/218) had cast posts or screw posts. The percentage of extraction due to VRF was 29.4 % in males and 34.7 % in females. In females, the percentage of extractions due to VRF (34.7 %) was higher than for periodontal disease (28.1 %). In males, the percentage of extractions due to VRF increased with age ( p  < 0.05). The tooth types with the highest percentage of extractions due to VRF were the upper canine (46.7 %), lower second premolar (48.0 %) and lower first molar (50.0 %) in males and the upper first premolar (43.3 %), upper second premolar (44.4 %), lower second premolar (53.8 %) and lower first molar (54.5 %) in females. Conclusions These results indicate that we need to pay more attention to maintaining vital teeth while being aware of the particular tooth types in which VRF most frequently occurs.

ABSTRACT Objectives This study was performed to identify the characteristics of oral and maxillofacial injuries in children and determine factors influencing a treatment duration of more than 1 month using medical records. Material and Methods This retrospective observational study reviewed medical records of 258 children (< 16 years of age) with maxillofacial trauma treated at a university hospital between 2011 and 2021. Patients with and without tooth fractures or dislocations were compared, and the prevalence of injuries was analyzed across three age groups (0–2, 3–5, ≥ 6 years). Long (> 1 month) and short (< 1 month) treatment durations were compared, and independent predictive factors for prolonged treatment were identified. Results Tooth injuries were observed in 204 (79.1%) patients. Deciduous central incisors in the primary dentition and central incisors in the permanent dentition were the most commonly affected. Soft tissue injuries occurred in 165 (64.0%) patients, while maxillofacial fractures were present in 7 (2.7%). Tooth fractures significantly increased with age (p < 0.001), while dislocations showed no age‐related differences. Logistic regression revealed that maxillofacial fractures, tooth fractures, and two or more dislocated teeth were independent predictors of prolonged treatment, with odds ratios of 14.666 (1.625–132.359), 2.411 (1.099–5.287), and 2.350 (1.208–4.570), respectively. Conclusions Maxillofacial fractures, multiple tooth dislocations, and tooth fractures were confirmed as key factors influencing longer treatment durations. These findings may assist in the early management of maxillofacial injuries and improve communication with pediatric patients and their families.

ABSTRACT Objectives The Covid‐19 pandemic increased stress, which may have led to more bruxism, TMDs, and thus tooth fractures. While previous studies, primarily from specialized clinics, reported an increase in cracked teeth during the pandemic, this retrospective study aimed to assess whether similar trends were observed in a general dental practice in Bavaria, Germany, which remained fully operational throughout the pandemic. Material and Methods Patient records from 2018 to 2023 (n = 4709 patients, 10,018 visits) were analyzed for symptomatic tooth fractures, categorized as wall/cusp fractures, incomplete cracks, or complete fractures. Results Statistical analysis using the Mann–Whitney U test revealed no significant differences in fracture incidence between pre‐pandemic (2018–2019), pandemic (2020–2021), and post‐pandemic (2022–2023) periods. Mandibular molars were the most frequently affected teeth (7.94%–12.43%), and composite restorations were most associated with fractures (51.85%). Conclusions Contrary to previous findings from endodontic practices, this study found no pandemic‐related surge in tooth fractures, suggesting that referral bias or patient selection in specialized settings may influence reported trends.

Background Chronic neurologic disorders (CND) comprise a heterogeneous group of disorders including disorders of motor and posture which mainly affect the body’s nervous system and have lasted for or are virtually certain to last for one year and produce at least one type of consequence namely functional limitation, reliance on compensatory assistance for functioning, or increased service. Objective The study identified the prevalence of dental diseases (dental caries, poor oral hygiene, traumatic dental injury) among children with CND. It also assessed the relationship between socio-demographic profile (age, sex, socio economic status) and presence of dental diseases in children with CND. Methods This was a cross-sectional study of 80 children attending neurology clinic of UNTH, Enugu and 72 children used as control attending a primary school in the study area. Data on sociodemographic profile, past dental visit, oral hygiene status, presence of dental caries, tooth fracture, and neurological condition were collected. Oral hygiene status was assessed using Oral Hygiene Index by Greene and Vermilion, presence of caries was assessed using World Health Organization criteria and presence of tooth fracture was assessed using Garcia Godoy classification. Data was analyzed using SPSS version 26. Association between the age, sex, SES, and oral hygiene, dental caries, traumatic dental injuries and Chronic neurological disease was conducted using Chi square test. P  < 0.05 was considered significant. Result The age range was 15 years and below and the mean age was 6.31 ± 4.05years. Many 39(48.8%) of the participants were 5 years and under, and a few 2(2.5%) were from a high socioeconomic class. For children with non chronic neurological disorder, there were more 39(54.2%) females than males 33(45.8%). Many children were aged 6–10 years and many 50(69.4%) were in the middle socio economic status. Epilepsy (66.3%) was the commonest neurological condition seen. There was significant association between oral hygiene status ( p  < 0.001) and the presence of chronic neurological disorder. Conclusion Epilepsy was the commonest neurological condition seen. A fifth (20%) of children with chronic neurological conditions had poor oral hygiene status and there was significant association between oral hygiene status and chronic neurological disorder among children in the study population.

Background/aim The aim of this study was to analyze a population of patients who had suffered from traumatic dental injuries (TDIs) by using different patient-, trauma- and treatment-related parameters. Material and methods All dental records of patients ≥ 3 years old who had presented at the dental emergency service between Jan 1, 2009 and Dec 31, 2016 for the treatment of dental trauma were analyzed. A total of 2758 patients were invited for a recall examination at the Department for Dental Surgery and Implantology, ZZMK Carolinum, Goethe University Frankfurt, Germany; of these, 269 patients attended their recall appointments. Results The enrolled patient population consisted of 1718 males and 1040 females, with a mean age of 19.63 years (median 12.00 ± 17.354 years). A total of 4909 injured teeth were assessed, with a mean of 1.78 injured teeth per patient (median 2.00 ± 1.279). Males were found to be more frequently affected by TDIs compared to females (1.65:1). The majority of these injuries occurred in the first two decades of life (66.1%; n  = 1824). The majority of the patients presented for initial treatment within 24 h of their accident (95.7%). The most frequent TDIs were isolated luxation injuries 49.4% ( n  = 2426) and isolated crown fractures 30% ( n  = 1472). Combination injuries were diagnosed in 20.6% of the cases ( n  = 1011). Conclusions Based on the findings of the present analysis, it can be concluded that males were more frequently affected by TDIs than females. Most patients had suffered from TDI before they had turned 10 years of age. Overall, the enamel–dentin fracture was found to be the most frequent injury, followed by concussions and lateral luxations. Graphical Abstract

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.

This study aimed to determine the injury prevention-, safety education-, and violence-related factors pertaining to tooth fracture experience (TFE) in Korean adolescents. We used data from the 14th Korea Youth Risk Behavior Survey (KYRBS) in 2018. The 60,040 participants were selected using a complex sampling design from middle and high schools. The participants completed a self-administered questionnaire. The explanatory variables, including school safety education and violence, were assessed in relation to prevention of traumatic injuries. Complex-samples multivariable logistic regression models were applied to explain the factors related to TFE over the past 12 months. The overall prevalence of TFE was 11.4%. Risk factors related to tooth fractures were not wearing a seatbelt on an express bus, not wearing helmets while riding motorcycles and bicycles, clinical treatment due to injuries at school, injuries associated with earphone/smartphones use, and lack of school safety education such as danger evacuation training. The top risk factor was injuries associated with earphone/smartphone usage, followed by lack of familiarity with school safety education. Thus, to prevent tooth fractures among adolescents, schools should strengthen their safety education, including education regarding mobile device usage, and wearing a seatbelt and wearing a helmet. Care should be taken to manage facilities around the school and to prevent injury related to tooth fracture. Further studies on various risk factors related to tooth fractures are warranted.

Objective: The objective of this study was to determine the prevalence of traumatic dental injuries (TDIs) in the anterior teeth among children attending paramilitary and nonparamilitary schools in Benin City, Nigeria. Materials and Methods: A multistage sampling technique was used to select children aged 8-12 years with a previous history of trauma to the orofacial region. A self-administered questionnaire was then applied, and each participant was examined clinically. Data collected included demographic characteristics, etiology and place of injury, affected teeth, type of dental injury, lip competence, and overjet values. Analysis of data was done with the SPSS version 21.0 software. Pearson's Chi-squared test was used to determine the association between variables and odds ratio. Statistical significance was determined at P < 0.05. Results: A total number of 1352 children (mean age: 9.89 ± 1.4 years) were examined and 154 (11.4%) had a previous history of TDI. The prevalence among respondents in the paramilitary schools was 84 (6.2%) and those in nonparamilitary schools 70 (5.2%). Falls and play was the most common cause of TDI and was higher in children in paramilitary schools. Ellis Class I was the most prevalent type of injury in 91 (59.1%), tooth number 21 was the most traumatized, and the school environment was the most common place. Of the total number of respondents with TDI, the relationship between etiology with age, lip competence, and overjet was statistically significant (P < 0.05). Conclusion: The prevalence of TDI among the study participants was 11.4% and more in the paramilitary schools than the nonparamilitary.