Glendor Ulf
Division of Social Medicine and Public Health Science, Department of Medicine and Society, Linköping University, Linköping, Sweden.
Dent Traumatol. 2009 Feb;25(1):19-31. doi: 10.1111/j.1600-9657.2008.00694.x.
BACKGROUND/AIM: During the past 30 years, the number of aetiologies of traumatic dental injuries (TDIs) has increased dramatically in the literature and now includes a broad spectrum of variables, including oral and environmental factors and human behaviour. The aim of this study is to present an international review of well-known as well as less well-known unintentional and intentional causes of TDIs. Moreover, some models that are useful in investigating contact sport injuries are presented.
The databases of Medline, Cochrane, Social Citation Index, Science Citation Index and CINAHL from 1995 to the present were used.
Oral factors (increased overjet with protrusion), environmental determinants (material deprivation) and human behaviour (risk-taking children, children being bullied, emotionally stressful conditions, obesity and attention-deficit hyperactivity disorder) were found to increase the risk for TDIs. Other factors increasing the risk for TDIs are presence of illness, learning difficulties, physical limitations and inappropriate use of teeth. A new cause of TDIs that is of particular interest is oral piercing. In traffic facial injury was similar in unrestrained occupants (no seat belts) and occupants restrained only with an air bag. Amateur athletes have been found to suffer from TDIs more often than professional athletes. Falls and collisions mask intentional TDIs, such as physical abuse, assaults and torture. Violence has increased in severity during the past few decades and its role has been underestimated when looking at intentional vs unintentional TDIs. There are useful models to prevent TDIs from occurring in sports. WHO Healthy Cities and WHO Health Promoting Schools Programmes offer a broad solution for dental trauma as a public health problem.
The number of known causes of TDIs has grown to alarming levels, probably because of increased interest of the causes and the underlying complexity of a TDI. Accepted oral, environmental and human aetiological factors must therefore be included in the registration of TDIs.
背景/目的：在过去30年里，创伤性牙损伤（TDIs）的病因数量在文献中急剧增加，现在涵盖了广泛的变量，包括口腔和环境因素以及人类行为。本研究的目的是对TDIs已知和不太知名的无意和有意病因进行国际综述。此外，还介绍了一些有助于调查接触性运动损伤的模型。
使用了1995年至今的Medline、Cochrane、社会引文索引、科学引文索引和CINAHL数据库。
发现口腔因素（深覆盖伴前突增加）、环境决定因素（物质匮乏）和人类行为（冒险的儿童、受欺负的儿童、情绪紧张的状况、肥胖和注意力缺陷多动障碍）会增加TDIs的风险。增加TDIs风险的其他因素包括疾病的存在、学习困难、身体限制和牙齿的不当使用。一个特别有趣的TDIs新病因是口腔穿刺。在交通事故中，未系安全带的乘客和仅使用安全气囊约束的乘客面部受伤情况相似。已发现业余运动员比职业运动员更容易遭受TDIs。跌倒和碰撞掩盖了故意的TDIs，如身体虐待、袭击和酷刑。在过去几十年中，暴力的严重程度有所增加，在考虑故意与非故意TDIs时，其作用被低估了。有一些有用的模型可用于预防运动中TDIs的发生。世界卫生组织健康城市和世界卫生组织健康促进学校计划为作为公共卫生问题的牙外伤提供了广泛的解决方案。
TDIs已知病因的数量已增长到令人担忧的水平，这可能是由于对病因的兴趣增加以及TDI潜在的复杂性。因此，在TDIs的登记中必须纳入公认的口腔、环境和人类病因因素。
