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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE KARNATAKA MASTER OF DENTAL SURGERY PEDODONTICS AND PREVENTIVE DENTISTRY SYNOPSIS FOR REGISTRATION OF DISSERTATION SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL CHOLANAGAR, RT NAGAR POST BANGALORE-560032 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE ANNEXURE-II PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION 1 NAME OF THE CANDIDATE DR.VARUN KUMAR SHARMA AND ADDRESS POST GRADUATE STUDENT, (IN BLOCK LETTERS) DEPARTMENT OF PEDODONTICS AND PREVENTIVE DENTISTRY, SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL, CHOLANAGAR, RT NAGAR POST, BANGALORE-560032 KARNATAKA 2 NAME OF THE INSTITUTION SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL, CHOLANAGAR, RT NAGAR POST, BANGALORE-560032 KARNATAKA 3 COURSE OF THE STUDY AND SUBJECT MASTER OF DENTAL SURGERY PEDODONTICS AND PREVENTIVE DENTISTRY 4 DATE OF ADMISSION 11/07/2013 5 TITLE OF THE TOPIC “ PREVALENCE OF TRAUMATIC DENTAL INJURIES TO THE ANTERIOR TEETH AMONG 8 TO 12 YEAR OLD SCHOOL CHILDREN IN NORTH BANGALORE” 6.1. NEED FOR THE STUDY WHO recognizes oral health as an integral part of general health. Furthermore, oral disease and conditions, including oral cancer, dental trauma and craniofacial anomalies, all have broad impacts on oral health and well-being.1 There is perhaps no single disturbance that has greater psychological impact on both the parents and children than the loss or fracture of a child’s anterior teeth. Traumatic dental injuries are a public health problem and one of the main reason for dental emergencies in children and adolescents.2 Reliable data on the frequency and severity of traumatic dental injuries are still lacking in most countries, particularly in developing countries.1 Therefore, the aim of the study is to assess the prevalence of dental trauma in 8-12 year old school children in North Bangalore and also to assess the risk factors associated with trauma such as overjet, lip coverage and malocclusion. REVIEW OF LITERATURE A study was done to assess the prevalence of traumatic injuries to incisor teeth in 2100, school children of South Kanara district in Karnataka. The children selected were in the age group of 8-14 years. The study concluded that the prevalence rate of fracture in incisor teeth was around 13.80%.3 A study was conducted to evaluate the prevalence of traumatic dental injuries among 12year-old school children in Kerala. Teeth examined were maxillary and mandibular incisors and canines. The study concluded that the prevalence of traumatized anterior teeth among 12-year-olds in Kerala was 6.1%, which was low when compared with other studies.4 Another study was conducted to investigate the prevalence and factors associated with traumatic injuries to permanent incisors of 12-year-old school children in Davangere, India. The sample size included 1020, 12-year- old school children and examination was done for lip coverage and maxillary overjet using the Community Periodontal Index probe. The maxillary incisors were commonly injured, with enamel fracture being the common injury. Children with excessive overjet and inadequate lip coverage were more likely to have injuries. The study concluded that TDI to permanent incisor teeth was (15.1%).5 In another study done to investigate the prevalence of traumatic dental injuries (TDI) in school children in Baddi-Barotiwala, Himachal Pradesh, India, the prevalence was found to be 4.15%. It was observed that maxillary central incisor was the most common tooth to be affected due to trauma. Overjet and inadequate lip coverage were found to be important contributing factors for TDI’s. The study concluded that children with inadequate lip coverage has 3.4 times more traumatic dental injury than those with adequate lip coverage.6 Another study was conducted to evaluate the prevalence and distribution of traumatic dental injuries (TDI) to anterior teeth among 3200 school children in the age group of 3 to 13 year old in Chidambaram, Tamilnadu. Information concerning sex, age, cause of trauma, number of injured teeth, type of the teeth, lip competence, terminal plane relationship and the molar relationship were recorded. The study concluded that the level of traumatic dental injuries in boys (10.7%) was significantly higher than the girls (9.3%).7 A study was conducted to investigate the prevalence of dental traumatic injuries in children of age group 7 to 12 years in private schools in Gulabgarh village, Mohali, India. The maxillary central incisor was found to be most commonly affected tooth and most common cause of injury reported was fall during playing. The study concluded that children with Angle’s class II Div 1 malocclusion exhibited 21.9% traumatic injuries.8 A study was done to investigate the prevalence of dental trauma among primary school children aged 6–11 years in Belgaum, India. The sample size included 13,200 children from primary schools of Belgaum district who were examined for dental trauma. It was observed that an overjet more than 3 mm and incompetent lips were significantly associated with dental trauma in children. The study concluded that the total number of children suffering from dental trauma was 14.74%.9 A cross-sectional survey was carried out in 1052 government and private school children to assess the prevalence of anterior tooth trauma. The data regarding the traumatic injuries to anterior teeth along with various risk factors were recorded using the Ellis and Davey’s classification. The study concluded that the prevalence of anterior tooth trauma was 18.25%. Increased overjet and overbite were found to be important contributing factors for traumatic dental injuries.10 A study was done to investigate the prevalence and role of socioeconomic status and anatomic risk factors in traumatic dental injuries (TDI) to permanent anterior teeth in 10 to 16 year old Sainik (Army) school children in India. The permanent anterior teeth of 446 male school children were examined for TDI. The reported prevalence of TDI to permanent anterior teeth was 23.8%. Inadequate lip coverage and a large maxillary overjet were identified as important predictors for dental trauma. The study concluded that a high prevalence of dental trauma was observed in the study population suggestive of low awareness regarding the cause, effects and prevention of the condition.11 OBJECTIVES OF THE STUDY To assess the prevalence of traumatic dental injuries in 8-12 year old school children of North Bangalore. To correlate the prevalence of traumatic dental injuries with associated risk factors such as lip coverage, overjet and malocclusion. 7. MATERIALS AND METHODS 7.1 SOURCE OF DATA: School children in the age group of 8-12 years, of North Bangalore. INCLUSION CRITERIA: School going children in the age group of 8-12 year from the selected schools with approval from the Block Education Officer and permission of the head of schools. EXCLUSION CRITERIA: School going children who are not cooperative. Special children Children undergoing orthodontic therapy. Traumatic dental injuries to the deciduous teeth. Teeth with developmental defects. Loss of teeth other than traumatic dental injuries. Subjects with clinical evidence of trauma, but with incoherent history. Root fractures are excluded as radiographs will not be taken during the clinical examination. MATERIALS REQUIRED: Mouth mirror Community Periodontal Index (CPI) probe Metallic scale Mouth mask Tongue retractor Pencil Gloves 7.2 STUDY DESIGN: This will be a cross sectional study conducted in both private and government school of North Bangalore. A complete list of schools and formal approval letter from the Block Education Officer as well as from the head of the schools will be obtained to carry out this study. The estimated sample size of 2230 school children was calculated based on the prevalence of traumatic dental injury at 15%, with 95% confidence interval and 10% margin of error. A cluster random sampling technique will be adapted to select the children. Children will be examined by a single examiner in selected schools for any signs of traumatic dental injury under natural day light. Sterilized mouth mirrors and probe will be used for examination. The cases which show clinical evidence of traumatic dental injury will be reexamined to classify the trauma according to WHO classification. Further in children who experienced traumatic dental injuries lip coverage, overjet and malocclusion will be recorded. Lip coverage will be recorded on visual inspection as adequate if lip covered the maxillary incisors in rest position and inadequate if two third of the crown height was exposed and visible. The overjet will be recorded using the CPI probe as described in 1997 WHO basic oral health survey guidelines. Malocclusion will be assessed by recording the molar relationship according to Angle’s classification with Dewey-Anderson modification. DATA ANALYSIS: Data collected will be subjected to statistical analysis. Chi-square test will be used to assess any difference in distribution of traumatic dental injuries according to children’s characteristics. If required any other statistical method will be used at the time of data analysis. 7.3 Does the study require any investigation or interventions to be conducted on patients or other human or animals? If so, please describe briefly. Yes This study requires a non-invasive oral examination to be conducted on 8-12 year old school children of North Bangalore. 7.4 Has the ethical clearance been obtained from your institution Yes 8. LIST OF REFERENCES: 1. Petersen PE. Priorities for research for oral health in 21st Century-the approach of the WHO Global Oral Health Programme. Community Dental Health 2005;22:71-4 . 2. Petersen PE. Challenges to improvement of oral health in the 21st century-the approach of WHO Global Oral Health Programme. Int Dent J 2004;54:329-43. 3. Gupta K, Tandon S, Prabhu D . Traumatic injuries to the incisors in children of South Kanara district. A prevalence study. J Indian Soc Pedod Prev Dent 2002;20(3):107-13. 4. David J, Astrom AN, Wang NJ. Factors associated with traumatic dental injuries among 12-year-old school children in South India. Dent Traumatol 2009;25:500-5. 5. Ravishankar TL, Kumar MA, Ramesh N, Chaitra TR. Prevalence of Traumatic Dental Injuries to Permanent Incisors Among 12-year-old School Children in Davangere, South India. The Chinese Journal of Dental Research 2010;13:57-60. 6. Gupta S, Jindal SK, Bansal M, Singla A. Prevalence of traumatic dental injuries and role of incisal overjet and inadequate lip coverage as risk factors among 4-15 years old government school children in Baddi-Barotiwala Area, Himachal Pradesh, India. Med Oral Patol Oral Cir Bucal 2011;16(7):e960-e5. 7. Govindarajan M, Reddy VN, Ramalingam K, Durai KS, Rao PA, Prabhu A. Prevalence of traumatic dental injuries to the anterior teeth among three to thirteen-year-old school children of Tamilnadu. Contemp Clin Dent 2012; 3(2):164-7. 8. Dua R, Sharma S. Prevalence, causes, and correlates of traumatic dental injuries among seven-to-twelve-year-old school children in Dera Bassi. Contemp Clin Dent 2012;3(1):38-41. 9. Ankola AV, Hebbal M, Sharma R, Nayak SS. Traumatic dental injuries in primary school children of South India - a report from district-wide oral health survey. Dent Traumatol 2013; 29(2): 134–138. 10. Ahlawat B, Kaur A, Thakur G, Mohindroo A. Anterior tooth trauma: A most neglected oral health aspect in adolescents. Indian Journal of Oral Sciences 2013;4(1):31-7. 11. Prabhu A, Rao AP, Govindarajan M, Reddy V, Krishnakumar R, Kaliyamoorthy S. Attributes of Dental Trauma in a School Population with Active Sports Involvement. Asian Journal of Sports Medicine 2013;4:190-4. 9. Signature of the Candidate 10. 10.1 Remarks of the Guide 10.2 Name and designation of Guide ( in block letters) DR. SANTHOSH T PAUL PROFESSOR AND HEAD DEPARTMENT OF PEDODONTICS AND PREVENTIVE DENTISTRY, SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL, BANGALORE 560032 10.3 Signature 11. 11.1 Co-Guide (If any) DR. UMME AZHER READER, DEPARTMENT OF PEDODONTICS AND PREVENTIVE DENTISTRY, SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL, BANGALORE 560032 11.2 Signature 12. 12.1 Head of the Department DR. SANTHOSH T PAUL PROFESSOR AND HEAD DEPARTMENT OF PEDODONTICS & PREVENTIVE DENTISTRY SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL, BANGALORE 560032 12.2 Signature 13. 13.1 Remarks of the Principal 13.2 Principal of the institution 13.3 Signature DR.VAIBHAVI JOSHIPURA PROFESSOR OF DEPARTMENT OF PERIODONTICS AND PRINCIPAL SRI RAJIV GANDHI COLLEGE OF DENTAL SCIENCES AND HOSPITAL, BANGALORE 560032