Title Large Anterior Overjet Increases Risk of Traumatic Dental Injury
Clinical Question In individuals with natural anterior dentition, is there a higher risk of traumatic dental injuries to the anterior teeth in individuals with large overjets as compared to individuals without large overjets?
Clinical Bottom Line A patient’s risk to traumatic dental injury can double to triple in the presence of a large anterior overjet. This statement is supported by a meta-analysis of over 50 different studies spanning 4 continents.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
25263806Petti/2014Over 10,000 children, adolescents, and adults with varying amounts of anterior overjetMeta-Analysis
Key resultsKey Results: Around the world, between 100- 300 traumatic dental injuries can be attributed to the root cause of having a large anterior overjet. Large anterior overjet increases the traumatic dental injury risk by two to three fold. This study separated 3 distinct subgroups based on the type of dentition and the amount of overjet as follows: 1.Patients with primary teeth and an overjet threshold of 3-4mm; denoted Primary3 2.Patients with permanent teeth and an overjet threshold of 3-4mm; denoted Permanent3 3.Patients with permanent teeth and overjet threshold of 6 ±1mm; denoted Permanent6 The adjusted odds ratio (OR) for each group was reported as: an OR of 2.31 (with a 95% confidence interval (95CI), 1.01-5.27) for Primary3, an OR of 2.01 (95CI, 1.39-2.91) for Permanent3, and an OR of 2.24 (95CI, 1.56-3.21) for Permanent6.
Evidence Search ("overbite"[MeSH Terms] OR "overbite"[All Fields] OR "overjet"[All Fields]) AND traumatic[All Fields] AND dental[All Fields] AND ("wounds and injuries"[MeSH Terms] OR ("wounds"[All Fields] AND "injuries"[All Fields]) OR "wounds and injuries"[All Fields] OR "injury"[All Fields])
Comments on
The Evidence
Validity: The meta-analysis found multiple, widely ranging studies that met the inclusion criteria. Within the studies, over 10,000 patients were included and this broad base increases the validity of the study. Perspective: Based on this meta-analysis, it appears that there is a strong correlation between large anterior overjet and traumatic dental injuries. The correlation holds true for all age ranges as well as in both primary and permanent dentition.
Applicability When a patient population present to dentists/providers with some degree of anterior overjet , the findings of this study are fundamental towards patient education, oral health promotion and injury prevention. However; it should be noted that the traumatic dental injuries discussed are primarily to the anterior teeth and the risk of traumatic dental injury is directly proportional to the amount of anterior overjet present.
Specialty (General Dentistry) (Oral Surgery) (Orthodontics) (Restorative Dentistry)
Keywords Overjet, traumatic, trauma, injury, anterior
ID# 2854
Date of submission 03/24/2015
E-mail farmerap@livemail.uthscsa.edu
Author Austin Paul Farmer
Co-author(s) e-mail
Faculty mentor Moshtagh Farokhi, DDS, MPH
Faculty mentor e-mail farokhi@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available