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Patidar D, Sogi S, Fry RR, Patidar DC, Malhotra A. Maxillofacial Trauma in Pediatric Patients: A Retrospective Study. J Maxillofac Oral Surg 2024; 23:99-106. [PMID: 38312951 PMCID: PMC10830960 DOI: 10.1007/s12663-022-01842-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
Objective The study was conducted to analyze the pattern, etiology and management of maxillofacial trauma in children up to 16 years of age. Study Design Records of the patients who sustained maxillofacial trauma from 2013 to 2018 were retrospectively evaluated for age, gender, etiology, pattern of injuries and their management. Children were divided into three groups-primary (0-5 yrs), mixed (6-11 yrs) and permanent dentition group (12-16 yrs). Maxillofacial trauma was observed as midface fracture, mandible fractures, soft tissue injuries and associated tooth fractures. SPSS software version 19.0 was used for the data analysis. Result A total record of 99 children were evaluated. Gender-wise distribution was reported twice in male than females. Fall was observed as the major etiological factor (73.7%) with a significant p value of 0.012 using chi-square test. The highest frequency of maxillofacial trauma is noted in mixed dentition group (47.4%). Mandible fracture was most frequently observed followed by associated soft tissue injury. Conservative approach/closed reduction for management was executed for the majority of cases. Conclusion Knowledge gained from the present study would help in assessing the effectiveness of present preventive modalities and facilitate elaboration of future preventive measures and new research works as well.
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Affiliation(s)
- Deepika Patidar
- Deptartment of Pediatric and Preventive Dentistry, College of Dental Science and Hospital, Rau, Indore, Madhya Pradesh India
| | - Suma Sogi
- Deptartment of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Ambala (Haryana), India
| | - Ramesh Ram Fry
- Deptartment of Oral and Maxillofacial Surgery, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Ambala (Haryana), India
| | | | - Aayush Malhotra
- Deptartment of Oral and Maxillofacial Surgery, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Ambala (Haryana), India
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Kelimu K, Wusiman P, Li W, Huang B, Wu J, Zhan J, Moming A. Epidemiology and Pattern of Pediatric Maxillofacial Trauma: A 5-Year Retrospective Study. J Craniofac Surg 2024; 35:150-153. [PMID: 37754755 DOI: 10.1097/scs.0000000000009723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 07/02/2023] [Indexed: 09/28/2023] Open
Abstract
PURPOSE To analyze the epidemiology, pattern, and prevent measurement of pediatric maxillofacial trauma in Xinjiang, China. PATIENTS AND METHODS Clinical records of patients aged 0 to 18 years with maxillofacial trauma over the 5 years were reviewed. Epidemiological features of data were collected for the cause of injury, age and sex distribution, frequency and type of injury, localization and frequency of soft tissue injuries, facial bone fractures, and presence of associated injuries. Statistical analyses performed included descriptive analysis, χ 2 test, and logistic regression analyses. RESULTS Among the 450 patients, 333 were male and 117 were female, with a male-to-female ratio of 3.8:1, the mean age was 9.2±5.4 years; 223 cases were soft tissue injuries and 227 cases were maxillofacial fractures. The 16 to 18-year-old group was the highest, with the prevalence of maxillofacial fractures. The most common cause of pediatric maxillofacial trauma was traffic injuries. CONCLUSION The incidence of maxillofacial trauma in pediatric patients correlates with a number of factors, including age, sex, and etiology of trauma. The 16 to 18-year-old group is the most prevalent group for maxillofacial trauma in pediatric patients, and traffic accidents are the leading cause of maxillofacial trauma in pediatric patients.
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Affiliation(s)
- Keyimu Kelimu
- Stomatological Institute of Stomatological Institute of Guangdong Meizhou Gucheng Hospital
| | - Patiguli Wusiman
- Orthodontic Department of the First Affiliated Hospital of Xinjiang Medical University (Stomatological Hospital of Xinjiang Medical University), Urumqi, Xinjiang
- Stomatological Research Institute of Xinjiang Uyghur Autonomous Region, Urumqi, Xinjiang
| | - Weidong Li
- Department of Oral & Maxillofacial Surgery, The First Affiliated Hospital Xinjiang Medical University (Stomatological hospital of Xinjiang Medical University), Urumqi, Xinjiang, People's Republic of China
| | - Bi Huang
- Stomatological Institute of Stomatological Institute of Guangdong Meizhou Gucheng Hospital
| | - Jianming Wu
- Stomatological Institute of Stomatological Institute of Guangdong Meizhou Gucheng Hospital
| | - Jinliang Zhan
- Stomatological Institute of Stomatological Institute of Guangdong Meizhou Gucheng Hospital
| | - Adili Moming
- Stomatological Institute of Stomatological Institute of Guangdong Meizhou Gucheng Hospital
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Mohammadi H, Roochi MM, Heidar H, Garajei A, Dallband M, Sadeghi M, Fatahian R, Tadakamadla SK. A meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies among children and adolescents. Dent Traumatol 2023; 39:403-417. [PMID: 37073864 DOI: 10.1111/edt.12845] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/07/2023] [Accepted: 03/23/2023] [Indexed: 04/20/2023]
Abstract
AIMS Children and adolescents who are affected by trauma may have complications that are more serious and dangerous. Herein, a meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies according to the geographic regions of the world among children and adolescents was conducted. MATERIALS AND METHODS A comprehensive search was performed in four databases of PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2006 until July 7, 2021. To evaluate the quality of included articles, an adapted version of the Newcastle-Ottawa scale was used. The prevalence of maxillofacial trauma was estimated by event rates and 95% confidence intervals in relation to etiology and geographic region of study population. RESULTS Through search in the databases and the electronic sources, 3071 records were identified, and 58 studies were eligible for inclusion in the meta-analysis. A total of 264,433 maxillofacial trauma cases were reported by all included studies. Globally, the overall prevalence of maxillofacial trauma was highest due to Road Traffic Crashes (RTC) (33.8%) followed by falls (20.7%), violence (9.9%), and sports (8.1%) in children/adolescents. The highest prevalence of maxillofacial trauma were observed in African population (48.3%) while trauma due to falls was most prevalent in Asian population (44.1%). Maxillofacial trauma due to violence (27.6%) and sports (13.3%) were highest in North Americans. CONCLUSION The findings demonstrate that RTC was the most prevalent etiology of maxillofacial trauma in the world. The prevalent causes of maxillofacial trauma differed between the regions of study population.
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Affiliation(s)
- Hady Mohammadi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, Health Services, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mehrnoush Momeni Roochi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Heidar
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ata Garajei
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Dallband
- Department of Oral and Maxillofacial Surgery, Dental School, Taleghani Hospital, Shahid Beheshti of Medical Sciences, Tehran, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Fatahian
- Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Santosh Kumar Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Victoria, Bendigo, Australia
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Victoria, Bendigo, Australia
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Kirvelä A, Snäll J, Suominen A, Puolakkainen T, Thorén H. Characteristics of Associated Injuries in Children and Teenagers With Craniofacial Fractures. J Craniofac Surg 2023; 34:1625-1628. [PMID: 37202848 PMCID: PMC10445634 DOI: 10.1097/scs.0000000000009343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 03/08/2023] [Indexed: 05/20/2023] Open
Abstract
The incidence of pediatric craniofacial fractures and heterogeneity of fractures is known to increase with age. This study aimed to determine the occurrence of associated injuries (AIs) to craniofacial fractures and identify differences in patterns of and predictors for AIs in children and teenagers. A 6-year retrospective cross-sectional cohort study was designed and implemented. The study population included 397 patients aged 19 years or less diagnosed with craniofacial fracture at Helsinki University Hospital from 2013 to 2018. Boys (71.0%) and teenagers (64.7%) were predominated. Associated injuries were more common in teenagers than children. Teenagers had more often AI in 2 or more organ systems. Assault and intoxication by alcohol were observed only in teenagers and predominantly boys. A total of 27.0% of all patients sustained AIs. In 18.1%, brain injury was reported. In children, motor vehicle accident (MVA) was an independent predictor for AI. In teenagers, independent predictors for AI were female sex, isolated cranial fracture, combined cranial fracture, and high-energy trauma mechanism. Injury patterns and AI related to craniofacial fractures in the pediatric population are age-specific, requiring multidisciplinary collaboration in the diagnosis, treatment, and follow-up of such trauma. Predictors for AIs increase in complexity with age, and the role of sex as a predictor is evident in teenagers.
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Affiliation(s)
- Aura Kirvelä
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Tero Puolakkainen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
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Miao R, Zhang J, Zhou J, Qiu X, Liu G, Tan X, Tao J, Yang B, Liu L, Tang W, Long J, Jing W. Maxillofacial Fractures: A Four-Year Retrospective Study of 1828 Cases in West China. Cureus 2023; 15:e40482. [PMID: 37461770 PMCID: PMC10349689 DOI: 10.7759/cureus.40482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE To analyze the epidemiological and clinical characteristics of maxillofacial fracture cases in a stomatological center in southwest China. METHODS This study includes 1828 cases of maxillofacial fractures treated in our hospital from January 2018 to December 2021. We analyzed the gender, age, causes of injury, fracture sites, concomitant injuries, treatment, and postoperative infection of these cases. Our data are also compared with those from similar domestic studies. RESULTS Among the 1828 cases, the male-to-female ratio was 2.48:1 with an average age of 34.55 ± 16.36 years. The highest incidence of fracture was 21-50 years old, and the most common cause of injury was falls (38.95%). There was a statistically significant difference in the composition of injury causes among different age groups(P<0.05). Mandible (37.56%) was the most easily fractured site, and limb injury (17.89%) was the most common concomitant body injury. In all cases, 85.23% of patients were treated with open reduction and internal fixation. Conclusions: Maxillofacial fractures often occur in the mandible of young and middle-aged men. Falls and traffic accidents are the main causes of injury, often accompanied by limb and brain injuries. Open reduction and internal fixation is still the most commonly used treatment. There are some differences in the results reported by different domestic hospitals.
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Affiliation(s)
- Rong Miao
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Jiankang Zhang
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Jing Zhou
- Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, CHN
| | - Xiaoning Qiu
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Gang Liu
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Xinzhi Tan
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Junming Tao
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Baohua Yang
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Lei Liu
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Wei Tang
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Jie Long
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Wei Jing
- Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
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6
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Zhou J, Wan T, Miao R, Tang W, Liu L, Long J, Jing W. Oral and maxillofacial emergencies: A retrospective study of 5220 cases in West China. Dent Traumatol 2023; 39:140-146. [PMID: 36366969 DOI: 10.1111/edt.12798] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND/AIM There are no epidemiological reports focused on the oral and maxillofacial surgery emergency department in the West China Hospital of Stomatology. The aim of this study was to analyse the epidemiological characteristics of emergency patients admitted for Trauma and Plastic Surgery Department of the West China Hospital of Stomatology from 2016-2019. MATERIALS AND METHODS In this retrospective study, 5220 patients with complete medical records were evaluated. The following data were collected: gender, age, etiology, disease type distribution, anatomic injury site and treatment modality. RESULTS There were 3046 males and 2174 females (ratio 1.40:1), with an average age of 16.2 years. The largest group was children aged between 3 and 6 years old (28.3%). Maxillofacial injuries were the most common condition (87.3%), which mostly occurred on the forehead (29.7%), followed by the lips (27.8%). A fall was the leading cause of injury (59.9%), especially in patients younger than 6 years old. There were 327 cases of maxillofacial space infections (MSI), and the mandibular third molars were the most common tooth associated with odontogenic infections (36.2%). Univariable analysis identified that multiple-space infection, visit time and systemic conditions were the risk factors for being admitted to the hospital for treatment. There were 116 patients (2.2%) with bleeding as the main complaint, and most of the maxillofacial bleeding patients could be stopped by compression (52.6%). CONCLUSION Males and children aged younger than 6 years were the highest risk populations. Trauma accounted for the majority of emergency patients in maxillofacial surgery. Most maxillofacial injuries involved the forehead and were mainly caused by accidental falls. The proportion of MSI was not high, but serious cases may be life-threatening. The causes of bleeding were diverse, and the bleeding was easy to control.
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Affiliation(s)
- Jing Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Ting Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Stomatology, Affiliated Hospital of Sichuan Nursing Vocational College, Chengdu, China
| | - Rong Miao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lei Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jie Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Razmara F, Badri A, Mahmoudi X. Maxillofacial Fracture Types and Their Management in 3-to 18-year-old Individuals Referred to Shariati Hospital, Tehran, Iran. Front Dent 2023; 20:5. [PMID: 37312823 PMCID: PMC10258397 DOI: 10.18502/fid.v20i5.12359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/01/2022] [Indexed: 06/15/2023] Open
Abstract
Objectives: This study was performed to find the most common types of maxillofacial fractures and their management in 3 to 18-year-old individuals referred to the Department of Oral and Maxillofacial Surgery at Shariati Hospital in Tehran, during a 9-year period. Materials and Methods: This retrospective study evaluated the records of 319 patients with maxillofacial fractures between 2012-2020, ranging in age from 3 to 18 years. Data regarding the etiology and location of the fracture, age, gender, and treatment approach were retrieved from the archival records and analyzed. Results: A total of 319 patients were included in the study, out of which, 255 (79.9%) were males and 64 (20.1%) were females. Motor-vehicle accidents were the most common cause of trauma (N=124, 38.9%). We recorded 605 fractures and among them, the parasymphysis (N=131, 21.6%) was the most common site of isolated fractures. Type of treatment varied depending on the fracture type and degree of displacement of the broken segments. It consisted of open reduction and internal fixation, and closed reduction procedures, which included the use of arch bars, ivy loops, lingual splints, and circummandibular wirings. Conclusion: Analysis of the results revealed that the severity of injury increased with age. Older individuals had higher a number of fracture sites and experienced greater displacement of the broken segments.
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Affiliation(s)
- Farnoosh Razmara
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Badri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Xaniar Mahmoudi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Analysis of Pediatric Maxillofacial Fractures: A 10-year Retrospective Study. J Craniofac Surg 2023; 34:448-453. [PMID: 36441830 DOI: 10.1097/scs.0000000000008846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim of this study is to analyze patterns of maxillofacial fractures in children and adolescent in southeast of China,in a period of 10 years. MATERIAL AND METHODS In this retrospective study, the medical records of 162 hospitalized patients under 18 years old were analyzed in the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Wenzhou Medical University, China. Age, gender, etiology, site, and type of fracture, monthly distribution, weekly distribution, dental complications, and treatment were evaluated. The cases were divided into 3 age groups: group A: 0 to 6 years, group B: 7 to 12 years, and group C: 13 to 18 years. RESULTS Three hundred thirty-four maxillofacial fractures in 162 patients younger than 18 years were analyzed. The male to female ratio was 2.24:1 and mean age of these patients was 9.85 years old . Falls were the leading cause of maxillofacial fractures.The most frequent fracture site was mandible. Most patients with maxillofacial fractures were treated by open reduction. And it was done more in adolescents than in children. CONCLUSIONS Falls were the main reason for maxillofacial fracutres in childern, and traffic accidents was the leading cause in adolescent. Preventive measures should be applied to reduce occurrences of pediatric facial fractures .Children can not be left at home alone, and monitoring is very necessary when children play in the high place. The government can consider related e-bike driving skills training. Teenagers must pass the relevant electric vehicle test before they can drive. Make the law that the driver of e-bike must wear a safety helmet. Our study shows that open reduction was a good choice for pediatric facial fractures, but usually conservative treatment is a better choice for condylar fractures.
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Hebballi NB, Xie L, Kane AA, Brown EL, Mathew MS, Messiah SE. Estimated prevalence of facial injury‐related mortality in the United States pediatric population. Dent Traumatol 2022; 39:223-232. [PMID: 36573910 DOI: 10.1111/edt.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND/AIMS In pediatric populations, the epidemiology of facial trauma, their injury patterns, distribution, and outcomes are well known, However, little is known about the risk factors and impacts of minor and moderate facial injuries on in-hospital mortality among children in the United States of America (USA). The aim of this study was to determine the prevalence and risk factors for in-hospital mortality among pediatric patients following facial injuries in the USA. MATERIAL AND METHODS A cross-sectional study was conducted with data from the National Trauma Data Bank's pediatric hospitalized patients (<18 years) with facial injuries (International Classification of Diseases, Ninth Revision codes 802.00 to 802.9 and Tenth Revision codes S02.2 to S02.92) between January 01, 2016-December 31, 2019. A multivariable logistic regression model was utilized to identify the risk factors for in-hospital mortality. RESULTS A total of 61,294 pediatric patients (mean age 11.9 years, 69.6% males) were included in the analysis. The estimated prevalence of in-hospital mortality following facial injuries was 2.4% (n = 1480). In terms of mortality, compared to those who sustained minor facial injuries, patients with (1) moderate injuries had 43% higher odds (OR = 1.43; 95% CI: 1.25-1.64, p < .0001), (2) serious injuries had seven times higher odds (OR = 7.81; 95% CI: 6.67-9.14, p < .0001), (3) severe injuries had 16 times higher odds (OR = 16.07; 95% CI: 12.62-20.46, p < .0001), and (4) critical/maximum injury virtually unsurvivable had 145 times higher odds (OR = 145.24; 95% CI: 113.82-185.33, p < .0001) of death after controlling for age, race, insurance status, comorbidities, and hospital complications. CONCLUSIONS The severity of facial injury, age 5-17 years, uninsured status, and those with a mental/personality disorder were risk factors for in-hospital mortality among pediatric patients following facial injuries in this population-level analysis. A better understanding of these risk factors is needed for clinical management of pediatric patients to prevent in-hospital mortality following facial injuries.
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Affiliation(s)
- Nutan B. Hebballi
- School of Public Health University of Texas Health Science Center at Houston, Houston Campus Houston Texas USA
| | - Luyu Xie
- School of Public Health University of Texas Health Science Center at Houston, Dallas Campus Dallas Texas USA
- Center for Pediatric Population Health University of Texas Health Science Center School of Public Health and Children's Health System of Texas Dallas Texas USA
| | - Alex A. Kane
- Department of Plastic Surgery University of Texas Southwestern Medical Center Dallas Texas USA
| | - Eric L. Brown
- School of Public Health University of Texas Health Science Center at Houston, Houston Campus Houston Texas USA
| | - Matthew S. Mathew
- Center for Pediatric Population Health University of Texas Health Science Center School of Public Health and Children's Health System of Texas Dallas Texas USA
| | - Sarah E. Messiah
- School of Public Health University of Texas Health Science Center at Houston, Dallas Campus Dallas Texas USA
- Center for Pediatric Population Health University of Texas Health Science Center School of Public Health and Children's Health System of Texas Dallas Texas USA
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10
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Stanbouly D, Stewart SJ, Harris JA, Chuang SK. Malar and maxillary fractures among pediatric patients and the risk factors for mortality. Dent Traumatol 2022; 38:466-476. [PMID: 35802839 DOI: 10.1111/edt.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS No studies have characterized the morbidity and mortality of maxillary & malar fractures on a national scale. The aim of this study was to examine the risk factors for mortality in pediatric patients who had sustained maxillary and malar fractures by using a national pediatric hospital inpatient care database. MATERIALS AND METHODS This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the cause of injury. The primary outcome variable was mortality rate. Additional predictor variables included age, gender, race, income, payer information, year and place of injury, number of facial fractures, concomitant facial fractures, other fractures of the body, and intracranial/internal organ injury. Univariate and multivariate regression models were performed to assess risk factors for mortality. Statistical significance was set to a p-value <.05. RESULTS A total of 5859 patients met the inclusion criteria. The most common age group was 13-17 years of age (n = 3816, 65.1%). Motor vehicle accidents were the most common mechanism of injury (n = 2172, 37.1%). The presence of cranial vault (OR = 2.81, p = .017), skull base (OR = 2.72, p < .001), and vertebral column fractures (OR = 2.13, p = .016), as well as sub-arachnoid hemorrhage (OR = 4.75, p = .005), traumatic pneumothorax/hemothorax (OR = 2.16, p = .015), and heart/lung injury (OR = 3.37, p < .001) were each independently associated with increased odds of mortality. CONCLUSIONS Patients in their late teens most commonly sustained malar and maxillary fractures, likely due to general trends in craniomaxillofacial development. The presence of other fractures located in close proximity to the mid-face increased the risk of mortality among pediatric patients with malar and maxillary fractures. This may be explained by the anatomical approximation of the mid-face to vital neurovascular structures of the head, which, when damaged, may prove fatal.
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Affiliation(s)
- Dani Stanbouly
- Columbia University College of Dental Medicine, New York City, New York, USA
| | - Sara J Stewart
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jack A Harris
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Sung-Kiang Chuang
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, Massachusetts, USA.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
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Țenț PA, Juncar RI, Moca AE, Moca RT, Juncar M. The Etiology and Epidemiology of Pediatric Facial Fractures in North-Western Romania: A 10-Year Retrospective Study. CHILDREN 2022; 9:children9070932. [PMID: 35883916 PMCID: PMC9323587 DOI: 10.3390/children9070932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Pediatric facial fractures are not as common as facial fractures occurring in the adult population. Their therapeutic approach is different because they affect patients with active growth, and have an etiology and epidemiology that vary depending on different cultural, religious and demographic factors. This research aimed to identify the main factors involved in the etiology of pediatric facial fractures, as well as the epidemiology of pediatric facial fractures in a sample of children and adolescents from North-Western Romania. This 10-year retrospective study was performed in a tertiary center for oral and maxillofacial surgery in North-Western Romania. Medical files of patients that were admitted between 1 January 2002 and 31 December 2022 were analyzed. Pediatric patients aged 0 to 18 years were included in this study. The final sample consisted of 142 children and adolescents diagnosed with facial fractures, with this number representing 14.1% of all patients affected by facial fractures. Most frequently, fractures were identified in the 13–18 age group (78.9%, n = 112), which were more often associated with fractures caused by interpersonal violence than caused by road traffic accidents, falls or animal attacks. Boys were more affected (88%, n = 125), and were more frequently associated with fractures caused by interpersonal violence. The most frequently identified etiological factors included interpersonal violence (50%, n = 71), falls (18.3%, n = 26) and road traffic accidents (11.3%, n = 16). In terms of location, the mandible was the most affected facial bone structure (66.2%, n = 94), and patients with mandibular fractures were more frequently associated with fractures caused by interpersonal violence. The incidence of pediatric facial fractures should be lowered because they may interfere with the proper development of the facial skeleton. Establishing measures aimed at preventing interpersonal violence, as well as other causes involved in the etiology of facial fractures is imperative.
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Affiliation(s)
- Paul Andrei Țenț
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (P.A.Ț.); (R.I.J.); (M.J.)
| | - Raluca Iulia Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (P.A.Ț.); (R.I.J.); (M.J.)
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (P.A.Ț.); (R.I.J.); (M.J.)
- Correspondence:
| | - Rahela Tabita Moca
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania;
| | - Mihai Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (P.A.Ț.); (R.I.J.); (M.J.)
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Patidar D, Sogi S, Patidar DC, Malhotra A. Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis. Int J Clin Pediatr Dent 2021; 14:506-511. [PMID: 34824505 PMCID: PMC8585915 DOI: 10.5005/jp-journals-10005-2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim This retrospective study aimed to analyze dental traumatic injuries and their management in children up to 16 years of age. Materials and methods Records of the patients who sustained dental trauma from 2013 to 2018 were evaluated for age, gender, etiology, type of injuries, and their management. Children were divided into three groups-primary (0-5 years), mixed (6-11 years), and permanent dentition group (12-16 years). Dental trauma was assessed by Ellis and Davey's classification of tooth fracture along with other associated injuries. Results Total records of 466 children with 750 injured teeth (665 permanent and 85 primary) were evaluated. Males were reported twice as females. Fall was noted as the major etiological factor (93.1%). The highest frequency of dental trauma was observed in the permanent dentition group (54.7%). Ellis class IV fracture was the most common dental injury and maxillary central incisor was the most frequently injured tooth. Soft tissue injury was noted as the most commonly associated injury. Most of the dental traumatic injuries in permanent teeth were treated by root canal treatment while the majority of primary dentitions were managed by observation and wound care. Conclusion Ellis class IV fracture was noted as the most frequent type of dental injury and fall was a major etiological factor. The permanent dentition group of children was more affected and a male predominance was observed. Clinical significance The information gained from the present study would help in providing various preventive modalities to parents, caregivers, and teachers regarding these injuries in the future and also facilitate several new researches in this field. How to cite this article Patidar D, Sogi S, Patidar DC, et al. Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis. Int J Clin Pediatr Dent 2021;14(4):506-511.
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Affiliation(s)
- Deepika Patidar
- Department of Pediatric and Preventive Dentistry, College of Dental Science and Hospital, Rau, Indore, Madhya Pradesh, India
| | - Suma Sogi
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | | | - Aayush Malhotra
- Department of Oral and Maxillofacial Surgery, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
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13
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Zygoma Fractures Are Associated With Increased Morbidity and Mortality in the Pediatric Population. J Craniofac Surg 2021; 32:559-563. [PMID: 33704980 DOI: 10.1097/scs.0000000000006948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Trauma involving the facial bones has been shown to be associated with high severity in previous studies. Characteristics of facial fractures in adults have been well described in the adult population, less so in the pediatric literature. Our investigation aims to define these epidemiological measures and risk factors for poor outcomes using the most recent data. METHODS The 2016 Trauma Quality Improvement Program data bank was examined to study facial fracture pattern, mechanism of injury, and demographic descriptive data to characterize pediatric trauma patients. Multivariable regression analysis was performed to assess risk factors for morbidity and mortality in pediatric facial fracture patients. RESULTS Of 51,168 total pediatric trauma patients, 2917 (5.7%) presented with facial fractures. Motor vehicle trauma was the most common mechanism of injury. Maxillary/malar fractures was the most common fracture type overall. Mandibular fractures were most common in the 0 to 1 age category while nasal bone fractures were more common in older patients. Patients with mandible fractures experienced the highest rate of operative management. Zygoma fracture was highly associated with concomitant traumatic brain injury. Multivariable regression analysis showed that fracture of the zygoma, concomitant traumatic brain injury, and cervical spine injury were risk factors for increased mortality. CONCLUSION Facial fractures are a rare but significant form of trauma in the pediatric population. Our data suggests a slight change in fracture patterns compared to previous studies. Zygoma fractures, traumatic brain injury, and cervical spine injury are risk factors of increased mortality that clinicians should be aware of.
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14
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Comparison of Maxillofacial Fractures Between Pedestrians and Passengers in Road Traffic Accidents. J Oral Maxillofac Surg 2020; 79:1098-1103. [PMID: 33347834 DOI: 10.1016/j.joms.2020.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Road traffic accidents remain as the most common cause of maxillofacial injuries in developed countries. To the best of our knowledge, comparative analysis of fracture localizations and injury types of injured pedestrians and passengers is seldom performed. Thus, this study aimed to compare maxillofacial injuries between pedestrians and passengers injured in road traffic accidents in terms of demographic characteristics of the patients, localization of fractures, and treatment. MATERIALS AND METHODS The study population was composed of patients who underwent surgery for maxillofacial fractures resulting from road traffic accidents. They were divided into the pedestrian group and passenger group. Demographic data, fracture sites, and treatment methods were investigated retrospectively. RESULTS Most of the patients were 20 to 30 years of age. Isolated mandible fractures occurred in 55.71% of the pedestrian group and 43.78% of the passenger group. Panfacial fractures were observed in 5.71% (n = 8) of the patients in the pedestrian group compared with 14.28% (n = 21) in the passenger group. CONCLUSIONS Based on the injury pattern and mechanism of in-vehicle accidents, fractures tend to be located in the middle and upper facial bones rather than in the mandible. Thus, careful management in triage is important, as each group has specific injury patterns. Patients with panfacial fractures require meticulous management because they are at risk for high-energy injury and comorbidities.
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Kannari L, Marttila E, Toivari M, Thorén H, Snäll J. Paediatric mandibular fracture-a diagnostic challenge? Int J Oral Maxillofac Surg 2020; 49:1439-1444. [PMID: 32680807 DOI: 10.1016/j.ijom.2020.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/16/2020] [Accepted: 06/15/2020] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to clarify the frequency of missed mandibular fractures and to identify possible predictive factors for missed diagnosis. This was a retrospective study that included patients <20 years of age with a recent mandibular fracture. The outcome variable was missed mandibular fracture, which was determined when a fracture was not suspected or diagnosed during the patient's first assessment in primary healthcare. The primary predictor variable was age group (i.e. children <13 years or teenagers/adolescents aged 13-19 years). The explanatory variables were sex, mechanism of injury, and type of facial facture. Other variables were clinical symptoms and findings. Mandibular fracture was missed at first contact in 27 of 182 patients (14.8%). Fracture was missed significantly more often in patients <13 years than in older patients (33.3% vs. 8.8%, P<0.001). The only significant symptom or clinical finding that was associated with missed fractures was skin wound of the jaw (P=0.009). There was no association between missed fracture and sex or mechanism of injury. Mandibular fractures in children are often missed at the first healthcare contact. Careful examination is necessary in paediatric mandibular injuries, particularly in the youngest age groups. Consultation should be smooth between paediatric trauma units and maxillofacial surgeons.
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Affiliation(s)
- L Kannari
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - E Marttila
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - M Toivari
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - H Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland; Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - J Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Analysis of pediatric maxillofacial trauma in North China: Epidemiology, pattern, and management. Injury 2020; 51:1561-1567. [PMID: 32471687 DOI: 10.1016/j.injury.2020.04.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze epidemiology, pattern, and management of pediatric maxillofacial trauma in North China. PATIENTS AND METHODS Clinical records of patients aged 0-18 years with maxillofacial trauma, from January 2008 to December 2016 were reviewed. 390 patients with an average age of 9.8 ±5.8 years (range: 8 months-18 years) and a male:female ratio of approximately 2:1 were included in the study. Epidemiological features (age, sex, etiology), characteristics of injuries (locations, types, associated injuries), treatments, and complications were analyzed. RESULTS Among 55 patients with soft tissue injuries, palate was the most common site (32.7%). Among 335 fracture cases, the most common age group was 16-18 years (25.1%); falls was the main cause (38.2%). Overall, there were 450 fractures (1.78 per capita), primarily mandible (69.3%), followed by zygoma (12.9%), maxilla (7.7%) and other sites. Multiple fractures occurred in 61.5% of patients. The most common site of mandibular fractures was condyle. The proportion of mid-face fractures to mandibular fractures increased with age (p < 0.01) and stabilized gradually after 12 (approximately 1.14:1). 77.5% of fractures were treated surgically. There was an independent association of surgical intervention with age older than 6 years old (p < 0.05). Absorbable plates were mainly applied to mandibular fractures in patients aged 0-7 and only 1 was removed because of insufficient fixation strength. CONCLUSIONS The primary cause of pediatric maxillofacial fractures in North China was falls; traffic accidents led more multiple fractures and associated injuries. Palate and mandible were the most common sites of pediatric maxillofacial soft tissue injuries and fractures, respectively. The proportion of mandibular fractures to mid-face fractures decreased with the increase of age until 12.
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Bilgen F, Ural A, Bekerecioğlu M. Our Treatment Approach in Pediatric Maxillofacial Traumas. J Craniofac Surg 2020; 30:2368-2371. [PMID: 31469744 DOI: 10.1097/scs.0000000000005896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Maxillofacial injuries in children are rarer in proportion in comparison to adult facial injuries, and they constitute 1% to 15% of all facial bone fractures. The causes and incidence of maxillofacial injuries in children differ based on social, cultural, and environmental factors. AIM The purpose of this study is to investigate the etiology, epidemiology, and type of injury in pediatric facial injuries, as well as analyzing types of fractures, related injuries, and treatment options. MATERIALS AND METHODS The study obtained the approval of the local ethics board to include 55 pediatric patients in the age group of 0 to 18 years who received inpatient treatment or surgical interventions owing to maxillofacial trauma at an Esthetic, Plastic and Reconstructive Surgery Clinic between January 2016 and December 2018. The patients were examined under 5 groups based on their causes of injury: motorized vehicle accidents (MVA); bicycle; falls (from height or ground level); assault; firearm injuries. They were examined under 6 groups based on the location of their fractures: mandibula, maxilla, orbita, frontal bone, zygomatic arch, nasal bone. RESULTS The study included 55 patients of the ages 0 to 18 with the mean age of 11.6 ± 3.2 years. Thirty-seven of the patients (67.2%) were male, whereas 18 (32.7%) were female. Among the causes of injury, the highest number of patients was 25 (45.4%) with MVA. The most frequent location of the fractures was the mandible. CONCLUSIONS Consequently, experiences regarding pediatric maxillofacial traumas are limited, and there is no complete consensus on treatment. In difference to the interventions in adults, the dental structure in pediatric patients need to be definitely considered, the least invasive intervention form should be preferred, and observation and follow-up should be practiced in minimally displaced fractures rather than surgical interventions.
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Affiliation(s)
- Fatma Bilgen
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Homma H, Okada M, Nakauchi A, Osawa E, Nagai N, Sakurai A, Shintani S. Treatment of Child with Four Lost Maxillary Incisors due to Traffic Injury. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 60:211-220. [DOI: 10.2209/tdcpublication.2018-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hiromi Homma
- Department of Pediatric Dentistry, Tokyo Dental College
| | | | | | - Eri Osawa
- Department of Pediatric Dentistry, Tokyo Dental College
| | - Nobuko Nagai
- Department of Pediatric Dentistry, Tokyo Dental College
| | - Atsuo Sakurai
- Department of Pediatric Dentistry, Tokyo Dental College
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