Oral trauma in Brazilian patients aged 0-3 years

Traumatic dental injuries over an 8-year period at a German dental center: a retrospective overview and cross-sectional analysis

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.

The risk of healing complications in primary teeth with root fractures: A retrospective cohort study

BACKGROUND/AIM

Primary teeth are frequently affected by traumatic dental injuries. Root fractures are rare and have a reported incidence of 2% in the primary dentition. Hence, there is limited evidence on this topic. This study aims to evaluate the risk of healing complications in primary teeth with root fracture and to identify possible sequelae in the permanent dentition following root fracture in the primary dentition.

MATERIALS AND METHODS

A retrospective analysis of a cohort of 53 patients with 74 root fractured primary teeth. The standard follow-up program included clinical and radiographic examination after 4 weeks, 8 weeks, 6 months, and 1 year after the trauma and when the patient was 6 years of age. The following complications were registered: pulp necrosis (PN), pulp canal obliteration (PCO), ankylosis with replacement root resorption (ARR), infection-related root resorption (IRR), premature tooth loss (PTL), and repair-related resorption (RRR).

STATISTICS

The Kaplan-Meier and Aalen-Johansen estimators were employed. The level of significance was 5%.

RESULTS

A total of 74 teeth were included. 42 teeth were extracted at the initial examination. Risks estimated after 3 years: PTL 45.9% [95% CI: 28.8-63.0], PCO 12.9% [95% CI: 2.3-23.4], PN 14.9% [95% CI: 3.9-25.9], RRR 2.6% [95% CI: 0.0-7.5]. No teeth showed ARR or IRR. All complications were diagnosed within the first year. Most common sequelae in the permanent dentition was demarcated opacities, with an estimated risk of 20% [95% CI: 8.2-41.3].

CONCLUSIONS

There is a low risk of healing complications following a root fracture in the primary dentition. Root fractures often result in early extraction of the coronal fragment. The remaining apical fragment will undergo a physiological resorption. Aside from opacities, there is a low risk of sequelae in the permanent dentition.

Relationships between Clinical and Non-Clinical Variables concerning Traumatic Dental Injuries in Deciduous Teeth Attended in a Children's Hospital

This study aimed to describe Traumatic Dental Injuries (TDI) in a child population, with a discussion focused on the impact of non-clinical variables on TDI. A cross-sectional, descriptive, and relational study about TDI in deciduous dentition in a children's hospital was performed. A total of 166 patients were included, of which 51.8% were male and 48.2% were female. Subluxation was the most observed injury (37.5%), and high-severity lesions predominated (60.2%). Regarding non-clinical variables, 89.2% of the patients attended urgent care centers within 24 h, and 43.4% within the first 3 h. Pointed objects were the leading cause of TDI (47%). Most TDIs were concentrated between the ages of 2 and 4 (53.5%). Concerning the place of TDI occurrence, the school (41.6%) was associated with faster urgent dental care attendance, and the home (37.3%) was associated with TDI occurrence in children under 2 years of age. Previous TDI experience (24.1% of patients) did not generate differences in the time interval between the TDI and arrival at the hospital, compared with children without a TDI history. While the behavior of clinical variables agrees with the literature reviewed, several non-clinical variables show wide differences. There is a need to identify the non-clinical variables that can significantly interact with phenomena specific to the study population (social, demographic, and cultural). The study of these variables can be useful in applying health policies. In the group studied, the non-clinical data reveals the need to educate parents or guardians on the importance of timely care in TDI, the long-term consequences of traumatism affecting deciduous dentition, and the implication of the maturation of the child's motor skills in TDI.

Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, Part 1: Epidemiology

OBJECTIVES

The retrospective study reported herein was the first of three that investigated dental trauma in primary teeth. This article discusses the study that aimed to reveal the epidemiology of trauma with data such as prevalence, risk factors, and types of injuries, and to highlight prevention.

MATERIALS AND METHODS

The records of 320 patients aged 0-9 years who visited the Erciyes University Faculty of Dentistry Pedodontics Department due to dental trauma were evaluated according to the age, gender, medical condition, season, oral habits, trauma environment/type/cause, personal characteristics, and number of siblings. The chi-square test was used to compare the categorical variables by group.

RESULTS

Of the patients, 25.9% were aged 24-35 months at the time of study, 62.8% were male, 38.1% had two siblings, 37.2% had a sucking habit, 93.4% had a healthy medical condition, 41.3% experienced the trauma in summer, and 26.3% were aged 30-34 months at the time they incurred the trauma. Of the traumas, 54.1% were caused by falling, 60% occurred at home, 23% pertained to lateral luxation, and 70% were incurred when the patients were with their mother.

CONCLUSION

Given the results of this study, mothers with low education levels should be informed about their children's risk of incurring injuries from falling at home, especially in summer. Parents should also be warned that their children's oral habits increase their risk of trauma.

CLINICAL RELEVANCE

This study can help increase the knowledge level of clinicians, can raise social awareness, and can guide plan formulation for preventing risks.

Root Fractures in the Primary Teeth and Their Management: A Scoping Review

(1) Background: Traumatic dental injuries constitute a major global health problem. Primary deciduous teeth of the upper frontal group are frequently affected by trauma, especially at an early age. It is important to treat primary traumatic injuries because early tooth loss can lead to aesthetic and functional alterations. The most common injuries are extrusion, lateral luxation, and intrusion. Root fracture is a less common complication that can lead to tooth extraction if not properly diagnosed and managed. However, there are a lack of data regarding primary root fracture treatment. The literature was reviewed to study the current knowledge on the treatment of these injuries, and to propose an operative protocol based on the results obtained. (2) Methods: A literature search was performed on Web of Science, PubMed/MEDLINE, and SCOPUS. The research focused on the following features: age of the patient; localization of the root fracture and type of displacement suffered (intrusive, extrusive, or lateral); type of emergency treatment or diagnostic test performed and their compliance with IADT guidelines; follow-up duration. (2) Results: Only 8 articles fully met the inclusion criteria, with a total of 46 patients and 62 root fractures. Out of a total of 62 root fractures, regarding only upper incisors, the most common treatment was splinting (n = 39) for a period ranging from 3 weeks to 3 months (with an average of six weeks). No treatment was performed for 23 of the root fractures. The splinting performed in most of the included cases was semi-rigid, with the splint held in place using a composite resin material. An orthodontic splint using brackets and 0.5 mm stainless steel wire was used in only in one study. (4) Conclusions: We deduced that the root fracture of primary teeth is a rare traumatic dental injury that can cause numerous complications, such as eruptive problems in the permanent teeth. Correct radiological diagnosis, immediate repositioning and semi-rigid splinting could be conservative methods to prevent premature tooth loss in very young patients.

Root Fracture and Extrusive Luxation in Primary Teeth and Their Management: A Case Report

Background: Extrusion, lateral luxation, and intrusion are among the most serious types of dental trauma. Only a few studies have specifically focused on extrusion; the present one was aimed at reporting a case of domestic traumatic dental injury to primary tooth and describing the measures taken in managing the trauma in order to avoid future consequences to the underlying permanent tooth germ. Case report: A 3.5-year-old boy reported a dental injury with extrusion and root fracture of deciduous tooth 5.1. After intraoral and radiographic evaluation, the element was repositioned and stabilized by an orthodontic flexible splint attached to the adjacent teeth. Several follow-up checkups were made and showed good healing of the tissues and physiological exfoliation of the tooth, with a healthy and unaffected corresponding central permanent incisor. Conclusion: This case report strengthens the importance of well-timed diagnosis and treatment and of regular follow-up of traumatized teeth as they may affect both dentitions with a negative impact on Oral Health-Related Quality of Life. Conservative treatment should be taken into consideration when possible, being in some cases more appropriate.

Complications following replantation of primary teeth: a case report

Abstract Introduction: the avulsion of primary teeth is a disturbing and unexpected event. Description: this report describes the clinical case of a three-year-old child who suffered an avulsion and replantation of the primary upper central incisors at the site of the injury. The guardians sought treatment for the child at the Federal University of Minas Gerais after the replantation. Four months later, the child suffered a new trauma and the replanted teeth presented advanced mobility, root resorption and fistula. The clinical conduct was extraction and rehabilitation with a fixed esthetic maintainer. Discussion: the literature describes two treatment options for avulsion of primary incisors: replantation and non-replantation. According to a recent systematic review, the difficulty in obtaining a consensus regarding the best clinical conduct is due, in part, to the scarcity of publications that present not only follow-ups with clinical success, but also with failures. The outcomes of replantation can be influenced by several factors. The time elapsed between replantation and splinting, and the new episode of trauma, negatively influenced the prognosis in the present case, leading to failure. Replantation of primary incisors is not yet evidence-based treatment. Therefore, this option must be chosen with caution and in ideal situations. It requires constant clinical and radiographic monitoring for evaluation of outcomes.

Dental trauma in toddlers 1-3 years of age living in multicultural areas of Stockholm, Sweden: A retrospective cohort study

BACKGROUND/AIM

Traumatic dental injuries are common and affect many children. The aim of this retrospective study was to investigate the prevalence and characteristics of dental trauma as well as the costs and resource use in a cohort of children aged 1-3 years in low socioeconomic areas (low income and educational level) of Stockholm.

MATERIALS AND METHODS

Data were extracted from a larger intervention trial and analyzed for the prevalence and other characteristics of dental trauma as well as patient characteristics of children (n = 1346) from six dental clinics in low-income, multicultural areas. Variables describing the trauma, socioeconomic status, direct and indirect costs, and time spent at the emergency visit for the dental trauma were retrieved from the dental records. The study also recorded which healthcare profession handled the first and follow-up visits.

RESULTS

The prevalence of dental trauma in the study cohort was 8.2%, and higher among boys (n = 71) than girls (n = 39). Boys exhibited a significantly higher risk for dental trauma (OR, 1.76; 95% CI = 1.17-2.65). Maxillary incisors were the teeth most often traumatized, and lateral luxation was the most common diagnosis. The mean time spent per child during the first year following the dental trauma was 36 min, and the mean costs per child were EUR 878. The total average per-child cost (direct and indirect costs) for dental trauma was EUR 2107. Dental visits due to traumatic injuries were significantly less common among children with an immigrant background and in families with an income ≤EUR 2000 per month.

CONCLUSIONS

Toddlers in families who have a low socioeconomic status, a foreign background, and live in multicultural areas of Stockholm visit dental clinics for traumatic dental injuries less often than non-immigrant children living in families with a high socioeconomic status.

Association between malocclusion and the severity of dental trauma in primary teeth

BACKGROUND/AIMS

The literature does not clearly state whether the type of malocclusion is associated with a specific type of trauma and the severity of the injury. Hence, the aim of this retrospective study was to assess the occlusal condition in children with traumatic dental injuries of the primary teeth, and the association between the occlusal characteristics and the type and severity of these injuries.

MATERIAL AND METHODS

Data were collected from records of children treated at a dental trauma center in Brazil over a period of 16 years. The data included age, gender, etiology of the trauma, place of occurrence, number of affected teeth, type of trauma, and injury severity. The occlusal condition was assessed by a trained dentist using photographs of the patients from their first visit. Chi-square tests and Poisson regression were used for data analyses.

RESULTS

This study included 209 patients, and most were aged between 2-4 years (50.55%). Multivariate regression analysis showed that children with an anterior open bite had a 47% higher prevalence of severe trauma than those who did not have an anterior open bite, and those with class II canines had a 56% higher prevalence of severe trauma than those with class I and III canines. Children with an anterior open bite had a 46% higher prevalence of injuries affecting multiple teeth than those without an anterior open bite.

CONCLUSIONS

Anterior open bite and class II canine relationship were associated with a higher prevalence of severe traumatic dental injury in primary teeth, and anterior open bite was associated with trauma affecting multiple teeth.

Oral injuries in children less than 24 months of age in a pediatric emergency department

BACKGROUND

Oral injuries in young children may indicate physical abuse. The prevalence of oral injuries in young children presenting to the emergency department is unknown. These data would assist providers in making decisions about the need for further abuse evaluation.

OBJECTIVE

To determine the prevalence of oral injuries, associated chief complaints and characteristics, and frequency of abuse evaluations in children younger than 24 months presenting to a pediatric emergency department (PED).

PARTICIPANTS AND SETTING

Twelve pediatric emergency medicine physicians consecutively enrolled children younger than 24 months in a tertiary care PED.

METHODS

We performed a prospective observational study. Enrolled patients underwent a complete oral examination. Providers recorded patient demographics, type of chief complaint, oral injury details, developmental ability, and the presence of an abuse evaluation.

RESULTS

Oral injuries occurred in 36/1303 (2.8%, 95% CI 1.9-3.8%) and were more common in patients with traumatic (26/200, 13%) versus medical chief complaints (10/1,103, 0.9%) (p < .001). Of patients with oral injuries (36), 78% were mobile and 72% had traumatic chief complaints. Nine (25%) children with oral injuries were evaluated for abuse. Oral injuries in children 0-11 months old were more likely to be evaluated for abuse than children 12-24 months old (70.0% vs. 7.7%, p < .001).

CONCLUSIONS

The prevalence of oral injuries in children <24 months old presenting to a PED was low. Most occurred in mobile children and in children with traumatic chief complaints. Younger, non-mobile children with oral injuries had a higher likelihood of having an abuse evaluation.

Profile of intrusive luxation and healing complications in deciduous and permanent teeth - a retrospective study

OBJECTIVE

This retrospective study analyse the profile of intrusion in deciduous (DT) and permanent teeth (PT), the occurrence of healing complications (HC), type of treatments and predisposing factors.

METHODS

The records of patients attended from 2005 to 2011 were analysed. Records of patients who had one or more intruded DT or PT were included in the study. Data collected from dental records included age, gender, attendance (immediate/mediate), healing complications and type of treatment. A Chi-square test and Logistic regression (p ≤ .05) were performed to evaluate the associations between the type of teeth and presence of HC, as well as to explore the interactions between predisposing factors.

RESULTS

The intrusion prevalence was 9.98% in DT and 2.45% in PT. Partial intrusion (57.3%) with palatal direction of the crown (61.8%) was most prevalent in DT, while complete intrusion (56.7%) with buccal direction of the crown (58.1%) was predominant for PT. Mobility was the most common HC in DT compared to root resorption in PT. Minimally invasive treatments were the most common therapy for DT compared to invasive treatments for PT. PT demonstrated increased HC when compared to DT (p = .004). A logistic regression illustrated that the level of intrusion and crown direction during the trauma did not influence the occurrence of HC (p > .05).

CONCLUSION

Intrusion's profile in DT and PT are different. PT showed more HC than DT, however the level of intrusion and crown direction were not associated with the presence of HC.

A Developmental Approach to Pediatric Oral Health

Orofacial growth and development is a complex process spanning the life course. This article provides an oral health overview in the context of overall growth, physical and social development from infancy through adolescence. It reviews oral health-specific developmental milestones during childhood (0-12 years) and adolescence (≥13 years). It examines issues particular to each age category or spanning multiple ages (eg, pediatric overweight and obesity, tobacco use, and dental trauma) in relation to oral health and development. In addition, the oral microbiome and its potential role in informing personalized oral health care across the life course is discussed.

Dental Anomalies in Permanent Teeth after Trauma in Primary Dentition

OBJECTIVE

This retrospective study aims to evaluate the prevalence of dental anomalies in permanent teeth as a result of a trauma concerning the predecessor primary teeth.

STUDY DESIGN

A total of 241 records of children (118 males and 123 females, mean age 3.62 &plusmn; 1.40) affected by trauma on primary teeth were analyzed. All patients were recalled to evaluate the status of the permanent successor teeth by clinical and radiographic investigations.

RESULTS

Out of 241 patients, 106 patients (for a total of 179 traumatized primary teeth) presented at the recall. Dental anomalies on successor permanent teeth were detected in 21 patients (19.8%), for a total of 26 teeth (14.5%) and 28 anomalies. Anomalies of the eruptive process were the most observed disturbances (60.7%), followed by enamel hypoplasia (25%) and white spots (14.3%). A higher percentage of anomalies on permanent teeth was observed when trauma occurred at an age less than 36 months (38.5% of cases). Intrusive and extrusive luxation were related with the most cases of clinical disturbances in the successor permanent teeth.

CONCLUSIONS

The results of this study highlight the risk of dental anomalies after a trauma in primary dentition, especially in early-aged children and in case of intrusive luxation.

Prevalence of primary tooth traumatic injuries among children in a large industrial centre of Russian Federation

BACKGROUND

Recently, the number of children seeking dental care for traumatic tooth injuries has increased substantially.

AIM

This study was aimed at assessing the prevalence of primary tooth traumatic injuries (PTTI) in the paediatric populace of Ekaterinburg, a large industrial centre of the Russian Federation.

DESIGN

Following ethical approval, an epidemiological investigation of primary dentition was conducted, evaluating 1,149 children aged 6-72 months (males 586/1,149, 51%; females 563/1,149, 49%). The average age of subjects overall was 43.9 ± 17.7 months (males 45.1 ± 17.9 months; females 42.6 ± 17.4 months).

RESULTS

The prevalence of PTTI among paediatric residents of this region was 9.75%, with uncomplicated crown fracture (36.9%) as the chief primary dental injury. Dental visits attributable to PTTI were most frequent in the age group of 25-36 months, which clearly constitutes the period of greatest vulnerability.

CONCLUSIONS

The findings of this study suggest that PTTI is a critical issue in children, requiring programmes that address preventive dental care and adhere to established medical treatment standards.

Association between Trauma to Primary Incisors and Crown Alterations in Permanent Successors

The aim of this study was to determine the prevalence of sequelae in permanent teeth that had their predecessors traumatized and investigate associated factors. The study was carried out with clinical and radiographic data from 137 patient charts of the Traumatized Patient Care Program, Federal University of Santa Catarina (Brazil), totalizing 253 teeth. Data were gathered on gender, age at the time of trauma, type of trauma, type of post-trauma sequelae, trauma recurrence and crown alteration in the permanent successors. No statistically significant associations were found between permanent successor's crown alteration and gender, age at the time of trauma, post-trauma sequelae or trauma recurrence (p>0.05). Significant associations were found between severe trauma (crown fracture with pulp exposure, lateral luxation, intrusion and extrusion) in the primary incisors and permanent successor's crown alteration (p<0.05). Multivariate analysis revealed an association between severe trauma to the primary incisors and permanent successor's crown alteration (OR: 4.1 - IC: 1.7-10.1). Alterations in the crown of permanent successors are associated with severe trauma to the primary incisors, as primary teeth affected by severe trauma have a fourfold greater chance of exhibiting permanent successor crown alteration in comparison to primary teeth that had minor trauma.

Crown fracture of the mandibular second primary molars in a 4-year-old child

Dental traumas are highly prevalent lesions in primary teeth, but crown root fractures are rare. Mostly anterior tooth segment is more commonly involved. Posterior crown root fractures are very rare. A 4-year-old girl reported to our paediatric dentistry department with a 10-day history of severe pain and discomfort in both right and left posterior teeth region. The child was suffering from severe and continuous pain and was unable to chew food. After an examination a fracture was noticed in intraoral periapical radiograph and treatment plan was decided to preserve the affected teeth.

Assessment of awareness amongst school teachers regarding prevention and emergency management of dentoalveolar traumatic injuries in school children in Pune City, before and 3 months after dental educational program

Children have boundless energy, so, they are continuously engaged in some or the other physical activity. It is seen that when child reaches school age, accidents in the school environment in the form of falls, injuries due to contact sports, fights, abuse, etc. are very common and the main cause of traumatic dental injuries. Trauma may vary from minor enamel chipping or avulsion to extensive maxillofacial damage, more serious neck and brain injury, which may cause pain, disfigurement and mental agony, having immediate and long lasting effects. In such cases, a school teacher is in the right position to handle such an emergency and refer the child to the concerned dental surgeon or a pedodontist for further needful care. The main reason for delayed treatment of dental trauma is that people present at the site of injury are unaware of protocol of rapid and appropriate management leading to improper first aid treatment. The purpose of this study was to investigate the awareness of a group of school teachers from different schools about the prevention and emergency management of dental trauma in school children, by means of a questionnaire. Then educating them and reassessing their knowledge after a period of 3 months. Unfortunately, the public is unaware of the risks and does not have enough information about first aid emergency treatment or to avoid traumatic injuries.

International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition

Traumatic injuries to the primary dentition present special problems and the management is often different as compared with the permanent dentition. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialities were included in the task group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care for management of primary teeth injuries. The IADT cannot and does not guarantee favorable outcomes from strict adherence to the guidelines, but believe that their application can maximize the chances of a positive outcome.

Dental emergencies in a university pediatric dentistry clinic: a retrospective study

A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%), pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%). Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used.

Temporary management of permanent central incisors loss caused by trauma in primary dentition with natural crowns: a case report

Primary teeth injuries may cause developmental disturbances in the permanent dentition and loss of permanent incisors could be treated with different options. In this case report, an 11-year-old boy, with a history of trauma at the age of 4 years, is presented. Premature loss of permanent upper right central and upper left central teeth because of the mobility and arrest in root development were treated using patient's own natural crowns on a removable appliance. This treatment option could be considered as an esthetic and functional temporary management of permanent central incisors loss until the definitive treatment will be completed in the future.

Facial and dental injuries due to dog bite in a 15-month-old child with sequelae in permanent teeth: a case report

This article reports a longitudinal follow-up of a 15-month-old child with dental trauma resulting from an attack by a dog. The injury consisted of laceration of the facial tissues and loss of the upper central deciduous incisors, in addition to loss of bone tissue in the same area. A malformation of the crown of the right central permanent incisor and complete change of the shape of the left central permanent incisor were observed. The etiological factors of childhood injuries as well as the importance of dental emergency care are discussed and the 14-year clinical and radiographic follow up of the case is presented.

Traumatic anterior dental injuries in Cuban preschool children

The purpose of this study was to determine the prevalence and distribution of traumatic dental injuries in 2-5 year-old children. It included 543 children of both sexes, all attending five urban nurseries in San José de las Lajas, Cuba. The prevalence of injuries was 34.2%. Type and prevalence of dental injuries was determined using Andreasen's classification. Enamel fracture was the predominant injury (67.1%). The maxillary central incisor was the most vulnerable to injuries. Boys (41.8%) experience more injuries than girls (26.8%).