A 3-Year retrospective study of traumatic dental Injuries to the primary dentition

Treatment priorities and arrival time of traumatic dental injuries-An 8-year retrospective study

BACKGROUND/AIM

Most of the previous studies in the available literature discussed the time of arrival in general to the healthcare system, while a minority studied the relationship between the type of trauma and arrival. The aim of this retrospective study is to assess the arrival time of traumatic dental injuries (TDIs) depending on the urgency of treatment according to Andreasen.

MATERIALS AND METHODS

This 8-year retrospective study was carried out at the Department of Pediatric Dentistry at the University Dental Clinic in Zagreb, Croatia. Andreasen's classification was used to define the kind of TDI as well as to divide them by the need for urgent treatment or treatment priorities in three groups: acute, subacute, and delayed.

RESULTS

The sample consisted of 1040 children (59% male and 41% female) with a median age of 7. Each year, the age group most affected by TDIs was 6-12 years old. While there is a general increase in the prevalence of TDIs overall, there is a decline in TDIs among children aged 6-12 and an increase among preschoolers and adolescents (below 6 and above 12 years old). Throughout the years, 52.73% red/acute and 41.16% yellow/subacute TDIs were not treated on time due to delayed arrival. More patients from Zagreb come in the first 24 h, while more patients from outside Zagreb come to the clinic a month or more after their injuries. Patients which suffered TDI accompanied with soft-tissue injury arrived sooner.

CONCLUSIONS

It is necessary to introduce monitoring and education of patients under the age of 6 and over 12, as well as their parents/caregivers. New programs should be implemented and new referent centers that specialize in treating TDIs outside of Zagreb should be established.

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.

Factors associated with the survival of primary maxillary anterior teeth after intrusive luxation: a retrospective longitudinal study

PURPOSE

To evaluate the survival rate of primary maxillary anterior teeth following intrusive luxation and identify associated factors.

METHODS

A retrospective longitudinal study was conducted at a primary dental trauma centre using 88 dental records of children with intrusive luxation between 2007 and 2018. The variables of interest were time the tooth remained in the alveolus, degree of intrusion, accentuated overjet, lip protection, visible plaque, compromised germ of the permanent successor, clinical signs of infectious and inflammatory processes, endodontic treatment, pulp canal obliteration, sex, age at the time of trauma, family income, mother's schooling, and immediate care. Descriptive, bivariate, and Cox regression analyses were performed (p < 0.05; 95% CI).

RESULTS

The 88 dental records of children with intrusive luxation included 128 teeth. Survival rate throughout the follow-up period was 65.6% (n = 84). Age older than three years and eight months (HR 2.28; 95% CI 1.04-4.99; p = 0.039), the development of an infectious process (HR 3.51; 95% CI 1.39-8.86; p = 0.008), development of an inflammatory process (HR 2.35; 95% CI 1.17-4.71; p = 0.016) and compromised germ of the permanent successor (HR 4.38; 95% CI 1.99-9.61; p < 0.001) were associated with a lower survival rate of intruded primary maxillary anterior teeth.

CONCLUSION

The survival rate during the follow-up period of intruded primary maxillary anterior teeth was considered high. A significantly lower survival rate was associated with age, the occurrence of an infectious process and inflammatory process, and the compromised germ of the permanent successor.

Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, part 2: dental injury types, treatment strategies, and complications

OBJECTIVES

This article focuses on treatments and complications in patients presenting dental trauma in primary teeth. Treatment alternatives begin with the decision of performing a procedure under clinical settings or pharmacological techniques (PC) in young children. Correct diagnosis and treatment are crucial to maximize the chances of a favorable outcome.

MATERIALS AND METHODS

The files of 320 patients aged 0-9 years who presented to the Erciyes University Faculty of Dentistry Department for dental trauma management in primary teeth were evaluated in between 2018 and 2021 for 3-year period. The following information were extracted from patients' records: injury type, affected teeth, caries condition of the teeth, treatment preferences of the dentists. Additionally postoperative complications and their management were evaluated.

RESULTS

While 63.1% of the traumatized teeth were caries-free, 35.8% of the teeth had caries. The most frequent dental injuries was simple crown fractures (42.9%), followed by complicated crown fractures (38.5%). Treatments were mostly done in clinical conditions (67.9%) and mostly patients attend regularly to follow-up visits (85.6%). Clinicians prefer more radical treatments under sedation or GA (92.4% extraction of injured tooth). Coronal discoloration was the most common complication, and 35.3% had pulp necrosis for longer term results.

CONCLUSION

Follow-up decisions made after concussion in the primary teeth might be appropriate for the patient. Examination of the complication status of primary teeth with simple crown fracture injury revealed that 59.5% of patients did not have any complications. Follow-up decisions were found to be appropriate for crowns with coloration alone.

CLINICAL RELEVANCE

All options should be considered to provide the best care for children after primary tooth trauma; this can be achieved by being informed about the treatment and its consequences, and if necessary, a positive prognosis can be achieved with an interdisciplinary approach.

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.

Extension of a novel diagnostic index to include soft tissue injuries: Modified Eden Baysal Dental Trauma Index

AIM

Accurate records of traumatic dental injuries are important for clinical management and data collection for research. Soft tissue injuries often accompany dental trauma and should be appropriately recorded. The Eden Baysal Dental Trauma Index (EBDTI) provides an easy recording system of useful information about traumatic dental injuries on a tooth basis. The aim of this study was to extend the EBDTI index to record soft tissue injuries in a concise format and to approve the face and content validity of this version as the modified EBDTI (MEBDTI).

MATERIALS AND METHODS

An extension to EBDTI was developed by adding superscript numbers from 0 to 8 to represent soft tissue injuries related to dental trauma. The Rand e-Delphi method was used to evaluate this version of the index. A definition and two statements about the index were sent to 15 international panel experts to be assessed independently on a 9-point Likert scale where 1 represented "total disagreement," and 9 indicated "total agreement." The panel needed to reach a 75% consensus for validation. A numerical code was suggested using zero to depict no soft tissue injury; 1-4 to record extra-oral injuries; and 5-8 to record intra-oral injuries (for example, gingiva, frenulum, and palate). Traumatic dental injury of the tooth/teeth is recorded using EBDTI in square brackets, and soft tissue codes are used as superscript numbers outside the brackets on a patient basis.

RESULTS

The panel reached a consensus on the definition (86.7%) and two statements (86.7% and 93.3%) in one round. Various cases are presented to demonstrate the application of the index.

CONCLUSION

The Modified Eden Baysal Dental Trauma Index was developed to record soft tissue. injuries on a patient basis and was approved for face and content validity.