Injuries In Primary Teeth Research Articles

A retrospective study of traumatic dental injuries in primary dentition: treatment outcomes of splinting

Objective: Splinting in primary dentition is limited to several traumatic dental injuries. The prognosis associated with splint use has not been fully investigated. In this study, we investigated the outcomes of traumatic injuries in primary teeth treated with splinting.Materials and methods: We retrospectively analysed 137 children with root fractures and lateral and extrusive luxation injuries to their primary teeth who were treated with semi-rigid splints between 2010 and 2016. Treatment outcomes were analysed in patients with follow-up periods of >6 months. The outcomes of splinting were based on clinical and radiographic evaluations performed during follow-up examinations.Results: In total, 182 primary teeth were examined, and of these, 90 teeth were treated using semi-rigid splints. In the splint group, pathological root resorption (31.1%) was the most common complication, whereas pathological tooth loss (25.0%) was found most common in the observation group. Splinting in root fractures showed a good prognosis, whereas in lateral and extrusive luxations, it did not (p < .05). There were no relationship between treatment delay and prognosis (p > .05).Conclusions: Depending on the type of luxation, splint therapy results in acceptable outcomes and may be a feasible treatment option.

A Retrospective Study of Luxation Injuries in Primary Teeth: Prognosis with Splinting

A Retrospective Study of Luxation Injuries in Primary Teeth: Prognosis with Splinting

Evaluation of knowledge among general dentists in treatment of traumatic injuries in primary teeth: A cross-sectional questionnaire study.

Objective:The purpose of the present study was to assess the knowledge of General dentist regarding the management of dental traumatic injuries of primary teeth.Materials and Methods:A total of 100 general dentists were selected and a validated questionnaire was distributed among the dentist to assess their knowledge on treatment strategies regarding traumatized primary teeth.Statistical Analysis:Data were entered into SPSS version 20.0 for percentages. The correct answers were tested in relation to the dentists’ years of experience using the Chi-square test.Results:Analyzing the questionnaire for knowledge, 49% of dentists answered accurately regarding avulsed primary teeth, 36% of dentists answered appropriately regarding crown and root fractures, and 55% of dentists gave appropriate answers regarding luxation injuries. Chi-square test showed a statistically significant difference only for 2 questions in relation to the dentist's years of experience (P < 0.05).Conclusion:There is a lack of consistency in the knowledge among general dentist regarding traumatic dental injuries of primary teeth. There is a need to create awareness and education regarding traumatic injuries of primary teeth.

Assessment of knowledge and awareness among medical doctors toward emergency management of dental trauma in State of Himachal Pradesh: A survey

Aim and Objectives: The aim of this study was to assess the knowledge and attitude of medical doctors towards the emergency management of dental trauma in the state of Himachal Pradesh. Materials and Methods: A cross-sectional survey in which, 500 medical doctors were randomly included in the study and the participation was voluntary. Data regarding the emergency management of avulsed tooth was collected using a self-administered questionnaire having questions which were close ended. Statistical analysis was carried out. Chi-square test was used to analyze the data gathered. Results: It was found that frequency of occurrence of soft tissue injuries of the face was 83%, laceration injuries was 79%, nasal bone fracture was 66%, intraoral soft tissue injuries of the lip was 67%, avulsion was 77%, and frequency of dental trauma of maxillary central incisor was 63%. Furthermore, the frequency of respondents having the knowledge about reimplantation was 46% and frequency of respondents having knowledge about the time of reimplantation was 60%. Frequency of respondents having knowledge about the preservation of tooth for reimplantation was 51%, whereas frequency of respondents having no knowledge about the preference of preservative medium was 47%. Frequency of respondents who have not seen traumatic injuries of primary teeth was 55% and the most frequently administered first aid was tetanus injection having 67%. Conclusion: The results from this study suggest that knowledge of the management of dental injuries among medical professionals/doctors was inadequate. However, appropriate training can significantly increase their knowledge.

A retrospective study on traumatic dental and soft-tissue injuries in preschool children in Zagreb, Croatia.

The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb, Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries.

Prevalence of traumatic dental injuries in primary teeth: A retrospective study

Introduction: Trauma to the oral region occurs frequently and comprises 5% of all injuries, which is more prevalent among preschoolers. Aim: The purpose of this retrospective study was to determine the prevalence of traumatic injuries to primary teeth reported to Department of Pedodontics and Preventive Dentistry, SRM Dental College, Chennai, during the years 2003-2013. Materials and Methods: The data was retrieved from records of patients according to sex, age, cause, number of injured teeth and type of tooth. A total number of 65,870 children reported, out of which 34,942 were boys and 30,928 were girls below the age of 6 years. All recorded data was analyzed with the SPSS software (15.0 version).The statistical analysis of the sample was performed using the Chi-square test. Results: The gender difference in the prevalence of traumatic dental injuries was statistically significant (males 66% vs. females 34% of which the maxillary central incisors are most affected (77.21%). Conclusion: Education to parents and caregivers regarding the epidemiology of traumatic injuries and emphasis on an early dental visit may play a major role in reducing the prevalence of dental injury and minimize their detrimental effects on children's quality of life.

Predisposing Factors for Traumatic Dental Injury in Primary Teeth and Seeking of Post-trauma Care

The aim of the present study was to investigate predisposing factors for traumatic dental injury (TDI) in the primary dentition and seeking of dental care after the occurrence of TDI. A randomized population-based cross-sectional study was carried out with 814 children aged 3 to 5 years enrolled at public and private preschools in the city of Campina Grande, PB, Brazil. Parents were asked to fill out a questionnaire on demographic data and the child's history of TDI. TDI was evaluated by clinical examinations performed by three previously calibrated dentists (Kappa: 0.85 to 0.90). Bivariate and multivariate Poisson regression models were constructed for TDI and the parent-reported search for dental care (α=0.05). The prevalence of TDI was 34.6%. The most common type of TDI was enamel fracture (55.0%). The central incisors were the most frequently affected teeth (87.5%). Predictors for TDI in the primary dentition were household income >U$312.50 (PR: 1.355; 95% CI: 1.050-1.724) and overjet >2 mm (PR: 1.539; 95% CI: 1.219-1.942). The predictor for seeking dental care following TDI was parent's age >30 years (PR: 1.753; 95% CI: 1.039-2.960). Household income and overjet were associated with TDI. Among children having suffered TDI, parent's age is a crucial determinant for seeking dental care.

Traumatic dental injuries in primary teeth: severity and related factors observed at a specialist treatment centre in Brazil

This retrospective study aimed to analyse demographic data and the severity of traumatic dental injuries (TDIs) to the primary dentition based on children's dental records at a university clinic. A cross-sectional retrospective study. The records of all patients were analysed according to gender, age, aetiology, teeth involved, number of affected teeth, place of occurrence, witness to the trauma, time elapsed between trauma occurrence and care-seeking, type of trauma and severity of injury. A total of 576 children aged 8-89 months suffered injuries to 1,043 teeth. Severe injuries were the most prevalent (45.5%). These occurred at all ages, but their frequency was higher in children aged between 13 and 24 months. The prevalence of mild injury was higher when the cause was a fall from one's own height. No differences were detected in severity according to the place of occurrence and witnesses of the accident. The prevalence of severe injury was higher in cases where three or more teeth were involved. In this specialist treatment centre, severe injuries were the most common TDIs, which occurred in children aged 13-24 months, mainly due to falls and most occurred at home. Professionals must be prepared to deliver the best and most efficient care to this population.

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.

Retrospective study of traumatic dental injuries in primary teeth in a Brazilian specialized pediatric practice

To determine the prevalence of traumatic dental injuries (TDI) in children younger than 7 years and the effect of predisposing clinical factors on their occurrence. Dental records of 2725 children younger than 7 years seen in a private pediatric dental clinic in Goiânia, Brazil, from February 1993 to December 2008 were analyzed. A group of 150 children without traumatic injuries and with similar characteristics to those of the trauma group were used to study predisposing clinical factors as follows: lip coverage (adequate/inadequate), overbite (normal/negative/deep), and overjet (less or greater than 3 mm). Frequency distribution and a chi-square test were used for data analysis. The level of significance was set at 5%. Clinical and radiographic data of 412 injured deciduous teeth were found in 383 records. TDI prevalence was 11.9%, with no significant difference between sexes. The maxillary central incisors were the teeth most frequently affected (83.3%), and the most frequent type of injury was subluxation (35.1%). TDI was most prevalent in the 13-to-36-month age group (47.7%). Home (43.5%) was the main place of occurrence, followed by school (10.1%); falls (50.3%) were the most common cause, followed by collisions with objects (18.2%). The first examination or treatment occurred in the first 24 h in 46.5% of the cases. The analysis of the association of predisposing clinical factors with TDI revealed no differences in lip coverage; however, overjet >3 mm and deep and negative overbite were significantly associated with TDI. TDI in primary dentition should receive careful attention, particularly when it affects children younger than 3 years and in the presence of overjet, overbite, or both.

Luxation injuries in primary teeth: a retrospective study in children assisted at an emergency service

The purpose of this study was to analyze luxation injuries in children between the ages of 0 and 5 years treated at an emergency service department. A total of 1,703 records, corresponding to a period of 10 years at the Emergency Center of the Baby Clinic at Londrina State University, Brazil, were analyzed. The age, gender, etiologic factors, type of injury, injured teeth, treatment and time interval between injury and treatment were determined for each patient. Of the examined records, 409 patients met the study criteria and included a total of 679 injured teeth. Statistical analyses were carried out using the chi-square test with the level of significance set at 5%. Trauma incidence was higher in boys (57.0%) and in children less than two years of age (40.3%). Falling while walking or running was the most predominant etiologic factor (37.7%), and the most prevalent type of injury was subluxation (32.6%). Luxation injuries decreased with increasing age (p = 0.045). Treatment usually occurred within the first 1-15 days and was significantly associated with the type of trauma (p = 0.041). "Monitor only" was the treatment most frequently observed (74.0%). In conclusion, more luxation injuries were found in younger children, predominantly in boys. Falls resulting from walking or running were the etiologic factor most observed, with subluxation as the most common type of trauma. Treatment usually occurred within the first 15 days after the injury. Despite the severity of these injuries, "monitor only" was the eligible treatment.

A retrospective study of intrusive injuries in primary dentition

The aim was to evaluate epidemiological aspects of intrusive injuries in primary teeth, extent and severity of injuries, provided treatment, and complications to the primary and permanent dentition. This was a retrospective study based on the clinical and radiographic data of 102 intruded teeth in 70 patients. Follow-up period varied from 6 months to 6 years, with the mean time of 2.7 +/- 1.5 years. Data were collected through dental files and dental trauma forms. The following parameters were analyzed at control examinations: rate of spontaneous re-eruption, presence of complications, time elapsed between the injury and complication, and possible sequels on permanent successors. Mean age of the patients was 2.5 +/- 1.3 years. Fifty-six children were injured because of the fall while walking or running. Most of children had one intruded tooth. Maxillary central incisors were the most frequently injured teeth. Seventy injured teeth were <2 mm intruded. Mean time elapsed from the injury until the professional help was 45.0 +/- 67.3 h. Within 2 months after trauma, 48 intruded teeth re-erupted spontaneously. Crown discoloration occurred in 10 intruded teeth, pulp necrosis was diagnosed in nine cases and pathologic root resorption was found in five injured teeth. The most common mechanism of injury was fall. Spontaneous re-eruption occurred in the majority of intruded primary teeth. In comparison with moderate or severe intrusions, mildly intruded teeth took less time to re-erupt. Mildly intruded teeth exhibited less complications in comparison with moderately and severely intruded teeth.

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.

Prevalence of sequelae in the permanent anterior teeth after trauma in their predecessors: a longitudinal study of 8 years

The aim of this study was to determine the prevalence of sequelae in the permanent anterior teeth following trauma in their predecessors, and also to verify the existence of association between the sequelae in the permanent teeth and the type of injury in their predecessors according to the age group at the time of injury. This study was performed based on data from the records of 169 boys and 138 girls who received assistance at the dental clinic of the State University of Rio de Janeiro from March 1996 to December 2004. The sample was collected from 753 traumatized deciduous teeth of children aged 0-10 years. The number of boys and girls with dental trauma corresponded to 55.0% and 45.0%, respectively. The more affected age period was between 1 and 4 years (75.3%). The most common type of traumatic injury was the intrusion (29.3%), followed by avulsion (14.1%). Concerning permanent dentition, the most common developmental disturbances were discoloration of enamel and/or enamel hypoplasia (46.08%) and eruption disturbances (17.97%) due to the traumatic injury in their predecessors. It was not possible to find an association between the type of injury in primary teeth and sequelae in their successors in the studied age groups (P </= 1.00). The study concluded that discolorations of enamel and/or enamel hypoplasia (46.08%) were the most prevalent sequelae on the permanent dentition and that there was no significant statistical association between the occurrence of sequelae in the permanent teeth and the type of traumatic injury in their predecessors in the studied age groups.

Direct and indirect costs of dental trauma in Sweden: a 2‐year prospective study of children and adolescents

Abstract – Objectives: To study total costs, including direct costs (health care service, loss of personal property, medicine and transport) and indirect costs (loss of production or leisure) of dental trauma to children and adolescents with special reference to predictors. Methods: The study was based on a random sample of 192 children and adolescents with a dental trauma reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years. Results: On average, health care service costs represented 2955 SEK (SD=3818) and total costs 4569 SEK (SD=3053) for dental trauma to permanent teeth, and 837 SEK (SD=898) and 1746 SEK (SD=1183) for trauma to primary teeth. The most extensive type of indirect cost was loss of production or leisure, which averaged 1286 SEK (SD=1830) for injuries to permanent teeth and 699 SEK (SD=1239) for injuries to primary teeth. Multiple regression analysis of demographic and dental injury variables showed that complicated trauma was of special importance to costs for permanent and primary teeth injuries. The average relative increase in total costs to patients and companions for complicated injury to permanent teeth was 140% (95% confidence interval [CI], 66–248%) for patients and 132% (95% CI, 54–249%) for companions. Lack of access to a dental clinic near the place of residence could increase the average total costs of injuries to permanent teeth by 91% for companions (95% CI, 20–204%) and for primary teeth by 134% (95% CI, 38–296%). Conclusions: Dental traumas result in both direct and indirect costs, with a predominance of direct costs. The direct costs primarily depend on degree of severity, while indirect costs are mostly due to compromised access to health care service. Traumas to permanent teeth are especially costly and, due to additional maintenance, the care may continue for several years. This study has drawn attention to the significant implications of dental trauma to patient and companion, a new area where further studies are warranted.

Direct and indirect costs of dental trauma in Sweden: a 2-year prospective study of children and adolescents.

To study total costs, including direct costs (health care service, loss of personal property, medicine and transport) and indirect costs (loss of production or leisure) of dental trauma to children and adolescents with special reference to predictors. The study was based on a random sample of 192 children and adolescents with a dental trauma reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years. On average, health care service costs represented 2,955 SEK (SD=3,818) and total costs 4,569 SEK (SD=3,053) for dental trauma to permanent teeth, and 837 SEK (SD=898) and 1,746 SEK (SD=1,183) for trauma to primary teeth. The most extensive type of indirect cost was loss of production or leisure, which averaged 1,286 SEK (SD=1,830) for injuries to permanent teeth and 699 SEK (SD=1,239) for injuries to primary teeth. Multiple regression analysis of demographic and dental injury variables showed that complicated trauma was of special importance to costs for permanent and primary teeth injuries. The average relative increase in total costs to patients and companions for complicated injury to permanent teeth was 140% (95% confidence interval [CI], 66-248%) for patients and 132% (95% CI, 54-249%) for companions. Lack of access to a dental clinic near the place of residence could increase the average total costs of injuries to permanent teeth by 91% for companions (95% CI, 20-204%) and for primary teeth by 134% (95% CI, 38-296%). Dental traumas result in both direct and indirect costs, with a predominance of direct costs. The direct costs primarily depend on degree of severity, while indirect costs are mostly due to compromised access to health care service. Traumas to permanent teeth are especially costly and, due to additional maintenance, the care may continue for several years. This study has drawn attention to the significant implications of dental trauma to patient and companion, a new area where further studies are warranted.

Direct and indirect time spent on care of dental trauma: a 2-year prospective study of children and adolescents.

The aim was to account for the total time spent by professional care-givers (direct time) and by patients and companions engaged as support and help (indirect time) to treat and otherwise attend to children and adolescents with dental trauma to primary and permanent teeth. The study was based on a random sample of 192 children and adolescents with dental traumas reported to an insurance company and prospectively followed up by telephone interviews over a period of 2 years after the trauma episode. On average, direct time represented 16% of total time for all visits for dental trauma to permanent teeth and 11% for trauma to primary teeth. The most extensive type of indirect time was transport time, which took up 30% of the total time spent on injuries to permanent teeth and 36% for injuries to primary teeth. Multiple regression analysis of the impact of dental and demographic injury variables on the time variables showed that complicated trauma was associated with extended time, direct as well as indirect, for permanent and primary teeth injuries. Our estimate of the average relative increase in total time spent by patients and companions in cases of complicated injury to permanent teeth was 117% (95% confidence interval [CI], 52-211) for patients and 112% (95% CI, 42-217) for companions. For transport time a strong predictor was access to a dental clinic near the place of residence. Lack of access could extend the average transport time by 180% (95% CI, 80-335) for patients and 163% (95% CI, 67-317) for their companions in cases of injuries to primary teeth.

Dental trauma in children and adolescents in Valparaiso, Chile.

This study analyzed traumatic injuries in the primary and permanent dentition in children treated from 1990 to 1992 at the Children's Dental Traumatology Service in Valparaiso, Chile. A total of 227 records from patients 2 to 21 years old was studied with regard to the cause of injury, location of injury, time elapsed before treatment, history of previous trauma, type of injury, number of injured teeth, and how patients seek treatment. A total of 73 patients had injuries to the primary dentition (pD) and 154 to the permanent dentition (PD) with a total of 357 injured teeth (115 primary, 242 permanent). Ten to 12-year-old children had the highest number of injuries (33%). Falling was the most common cause of injury in both groups (82% pD, 58% PD), followed by striking against objects (13% pD, 19% PD) and bicycle accidents (9% PD). Most injuries in children with primary dentition (68%) occurred at home, while children with permanent dentition had most accidents at school (38%). Most children (61%) sought treatment after 24 h (52% pD, 65% PD), 61 children had suffered previous trauma (36% pD, 23% PD). The most common injuries in primary teeth were luxation (26%), intrusion (21%) and subluxation (18%). Uncomplicated crown fracture (34%), followed by complicated crown fracture (21%), were the main injuries in permanent teeth. There was no difference in the number of teeth involved for either dentition. A single tooth injury was found in 54%. Two teeth were involved in 35%, and three or more teeth in 11%.(ABSTRACT TRUNCATED AT 250 WORDS)

Developmental disturbances of permanent teeth following trauma to the primary dentition

The topographic relationship of the apices of the primary teeth to the permanent tooth germs explains the potential for possible developmental disturbances of the permanent teeth after injuries to their predecessors. The anatomical, histologic and clinical aspects of permanent tooth malformation following trauma to the primary teeth are described. One hundred and fourteen children with originally 255 traumatized primary teeth have been re-examined (with an average period of 5.1 years after the trauma) to assess any developmental disturbances of the corresponding permanent teeth. Twenty-three per cent of partially or completely erupted permanent teeth showed developmental disturbances. The most frequent malformation was enamel hypoplasia including enamel discoloration and/or enamel defects. The highest prevalence of developmental disturbances of permanent teeth was found after intrusive injuries of primary teeth.