A 5-year data report of traumatic dental injuries in children and adolescents from a major dental trauma center in Greece

Prevalence and Risk Factors of Traumatic Dental Injuries among Conflict-Affected Schoolchildren in Syria (2023-2024)

AIM

The prevalence of traumatic dental injuries (TDIs) and their contributing factors among Syrian children has not been explored in any previous epidemiological studies since the onset of the crisis. This study aimed to assess the prevalence of TDIs and their associated characteristics among schoolchildren aged 9 to 12 in Damascus, Syria.

MATERIALS AND METHODS

We conducted this cross-sectional study from 2023 to 2024, collecting sociodemographic data and performing dental examinations, and the presence of TDIs, which were classified according to the World Health Organization's guidelines. We recorded Screen time and categorized it into two groups. We measured Overjet in millimeters, and the statistical significance was set at P < 0.05.

RESULTS

We identified TDIs in 17.6% of children, with uncomplicated crown fractures being the most common. Falls were the leading cause, and the home was the most frequent injury location. Significant risk factors included age, gender, socioeconomic status, screen time, Body Mass Index, and overjet. Males had twice the risk of TDIs compared to females (OR = 2.104, 95% CI: 1.399-3.165), and children from lower socioeconomic backgrounds had a 2.29 times higher risk (OR = 2.299, 95% CI: 1.364-3.877).

CONCLUSION

This study found that a significant proportion (17.6%) of Syrian children experienced TDIs, highlighting the urgent need for preventive programs and improved dental care for Syrian children affected by TDIs.

CLINICAL RELEVANCE

Early identification of children at higher risk, prompt management of dental trauma, and educational initiatives for parents and educators are essential. Schools, as primary injury sites, should adopt safety measures, while dentists should engage in community outreach to enhance awareness, early diagnosis, and intervention.

Influence of Conservative or Invasive Treatments on the Occurrence of Sequelae in Permanent Successors After Injuries in the Support Tissues of Incisors Deciduous Teeth: A Cohort Study

OBJECTIVE

To assess the influence of conservative or invasive treatments on the appearance of sequelae in permanent successor teeth (SPT) after injuries in the support tissues of anterior deciduous teeth (ISTDT).

METHODS

This cohort study accompanied 52 children with ISTDT up to the complete eruption of the permanent successor to investigate the presence or not of SPT. Trauma was clinically evaluated according to the International Association for Dental Traumatology. Sex, age at the time of trauma (ATT), type and severity of trauma, sequelae in anterior deciduous teeth (SDT), treatment type (conservative-without exodontia/ invasive-with exodontia), seeking care (immediate/late), and the caregiver's education level (CEL) were collected. Regression models were performed (p = 0.05).

RESULTS

Of the children (ATT = 3.6 ± 1.5 years), boys (52/57.1%) were the majority. The teeth (n = 91) injuries were lateral luxation (26/28.6%), intrusion (22/24.1%), concussion (20/22.0%), subluxation (19/20.9%), and extrusion (4/4.4%), that affected only incisors. Most teeth (63/69.2%) received late care, presented SDT (62/68.1%) and were treated conservatively (73/80.2%). There was no association of sex (p = 0.611), SDT (p = 0.705) and seeking care (p = 0.800) with SPT. The treatment type did not influence the SPT occurrence (p = 0.923), independent of the ATT, trauma severity and the educational level of the caregiver. The lower the ATT (p = 0.026) and the more severe the trauma (p = 0.009), the higher the number of SPT.

CONCLUSION

The treatment type of anterior deciduous teeth, mainly considering incisors, did not influence the appearance of SPT, which leads us to always choose the most conservative treatment, independent of the child's age, the injury severity, and the caregiver's educational level.

Traumatic Dental Injuries in Children and Adolescents from a Major Dental Clinic in Bosnia and Herzegovina: A 5-Year Retrospective Study

The aim of this study was to investigate the epidemiology of dental trauma in a public dental clinic in Banja Luka, Bosnia and Herzegovina, from 2019 to 2024.

METHODS

This research was conducted as a retrospective cross-sectional study. The data were analysed and compared between injured primary and permanent maxillary and mandibular teeth.

RESULTS

The review of the dental records revealed 73 patients (49 boys and 24 girls) with TDIs, involving 55 primary and 64 permanent teeth. Most of the patients (27 patients, 36.98%) were aged 7-9 years. The main cause of TDI was falls in both dentitions (81.81% of injured primary teeth and 73.43% of injured permanent teeth). The time of arrival after a TDI for assistance in the dental clinic for most cases was after 24 h in both dentitions, 45.45% of injured primary teeth and 48.43% of permanent teeth. For both dentitions, enamel fractures were the most common injury of hard dental tissues and the pulp, and the necrosis of the maxillary central incisor was the most common complication.

CONCLUSIONS

It is very important to improve trauma management and increase public knowledge on the way parents seek proper treatment for the TDIs of their children, and in due time.

Prevalence of Traumatic Dental Injuries and Associated Risk Factors Among Preschool Children in Goa: A Cross-Sectional Study

BACKGROUND AND AIM

Primary teeth trauma has received very little attention compared to permanent teeth due to their eventual exfoliation. Enamel discolorations, hypoplasias, and enamel-surface abnormalities have been reported in the permanent dentition following primary tooth trauma. Traumatic dental injuries (TDI) also have an impact on the quality of life of an individual. The study aims to determine the prevalence of TDI and its association with various risk factors in preschool children in the state of Goa. The primary objective is to determine the prevalence of TDI in primary anterior teeth in preschool children in the state of Goa. The secondary objective is to determine the association of various risk factors with TDI in preschool children in the state of Goa.

METHODS

A cross-sectional survey was conducted among preschool children aged three to five years across the state of Goa. A total of 971 children were included in the study. Parents or guardians of participants who reported trauma answered an interview addressing the history of the injury. The anterior dental trauma and associated factors such as age, gender, time of injury, month of injury, place of injury, occlusal relationship, lip competence, oral habits, and ordinal position of the child were assessed and analyzed.

RESULTS

Out of the 971 children examined, TDI was reported in 157 (16.1%) children. Of these, 83 of 157 (52.8%) children had experienced TDI at home. Three-year-old children had the highest TDI prevalence of any age group, with 32 of 145 (22.0%) experiencing TDI. The most commonly affected tooth (100 of 233, 10.3%) was the primary maxillary right central incisor. Of the 233 traumatized teeth, 100 (42.9%) had code 2 injuries (enamel fractures only), which were the most frequently reported injuries. Mesio-incisal angle fracture was detected in 84 (34.3%) teeth affected with TDI. With respect to the number of teeth traumatized, 99 of 157 (63.0%) of children had a single tooth traumatized. Among all children who had sustained TDI, 103 (65.6%) were firstborns, 50 (31.8%) were secondborns, and four (2.5%) were thirdborn children. Only eight children received treatment, of which seven received medications and only one child received dental treatment. Parents being unaware of TDI was the main reason for not seeking treatment.

CONCLUSIONS

This study highlights the critical need for educating parents and teachers about TDI prevention and the importance of prompt dental care. The findings offer valuable insights for formulating state- and national-level policies and preventive strategies for managing TDI.

Contextual and individual factors associated with traumatic dental injuries in deprived 12-year-old schoolchildren: A cohort study

AIM

Traumatic dental injuries (TDIs) among children and adolescents have been acknowledged as of public health concern worldwide. The aim of the study was to assess the relationship between contextual and individual characteristics and TDIs in 12-year-old schoolchildren.

MATERIALS AND METHODS

A cohort study was conducted with 355 schoolchildren living in deprived communities in the city of Manaus, Brazil. Contextual factors (place of residence and socio-economic indicators) and individual characteristics, including sex, family income, parents/guardians years of schooling, overjet and open bite (Dental Aesthetic Index), self-esteem (Rosenberg Self-Esteem Scale), sense of coherence (Sense of Coherence Scale), oral health beliefs, social support (Social Support Appraisals) were assessed at baseline. TDIs were measured at baseline and at 2-year follow-up using the O'Brien Index. Data were analysed through confirmatory factor analysis and structural equation modeling.

RESULTS

The baseline prevalence of TDIs was 17.6% and the incidence of TDIs at 2-year follow-up was 26.8%. Better psychosocial status had a direct protective effect on the incidence of TDIs (β = -.184). Better contextual characteristics (β = -.135) and greater overjet (β = -.203) were directly associated with poor psychosocial status. Higher schooling of parents/guardians directly predicted better psychosocial status (β = .154). Psychosocial status mediated the relationship of greater overjet (β = .036), contextual factors (β = .024) and parental/guardian schooling (β = -.027) with TDIs.

CONCLUSIONS

Contextual factors and individual characteristics predicted TDIs. Psychosocial status was a relevant individual attribute in the causal network of TDIs, due to the direct effect on the incidence of TDIs as well as a mediator on the influence of contextual factors, overjet and parents/guardians schooling on the incidence of TDIs.

Epidemiological profile of luxations injuries with or without dental fractures in permanent teeth: A 10-years retrospective study

BACKGROUND/AIM

This study assessed the epidemiology of luxation injuries with or without dental fractures in patients attending the outpatient clinic of a Brazilian dental school over the past decade.

MATERIAL AND METHODS

We reviewed clinical records from a specialized center for dental trauma care in Brazil, focusing on patients who experienced at least one traumatic dental injury (TDI) in a permanent tooth between 2012 and 2022. The extracted data included sex, age, etiology, time between trauma occurrence and the search for initial care, TDI classification, and the need for endodontic treatment. The statistical analysis involved Pearson's chi-squared and Fisher's exact tests at a 5% significance level.

RESULTS

The 366 analyzed clinical records included 166 patients (350 teeth) with luxation injuries. Men (n = 102) showed a higher prevalence of luxation injuries than women (n = 64). Extrusive luxation prevailed (n = 99 patients and 208 teeth). Patients with luxation injuries sought care promptly after dental trauma incidents (p = .02) and demonstrated a higher incidence of endodontic treatment (p < .0001) than those without luxation injuries. Lateral luxation was notably associated with traffic accidents (p < .0001). The combination of luxation injuries and tooth fractures did not correlate with a higher need for endodontic treatment (p > .05).

CONCLUSIONS

Age and trauma etiology seemed to have influenced the epidemiological profile of luxation injuries. Additionally, these injuries affected the time to seek initial care and the need for endodontic treatment.

Traumatic Dental Injuries among Adolescents and Young Adults in Iași, Romania: Legal and Medical Perspectives

Adolescents and young adults' active lifestyles make dental trauma a significant medical concern.

AIM

This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence.

RESULTS

Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241).

CONCLUSIONS

Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups.

In-vivo evaluation of the effects of short-term dehydration and rehydration on the color differences of immature permanent incisor teeth

OBJECTIVE

It is aimed to evaluate the color changes of upper central incisor teeth with different root maturation levels after 15 min of dehydration and rehydration.

MATERIALS AND METHODS

Using the Cvek classification, 60 participants were divided into five groups. A spectrophotometer, equipped with a specially designed jig, was utilized for color measurements. Following isolation, color measurements were conducted at the dehydration process intervals of baseline, 1st, 2nd, 3rd, 5th, 7th, 10th, and 15th minutes. After mouth rinsing, measurements were repeated at the same time intervals during the rehydration process. CIEDE2000 (ΔE00) values and the Whiteness Index (WID) were obtained to compare the color changes between the initial readings and each interval. Friedman and Repeated Measures ANOVA were applied to compare classes by time during the dehydration and rehydration periods, as well as ANOVA and Kruskal-Wallis tests to compare by classes for each time (p < 0.05).

RESULTS

Significant differences emerged in the mean ΔE00 values during dehydration and rehydration periods across all Cvek Classes (p < 0.05). While no statistically significant differences were observed among Classes at different minutes during the rehydration period (p > 0.05), it was particularly noted that the mean ΔE00 values of Classes 2, 3, and 5 at the 2nd minute of dehydration were statistically significantly higher than the mean of Class 1 (p < 0.05). However, when evaluating the starting and ending measurements of both dehydration and rehydration processes, and the overall change in ΔE00 and ΔWID, no significant variations were detected across the Classes (p > 0.05).

CONCLUSIONS

In teeth that have just erupted and are still undergoing root development, dehydration in the initial minutes results in noticeable color changes. However, the change in ΔE00 and ΔWID of the teeth was found to be similar after the dehydration and rehydration processes.

CLINICAL SIGNIFICANCE

According to the Cvek classification, the lower color change in Class 1 teeth within the first 2 min of dehydration and the need for more than 15 min of rehydration for immature teeth with an open apex to return to their initial state after a 15-min dehydration are crucial for clinicians in terms of color assessment timing.

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.

Epidemiology and severity of traumatic dental injuries in permanent teeth: A 20-year retrospective study

This study aimed to assess the traumatic dental injuries (TDIs) in permanent dentition among patients who attended at the outpatient clinic of a Brazilian dental school, during the last 20 years, and to investigate factors associated with the severity of these injuries. Clinical records of patients who attended a specialized center for dental trauma care in Brazil presenting at least one TDI in a permanent tooth, between the years 2000 and 2019, were reviewed. The data recorded were sex, age, affected arch, etiology, number, and type of the teeth affected, and classification and severity of the TDIs. The diagnosis and classification of the TDIs were based on the guidelines of the International Association of Dental Traumatology (IADT). The severity of each patient's injuries was defined as mild, moderate, or severe. Descriptive statistics, chi-square and multinomial regression analyses were used to evaluate the results. The significance level was set at 5%. A total of 837 clinical records were included, totaling 2357 teeth. Males were more prevalent than females. The patients' age ranged from 5 to 71 years. The most common traumas were avulsion (n=512) and uncomplicated enamel-dentin fracture (n=488). Univariate analyses showed that there was a statistically significant association between age group (p=0.004), etiology (p=0.000) and number of teeth affected (p=0.000) with severity of dental trauma. In conclusion, TDIs that occurred in Piracicaba and region are epidemiologically similar to those found worldwide, and that more severe injuries are related to age range, etiology and number of teeth affected.

Prevalence and Patterns of Traumatic Dental Injuries in the Permanent Dentition: A Three-Year Retrospective Overview Study at the University Dental Clinic of Vienna

The aim of this study was to retrospectively analyze the prevalence and patterns of traumatic dental injuries (TDIs) in permanent teeth at the University Dental Clinic of Vienna and examine influential variables. The study included all patients with dental trauma in permanent teeth who presented at the University Dental Clinic of Vienna (Austria) between 2014 and 2016. Dental records, including age, gender, location of trauma, type of trauma, cause of TDI, and location of the traumatic incident, were obtained. Clinical oral and radiographic examinations were conducted in accordance with the current guidelines of the German Society of Dental, Oral, and Craniomandibular Sciences (DGZMK). The sample comprised 1132 permanent teeth of 578 patients with TDIs. The most frequently injured teeth were upper central incisors (n = 719, 63.5%), followed by upper lateral incisors (n = 231, 20.4%). Fractures were the most frequent injury type (53%, n = 596). TDIs mostly occur due to falling accidents. The majority of traumatic incidents occurred at home (79.4%, n = 459). The injury characteristics are comparable to the results of other international studies. Due to the high prevalence of TDIs in dental medicine, dental practitioners should be equipped to effectively manage their immediate care and treat potential long-term complications.

Prevalence, Etiology, and Types of Dental Trauma in Self-Assessment of 18-Year-Olds in Poland

The aim of the study is to determine the occurrence and etiology of traumatic dental injuries of permanent teeth and to evaluate the relationship between diagnosed injuries and selected socio-economic indicators. In total, 1741 students aged 18 years, representing all the regions of Poland, took part in the survey. Questionnaires for monitoring studies were prepared in accordance with the criteria of the World Health Organization. Among the respondents, tooth trauma was reported by 18% of adolescents. The most common trauma occurred during other activities (e.g., playing) (64%). The most common direct cause of injury was a fall (43%) or a collision with an object or another person (36%). Risk of injury was increased by a low level of parents' education and poor financial situation of the family. Playing sports is important in the etiology of injuries. The incidence of injuries was highest in school, demonstrating the need for school education in injury prevention and first aid. Occurrence of injuries, their causes, therapy, and post-traumatic complications were similar in respondents of both genders, which can be explained by secularization trends. Risk of injury was increased by parents' low level of education and poor economic status. The research demonstrates the need for universal education on treatment of dental injuries.

Prevalence and patterns of traumatic dental injuries in primary teeth: a 3-year retrospective overview study in Vienna

OBJECTIVES

The aim of this study was to retrospectively identify the prevalence, patterns, and accident types of traumatic dental injuries (TDIs) in children with primary teeth in Vienna, Austria.

MATERIAL AND METHODS

The investigation was conducted as a retrospective overview study including all children with TDIs in primary teeth at the University Dental Clinic of Vienna (Austria) between 2014 and 2016. Dental records including age, gender, location of trauma, type of trauma, cause of TDI, and location of traumatic incident were obtained. Furthermore, the time of presentation and the time span between TDI and initial treatment were evaluated.

RESULTS

The sample comprised TDIs in 243 patients with 403 primary teeth. In a ratio of 1:1.45, boys were significantly more involved than girls. Upper central and lateral incisors were most frequently affected (n = 371, 92.1%). Dislocations were the most common type of injury (n = 298, 74%) with subluxations being the most prevalent form (n = 85, 28.5%). In 23% (n = 92), fractures were observed. The majority of traumatic incidents occurred at home (88.5%).

CONCLUSION

The injury characteristics are comparable to what has previously been reported in other studies in pediatric populations.

CLINICAL RELEVANCE

TDIs are a prevalent event in children worldwide and incisors are the most affected teeth in the primary dentition. Thus, dental practitioners should be able to handle these injuries.