Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (2): 384-389. doi: 10.19723/j.issn.1671-167X.2021.02.025

Previous Articles     Next Articles

Clinical analysis of children and adolescents emergency dental trauma cases

YANG Xue,SUN Wei,WANG Zhe,JI Ai-ping,BAI Jie()   

  1. Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2020-10-09 Online:2021-04-18 Published:2021-04-21
  • Contact: Jie BAI E-mail:jiebai1999@163.com
  • Supported by:
    New Technology and New Therapy Project of Peking University School and Hospital of Stomatology(PKUSSNCT-18B06)

RICH HTML

 17   

PDF (PC)

213

Abstract:

Objective: To analyze the etiological and clinical characteristics of oral emergency patients under 18 years with dental trauma, and to provide guidance on the prevention and treatment in children and adolescents. Methods: A retrospective study on the intact data of the dental trauma patients under 18 years from January 2016 to December 2018 in the Department of Oral Emergency in Peking University School of Stomatology was conducted, and the distribution of the patients’ gender, age and visiting time, as well as the number and position of traumatic teeth, diagnostic classification, and multiple injury with dental trauma were analyzed. Results: During the period, 54.2% of the first visit dental trauma patients (10 164) were children or adolescents (5 506). The two peak ages were 3-4 and 7-9 years. The incidence of the male was higher than the female in every age group (Wilcoxon test, P<0.001). From May to June and September to November, there were more cases of dental trauma. The peak time of daily dental trauma cases was from 19:00 to 20:00 (Jonckheere-Terpstra test, P<0.001). The positions of traumatic teeth in both sides were approximate symmetrical, and maxillary central incisors were the most affected. 52.3% of the patients suffered multiple teeth injuries. Among the permanent teeth trauma, enamel and dentin fracture was the most common (24.7%), followed by concussion (20.5%), sub-luxation (17.9%) and complicated crown fracture (14.4%). And among the primary teeth trauma, subluxation was the most common (31.1%), followed by concussion (14.5%) and lateral luxation (9.5%). 19.7% of the children and adolescent dental trauma patients were also suffered maxillofacial soft or hard tissue injury. Conclusion: The incidence of dental trauma in children and adolescents is higher than that in adults. There were two age peaks among the children and adolescents patients. Primary teeth and young permanent teeth were usually suffered. Clinical treatment should be considered along with the characteristics of child tooth growth. In order to prevent the occurrence of dental trauma, early orthodontic intervention should be carried out in children with severe overjet. Families, schools and nursery institutions should strengthen the protection against dental trauma.

Key words: Tooth injuries, Emergencies, Adolescent, Child

CLC Number: 

  • R782.4

Figure 1

Distribution of gender in different ages of children and adolescents with dental trauma"

Figure 2

Month distribution of children and adolescents with dental trauma"

Figure 3

Day time distribution of children and adolescents with dental trauma"

Table 1

Position of traumatic permanent teeth"

Position Number Percentage
Right upper central incisor 2 118 37.1%
Left upper central incisor 2 115 37.0%
Left upper lateral incisor 415 7.3%
Right upper lateral incisor 382 6.7%
Right lower central incisor 217 3.8%
Left lower central incisor 200 3.5%
Right lower lateral incisor 93 1.6%
Left lower lateral incisor 84 1.5%
Canine 59 1.0%
Premolar 23 0.4%
Molar 5 0.1%
Total 5 711 100.0%

Table 2

Position of traumatic primary teeth"

Position Number Percentage
Right upper central incisor 1 672 37.7%
Left upper central incisor 1 664 37.5%
Left upper lateral incisor 311 7.0%
Right upper lateral incisor 287 6.5%
Left lower central incisor 125 2.8%
Right lower central incisor 123 2.8%
Left lower lateral incisor 50 1.1%
Right lower lateral incisor 45 1.0%
Canine 121 2.7%
Molar 37 0.8%
Total 4 435 100.0%

Table 3

Number of traumatic teeth of children and adolescents"

Number of teeth Patient number Percentage
1 2 624 47.7%
2 1 898 34.5%
3 501 9.1%
4 336 6.1%
5 66 1.2%
6 44 0.8%
7 22 0.4%
8 8 0.1%
9 4 0.1%
10 2 <0.1%
11 1 <0.1%
Total 5 506 100.0%

Table 4

Category of traumatic permanent teeth"

Diagnosis Age group/years Total Percentage
3-5 6-8 9-11 12-14 15-17
Enamel-dentin fracture 565 535 197 116 1 413 24.7%
Concussion 6 533 359 166 107 1 171 20.5%
Subluxation 18 491 303 125 83 1 020 17.9%
Complicated crown fracture 267 381 108 69 825 14.4%
Complicated crown-root fracture 68 113 51 41 273 4.8%
Avulsion 73 88 63 28 252 4.4%
Lateral luxation 57 36 52 45 190 3.3%
Luxation 46 61 20 29 156 2.7%
Enamel infraction 34 46 22 13 115 2.0%
Intrusive luxation 57 32 14 6 109 1.9%
Root fracture 35 33 20 21 109 1.9%
Enamel fracture 18 18 6 5 47 0.8%
Uncomplicated crown-root fracture 13 9 7 2 31 0.5%
Total 24 2 257 2 014 851 565 5 711 100.0%

Table 5

Category of traumatic primary teeth"

Diagnosis Age group/years Total Percentage
0-2 3-5 6-8 9-11 12-14
Subluxation 314 871 177 16 1 378 31.1%
Concussion 159 408 68 6 641 14.5%
Lateral luxation 124 254 41 3 422 9.5%
Avulsion 108 192 99 14 3 416 9.4%
Complicated crown fracture 208 88 6 302 6.8%
Root fracture 36 241 16 293 6.6%
Intrusive luxation 137 100 5 242 5.5%
Complicated crown-root fracture 159 80 8 247 5.5%
luxation 24 152 57 2 235 5.3%
Enamel-dentin fracture 142 82 5 1 230 5.2%
Enamel infraction 11 3 14 0.3%
Enamel fracture 6 6 12 0.3%
Uncomplicated crown-root fracture 3 3 0.1%
Total 1 431 2 477 482 42 3 4 435 100.0%
[1] Ghadimi S, Seraj B, Keshavarz H, et al. The effect of using an educational poster on elementary school health teachers’ know-ledge of emergency management of traumatic dental injuries[J]. J Dent (Tehran), 2014,11(6):620-628.
[2] Lee JY, Divaris K. Hidden consequences of dental trauma: the social and psychological effects[J]. Pediatr Dent, 2009,31(2):96-101.
pmid: 19455926
[3] 白洁, 姬爱平, 于冬梅. 急诊牙外伤患者临床分析[J]. 北京大学学报(医学版), 2010,42(1):90-93.
[4] 王晓敏, 苏雪龙, 王红, 等. 西安市学龄儿童年轻恒牙外伤的现况调查[J]. 华西口腔医学杂志, 2018,36(2):194-198.
[5] Kirzioglu Z, Oz E. Changes in the etiological factors of dental trauma in children over time: An 18-year retrospective study[J]. Dent Traumatol, 2019,35(4-5):259-267.
pmid: 31054189
[6] 夏斌, 葛立宏, 王忠桂, 等. 北京大学口腔医学院256例急诊就诊儿童情况分析[J]. 现代口腔医学杂志, 2006,20(2):214-215.
[7] Ivancic Jokic N, Bakarcic D, Fugosic V, et al. Dental trauma in children and young adults visiting a University Dental Clinic[J]. Dent Traumatol, 2009,25(1):84-87.
doi: 10.1111/j.1600-9657.2008.00711.x pmid: 19208016
[8] Llarena del Rosario ME, Acosta Alfaro VM, Garcia-Godoy F. Traumatic injuries to primary teeth in Mexico City children[J]. Dent Traumatol, 2010,8(5):213-214.
[9] Levin L, Day PF, Hicks L, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction[J]. Dent Traumatol, 2020,36(4):309-313.
pmid: 32472740
[10] 葛立宏. 儿童口腔医学[M]. 4版. 北京: 人民卫生出版社, 2012.
[11] 樊明文. 牙体牙髓病学[M]. 4版. 北京: 人民卫生出版社, 2016.
[12] 王晓敏, 苏雪龙, 王红, 等. 西安市学龄儿童年轻恒牙外伤就诊及预后的现况调查[J]. 华西口腔医学杂志, 2018,36(3):308-313.
[13] Kim C, Choi E, Park KM, et al. Characteristics of patients who visit the dental emergency room in a dental college hospital[J]. J Dent Anesth Pain Med, 2019,19(1):21-27.
pmid: 30859130
[14] Blagojevic D, Petrovic B, Markovic D, et al. Pulp vitality preservation after traumatic dental injuries to permanent teeth[J]. Med Pregl, 2013,66(3/4):149-152.
[15] 迟丹丹, 徐海峰, 马卫东. 202例急诊牙外伤临床分析[J]. 口腔医学研究, 2012,28(5):443-446.
[16] Francisco SS, Filho FJ, Pinheiro ET, et al. Prevalence of traumatic dental injuries and associated factors among Brazilian schoolchildren[J]. Oral Health Prev Dent, 2013,11(1):31-38.
doi: 10.3290/j.ohpd.a29373 pmid: 23507679
[17] 白洁, 姬爱平, 于冬梅. 175例急诊儿童牙外伤情况分析[J]. 北京口腔医学, 2010,18(4):231-233.
[18] Suhasini SJ, Gheena S. Dental trauma in children and young adults[J]. J Pharm Sci Res, 2015,7(6):344-346.
[19] Fouad AF, Abbott PV, Tsilingaridis G, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth[J]. Dent Traumatol, 2020,36(4):331-342.
doi: 10.1111/edt.12573 pmid: 32460393
[20] Day PF, Flores MT, O’Connell AC, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition[J]. Dent Traumatol, 2020,36(4):343-359.
pmid: 32458553
[1] Zi-jing WANG,Zai-ling LI. Characteristics of gastric microbiota in children with Helicobacter pylori infection family history [J]. Journal of Peking University (Health Sciences), 2021, 53(6): 1115-1121.
[2] Ya-fei LIU,Lin-lin SONG,Mao-wei XING,Li-xin CAI,Dong-xin WANG. Comparison of pulse pressure variation, stroke volume variation, and plethysmographic variability index in pediatric patients undergoing craniotomy [J]. Journal of Peking University (Health Sciences), 2021, 53(5): 946-951.
[3] CHEN Man-man,YANG Zhao-geng,SU Bin-bin,LI Yan-hui,GAO Di,MA Ying,MA Tao,DONG Yan-hui,MA Jun. Analysis on the law of height growth spurt in adolescence of children and adolescents in Zhongshan City [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 506-510.
[4] ZHOU Jing,LIU Yi. Cone-beam CT evaluation of temporomandibular joint in skeletal class Ⅱ female adolescents with different vertical patterns [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 109-119.
[5] Zi-yi ZHANG,Bin XIA,Ming-ming XU,Yi-ping LI,Zhan-gui TANG,Yong-qing CHEN. Evaluation of effect of oral health intervention on children in Shaoshan area of Hunan province [J]. Journal of Peking University (Health Sciences), 2020, 52(5): 913-918.
[6] Xiao-xian CHEN,Jie ZHONG,Wen-juan YAN,Hong-mei ZHANG,Xia JIANG,Qian HUANG,Shi-hua XUE,Xing-gang LIU. Clinical performance of rensin-bonded composite strip crowns in primary incisors [J]. Journal of Peking University (Health Sciences), 2020, 52(5): 907-912.
[7] Dong-mei LUO,Xiao-jin YAN,Pei-jin HU,Jing-shu ZHANG,Yi SONG,Jun MA. Subnational inequalities of early marriage and fertility among Chinese females from 1990 to 2010 [J]. Journal of Peking University (Health Sciences), 2020, 52(3): 479-485.
[8] Jun LI,Fang GU,Zai-ling LI,Yu-min LU. Pediatric colonoscopy findings and changing patterns from Beijing in one institutional experience over 12 years [J]. Journal of Peking University(Health Sciences), 2019, 51(5): 819-823.
[9] Li-jun ZHAO,Hong-tian LI,Ya-li ZHANG,Yu-bo ZHOU,Jian-meng LIU. Mobile terminal-based survey on the birth characteristics for Chinese newborns [J]. Journal of Peking University(Health Sciences), 2019, 51(5): 813-818.
[10] Chun-yan TAO,Hong-xia LI,Xue-ying LI,Chao-shu TANG,Hong-fang JIN,Jun-bao DU. Hemodynamic changes in standing-up test of children and adolescents with postural tachycardia syndrome [J]. Journal of Peking University(Health Sciences), 2019, 51(3): 414-421.
[11] Ling GAO,Yun LIU,Xu-dong YANG. Effects of intranasal dexmedetomidine for children undergoing dental rehabilitation under general anesthesia: a double-blinded randomized controlled trial [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1078-1082.
[12] WU Peng-hui, XIE Yao, ZHAO Wei-hong, HUA Ying, SUN Qing, LI Shuo, WU Ye, LU Xin-tian. Clinical characteristics analysis of children with reversible posterior leukoen-cephalopathy syndrome during the treatment of hematological tumor [J]. Journal of Peking University(Health Sciences), 2018, 50(4): 662-665.
[13] LU Jin-hui, QIAN Jun, LIU He, ZHU Jun-xia. Clinical study on autologus platelet-rich fibrin aided revascularization of immature permanent teeth [J]. Journal of Peking University(Health Sciences), 2018, 50(4): 672-679.
[14] DONG Yan-hui, SONG Yi, DONG Bin, ZOU Zhi-yong, WANG Zheng-he, YANG Zhao-geng, WANG Xi-jie, LI Yan-hui, MA Jun. Association between the blood pressure status and nutritional status among Chinese students aged 7-18 years in 2014： based on the national blood pressure reference for Chinese children and adolescents [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 422-428.
[15] CHEN Tian-qi, DONG Bin, ZHANG Wen-jing, GAO Di-si, DONG Yan-hui, MA Jun, MA Ying-hua. Association between speed and endurance performance with sleep duration in children and adolescents [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 429-435.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. Journal of Peking University(Health Sciences), 2009, 41(4): 456 -458 .
[2] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 135 -140 .
[3] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 158 -161 .
[4] . [J]. Journal of Peking University(Health Sciences), 2009, 41(2): 217 -220 .
[5] . [J]. Journal of Peking University(Health Sciences), 2009, 41(1): 52 -55 .
[6] . [J]. Journal of Peking University(Health Sciences), 2009, 41(1): 109 -111 .
[7] . [J]. Journal of Peking University(Health Sciences), 2009, 41(3): 297 -301 .
[8] . [J]. Journal of Peking University(Health Sciences), 2009, 41(5): 516 -520 .
[9] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 304 -309 .
[10] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 310 -314 .
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd