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

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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)

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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%
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