Recent trends in the management of dentoalveolar traumatic injuries to primary and young permanent teeth

Abstract

Recent trends in the management of dentoalveolar traumatic injuries to primary and young permanent teeth REVIEW ARTICLE BackgroundOne of the commonly encountered dental emergencies is dentoalveolar traumatic injuries (DTIs). Unfortunately, DTIs result in fractured, displaced, or lost anterior teeth and this could have significant functional, esthetic, speech, and psychological effects on children thus affecting their quality of life (1). Although it is impossible to guarantee permanent retention of a traumatized tooth, patient age, severity of injury, and timely treatment and follow up of the tooth using recommended procedures can maximize the chances for success (2,3). This review examines the recent trends in the management of DTI to primary and young permanent teeth. Electronic search of scientific papers from 1990s to 2009 was accomplished using Pub Med search engine. The inclusion criteria were English language, publication year, experimental studies and review articles, the age of the study group, and the management technique. The search terms used were the following: dental, trauma, injury, primary teeth, permanent teeth, enamel infraction, crown fracture, crown-root fracture, root fracture, luxation, avulsion, and replantation. In addition, some text books and guidelines were used in this review. A proper definition of DTI is an injury that results from an external force, involving the teeth, the alveolar portion of the maxilla or mandible, and the adjacent soft tissues (4, 5). Different frequencies of DTI are reported in the literature, depending on the employed methodology, the type of dentition, and patients' age.The frequency of DTI is inversely proportional to age (6, 7). Several epidemiological studies investigated DTI in schoolchildren by means of clinical examinations and questionnaires, which might increase significantly the number of cases (8, 9). The number of DTI decreases significantly when epidemiologic studies are performed in a hospital environment (6,10). This is attributed to two reasons: minor dental injuries such as concussion and subluxation are not usually reported in hospital settings, and school-based studies usually involved large slice of the community in contrast to the limited hospital reported cases.The greatest occurrence of DTI to the primary dentition is when motor coordination is developing and children are more susceptible to falls (6, 11). Most injuries to permanent teeth occur secondary to falls, followed by traffic accidents, violence, and sports (6,(12)(13)(14). Boys are twice as likely as girls to report DTI and are much more likely to experience such trauma more than once (7). Children with special needs are in more danger of having trauma than others. This occurs more frequently in people who have intellectual disability, sensory impairment, attention-deficit/hypersensitivity disorder, seizures, abnormal protective reflexes, or muscle incoordination (15)(16)(17)(18)(19)(20). Occlusal relationship is another risk factor because the frequency of DTI is significant...

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