A two-year retrospective study on traumatic dental injury in the primary dentition

The aim of this study was to analyze the causes, clinical characteristics, social factors, and current status of treatment of traumatic dental injury (TDI) in the primary dentition. A retrospective analysis was performed on 144 children (213 teeth) with TDI in the primary dentition from our hospital between December 2017 and June 2020. Data were analyzed using the chi-square test and the Mann-Withney-Wilcoxon test. Boys accounted for 68.1% (98/144) and girls for 31.9% (46/144) of all 144 children with TDI in the primary dentition, with a boy-girl ratio of 2.13:1. The primary age of TDI in deciduous teeth was 2 to 4 years old, accounting for 59% of all cases. Collision with others and fall were the 2 main causes of trauma to the deciduous teeth, making up 52.1% and 44.4% of all causes, respectively. Crown fracture injury was the most common type of TDI in the primary dentition, accounting for 37% of all cases (53/144). Of the 144 cases, 17.4% (25/144) was accompanied by soft tissue laceration, while 22.2% (32/144) by swelling or contusion of tissue. Maxillary teeth (92.4%) were more vulnerable to injury than mandibular teeth (7.5%), with maxillary incisor being the most vulnerable 1 (91.5%). The percentage of children arrived at the hospital for treatment 24 hours after the injury was the highest (57.0%, 82/144). After the hospital visit, 74.3% of children received treatment for the dental trauma. In terms of the treatment modalities, extraction of the traumatized teeth (27.1%) and pulpectomy + resin filling (or preformed crown) restoration were predominant. Approximately 28.5% (41/144) of cases were reviewed within 2 years, with the proportion of children with pulpitis or periapical infection being the highest (29.3%, 12/41). Age, gender, collision, and fall are the factors linked to a higher risk of TDI in the primary dentition in children under the age of 7. Resin filling (or preformed crown) restoration and pulpectomy are effective in preserving the affected tooth and controlling infection. However, the preservation of the affected tooth and the prevention of infection may be hampered by late visits and low follow-up rates.