Traumatic dental injuries in the primary dentition: exploratory medico-legal framework for temporary damage...

Traumatic dental injuries (TDIs) in the primary dentition are frequent in early childhood and may lead to sequelae affecting both injured primary teeth and their permanent successors. They also raise medico-legal questions when premature loss of a primary tooth results in a time-dependent functional, aesthetic, and psychosocial impairment before the permanent successor can be evaluated. This retrospective single-center study reviewed the records of 419 children (262 males, 157 females; mean age 3.23 ± 1.85 years) treated for TDIs to the primary dentition between 2013 and 2022, comprising 428 traumatic events and 780 affected primary teeth. Demographic data, injury circumstances, trauma type, affected teeth, treatment, follow-up, and sequelae were analysed at the patient, event, and tooth levels. Luxation injuries predominated, domestic accidents were the most frequent circumstance of injury, and maxillary central incisors were the most commonly affected teeth. Pulp necrosis was recorded in 14.3% of injured teeth, delayed premature loss in 21.0%, and permanent successor sequelae in 19.0% based on available follow-up records. The secondary aim was medico-legal: to inform an exploratory framework for assessing temporary biological damage during the interval between premature tooth loss and eruption of the permanent successor. The proposed framework is not presented as a validated compensation scale but as a conceptual aid for expert appraisal. Prospective multicenter validation is required before any normative or compensation use.