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      Epidemiology of dental trauma: a review of the literature.

      Australian Dental Journal
      Accidents, statistics & numerical data, Accidents, Home, Australia, epidemiology, Female, Humans, Incisor, injuries, Male, Periodontium, Population Surveillance, Prospective Studies, Sex Factors, Tooth Fractures, Tooth Injuries, classification, prevention & control, Tooth, Deciduous

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          Abstract

          This article reviews recent reports describing the aetiology of dental trauma from national and international studies as well as the different classifications currently used to report dental injuries. It also discusses possible preventive measures to reduce the increasing frequency of dental trauma. Reported studies demonstrate that males tend to experience more dental trauma in the permanent dentition than females, however, there does not appear to be a difference between the sexes in the primary dentition. Accidents within and around the home were the major sources of injury to the primary dentition, while accidents at home and school accounted for most of the injuries to the permanent dentition. The most frequent type of injury was a simple crown fracture of the maxillary central incisors in the permanent dentition while injuries to the periodontal tissues were more common in the primary dentition. When preventive measures are being planned, knowledge of aetiology is important. More prospective studies from representative populations are required to understand the complexities of dental trauma epidemiology and to allow implementation of preventive strategies to reduce the increasing frequency of dental trauma.

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          Most cited references14

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          Traumatic injuries to permanent incisors.

          The prevalence of traumatic injuries to permanent incisors and their distribution according to type and some clinical factors, were analysed in a total population of 2798 patients, aged 6-21 years, examined over a 5-year period in the Dental Clinic of the University of Verona, Italy. The material consisted of case histories and radiograms taken during the examination of injured teeth. The number of injured patients was 178 (131 males and 47 females), the number of injured incisors was 326. The prevalence of injuries was 7.3%. A very large number of dental injuries occurred to children aged between 6 and 13 years. The ratio of boys to girls was 2.7:1. Most frequent causes of injuries were falls and traffic accidents. Most injuries involved two teeth. About 80% of the teeth were maxillary central incisors. The most common type of injury was non complicated crown fracture. In 87 cases (48%) there was an associated injury to soft tissue. Alveolar fractures occurred in 22 cases (12%). Traumas involving periodontal ligament constituted nearly 40% of the total. This study noted the following points: 1) preventive education programs should be instituted in the region, directed at parents and school teachers, to inform them about the problems of dental trauma and to obtain cooperative attitude to treatment and good motivation in controls; 2) the necessity to unify the diagnostic and therapeutic protocol to provide reliable information in clinical investigations, to permit valid comparison with other studies and to improve the long-term prognosis of many cases.
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            Incidence of dental trauma in the Western Australian School Dental Service.

            A prospective study was undertaken to determine the annual incidence of trauma to the anterior permanent teeth of children enrolled in the Western Australian School Dental Service. The population comprised 66,500 6-12-yr-old children. 1.66 children and 2.05 teeth per 100 children received trauma. Of the children incurring trauma the incidence per 100 erupted teeth was 11.7. 80.5% of children traumatised one tooth only per incident, but 35% of all teeth that were traumatised involved trauma to two or more teeth. 88% of all traumatised teeth were central incisors. Girls received proportionately more trauma to the maxillary dental arch than did boys. Fracture involving both the enamel and the dentine was the most commonly recorded class of trauma (42.7% of cases). There was no obvious pattern to the overall distribution of trauma through the week or the year. Approximately one-third of all traumata occurred at school, one-third at home, and the remainder elsewhere. Trauma to the maxillary dental arch occurred most frequently at home, while trauma to more than one tooth (multiple trauma) occurred most commonly at school. Trauma incidence resulting from falling or being pushed was almost twice as high among girls as among boys. Bicycle accidents caused a higher than average rate of multiple trauma and of pulpal exposure.
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              Dental trauma in children and adolescents in Valparaiso, Chile.

              This study analyzed traumatic injuries in the primary and permanent dentition in children treated from 1990 to 1992 at the Children's Dental Traumatology Service in Valparaiso, Chile. A total of 227 records from patients 2 to 21 years old was studied with regard to the cause of injury, location of injury, time elapsed before treatment, history of previous trauma, type of injury, number of injured teeth, and how patients seek treatment. A total of 73 patients had injuries to the primary dentition (pD) and 154 to the permanent dentition (PD) with a total of 357 injured teeth (115 primary, 242 permanent). Ten to 12-year-old children had the highest number of injuries (33%). Falling was the most common cause of injury in both groups (82% pD, 58% PD), followed by striking against objects (13% pD, 19% PD) and bicycle accidents (9% PD). Most injuries in children with primary dentition (68%) occurred at home, while children with permanent dentition had most accidents at school (38%). Most children (61%) sought treatment after 24 h (52% pD, 65% PD), 61 children had suffered previous trauma (36% pD, 23% PD). The most common injuries in primary teeth were luxation (26%), intrusion (21%) and subluxation (18%). Uncomplicated crown fracture (34%), followed by complicated crown fracture (21%), were the main injuries in permanent teeth. There was no difference in the number of teeth involved for either dentition. A single tooth injury was found in 54%. Two teeth were involved in 35%, and three or more teeth in 11%.(ABSTRACT TRUNCATED AT 250 WORDS)
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