Evaluation of Dentoalveolar Trauma in Children and Adolescents: a Modified Classification System and Surgical Treatment Strategies for Its Management

J Craniofac Surg. 2017 Jun;28(4):e383-e387. doi: 10.1097/SCS.0000000000003720.

Abstract

Objective: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective.

Patients and methods: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed.

Results: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department. The most common injury mechanism was falls. The trauma was graded as class II in most patients (41.65%). The anterior maxilla was injured in the majority of the patients (78.35%). In 230 patients (63%) the trauma involved the primary dentition. Two hundred eighty-nine of the patients were treated with local anesthesia on an emergency basis, while in the rest 76 patients general anesthesia was considered mandatory.

Conclusions: Accurate diagnosis, timely treatment, and follow-up are critical for the management of dentoalveolar trauma in pediatric patients. A modified more detailed and severity-specific classification and guidelines for its surgical management may assist practitioners in decision making and effective treatment planning.

MeSH terms

  • Accidental Falls / statistics & numerical data
  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Greece / epidemiology
  • Humans
  • Infant
  • Male
  • Maxillofacial Injuries* / diagnosis
  • Maxillofacial Injuries* / epidemiology
  • Maxillofacial Injuries* / etiology
  • Maxillofacial Injuries* / therapy
  • Retrospective Studies
  • Tooth Injuries* / diagnosis
  • Tooth Injuries* / epidemiology
  • Tooth Injuries* / etiology
  • Tooth Injuries* / therapy
  • Treatment Outcome