Maguire Sabine, Hunter Bruce, Hunter Lindsay, Sibert Jo Richard, Mann Mala, Kemp Alison Mary
Department of Child Health, Cardiff University, Cardiff, UK.
Arch Dis Child. 2007 Dec;92(12):1113-7. doi: 10.1136/adc.2006.113001. Epub 2007 Apr 27.
A torn labial frenum is widely regarded as pathognomonic of abuse.
We systematically reviewed the evidence for this, and to define other intra-oral injuries found in physical abuse. Nine studies documented abusive torn labial frena in 27 children and 24 [corrected] were fatally abused: 22 were less than 5 years old. Only a direct blow to the face was substantiated as a mechanism of injury.
Two studies noted accidentally torn labial frena, both from intubation. Abusive intra-oral injuries were widely distributed to the lips, gums, tongue and palate and included fractures, intrusion and extraction of the dentition, bites and contusions.
Current literature does not support the diagnosis of abuse based on a torn labial frenum in isolation. The intra-oral hard and soft tissue should be examined in all suspected abuse cases, and a dental opinion sought where abnormalities are found.
唇系带撕裂被广泛认为是虐待的特征性表现。
我们系统地回顾了相关证据，以明确身体虐待中发现的其他口腔内损伤。九项研究记录了27名儿童中存在虐待性唇系带撕裂，其中24名[已修正]遭受致命虐待：22名年龄小于5岁。只有面部直接打击被证实为损伤机制。
两项研究指出唇系带意外撕裂，均因插管所致。虐待性口腔内损伤广泛分布于嘴唇、牙龈、舌头和腭部，包括牙列骨折、嵌入和拔除、咬伤和挫伤。
目前的文献不支持仅基于唇系带撕裂来诊断虐待。在所有疑似虐待病例中均应检查口腔内软硬组织，发现异常时应寻求牙科专业意见。
