Department of Pedodontics, Specialist Unit, Public Dental Health, Uddevalla, Sweden.
Dent Traumatol. 2010 Apr;26(2):129-32. doi: 10.1111/j.1600-9657.2009.00862.x. Epub 2010 Feb 5.
The aim of this prospective study was to compare diagnosis, severity of trauma and treatment of traumatic injuries to the primary dentition in two groups of children, the first recommended for treatment by general practitioners and the second referred for treatment by a specialist paediatric dentist.
A total of 323 children with traumatic injuries, 184 boys and 139 girls aged 7-83 months, participated in the study. All the children had first presented at a Public Dental Service clinic where they were examined by general dentists who decided, based on the severity of the trauma, to assign each child to one of the following two groups: Group A--recommended for treatment at the general practise (166 children with 257 traumatized incisor teeth). Group B--recommended for referral to a specialist in paediatric dentistry (157 children with 261 traumatized incisor teeth). Even in Group A, the specialist controlled the treatment decisions. The clinical diagnose and follow-up followed the recommendations presented by Andreasen & Andreasen.
The distribution of trauma by age was similar in both groups, with about 60% occurring between 1 and 3 years. More injured teeth were extracted in children in Group B (n = 111) than in Group A (n = 33). A higher percentage of intruded primary incisors were recorded in Group B (24%) compared with Group A (16%). Similarly, the percentage of concussions/subluxations, lateral luxations and complicated crown fractures was higher in Group B than in Group A.
The group referred for specialist treatment had more severe injuries and needed more complicated treatment than the group recommended for care by general dentists. However, the rate of sequelae in permanent successors was the same in both.
本前瞻性研究旨在比较两组儿童的原发性外伤的诊断、创伤严重程度和治疗情况，一组推荐由全科医生治疗，另一组推荐由儿科牙医治疗。
共有 323 名外伤性损伤患儿（男 184 例，女 139 例）参与本研究，年龄 7-83 个月。所有患儿均首先到公共牙科诊所就诊，由全科牙医进行检查，根据创伤的严重程度，决定将每个患儿分配到以下两组之一：A 组-推荐在全科治疗（166 例患儿，257 颗外伤性切牙）。B 组-推荐转介至儿科牙医（157 例患儿，261 颗外伤性切牙）。即使在 A 组，专家也会控制治疗决策。临床诊断和随访均按照 Andreasen 和 Andreasen 的建议进行。
两组患儿的外伤分布相似，约 60%发生在 1-3 岁之间。B 组（n = 111）需要拔牙的受伤牙齿多于 A 组（n = 33）。B 组（24%）记录的嵌入性外伤发生率高于 A 组（16%）。同样，B 组的震荡/半脱位、侧向脱位和复杂冠折的比例也高于 A 组。
转诊接受专家治疗的组患儿的损伤更严重，需要更复杂的治疗，而推荐由全科牙医治疗的组患儿则需要更复杂的治疗。然而，两组患儿的永久性后继牙发生后遗症的比例相同。
