Ng Lydia, Malandris Michael, Cheung Wendy, Rossi-Fedele Giampiero
Dental Department, Hutt Valley District Health Board, Hut Hospital, Wellington, New Zealand.
Adelaide Dental School, The University of Adelaide, Adelaide, Australia.
Dent Traumatol. 2020 Aug;36(4):360-370. doi: 10.1111/edt.12548. Epub 2020 Feb 18.
BACKGROUND/AIM: There is a scarcity of data regarding paediatric traumatic dental injuries (TDI) in tertiary teaching hospitals. Therefore, the aim of this study was to review the TDI presenting to the Women's and Children's Hospital in Adelaide (Australia) on an emergency basis and to identify the characteristics of the presenting patient cohort, their accident, injuries and management.
Medical health records of 337 paediatric patients attending the Paediatric Emergency Department (PED) for the management of TDI over 18 months were prospectively reviewed.
TDI were more frequent in children under 5 years of age (56.1%) with a predominance of injuries sustained by males (63.8%). The accident characteristics included weekend occurrence (35.6%), the most common aetiology was falls (64.4%) and many incidents occurred at home (48.5%). Overall, 654 teeth were injured with the majority affecting deciduous teeth (58.4%) and the maxillary central incisors (69.9%). The most frequent injury was lateral luxation (27.5%). The majority of patients were referred to the Paediatric Dentistry Department (60.8%). However, almost half of presenting patients did not require further management locally and were subsequently discharged to their dental practitioners (39.2%). Most patients receiving treatment were managed under general anaesthetic (36.9%), and there was often a delay of 3-12 hours before treatment commenced (49.1%). Similarly, more severe injuries in the permanent dentition (avulsion, extrusion, root fracture, intrusion, alveolar fracture) were more frequently managed between 3 and 12 hours following the accident.
The patient, accident, injury and management characteristics are comparable to what has previously been reported in other studies in paediatric populations. Injuries affecting the permanent dentition are more likely to be managed within 3 and 12 hours in an outpatient setting, whereas injuries affecting the deciduous dentition had a delay in management between 12 and 24 hours under general anaesthetic.
背景/目的：关于三级教学医院儿童创伤性牙损伤（TDI）的数据匮乏。因此，本研究的目的是回顾澳大利亚阿德莱德妇女儿童医院急诊的TDI情况，并确定就诊患者群体的特征、他们的事故、损伤及处理情况。
前瞻性地回顾了18个月内到儿科急诊科（PED）处理TDI的337例儿科患者的医疗健康记录。
5岁以下儿童的TDI更为常见（56.1%），男性受伤居多（63.8%）。事故特征包括周末发生（35.6%），最常见的病因是跌倒（64.4%），许多事故发生在家中（48.5%）。总体而言，654颗牙齿受伤，大多数影响乳牙（58.4%）和上颌中切牙（69.9%）。最常见的损伤是侧向脱位（27.5%）。大多数患者被转诊至儿童牙科科室（60.8%）。然而，近一半就诊患者在当地不需要进一步处理，随后被转交给他们的牙医（39.2%）。大多数接受治疗的患者在全身麻醉下进行处理（36.9%），治疗开始前通常延迟3至12小时（49.1%）。同样，恒牙列中的更严重损伤（牙脱位、牙脱出、牙根折断、牙嵌入、牙槽骨骨折）在事故发生后3至12小时内处理更为频繁。
患者、事故、损伤及处理特征与之前在其他儿科人群研究中报告的情况相当。影响恒牙列的损伤更有可能在门诊环境中于3至12小时内处理，而影响乳牙列的损伤在全身麻醉下处理延迟12至24小时。
