Yang X, Sun W, Wang Z, Ji A P, Bai J
Department of Oral Emergency, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Mar 3;53(2):384-389. doi: 10.19723/j.issn.1671-167X.2021.02.025.
To analyze the etiological and clinical characteristics of oral emergency patients under 18 years with dental trauma, and to provide guidance on the prevention and treatment in children and adolescents.
A retrospective study on the intact data of the dental trauma patients under 18 years from January 2016 to December 2018 in the Department of Oral Emergency in Peking University School of Stomatology was conducted, and the distribution of the patients' gender, age and visiting time, as well as the number and position of traumatic teeth, diagnostic classification, and multiple injury with dental trauma were analyzed.
During the period, 54.2% of the first visit dental trauma patients (10 164) were children or adolescents (5 506). The two peak ages were 3-4 and 7-9 years. The incidence of the male was higher than the female in every age group (Wilcoxon test, < 0.001). From May to June and September to November, there were more cases of dental trauma. The peak time of daily dental trauma cases was from 19:00 to 20:00 (Jonckheere-Terpstra test, < 0.001). The positions of traumatic teeth in both sides were approximate symmetrical, and maxillary central incisors were the most affected. 52.3% of the patients suffered multiple teeth injuries. Among the permanent teeth trauma, enamel and dentin fracture was the most common (24.7%), followed by concussion (20.5%), sub-luxation (17.9%) and complicated crown fracture (14.4%). And among the primary teeth trauma, subluxation was the most common (31.1%), followed by concussion (14.5%) and lateral luxation (9.5%). 19.7% of the children and adolescent dental trauma patients were also suffered maxillofacial soft or hard tissue injury.
The incidence of dental trauma in children and adolescents is higher than that in adults. There were two age peaks among the children and adolescents patients. Primary teeth and young permanent teeth were usually suffered. Clinical treatment should be considered along with the characteristics of child tooth growth. In order to prevent the occurrence of dental trauma, early orthodontic intervention should be carried out in children with severe overjet. Families, schools and nursery institutions should strengthen the protection against dental trauma.
分析18岁以下牙外伤口腔急诊患者的病因及临床特点，为儿童及青少年牙外伤的防治提供指导。
对北京大学口腔医学院口腔急诊2016年1月至2018年12月期间18岁以下牙外伤患者的完整资料进行回顾性研究，分析患者的性别、年龄、就诊时间分布，以及外伤牙的数量、位置、诊断分类和牙外伤合并多发伤情况。
在此期间，初诊牙外伤患者中54.2%（10164例）为儿童或青少年（5506例）。两个年龄高峰分别为3 - 4岁和7 - 9岁。各年龄组男性发病率均高于女性（Wilcoxon检验，<0.001）。5月至6月以及9月至11月牙外伤病例较多。每日牙外伤病例高峰时间为19:00至20:00（Jonckheere - Terpstra检验，<0.001）。双侧外伤牙位置大致对称，上颌中切牙最易受累。52.3%的患者有多颗牙损伤。恒牙外伤中，釉质和牙本质折断最常见（24.7%），其次为牙震荡（20.5%）、亚脱位（17.9%）和复杂冠折（14.4%）。乳牙外伤中，亚脱位最常见（31.1%），其次为牙震荡（14.5%）和侧方脱位（9.5%）。19.7%的儿童及青少年牙外伤患者还合并颌面部软硬组织损伤。
儿童及青少年牙外伤发病率高于成人。儿童及青少年患者有两个年龄高峰。乳牙和年轻恒牙常受累。临床治疗应结合儿童牙齿生长特点考虑。为预防牙外伤发生，对严重深覆盖儿童应尽早进行正畸干预。家庭、学校和托幼机构应加强对牙外伤的防护。
