Newcastle Dental Hospital, Newcastle, NE2 4AZ, UK.
Evid Based Dent. 2021 Dec;22(4):136-137. doi: 10.1038/s41432-021-0228-5. Epub 2021 Dec 16.
Design Retrospective cohort study.Cohort selection Records of 2,922 patients, who attended a reference centre between 1998 and 2019 with primary dental trauma and who had radiographs and photographs, were screened to identify primary dental avulsion injuries that were followed-up until complete eruption of the permanent successors. 240 records were eligible and 194 fulfilled the inclusion criteria.Data analysis Exploratory descriptive analysis was carried out to map the occurrence and type of sequelae to the permanent tooth following primary avulsion, comparing this to the control group of permanent anterior teeth from the same children where the predecessor teeth had not suffered any type of dental trauma. Exploratory descriptive analysis was also used to link the age the primary avulsion occurred to the type of sequelae to permanent dentition. Multilevel Poisson regression analysis was performed and relative risk values and respective 95% confidence intervals were calculated to evaluate the association between avulsion and occurrence of sequelae. Confounders were included in the model to calculate their effect.Results Of the 194 patients included, there were 266 avulsed primary teeth and 115 of the permanent successors presenting with sequelae (43.2%), compared to 15.4% in the control group. Demarcated opacities were most common in both groups. Primary tooth avulsions occurring in children under two years old had a higher risk of sequelae to the permanent successor. There was also a higher risk of successor sequelae with avulsions of the lower arch compared to the upper and when three or more teeth were affected by the trauma compared to a single tooth. Avulsions in children over three years old had a lower risk of hypoplasia and those over four years old had a low risk of opacities to the successor.Conclusions Following avulsions of primary teeth, there is a higher risk of sequelae to the permanent successor in children younger than two years, where the lower jaw is involved and when multiple teeth are involved.
设计 回顾性队列研究。队列选择 筛选了 1998 年至 2019 年间在一家参考中心就诊的 2922 名原发性牙外伤患者的记录，这些患者有放射照片和照片，以确定原发性牙脱位伤，这些患者接受了随访，直到恒牙完全萌出。有 240 份记录符合条件，194 份符合纳入标准。数据分析 进行了探索性描述性分析，以确定原发性牙脱位后恒牙发生的后遗症类型，并将其与同一儿童中未遭受任何类型牙外伤的恒牙前牙的对照组进行比较。还使用探索性描述性分析来将原发性牙脱位发生的年龄与恒牙的后遗症类型联系起来。进行了多水平泊松回归分析，并计算了相对风险值及其 95%置信区间，以评估牙脱位与后遗症发生之间的关联。在模型中纳入混杂因素以计算其影响。结果 在纳入的 194 名患者中，有 266 颗脱位的原发性牙齿和 115 颗恒牙出现后遗症（43.2%），而对照组为 15.4%。两组中最常见的是界限分明的不透明。两岁以下儿童的原发性牙脱位发生后继发恒牙出现后遗症的风险较高。与上颚相比，下颚的原发性牙脱位发生后继发恒牙出现后遗症的风险更高，与单个牙齿受伤相比，三个或更多牙齿受伤的风险更高。三岁以上儿童的原发性牙脱位发生后发生发育不全的风险较低，四岁以上儿童发生后继恒牙不透明的风险较低。
