Dentoalveolar trauma 2

Question 1

What proprtion of children will get dental injury?

Answer 1

30% of children to primary dentition

22% to permanent dentition by age 14.

1 in 2 chance a child will have a dental injury.

Question 2

Which children most commonly have dental trauma?

Answer 2

Boys 2x more often than girls

Most common at 2 - 4 (primary) and 8 - 10 years old (permanent but immature tooth)

Question 3

Which teeth are most commonly affected by dental trauma?

Answer 3

Mainly upper anterior teeth. Especially 11 and 21.

Often only a single tooth.

Question 4

What are the most common causes of dental trauma?

Answer 4

Falls

Collisions

Bumps

BIcycles

Fights

Epilepsy

Drug addicts

Etc

Varies according to age, gender, location (typical sports played)

Question 5

What differences are seen between boys and girls in dental trauma?

Answer 5

Boys more likely through fights and sport

Girls more likely from falls or bikes

Question 6

What are the most common causes of dental trauma?

Answer 6

Based on stockwell 1988 data:

Fell or pushed

Impact with person

Impact with object

Various sport

Question 7

Where are dental injuries most likely to occur in children?

Answer 7

Stockwell 1988 data:

School = 1/3rd

Home = 1/3rd

Elsewhere = 1/3rd

Question 8

What kind of injuries most commonly cause damage to permanent dentition and what kind of injuries most commonly cause injury to deciduous dentition?

Answer 8

Permanent = Sport accidents while playing

Deciduous dentition = Falls while playing.

Question 9

What are the most common types of dental injuries?

Answer 9

Uncomplicated crown fractures

Subluxation

Lateral luxation

Question 10

How much time typically occurs between the injury and presentation for treatment?

Answer 10

1/3rd of patients were seen within 24 hours

1/3rd within 1 week

1/3rd delayed for weeks/months/years

Question 11

What are the main predisposing factors for dental trauma injuries?

Answer 11

Increased overjet

Protruding upper incisors

Insufficient lip closure

Question 12

What are the mechanisms of injuries?

Answer 12

Direct and indirect trauma

Direct occurs when the tooth itself is struck and this implies injuries in anterior region.

Indirect injury when the lower arch is forced against the upper arch.

Question 13

What kind of injuries does indirect trauma cause?

Answer 13

Favours crown fractures and crown-root fractures in posterior teeth

Also causes jaw fracures in condyle and symphysis regions

Question 14

What impact characteristics determine the extent of dental injuries?

Answer 14

Energy of the impact (mass x v^2)

Resiliency of impacting object

Shape of impacting object

Direction of impacting force

Question 15

How does velocity impact the type of injury that a tooth sustains?

Answer 15

Low velocity = more damage to supporting structures (more subluxations and luxations)

High velocity = more crown fractures with little damage to supporting structurs.

Question 16

How does resiliency of the impacting object affect the impact?

Answer 16

Resilient or cushioned objects distribute the impact more.

Higher chance of luxation and alveolar fracture in resilient objects and less chance of crown fracture.

Lips can provide more resiliency.

Question 17

How does the shape of an impacting object affect the impact?

Answer 17

Sharp object more likely crown fracture with no displacement of tooth

Blunt object more likely to lead displacement of the tooth and more likely to affect multiple teeth.

Question 18

How does direction of the impacting force affect the impact?

Answer 18

Facial or labial forces cause subluxation, concussion, or lateral luxation

If coming from apical to coronal then extrusion is more likely.

Coronally to apically = intrusion.