Long-term effects of traumatic injuries to incisors and periodontal tissues during childhood: a retrospective study.
OBJECTIVE
The purpose of this study was to investigate the incidence of dentoalveolar growth disturbances, loss of teeth and esthetic impairment after the end of growth following traumatic injuries to incisors and periodontal tissues during childhood.


METHODS
41 patients having sustained dentoalveolar trauma before age 10 and who were now at least aged 16 years, and a total of 68 traumatized teeth were documented by clinical examination, dental casts and photographs. We determined the three-dimensional position of the traumatized teeth on the casts, as well as the traumatized teeth's pulp sensibility, percussive sound and sensitivity, shape and color.


RESULTS
82% of the traumatized teeth were in the upper dentition. 45% of the traumatized teeth experienced subluxation, nearly 30% luxation, 16% avulsion. At the time of the follow-up examination (mean 17.0 years post-trauma), 57% of the traumatized teeth were still in situ. Immediately after trauma 7.4% of the teeth were lost; up to 16 years post-trauma 35.6% of the teeth were lost because of failed root canal filling, root resorption or ankylosis. We observed no functional deviations. Dentoalveolar growth disturbances were rare. Three teeth were markedly discolored.


CONCLUSIONS
Following dentoalveolar trauma during childhood, negative effects on growth, function and esthetics can be minimized by timely interdisciplinary treatment and by follow-up controls until the end of growth to achieve an outcome satisfying both the patient and clinician.
Department of Orthodontics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany. wriedt@kieferortho.klinik.uni-mainz.de
Susanne
S
Wriedt
Monika
M
Martin
Bilal
B
Al-Nawas
Heiner
H
Wehrbein
D000293:Adolescent; D000328:Adult; D000539:Alveolar Process / Q000293:injuries*; D002648:Child; D003791:Dental Pulp Test; D004954:Esthetics; D005260:Female; D006801:Humans; D007180:Incisor / Q000293:injuries*; D008297:Male; D008310:Malocclusion / Q000209:etiology*; D008445:Maxillofacial Development; D003765:Models, Dental; D023861:Photography, Dental; D012189:Retrospective Studies; D014075:Tooth Discoloration / Q000209:etiology*; D016388:Tooth Loss / Q000209:etiology*; D055815:Young Adult