| Traumatic dental injury(TDI) is one of the common diseases of oral emergency. Caused by an external impact on a tooth, the supporting structures, the hard tissues of tooth and the pulp can be injured. Dental injury not only affects patients' appearance, but also brings mental traumas to them, especially for the teenagers. With the rapid development of society and the improvement of living standards, the number of dental trauma increased year by year in recent years. Compared with abroad, the research of dental trauma in China started relatively late. Due to closely related to residents' medical level, age, gender and habits, the epidemiological characteristics of dental trauma show notable regional features. Given the lack of the epidemiological data of dental trauma in northwestern China, we conducted a retrospective study to enrich the epidemiological database and to provide reference for the prevention and treatment in the region of Xi'an.The content of this item includes two part summarized as following.Part 1: A retrospective study of permanent TDIs in Xi'an, ChinaThe aim of this part of study was to determine the distribution features of traumatic dental injury in Xi'an, China. According to the inclusion and exclusion criteria, data from medical records of 623 patients(aged 6 to 78 years) visiting the department of emergency from Apr 2012 to Jun 2014 were evaluated and analyzed, including age, gender, etiology, injury time, the predilection teeth, the type of traumatic teeth and elapsed time following trauma.Part 2: Effect of luxation traumatic of pulp healingThis part can be divided into two experiments:1. According to the inclusion and exclusion criteria, 345 luxation teeth of 245 patients who presented to hospital from Apr 2012 to Mar 2015 were collected. Standard treatment was conducted by the International Association of Dental Traumatology(IADT) guidelines. Pulp healing of different types of luxation teeth was evaluated through clinical examination, pulp vitality tests and the radiographic examination. Correlation analysis of each epidemiologic factor was performed using Logistic regression model to select the factors which influenced the pulp healing.2. The pulp healing of subluxation teeth was evaluated in this part of study. 112 subluxation teeth of 72 patients were involved in the trial according to predefined inclusion and exclusion criteria. The teeth were divided into different groups according to the degree of root development, mobility and fixed type, and the pulp healing was observed after a 6-month follow-up. A mixed-effects model was used to analyze the impact of above factors on pulp prognosis of subluxation tooth.The results showed as following.1. The results showed the occurrence of dental trauma was higher in male patients; furthermore, most of the dental trauma occurred in childhood and adolescence. The most common seasonal variation of the trauma were from April to June. Hospital visits occurred most frequently from 18:00 to 22:00. The injuries most commonly afflicted the maxillary central incisors, and most of them involved multiple teeth. Falls caused the most injuries(50.2%), while concussion was the most frequent type of tooth injuries. The cause and the injury type were found to be related with the age and sex of subjects. Infraction, uncomplicated crown fracture, concussion and subluxation were the most frequent injury types among the combination injuries. The cause and the injury type were found to be related with the time elapsed following injury.2. The gender, cause and time elapsed following injury were not statistically significant with the pulp prognosis of luxation teeth(P>0.05). However, a statistically significant and direct relationship was shown between the development degree of root and pulp healing, and injury type as well(P<0.05). Pulp vitality of immature teeth was better than that of the mature teeth. The pulp necrosis was most common to see in lateral luxation of immature tooth and intrusive luxation of mature tooth, while the occurrence was lowest in subluxation no matter in immature or mature teeth.3. The degree of root development, mobility and fixed type all had an impact on the pulp healing of subluxation tooth. Pulp survival was statistically significant in 2 weeks(P<0.05). The pulp prognosis of immature tooth was better than mature tooth in the same conditions of mobility and fixed type. For immature tooth, the mobility was the more important factor for pulp healing, while for mature tooth, whether to fix or not affected the pulp healing mainly.Summary:1. This retrospective study in Xi'an showed some epidemiological characteristics of dental trauma. There are many factors affecting the epidemiological feature of dental trauma, such as age, gender, time, type of injury, cause of injury and so on, and some relationships were found among different factors.2. The pulp prognosis of different types of luxation teeth was varied. Compared with extrusive, lateral and intrusive luxation, the pulp healing of subluxation tooth was better. Furthermore, the pulp prognosis was related to the degree of root development.3. The pulp healing of immature tooth is better than that of mature tooth in subluxation. For the treatment, a flexible splint was recommended when the tooth was loose, even if it not need to be fixed according to conventional treatment. For subluxation, it is necessary to follow up at least for 3 months and pay close attention to the pulp vitality 2 weeks post-injury. |
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