International Journal of Medical Dentistry 259

AbstractA considerable increase in the number of temporary

teeth trauma has been registered in recent years. The aim.Evaluation of the actual epidemiological tendencies oftemporary teeth trauma and, implicitly, of theiretiopathogenic characteristics. Materials and method.The study was performed on a group of 2,531 patientsfrom the Clinics of Pediatric Stomatology, who requiredmedical assistance between 2003-2006, as well as on sev-eral kindergarten children. Dental-periodontal trauma ofthe temporary teeth were present in 607 children, with achronological age between 0-9 years. Results and discus-sion. Over the time interval consdiered for analysis, anascending tendency was observed in the experimentalgroup, as to the prevalence of the dental-periodontaltrauma of the temporary teeth. A statistically significantcorrelation was established between children’s age andthe presence of trauma, as illustrated by the large slope ofthe regression straight line (r = -0.539, 95% CI). The maleswere seen as most affected by dental-periodontal traumaof the temporary teeth, the Kendall non-parametric cor-relation (95% CI) illustrating a significant association oftrauma in male patients (r= -0.413, p= 0.005162). Conclu-sions. The increasing tendency of both frequency andprevalence of dental-periodontal trauma in temporaryteeth, as well as their possible consequences fully justifythe necessary implementation of specific programs andof preventive strategies.

Keywords: temporaty teeth, trauma, prevalence

Child’s oro-maxillo-facial traumatic pathol-ogy represents a complex problem to be solved,with deep impact upon the oro-dento-cervico-facial and psycho-somatic harmony, and epide-miological, clinical, therapeutic and evolutivepeculiarities different from those of adult trau-matology. Identification of the risk factors, in fullagreement with the anatomical and morpho-structural characteristics of the temporary teethand corroborated with the incidence of dento-periodontal trauma, represents a sine-qua-noncondition for a specific therapy [1].

ON THE EPIDEMIOLOGICAL PECULIARITIES OF TEMPORARY TEETHTRAUMA

Adriana Balan1, Marinela Pasareanu1, Vasilica Toma2, Dana Cristiana Maxim3,C. Rotariu3, Carmen Savin3

1. Assoc Prof. PhD. Dept of Pedhodontics, Faculty of Med Dent., „Gr.T. Popa” U.M. Ph. Iasi2. Lecturer PhD. Dept of Pedhodontics, Faculty of Med Dent., „Gr.T. Popa” U.M. Ph. Iasi3. Assist Prof. Dept of Pedhodontics, Faculty of Med Dent., „Gr.T. Popa” U.M. Ph. IasiCorresponding author: Conf. Dr. Adriana Balan – email: balan.gheo@yahoo.com

In latest years, a considerably increasednumber of temporary teeth trauma has been reg-istered, the variability elements being deter-mined by a multitude of etiological factors, [2]which calls for a better knowledge on the epide-miology of traumatic lesions in temporary den-tation, as a necessary condition for the settlementof preventive, interceptive and curative meas-ures.

The present study aims at evaluating the ac-tual epidemiological tendencies of temporaryteeth trauma and, implicitly, of theiretiopathogenic peculiarities, for establishing theprevalence and incidence of the traumatic pa-thology in temporary teeth.

MATERIALS AND METHOD

The study was performed on a group of 1,223patients who came to the Clinics of Pediatric Sto-matology of Iasi between 2003-2006, with quitediverse pathologies, among which the dental-periodontal trauma of the temporary teeth oc-curred in a number of 315 children, as well as ona group of 1308 kindergarten children, of which256 demonstrated dental-periodontal trauma ofthe temporary teeth. The final experimentalgroup was represented by 607 children with den-tal-periodontal trauma of the temporary teeth,with chronological ages between 0-9 years(Fig.1).

Registering of the dental-periodontal traumaticlesions was based on WHO coding, the main as-pects had in view referring to the following ele-ments: chronological age at which the dental-periodontal trauma occurred, sex of the patient,

Pedodontics

260 volume 1 • issue 3 July / September 2011 •

etiology of the trauma, its localization, type ofdental-periodontal trauma, presence or absenceof lesions at the level of the soft tissues.

76.02%

23.98%

no traumawith trauma

Fig.1. Distribution of cases in the experimentalgroup

The analysis, comparison and statisticalprocessing of the obtained data were made withthe STATISTICA programme, within which testsspecific to various types of data (ANOVA,Pearson, qui-square, Fisher, etc.) were devel-oped.

RESULTS AND DISCUSSION

Within the time interval considered for analy-sis, an ascending trend of the prevalence of thedental-periodontal trauma of temporary teethwas registered, from 4.99% to 28.70%, in thecases having required medical assistance in theClinics of Infantile Stomatology of Iasi, and from3.67% to 19.57%, respectively, in kindergartenchildren (Table 1).

Table 1. Prevalence of dental-periodontal trauma

Prevalence 2003 2004 2005

September

2006

61 142 229 351 Clinical group

4.99% 11.61% 18.72% 28.70%

1223

48 115 180 256 Kindergarten children

3.67% 8.79% 13.76% 19.57%

1308

In a study performed in Brasil on subjectswith ages between 0-3 years, Cunha R.F. re-

ported a prevalence of temporary teeth traumaof 11-30% [3]. Garcia-Godoy et al., who exam-ined a group of 200 children with chronologicalages between 3-5 years, reported a prevalence oftraumatic lesions of 35% at the level of incisorsand temporary canines [4], which is a value quiteclose to that of 30%, obtained by Andreasen J.O.et al. in an investigation performed in Denmarkin 1990 [5].

Analysis of other literature data showed that,in the sample group, temporary teeth trauma aremore numerous than in England, Denmark orSweden, where the prevention and interceptionmethods are competitively applied, being in-stead closer to the percent values recorded inHungary and Turkey.

The deduction to be made is, therefore, a largevariability range of the prevalence values, whichmay be explained by the quite different geo-graphical areas and time periods considered, bythe populational groups under analysis, largelydiffering as to age and number, as well as by theapplication of different working methodologies.

As to the trauma incidence in the experimen-tal group, it registered lower values than theprevalence, the structure of this notion includ-ing the new cases, added within the time inter-val under study, the recorded values maintain-ing the same ascending direction, i.e., from 4.99%to 9.98% in the children having addressed theClinics of Infantile Stomatology of Iasi, and from3.67% to 5.81%, respectively, in kindergartenchildren (Fig. 2).

Fig. 2. Incidence and prevalence of dental-periodontal trauma in temporary dentation

Adriana Balan, Marinela Pasareanu, Vasilica Toma, Dana Cristiana Maxim, C. Rotariu, Carmen Savin

pp 259-262

International Journal of Medical Dentistry 261

The highest values of the temporary teethtrauma were registered at an average chrono-logical age of 2-3 years, which agrees with theexisting literature data [6]. Also, a study per-formed by Scheller on a group of 487 patientswith dental trauma showed that most of themoccur around the age of 2 years. Mention shouldbe made of the fact that the real (absolute) fre-quency is not known, as large part of such le-sions are not solved medically, so that, once notregistered anywhere, only a relative frequencyof theirs may be acknowledged.

A statistically-significant correlation existsbetween the age of the children and the presenceof trauma, expressed by the large slope of theregression straight line (r = –0.539, 95% CI – con-fidence interval) (Fig. 3).

Kendall non-parametric correlation age vs. Trauma

Correlation coefficient R Z p – significance level

(95% confidence interval)

-0.5394162 -13.8810 0.000000

Scatterplot: Age vs. trauma (casewise MD deletion)Var5 = .54873 - .0547 * age

Correlation: r = - 0.5394162

1 2 3 4 5 6 7 8 9 10

Age [years]

no tr

aum

aw

ith tr

aum

a

Trau

ma

95% confidence

Fig. 3. Age vs. trauma regression straight line

As to sex, the most frequently affected by thedental-periodontal trauma of the temporaryteeth were the males, the ratio recorded being of1.5:1 M/F, the Kendall non-parametric correla-tion (95% CI) illustrating the significant associa-tion of trauma in patiens of masculine sex (r =–0.413, p = 0.005162) (Table 2, Fig. 4).

Table 4. Distribution of dental-periodontal traumaaccording to sex

Incidence 2003 2004 2005 September 2006

Masculine 44 55 56 81

% 12.54% 15.67% 15.95% 23.08%

Feminine 17 26 31 41

351 Clinical group

% 4.84% 7.41% 8.83% 11.68%

Masculine 32 54 49 52

% 12.50% 21.09% 19.14% 20.31%

Feminine 16 13 16 24

Kindergarten

children

% 6.25% 5.08% 6.25% 9.38%

256

Kendall non-parametric correlation Child sexr vs. trauma

Correlation coefficient R Z p – significance level

(95% confidence interval)

-0.413633 -11.4721 0.000000

Scatterplot: Patients sex vs. trauma (casewise MD deletion)Trauma = 14.473 - 0.405 * Sex

Correlation coefficient: r = - 0.413633

male female

Children sex

no tr

aum

aw

ith tr

aum

a

Trau

ma

95% confidence

Figure 4. Trauma vs. sex regression straight line

The observation was made that the preva-lence of trauma in males records - over the timeinterval here considered - higher annual values.

The frequency of temporary teeth trauma isinfluenced by several factors, the most repre-sentative ones being the sex and age of the child.The correlative pacient sex/ pacient age aspects(Fig.5) decisively influence the increase of theannual values, so that the incidence/prevalenceratio registers final results quite close to the av-erage values recorded at European level in thelast 5 years.

ON THE EPIDEMIOLOGICAL PECULIARITIES OF TEMPORARY TEETH TRAUMA

262 volume 1 • issue 3 July / September 2011 •

Figure 5. Incidence and prevalence of trauma according tochild sex and age

CONCLUSIONS

The increasing tendency of both frequencyand prevalence of dental-periodontal trauma oftemporary teeth, as well as their potential conse-quences fully motivate the necessary implemen-

tation of preventive programs and strategies ca-pable of assuring the oral health of the child anda higher quality of the life of the future adult.

ReferencesMaxim A., Dentatia temporara predictor integrativ

sistemic al calitatii vietii copilului – o revizuire aliteraturii de specialitate, Revista Romana deMedicina Dentara, Bucuresti, 2006.

1. Flores M.T., Traumatic injuries in the primary denti-tion, Dental Traumatol., 2002;18(6):287-98.

2. Cunha R.F., Pugliesi D.M.C., VIeira A.E.M., Oraltrauma in Brazilian patients aged 0-3 years, DentalTraumatol., 2001; 17:210-212.

3. Garcia-Godoy F., Pulver F., Treatment of trauma to theprimary and young permanent dentitions, Dent. Clin.North Am., 2000; 44:597-632.

4. Andreasen J.O., Andreasen F.M., Injuries to the pri-mary dentition.Essential of traumatic dental injuriesto the teeth, Conpenhagen, Munskgaard, 1994;141-154.

5. Fried I., Erickson P., Anterior tooth trauma in the pri-mary dentition: Incidence, classification, treatmentmethods, and sequelae: A review of literature. J. Dent.Child, 1995(4):256-61.

Adriana Balan, Marinela Pasareanu, Vasilica Toma, Dana Cristiana Maxim, C. Rotariu, Carmen Savin

pp 259-262