ETIOLOGY AND MANAGEMENT OF TRAUMATIC DENTAL INJURIES IN CHILDREN LESS THAN 12 YEARS OLD IN YAOUNDÉ

Abstract

Abstract Children are born with certain instinct, neurological make-up and temperament that develop as they grow older and interact with their environment. As children try to play or learn about their environment, they are exposed to certain traumatic injuries. The aim of our study was to evaluate the management of oral trauma in children under 12 in three hospitals in the city of Yaoundé. It was a descriptive study with a retrospective phase and a prospective phase carried out on children below 12 years using convenience sampling. The study was conducted at the service of odontostomatology of the Yaoundé military hospital between March to April 30, 2019. Out of 841 children were examined,52 children had a previous history of dento-alveolar injuries. This was made up of 55.8% boys and 44.2% of girls, a sex ratio of 1.26. The mean age at diagnosis was 7 years ± 4 s.d. The most represented age groups were 6 to 12 years old. The frequency if TDI was 6.2% .More than half (54,0%) of the affected teeth were temporary teeth 27(54.0%) than permanent teeth and 25(46.0%) affecting up to 7 teeth in the mouth. Falls accounted for 30(89.6 %) and play with 12(23.1%) of the injuries. Road traffic accident 5(9.6%), falls from bicycle 3(5.8%), fight 2(3.8%). Twenty-four patients (46.2%) presented with trauma to the hard tissue of the tooth and pulp, 26 (50.0) had trauma to the periodontal support tissue, 13 (25.0%) had trauma to the bone support tissues; and 26 (50.0%) had trauma to the gum tissue and oral mucosa. The most frequent hard issue trauma were coronary fractures 11 (45.8%) , 13 ( 50%) of the injuries among periodontal support tissue injuries was complete subluxation, 8 (61.5%) of fractures of the alveoli were observed, which is the most frequent lesion, 23 (88.5%) had bruising and 16 (61.5%) laceration were observed. The most frequently affected tooth was the maxillary right central incisor, 11 (21.5%) followed by the maxillary left central incisor 10( 19.2%), 6(11.5%) temporary right maxillary central incisor, and 5 (9.6%) on both teeth number 22 and 61. Temporary teeth are the most commonly affected teeth regardless of trauma. Two thirds16 (64.0%) of trauma were from temporary teeth and a third 9 (36.0%) of trauma from permanent teeth when it comes to trauma to periodontal support tissues. Hard tissues trauma included the coronary fractures 11 (45.8%),the simple or complex corono-radicular fracture 5 (20.8%) and enamel fractures to 4 ( 16, 7%) .A third 38.5%, of the participants presented with subluxation. Forty-three (82.7%) patients were treated with trauma medication, 12 (23.1%) patients received conservative therapy, and 12 (23.1%) patients received treatment orthopedic treatment and 15 (28.8%) patients underwent surgical treatment. Half of the patients 79(50.6%) were treated by medication, while 34(22.8%) by surgical interventions, P= 0.032 .