Lesiones traumáticas en dientes permanentes en escolares atendidos en la Clínica Estomatológica Héroes de Bolivia

Introducción: las lesiones traumáticas provocan alteraciones biológicas, psicológicas y sociales en los niños y adolescentes que la padecen. Objetivo: caracterizar a los escolares con lesiones traumáticas en dientes permanentes, jóvenes de la Clínica Estomatológica Héroes de Bolivia, de Las Tunas, en el período septiembre de 2017 a septiembre de 2019. Materiales y métodos: se realizó un estudio descriptivo transversal en escolares de la clínica estomatológica "Héroes de Bolivia". La población estudio estuvo constituido por 169 escolares que por muestreo probabilístico se estableció, incluyendo a los escolares de 5 a 11 años, con lesiones traumáticas en dientes permanentes anteriores. Las variables estudiadas fueron: edad, sexo, presencia del trauma y tipo según la clasificación de Ingeborg Jacobsen, dientes lesionados, etiología y lugar donde ocurrió la lesión. Se utilizó un formulario. Resultados: el grupo de 9 años con un 21,3 % y el sexo masculino con 113 afectados resultaron los más representativos. El 56,2 % presentó fractura no complicada de corona. El 70,4 % correspondió a incisivos centrales superiores. Las caídas y las prácticas de deporte con 37,2 % y 29,0 % respectivamente fueron las principales causas y el 41,4 % de los traumatismos dentarios ocurrieron en las instituciones escolares. Conclusiones: las lesiones traumáticas de dientes permanentes jóvenes fueron más frecuentes a la edad de 9 años y en el sexo masculino. Las lesiones más frecuentes fue la fractura no complicada de corona y los incisivos centrales superiores los más afectados.

Introduction: traumatic injuries cause biological, psychological and social alterations in children and adolescent who suffer them. Objective: to characterize schoolchildren with traumatic lesions in their young permanent teeth, from Heroes de Bolivia Dental Clinic, Las Tunas, in the period from September 2017 to September 2019. Materials and methods: a cross-sectional descriptive study was conducted in schoolchildren treated at Heroes de Bolivia Dental Clinic. The study population, selected by probabilistic sampling, consisted of 169 schoolchildren aged 5 to 11 years, with traumatic injuries in anterior permanent teeth. The variables studied were: age, gender, presence of trauma and kind according to Ingeborg Jacobsen classification, injured teeth, etiology and place where the lesion occurred. Results: the 9-years-old group, with 21.3 %, and male gender, with 113 children affected, resulted the most representative. 56.2 % presented uncomplicated crown fracture. 70.4 % corresponded to upper central incisors. Falls and sport practices, with 37.2 % and 29.0 % respectively, were the main causes, and 41.4 % of the dental injuries occurred in schools. Conclusions: traumatic injuries of young permanent teeth were more frequent at the age of 9, and in males. The most frequent injury was non-complicated crown fracture, and upper central incisors were the most affected.

Extrusive, Intrusive Luxation and Avulsion in a 7-Year- Old Child: One year of Clinical, Radiographic and Tomographic Follow-Up

ABSTRACT: Dental trauma is a serious injury that occurs frequently in children and adolescents, requiring urgent dental care. The upper central incisors are the most vulnerable teeth to such traumatic injuries, which can lead to bite restrictions, difficulties in phonation and esthetical questions. The aim of this study was to report the success of a conserva tive approach carried out on a 7-year-old patient, victim of multiple dental trauma, involving permanent and deciduous teeth. The male patient fell from his own height, causing soft tissue lacerations and dento-alveolar traumatism in both deciduous and permanent teeth. Complementary examinations (periapical radiographs and computed tomography) were carried out. Based on the diagnoses the patient was referred to specialists for appropriate treatment. The present report highlights the importanc e of an early diagnosis, suitable treatment and follow-up of patients after an alveoli-dental trauma and shows the direct relationship of this approach with the prognosis of the patient and the tooth.

RESUMEN: El trauma dentario es una lesión grave que ocurre con frecuencia en niños y adolescentes y requiere atención dental urgente. Los incisivos centrales superiores son las piezas dentarias más vulnerables a dichos traumas, pudiendo generar restricciones en la mordida, la fonación y a nivel estético. El objetivo de este estudio fue reportar el éxito de un enfoque conservador llevado a cabo en un niño de 7 años de edad, víctima de un trauma dentario múltiple, que involucró tanto dientes temporales como permanentes. El paciente masculino, cayó desde su propia altura, causando laceraciones en los tejidos blandos y traumatismo dento- alveolar en piezas de ambas denticiones. Se llevaron a cabo exámenes complementarios (radiografías periapicales y tomografía computarizada). Basado en el diagnóstico, el paciente fue referido a especialistas para realizar el tratamiento apropiado. El presente reporte destaca la importancia de un diagnóstico precoz, un tratamiento adecuado y el seguimiento de los pacientes luego de un trauma dento-alveolar, y cómo este enfoque muestra relación directa con el pronóstico del paciente y del diente.

Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population / Trauma oral e maxilofacial em pessoas com epilepsia: estudo prospectivo com base ambulatorial

OBJECTIVE: This study aimed to evaluate oral and maxillofacial trauma caused by falls during epileptic seizures. METHOD: A prospective case-control study was carried out among patients recruited from both the Epileptic Outpatient Clinic and the Emergency Room of Hospital de Base during 2006. The study group was composed of patients with epilepsy that had been diagnosed by a specialist. Oral and maxillofacial trauma was diagnosed using a questionnaire together with physical and radiographic examinations. A control group was formed from non-epileptic relatives or neighbors of the patients. The two groups were compared with regard to the number and type of oral and maxillofacial trauma events suffered. Odds ratios with a 95 percent confidence interval, dependency analysis and the Pearson c² test were used for statistical analysis, and the significance level was set at p≤0.05. RESULTS: A total of 159 patients with epilepsy (91 males; 57.3 percent) and 68 control individuals (28 males; 41.1 percent) were enrolled in the study. The frequencies of oromaxillary trauma in the study and control groups were 23.9 percent and 4.4 percent, respectively. Generalized tonic-clonic, generalized and non-classified seizures were strongly associated with trauma. The commonest lesions were fractures of dental tooth crowns (32.9 percent), followed by tooth avulsion (7.6 percent), tooth luxation (5 percent) and fracturing of prostheses in edentulous patients (3.8 percent). CONCLUSION: This work shows that injuries to the face and teeth are statistically more common in patients with epilepsy than in the general population, and that individuals who suffer seizures without aura are the most affected.

OBJETIVO: O objetivo desse estudo foi avaliar a relação da epilepsia sobre as ocorrências de trauma dento-alveolar e maxilofacial causados por quedas. MÉTODO: Estudo caso-controle prospectivo foi conduzido no ambulatório de epilepsia e do Pronto Atendimento do Hospital de Base de São José do Rio Preto-SP no ano de 2006. Pacientes do grupo caso foram diagnosticados pelo neurologista chefe (sênior) especialista em epilepsia e avaliados quanto ao trauma oral e maxilo-facial pelo pesquisador, por meio de questionário, exame clínico e radiográfico, por ordem de chegada. O grupo controle (GC) foi constituído incluindo indivíduos sem crises, que fossem familiares ou vizinhos próximos dos pacientes com diagnóstico de epilepsia. Intervalo de confiança 95 por cento, ODD, análise de dependência (ANADEP) e c² de Pearson foram utilizados para análise estatística e se adotou nível de significância de p≤0,05. RESULTADOS: Analisaram-se 159 pacientes com epilepsia, dos quais 91(57,3 por cento) masculinos e 68 do GC, dos quais 28 (41,1 por cento) masculinos. A frequência do trauma oro-maxilar em paciente com epilepsia foi 23,9 por cento e no GC foi de 4,4. As crises tônico-clônicas generalizadas, crises generalizadas e as não classificadas estão fortemente co-relacionadas ao trauma. Fraturas das coroas dentais (32,9 por cento), seguidas de avulsão dentária (7,6 por cento), luxação dentária (5 por cento) e fratura da prótese em pacientes edêntulos (3,8 por cento) foram as lesões mais encontradas. CONCLUSÃO: O trabalho mostra que os ferimentos na face e dentes são frequentes em pacientes com crises epilépticas quando comparados ao GC, sendo as pessoas com crises sem a aura as mais afetadas.