Subluxation Injuries of Maxillary primary anterior teeth

Resident: Swan

Article Title: Subluxation Injuries of Maxillary primary Anterior Teeth: Epidemiology and prognosis of 207 traumatized teeth

Journal: Pediatric Dentistry

Volume (Number): 18:2 1996

Major Topic: Causes of and sequelae following subluxation injuries

Overview of method of research: The authors performed a retrospective chart audit at Montreal Children’s Hospital to identify patients who sustained a subluxation injury to the maxillary primary anterior dentition between 1982 and 1993. The information was collected on standardized trauma assessment forms by various residents and staff members practicing at the hospital. Information was gathered concerning the patient and their trauma history, along with the many possible sequelae after subluxation. Sequelae evaluated included: discomfort, discoloration, occlusal interference, presence of fistula, percussion sensitivity, sound on percussion, mobility, pulpal calcification, rate of physiological root resorption. Post-traumatic treatment and antibiotic use was evaluated as well. Data were broken into six follow up time intervals: 0-10 days, 10 days-1 month, 1-3 months, 3-6 months, 6-12 months, 1-2 years.

Findings: Central incisors were involved 66.2 % of the time. The average age of subluxation injury for boys was between 3 and 4, for girls, between 1 and 2. The most common cause of trauma was simple falls indoors (52%). 6.8% of the trauamatized teeth showed pathological root resorption. Virtually no subluxated teeth were associated with crown, root, or alveolar fracture. Treatment of these teeth ranged from no treatment (80.2%) to extraction (9.2%). At follow up intervals, patient discomfort and occlusal interference were not common complaints; discoloration and pulp calcification tended to increase over time. Mobility lessened over time.

Key Points/Summary:

1. Indidence of trauma occurred at a higher average age for boys than girls
2. More than 50% of patients were seen within 3 hours of injury
3. Mobility of subluxated teeth ranged from 1.6-2.5 mm.
4. Treatments rendered included occlusal relief, splinting, extraction, and no treatment
5. Tooth discoloration and pulpal calcification increased over time
6. Subluxation injuries have LOW morbidity. (Hard to track follow up for a long time).

Assessment of Article: This study basically concludes that subluxation injuries are not that big of a deal, so we can reassure parents of this. Some of the findings, like increased discoloration, are a little skewed, because as time went on, only those parents noticing observable problems came in for evaluation. Pulpal calcification, however, did increase over time as well—most studies have shown calcified teeth to have good prognoses and normal resorption.