Bifid canal in a mandibular first pre-molar. A case report.
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Biomedical subjects
Publications and source records attributed to I Fried.
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A review of the literature is presented to discuss anterior tooth trauma in the primary dentition. Studies show that the incidence ranges from 4 percent to 30 percent and varies depending upon the sex and age of the child. Classification of the type of trauma is subdivided into trauma to the tooth and trauma to the periodontium. Treatment modalities depend upon various factors and range from nontreatment to splinting to extraction. Possible sequelae of primary tooth trauma may include tooth discoloration, loss of vitality, root resorption and/or abscess formation. Careful follow-up is recommended following any type of trauma, because the ultimate goal in treatment is to prevent damage to the permanent successor.
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This study investigated the epidemiology, sequelae, and prognosis of subluxation injuries to the maxillary primary anterior dentition. Data were collected from dental records at the Montreal Children's Hospital, Montreal, Canada, of patients sustaining trauma between 1982 and 1993. The study group consisted of 207 teeth in 134 patients, 81 males and 53 females. The age of the patients ranged from 0.8 years to 7.5 years, with a mean of 3.5 years. The highest incidence of trauma was in males between the ages of 3 and 4 years, and in females between 1 and 3 years. The highest incidence of trauma (66.2%) involved the primary central incisors. The most common cause of trauma (52%) was simple falls indoors. Occlusal or periapical radiographs were the radiographic view of choice unless an anterior nasal spine fracture was suspected, in which case a lateral projection was exposed. Approximately 64% of the study teeth had a mobility ranging from 0.6 to 1.5 mm. Treatment varied from no treatment (80% of teeth) to extraction. Post-traumatic evaluations were distributed into six common time intervals used by dentists for follow up. The results indicated that patient discomfort and occlusal interference were not common. Discoloration and pulpal calcification increased with time. Mobility decreased with time, with the majority of teeth returning to a normal physiologic range. External resorption may have been present, but was rare. Treatment or antibiotics were rarely needed at follow-up visits. Overall, these teeth responded positively, and there was a low morbidity associated with subluxation injuries.