201 - Traumatic Dental Injury Management and Assessment of Orthodontic Risk Factors

Purpose: To assess the prevalence and treatment of TDIs among children and adolescents and explore orthodontic characteristics that may be associated with orofacial trauma.

Methods: This retrospective chart review included electronic health records of patients, ages 1 to 17 years old, seeking care for TDIs at Columbia University/NewYork-Presbyterian Hospital from January 2020 to October 2023. Data abstracted and analyzed included demographic characteristics (sex; age: 0-3yo, 4-7yo, 8-11yo, +12yo), medical history (cognitive/medical special health care needs), dental history (injured tooth number; type: primary/permanent; TDI type and classification; orthodontic characteristics: overjet, overbite, crossbite, molar classification) and emergency treatment received.

Results: The study sample included 94 children (53 male, 41 female) with a mean age of 8 years (range: 1-17 years). Management of 167 traumatized teeth were reviewed, including 76 primary teeth and 92 permanent teeth. Among both dentitions, maxillary central incisors were the most common tooth injured. Subluxation injury was the most common TDI type (49%) involving the primary dentition, while fracture of enamel-dentin without pulpal involvement was the most common injury involving the permanent dentition (39%). Forty-eight children (51%) with a history of TDIs received a formal orthodontic consultation. Among those children, 67% had permanent incisors with excessive overjet greater than 3mm, 14% had a overjet greater than 7mm.

Conclusions: The findings reinforce existing literature, highlighting increased incidence of TDIs involving maxillary central incisors, and recognizing orthodontic risk factors. More research is needed to explore the long-term outcomes of TDIs and their management strategies, and their impact on orthodontic treatment outcomes.