Retrospective analysis of pulp necrosis frequency after uncomplicated crown-fractures in children

Abstract

Crown fractures are the most common injury of the permanent teeth, and a possible pathway for bacteria to enter pulp space and to become a cause of inflammation and necrosis, as a most frequent consequences. The aim of the present study was to analyze the frequency of pulp necrosis after uncomlicated crown fractures of permanent teeth in children. Retrospective analysis of patients trauma records was performed. The sample consisted of patient who had been referred to the department of dentistry for a crown fracture to permanent teeth. We recorded type of injury, time elapsed between dental injury and treatment, state of vitality during the first visit and subsequent chec-ups, and the stage of root development. Standard descriptive statistic methods, Chi-square test and linear regression were used for statistical analysis. The study involved 104 crown fractured teeth. 34 of them suffered luxation injuries at the same time. Simultaneous periodontal injuries increases chances for necrosis development ( χ2 = 38.2837, p lt 0.001). Complited root development has a positive influence on pulp necrosis development in fractured teeth with simultaneous luxational injuries ( χ2=16.067; p lt 0.001; c=0.572). If time elapsed between dental injury and treatment was longer necrosis was more frequent ( χ2=14.303; p lt 0.001; c=0.415) in fractured teeth. No response to pulp vitality test increases the risk of necrosis( χ2=12.29, p lt 0.001; f=0.6838). Conclusion: simultaneous luxation injury and completed root development are the key risk factors in pulp necrosis occurrence in teeth with uncomplicatad fractures.

Frakture krunica najčešći su tip trauma stalnih zuba i mogući put za bakterijsku invaziju pulpe što dovodi do nastanka inflamacije i posledično, komplikacija različite vrste i težine među kojima je nekroza pulpe najčešća. Cilj studije: analiza učestalosti nekroze pulpe koja prati nekomplikovane frakture krunica (sa i bez pridruženih luksacija) stalnih zuba u dece. Izvršena je retrospektivna analiza kartona traume pacijenata.Uzorak su činili slučajevi sa nekomplikovanim frakturama krunica stalnih zuba lečenih na klinici za dečju i preventivnu stomatologiju. Beležena je vrsta povrede, vreme proteklo od traume do prvog tretmana, stanje vitaliteta na prvom i kontrolnim pregledima i stadijum razvoja korena. Statistička analiza izvedena je standardnim metodama deskriptivne statistike, primenom Chi-kvadrat testa i linearne regresije. Studijom je obuhvaćeno 104 zuba sa nekomplikovanim frakturama krunica od kojih je 34 imalo pridružene luksacije. Prisustvo luksacije kod traumatski frakturiranih zuba značajno povećava izglede za nastanak nekroze (χ2 = 38.2837, p lt 0,001). Završen rast korena pozitivno je povezan sa učestalošću nekroze pulpe frakturiranih zuba sa luksacijama( χ2=16,067; p lt 0,001; c=0,572). Zakasnelo lečenje doprinosi učestalijoj pojavi nekroze (χ2=14,303; p lt 0,001; c=0,415) u grupi samo frakturitanih zuba.Odsustvo vitaliteta prilikom prvog pregleda nosi veći rizik za razvoj nekroze (χ2=12,29, p lt 0,001; f=0,6838). Prisustvo luksacije i završen rast korena važni su faktori rizika za nastanak nekroze pulpe zuba sa nekomplikovanim frakturama.