J Korean Assoc Oral Maxillofac Surg.  2020 Jun;46(3):183-190. 10.5125/jkaoms.2020.46.3.183.

Oral and maxillofacial injuries in children: a retrospective study

• Mukhopadhyay S
• Galui S
• Biswas R
• Saha S
• Sarkar S

• KMID: 2504304
• DOI: http://doi.org/10.5125/jkaoms.2020.46.3.183

Abstract

Objectives
The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population.
Materials and Methods
Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%.
Results
Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46).
Conclusion
Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.

Keyword

Maxillofacial injuries; Child; Epidemiology

Figure

• 

  Fig. 1 Cone-beam computed tomography showing parasymphyseal fracture of the mandible.

• 

  Fig. 2 Radiograph showing parasymphyseal fractures.

• 

  Fig. 3 Distribution of facial bone fracture types.

• 

  Fig. 4 Distribution of dentoalveolar fractures according to age.

• 

  Fig. 5 Soft tissue injuries according to sex.

Reference

References

1. Muñante-Cárdenas JL, Olate S, Asprino L, de Albergaria Barbosa JR, de Moraes M, Moreira RW. 2011; Pattern and treatment of facial trauma in pediatric and adolescent patients. J Craniofac Surg. 22:1251–5. DOI: 10.1097/SCS.0b013e31821c696c. PMID: 21772206.

2. Mukhopadhyay S. 2018; A retrospective study of mandibular fractures in children. J Korean Assoc Oral Maxillofac Surg. 44:269–74. DOI: 10.5125/jkaoms.2018.44.6.269. PMID: 30637240. PMCID: PMC6327018.

3. Singaram M, G SV, Udhayakumar RK. 2016; Prevalence, pattern, etiology, and management of maxillofacial trauma in a developing country: a retrospective study. J Korean Assoc Oral Maxillofac Surg. 42:174–81. DOI: 10.5125/jkaoms.2016.42.4.174. PMID: 27595083. PMCID: PMC5009190.

4. Haug RH, Foss J. 2000; Maxillofacial injuries in the pediatric patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 90:126–34. DOI: 10.1067/moe.2000.107974. PMID: 10936829.

5. Iida S, Matsuya T. 2002; Paediatric maxillofacial fractures: their aetiological characters and fracture patterns. J Craniomaxillofac Surg. 30:237–41. DOI: 10.1054/jcms.2002.0295. PMID: 12231205.

6. Almahdi HM, Higzi MA. 2016; Maxillofacial fractures among Sudanese children at Khartoum Dental Teaching Hospital. BMC Res Notes. 9:120. DOI: 10.1186/s13104-016-1934-5. PMID: 26905310. PMCID: PMC4765085.

7. Khan MA, Ishfaq M, Akhtar M, Rana SAA, Kashif M. 2018; Frequency of paediatric facial trauma in a tertiary care dental hospital. Int Surg J. 5:310–4. DOI: 10.18203/2349-2902.isj20175917.

8. Bregagnolo LA, Bregagnolo JC, Silveira Fd, Bérgamo AL, Santi LN, Watanabe MG. 2013; Oral and maxillofacial trauma in Brazilian children and adolescents. Braz Dent J. 24:397–401. DOI: 10.1590/0103-6440201302227. PMID: 24173264.

9. Zimmermann CE, Troulis MJ, Kaban LB. 2006; Pediatric facial fractures: recent advances in prevention, diagnosis and management. Int J Oral Maxillofac Surg. 35:2–13. DOI: 10.1016/j.ijom.2005.09.014. PMID: 16425444.

10. Leles JL, dos Santos EJ, Jorge FD, da Silva ET, Leles CR. 2010; Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample. J Appl Oral Sci. 18:23–9. DOI: 10.1590/S1678-77572010000100006. PMID: 20379678. PMCID: PMC5349033.

11. Kumaraswamy SV, Madan N, Keerthi R, Singh DS. 2009; Pediatric injuries in maxillofacial trauma: a 5 year study. J Maxillofac Oral Surg. 8:150–3. DOI: 10.1007/s12663-009-0037-4. PMID: 23139495. PMCID: PMC3453932.

12. Khalifa GA, El-Kilani NS, Nasr TA. 2017; Clinical outcomes of pediatric maxillofacial fractures management in three hospital series in Egypt. J Oral Maxillofac Surg Med Pathol. 29:511–7. DOI: 10.1016/j.ajoms.2017.06.008.

13. Collao-González C, Carrasco-Labra A, Sung-Hsieh HH, Cortés-Araya J. 2014; Epidemiology of pediatric facial trauma in Chile: a retrospective study of 7,617 cases in 3 years. Med Oral Patol Oral Cir Bucal. 19:e99–105. DOI: 10.4317/medoral.19035. PMID: 23986019. PMCID: PMC4015049.

14. Karim T, Khan AH, Ahmed SS. 2010; Trauma of facial skeleton in children: an Indian perspective. Indian J Surg. 72:232–5. DOI: 10.1007/s12262-010-0056-x. PMID: 23133253. PMCID: PMC3452650.

15. Rowe NL. 1968; Fractures of the facial skeleton in children. J Oral Surg. 26:505–15.

16. Posnick JC, Wells M, Pron GE. 1993; Pediatric facial fractures: evolving patterns of treatment. J Oral Maxillofac Surg. 51:836–44. discussion 844-5. DOI: 10.1016/S0278-2391(10)80098-9. PMID: 8336220.

17. Gassner R, Tuli T, Hächl O, Moreira R, Ulmer H. 2004; Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years. J Oral Maxillofac Surg. 62:399–407. DOI: 10.1016/j.joms.2003.05.013. PMID: 15085503.

18. Eggensperger Wymann NM, Hölzle A, Zachariou Z, Iizuka T. 2008; Pediatric craniofacial trauma. J Oral Maxillofac Surg. 66:58–64. DOI: 10.1016/j.joms.2007.04.023. PMID: 18083416.

19. Chang LT, Tsai MC. 2007; Craniofacial injuries from slip, trip, and fall accidents of children. J Trauma. 63:70–4. DOI: 10.1097/01.ta.0000219142.15584.b8. PMID: 17622871.

20. Kotecha S, Scannell J, Monaghan A, Williams RW. 2008; A four year retrospective study of 1,062 patients presenting with maxillofacial emergencies at a specialist paediatric hospital. Br J Oral Maxillofac Surg. 46:293–6. DOI: 10.1016/j.bjoms.2007.11.011. PMID: 18177983.

21. Kambalimath HV, Agarwal SM, Kambalimath DH, Singh M, Jain N, Michael P. 2013; Maxillofacial injuries in children: a 10 year retrospective study. J Maxillofac Oral Surg. 12:140–4. DOI: 10.1007/s12663-012-0402-6. PMID: 24431831. PMCID: PMC3681997.

22. Oji C. 1998; Fractures of the facial skeleton in children: a survey of patients under the age of 11 years. J Craniomaxillofac Surg. 26:322–5. DOI: 10.1016/S1010-5182(98)80062-0.

23. Holland AJ, Broome C, Steinberg A, Cass DT. 2001; Facial fractures in children. Pediatr Emerg Care. 17:157–60. DOI: 10.1097/00006565-200106000-00002. PMID: 11437137.

24. Alcalá-Galiano A, Arribas-García IJ, Martín-Pérez MA, Romance A, Montalvo-Moreno JJ, Juncos JM. 2008; Pediatric facial fractures: children are not just small adults. Radiographics. 28:441–61. quiz 618. DOI: 10.1148/rg.282075060. PMID: 18349450.

25. Rahman RA, Ramli R, Rahman NA, Hussaini HM, Idrus SM, Hamid AL. 2007; Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals. Int J Pediatr Otorhinolaryngol. 71:929–36. DOI: 10.1016/j.ijporl.2007.03.003. PMID: 17442408.

26. Cavalcanti AL, Melo TR. 2008; Facial and oral injuries in Brazilian children aged 5-17 years: 5-year review. Eur Arch Paediatr Dent. 9:102–4. DOI: 10.1007/BF03262619. PMID: 18534180.

27. Osunde OD, Amole IO, Ver-or N, Akhiwu BI, Adebola RA, Iyogun CA, et al. 2013; Pediatric maxillofacial injuries at a Nigerian teaching hospital: a three-year review. Niger J Clin Pract. 16:149–54. DOI: 10.4103/1119-3077.110126. PMID: 23563452.

28. Ul Haq ME, Khan AS. 2018; A retrospective study of causes, management, and complications of pediatric facial fractures. Eur J Dent. 12:247–52. DOI: 10.4103/ejd.ejd_370_17. PMID: 29988232. PMCID: PMC6004801.

29. Kim SH, Lee SH, Cho PD. 2012; Analysis of 809 facial bone fractures in a pediatric and adolescent population. Arch Plast Surg. 39:606–11. DOI: 10.5999/aps.2012.39.6.606. PMID: 23233885. PMCID: PMC3518003.

30. Yang RT, Li Z, Li ZB. 2014; Maxillofacial injuries in infants and preschools: a 2.5-year study. J Craniofac Surg. 25:964–7. DOI: 10.1097/SCS.0000000000000760. PMID: 24820716.

31. Arenas M, Barbería E, Lucavechi T, Maroto M. 2006; Severe trauma in the primary dentition--diagnosis and treatment of sequelae in permanent dentition. Dent Traumatol. 22:226–30. DOI: 10.1111/j.1600-9657.2006.00352.x. PMID: 16872394.