Evaluating the outcomes of extrusive luxation injury in children's permanent teeth and their impact on dental pulp vitality: a one-year follow-up study

评估儿童恒牙脱位损伤的后果及其对牙髓活力的影响:一项为期一年的随访研究

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Abstract

OBJECTIVE: To analyze the consequences of extrusive luxation injury of permanent teeth in children and its influence on pulp vitality, and conduct a one-year follow-up study. METHODS: A retrospective analysis was conducted on the data of children with permanent tooth protrusion injury who visited the outpatient department of our hospital from August 2022 to July 2023. Based on the X-ray and clinical assessment results of the 3-month follow-up, the children were divided into the poor prognosis group (pulp calcification + pulp necrosis, n = 30) and the good prognosis group (pulp survival, n = 40). The clinical and general data of the two groups of children were collected and compared. Multivariate Logistic regression was used to analyze the influencing factors of poor pulp prognosis. RESULTS: Among the 70 children patients, 40 had a good prognosis and 30 had a poor prognosis after one-year follow-up (27 cases of pulp necrosis and 3 cases of pulp calcification). The main site of trauma was the maxillary central incisors (87.14%), and the most common injury type was extruded dislocation (partial dislocation) (41.43%). Univariate analysis showed that the proportion of the poor prognosis group in terms of trauma type displacement, mature tooth root development, severity of extrusive luxation injury (Grade 3), severe periodontal tissue injury, positive initial percussion pain, and crown fracture type (type Ⅲ - type Ⅳ) was significantly higher than that of the good prognosis group, and the proportion of positive temperature test was significantly lower than that of the good prognosis group (all P < 0.05). Multivariate Logistic regression analysis further confirmed that the above factors were independent risk factors for poor pulp prognosis (all P < 0.05). CONCLUSION: The results of this retrospective study indicated that after permanent tooth extraction injury in children, the types of trauma displacement, grade 3 extraction injury, severe periodontal tissue injury, positive percussion pain at the initial diagnosis, and complex crown fractures (types Ⅲ to Ⅳ) were significantly associated with poor pulp prognosis. Clinicians should pay close attention to and conduct long-term monitoring of children with these high-risk factors.

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