Descriptive Evaluation of Medium‐ and Long‐Term Complications of Traumatic Dental Injuries in Children and Adolescents Reporting to a Tertiary Care Hospital
Shailja Srivastava, Nitesh Tewari, Vijay Prakash Mathur, Morankar Rahul, Kalpana Bansal, Georgios TsilingaridisABSTRACT
Background/Aims
Traumatic dental injuries (TDIs) frequently present with acute symptoms, yet many adverse outcomes manifest months or years later as medium‐ and long‐term consequences. These sequelae, such as pulp necrosis with infection of root canal system, periapical radiolucency, and external inflammatory resorption, pose significant diagnostic and therapeutic challenges. Evidence describing such healing complications as the first presenting complaint remains limited. The aim of this study was to describe the pattern of such complications in children and adolescents reporting to a tertiary care hospital and to evaluate associated patient‐ and injury‐related factors.
Methods
A hospital‐based cross‐sectional study was conducted on patients aged 6–18 years presenting with a history of TDI to permanent teeth and exhibiting clinical and/or radiographic signs of medium‐ and long‐term complications. Standardized assessment protocols were followed, including NA0D classification for injury type, Miller's criteria for mobility, thermal and electric pulp testing for pulp sensibility, and radiographic evaluation using RVG and CBCT when indicated. Medium‐ and long‐term consequences were categorized using established criteria. Statistical analysis included Student's t ‐test and ordered logistic regression.
Results
A total of 185 participants (218 teeth) were evaluated. Maxillary central incisors were most frequently affected (39.9%). The predominant injuries were enamel‐dentin fractures (43.1%) and complicated crown fractures (41.3%). The most common medium‐ and long‐term consequences were periapical radiolucency (90.3%), pulp necrosis with infection of root canal system (77.1%), and external inflammatory resorption (67.4%). Delay in reporting showed significant associations with discoloration, tenderness on percussion, and external inflammatory resorption ( p < 0.01). Type of injury was significantly associated with multiple complications. Root maturity and age showed limited association.
Conclusion
Medium‐ and long‐term complications of TDIs predominantly involved pulp necrosis with infection of root canal system, apical pathology, and external inflammatory resorption. Longer delays in seeking care significantly increased the likelihood of adverse outcomes. The findings highlight the need for improved awareness, early emergency management, and future research focusing on combined injury patterns to better predict long‐term prognosis.