The goal of the present study was to identify the factors related to the occurrence of dental trauma in deciduous teeth. Over a period of 25 months, 85 children between 10 months and 6 years of age were assisted by the staff of the Pediatric Dentistry Clinic of the Federal University of Santa Catarina (UFSC) Florianópolis, Brazil. The children, all assisted by only one professional, a dentist working as a trainee in the Pediatric Dentistry Clinic, had 157 traumatized teeth treated. The occurrence of trauma was higher in male patients (51.8%) and in children between 1 and 3 years old. The average age was about =2.7 years. The 54.1% of the assisted children had more than one traumatized tooth and the repeat trauma occurred 16.7% of the time. Anterior teeth represented 98.7% of the cases and 76.4% of the trauma were on the maxillary central incisor teeth. Both sides of the mouth had approximately the same number of traumatic injuries. Luxations were more frequent (85.4%) than fractures (14.6%). Subluxations represented 38.8% of the luxated teeth. Falls were the main cause of trauma (78%). A percentage of 41.9 children were assisted by a dental professional during the first 24h after the incident. The study concluded that the deciduous dentition is mostly affected by luxations (subluxations) that occur specially on the maxillary central incisor teeth, in patients between 1 and 3 years of age. Falls are the most common etiological factor and more than one traumatized tooth is common. Some of the cases were repeat traumatic injuries.

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The aim of the present study was to determine the association of tooth discoloration in traumatized primary teeth with clinical and radiographic signs of pulp necrosis, and pulp status at the time of endodontic access. Clinical and radiographic data from dental reports of the 47 patient charts of the Trauma Patient Care Program were used totaling 55 teeth that underwent endodontic treatment following the protocol of the Federal University of Santa Catarina (Brazil). The following data were collected: gender, age of child at time of trauma; crown discoloration; abscess and/or fistula; periapical bone rarefaction and/or pathological root resorption; and pulp status at the time of endodontic access. The Chi-square test and logistic regression were used in the statistical analysis. The associations between crown discoloration and gender, age, tooth, type of trauma, clinical alteration, and radiographic alteration were not statistically significant. There was a significant association between crown discoloration and pulp necrosis at the time of endodontic access (χ(2)  = 7.672; P < 0.05). Traumatized primary teeth with crown discoloration had a fivefold greater likelihood of exhibiting pulp necrosis than teeth without crown discoloration (95% CI: 1.5-17.1). Thus, a significant association was found between crown discoloration and pulp necrosis in traumatized primary teeth.

The objective of this study was to verify if the follow-up management routine of traumatized primary teeth set up by Federal University of Santa Catarina, which performs clinical and radiographic assessments (15 and 45 days; 4, 8 and 12 months) after the oral trauma, enabled an early diagnosis of sequelae which would indicate the need for endodontic intervention, as well as the influence a type of trauma and the child's age could have in the severity of the sequelae. In this study 52 sets of records were used of patients being seen in the last 6 months, with a total of 70 teeth that were receiving follow-up treatment. Patients returned for regular visits set up by the management routine, where clinical and radiographic examinations were performed to check for sequelae, which justified endodontic intervention. Mobility (51.2%) and crown discoloration (25.6%) were the most common sequelae found in the patient's first appointment. In the follow-up visits, replacement root resorption (22.5%) was the second most common sequela found, suggesting endodontic intervention. No significant association was found between severe sequelae, types of trauma and a child's age (chi(2) = 0.3, P = 0.8613). During the intervals of the follow-up visits, it was noticed that between 46 days and 8 months a higher number of sequelae were diagnosed (P < 0.05). The diagnosis of sequelae such inflammatory and replacement root resorption, which can lead to an early loss of a primary tooth, are frequent and that the interval between the follow-up visits has to be changed, suggesting the setting up of management routine 2. The study also concluded that the type of trauma and the child's age are not fundamental factors in the diagnosis of severe sequelae.

This article reports a clinical case of a primary tooth avulsion followed by dental reimplantation and endodontic treatment according to the protocol established by the Federal University of Santa Catarina for the treatment of traumatized primary teeth. A patient, 2 years and 6 months of age, MR, suffered the avulsion of tooth 61 because of a fall at school. The child was given dental assistance within 30 min, and the avulsed tooth was stored in milk during the period. After radiographic examination, the tooth was reimplanted and splinted. This procedure was performed after having obtained the mother's permission. Endodontic treatment was implemented a few days after the reimplantation because of the pulp necrosis that originated from a neurovascular bundle rupture. The endodontic treatment consisted of calcium hydroxide manipulated using glycol propylene dressings. After 12 months of treatment, the avulsed tooth presented the absence of periapical bone rarefaction in addition to a dry root canal, presenting ideal conditions for a definitive obturation. The obturation was applied using ZOE. The follow-up procedures on the obturated tooth were performed until the total eruption of the succeeding permanent tooth had been achieved, with no sequelae. Reimplantation, followed by endodontic treatment performed according to biological principles, has proven to be a good option for avulsed primary teeth.