DOI QR코드

DOI QR Code

원주세브란스기독병원 응급실로 내원한 0 - 15세 어린이의 치과적 외상에 관한 후향적 분석

Retrospective Study of Traumatic Dental Injuries among Children Aged 0 - 15 Years in Wonju

  • 배두환 (연세대학교 원주세브란스 기독병원 소아치과학교실) ;
  • 김지훈 (연세대학교 원주세브란스 기독병원 소아치과학교실)
  • Bae, Doo-Hwan (Department of Pediatric Dentistry, Wonju Severance Christian Hospital, Yonsei University) ;
  • Kim, Ji-Hun (Department of Pediatric Dentistry, Wonju Severance Christian Hospital, Yonsei University)
  • 투고 : 2016.05.13
  • 심사 : 2016.07.19
  • 발행 : 2017.02.28

초록

본 연구는 원주세브란스기독병원 응급실에 내원한 소아 환자들의 나이, 성별, 외상 발생 장소, 외상의 원인, 외상의 위치, 외상 후 경과시간, 응급실 내원시간, 처치의 유형 등을 파악하기 위해 시행되었다. 2011년 3월부터 2015년 10월까지 치과적 외상으로 인해 원주세브란스기독병원 외상 센터에 내원한 0 - 15세 사이 841명의 환자들의 정보를 수집하였다. 외상은 남아에서 호발하였으며, 호발하는 나이는 0 - 3세였다. 6세 미만에서는 집에서 외상이 가장 호발하고, 넘어지는 것이 외상의 가장 주된 원인이었다. 하지만 6세 이상에서는 외상의 장소로 집이 크게 줄어들었으며, 외상의 원인으로 넘어지는 것이 줄어들고 스포츠와 기타 원인이 매우 크게 증가하였다. 나이 대 별로 외상의 원인과 장소에서는 유의한 차이를 보였다. 외상의 위치로는 입술과 상악 절치가 가장 많은 빈도수를 보였다. 응급실을 내원하는 시간대로는 18 - 24시(53.3%)에 내원하는 환자가 가장 많았으며, 0 - 6시(4.6%)에 내원하는 환자는 가장 적었다. 외상 후 경과 시간은 1시간 이내가 51.5%, 1 - 2시간이 26.8%, 2 - 3시간이 11.5%로, 3시간 이내에 내원하는 환자가 89.8%에 달했다. 응급에서 행해지는 처치의 유형으로는 경과관찰을 하는 경우가 가장 많았으며, 가장 많이 행해지는 술식은 봉합술이었다. 본 연구를 통해 소아의 치과적 외상과 응급실 방문은 환아의 성별, 나이, 상황에 따라 역학적인 특징을 보인다는 것을 살펴보았다. 외상의 양상은 어린이의 사회, 발달, 생리적인 요인이 종합되어 나타난다.

This study was designed to evaluate the age, gender, location of trauma, etiology, injury site, types of treatment, elapsed time after trauma, and arrival time of children who visited trauma center of Wonju Severance Christian Hospital. Records of a total of 841 patients who were 0 - 15 years old and received care in the period from March 2011 to October 2015 at the Trauma Center, Wonju Severance Christian Hospital were analyzed. This study showed that traumatic dental injuries were more common in boys and patients between 0 - 3 years old. Under 6 years old, fall was the most common etiology and home was the most common place of trauma. However, fall decreased, and sports and etc increased largely in etiologic factors over 6 years old. Besides, home decreased, and road and kindergarten school increased largely in the place of trauma. Etiology and location of trauma were statistically influenced by the age (p < 0.05). The most commonly affected injury sites were maxillary incisors and lips. The most patients visited trauma center between 18 - 24 o'clock (53.3%), and the least patients visited between 0 - 6 o'clock (4.6%). 51.5% of patients visited the trauma center within 1 hour of sustaining trauma, and 26.8% and 11.5% of patients visited between 1 - 2 hours and 2 - 3 hours respectively. The most common treatment of traumatic dental injuries was observation, and the second most common treatment was suture. Traumatic dental injuries in children exhibit specific epidemiological features according to children's gender, age, and other conditions. These result from combination of social, developmental, and physiologic factors.

키워드

참고문헌

  1. John MT, Rener-Sitar K, Baba K, et al. : Patterns of impaired oral health-related quality of life dimensions. J Oral Rehabil, 43:519-527, 2016. https://doi.org/10.1111/joor.12396
  2. Berscheid E, Gangestad S : The social psychological implications of facial physical attractiveness. Clin Plast Surg, 9:289-296, 1982.
  3. Kiyak HA : Does orthodontic treatment affect patients'quality of life? J Dent Educ, 72:886-894, 2008.
  4. Dion K, Berscheid E, Walster E : What is beautiful is good. J Pers Soc Psychol, 24:285-290, 1972. https://doi.org/10.1037/h0033731
  5. Mathes EW, Kahn A : Physical attractiveness, happiness, neuroticism, and self-esteem. J Psychol, 90:27-30, 1975. https://doi.org/10.1080/00223980.1975.9923921
  6. Mandall NA, McCord JF, Blinkhorn AS, et al. : Perceived aesthetic impact of malocclusion and oral self-perceptions in 14-15-year-old Asian and Caucasian children in greater Manchester. Eur J Orthod, 22:175-183, 2000. https://doi.org/10.1093/ejo/22.2.175
  7. Birkeland K, Boe OE, Wisth PJ : Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study. Eur J Orthod, 22:509-518, 2000. https://doi.org/10.1093/ejo/22.5.509
  8. Birkeland K, Katle A, Lovgreen S, et al. : Factors influencing the decision about orthodontic treatment. A longitudinal study among 11- and 15-year-olds and their parents. J Orofac Orthop, 60:292-307, 1999. https://doi.org/10.1007/BF01301243
  9. Tin-Oo MM, Saddki N, Hassan N : Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health, 11:6, 2011. https://doi.org/10.1186/1472-6831-11-6
  10. Traebert J, Lacerda JT, Foster Page LA, et al. : Impact of traumatic dental injuries on the quality of life of schoolchildren. Dent Traumatol, 28:423-428, 2012. https://doi.org/10.1111/j.1600-9657.2012.01114.x
  11. Ramos-Jorge J, Paiva SM, Tataounoff J, et al. : Impact of treated/untreated traumatic dental injuries on quality of life among Brazilian schoolchildren. Dent Traumatol, 30:27-31, 2014. https://doi.org/10.1111/edt.12048
  12. Aldrigui JM, Abanto J, Carvalho TS, et al. : Impact of traumatic dental injuries and malocclusions on quality of life of young children. Health Qual Life Outcomes, 9:78, 2011. https://doi.org/10.1186/1477-7525-9-78
  13. Ward JA, Vig KW, Firestone AR, et al. : Oral health-related quality of life in children with orofacial clefts. Cleft Palate Craniofac J, 50:174-181, 2013. https://doi.org/10.1597/11-055
  14. Cook AK, Kerins CA, Heppner CE : Dental Impacts on Health-related Quality of Life of Children with Orofacial Clefts. Pediatr Dent, 38:218-223, 2016.
  15. De Oliveira KM, Silva RA, Carvalho FK, et al. : Clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome. Contemp Clin Dent, 7:240-242, 2016. https://doi.org/10.4103/0976-237X.183052
  16. Petersson EE, Andersson L, Sorensen S : Traumatic oral vs non-oral injuries. Swed Dent J, 21:55-68, 1997.
  17. Kellman RM, Tatum SA : Pediatric Craniomaxillofacial Trauma. Facial Plastic Surgery Clinics of North America, 22:559-572, 2014. https://doi.org/10.1016/j.fsc.2014.07.009
  18. Allred LJ, Crantford JC, Reynolds MF, David LR : Analysis of pediatric maxillofacial fractures requiring operative treatment: Characteristics, management, and outcomes. J Craniofac Surg, 26:2368-2374, 2015. https://doi.org/10.1097/SCS.0000000000002087
  19. Armstrong BD : Lacerations of the mouth. Emerg Med Clin North Am, 18:471-480, vi, 2000. https://doi.org/10.1016/S0733-8627(05)70139-5
  20. Sabatino F, Moskovitz JB : Facial wound management. Emerg Med Clin North Am, 31:529-538, 2013. https://doi.org/10.1016/j.emc.2013.01.005
  21. Kim DW, Lee KS : A study on the traumatic injury of patients in department of Pediatric Dentistry, Kangnung National University Dental Hospital. J Korean Acad Pediatr Dent, 28:247-254, 2001.
  22. Baik BJ, Yang YM, Yang CH, Kim JG : An investigation of traumatic dental injuries in children. J Korean Acad Pediatr Dent, 28:600-612, 2001.
  23. Kim Y, Kim S, Choi N : A retrospective study of the pattern and treatment of traumatic dental injury to primary and permanent teeth. J Korean Acad Pediatr Dent, 41:314-321, 2014. https://doi.org/10.5933/JKAPD.2014.41.4.314
  24. Skaare AB, Jacobsen I : Primary tooth injuries in Norwegian children (1-8 years). Dent Traumatol, 21:315-319, 2005. https://doi.org/10.1111/j.1600-9657.2005.00362.x
  25. Bastone EB, Freer TJ, McNamara JR : Epidemiology of dental trauma: a review of the literature. Aust Dent J, 45:2-9, 2000. https://doi.org/10.1111/j.1834-7819.2000.tb00234.x
  26. Kramer PF, Onetto J, Flores MT, et al. : Traumatic Dental Injuries in the primary dentition: a 15-year bibliometric analysis of Dental Traumatology. Dent Traumatol, 32:341-346, 2016. https://doi.org/10.1111/edt.12262
  27. Onetto JE, Flores MT, Garbarino ML : Dental trauma in children and adolescents in Valparaiso, Chile. Endod Dent Traumatol, 10:223-227, 1994. https://doi.org/10.1111/j.1600-9657.1994.tb00074.x
  28. Zeng Y, Sheller B, Milgrom P : Epidemiology of dental emergency visits to an urban children's hospital. Pediatr Dent, 16:419-423, 1994.
  29. Choi SC, Park JH, Pae A, Kim JR : Retrospective study on traumatic dental injuries in preschool children at Kyung Hee Dental Hospital, Seoul, South Korea. Dent Traumatol, 26:70-75, 2010. https://doi.org/10.1111/j.1600-9657.2009.00840.x
  30. Yang RT, Li Z, Li ZB : Maxillofacial injuries in infants and preschools: a 2.5-year study. J Craniofac Surg, 25:964-967, 2014. https://doi.org/10.1097/SCS.0000000000000760
  31. Soares TR, Barbosa AC, de Oliveira SN, et al. : Prevalence of soft tissue injuries in pediatric patients and its relationship with the quest for treatment. Dent Traumatol, 32:48-51, 2016. https://doi.org/10.1111/edt.12216
  32. Heo SK, Choi NK, Kim SM, et al. : A retrospective study of the traumatiic injuries in the primary and permanent teeth. J Korean Acad Pediatr Dent, 35:642-651, 2008.
  33. Chung YJ, Kim KC, Park JH, Choi SC : A study on the traumatic injuries to primary teeth. J Korean Acad Pediatr Dent, 37:328-337, 2010.
  34. Ranka M, Dhaliwal H, Albadri S, Brown C : Trauma to the primary dentition and its sequelae. Dent Update, 40:534-536, 539-540, 542, 2013.
  35. Kovacs M, Pacurar M, Petcu B, Bukhari C : Prevalence of traumatic dental injuries in children who attended two dental clinics in Targu Mures between 2003 and 2011. Oral Health Dent Manag, 11:116-124, 2012.
  36. Cardoso M, de Carvalho Rocha MJ : Traumatized primary teeth in children assisted at the Federal University of Santa Catarina, Brazil. Dent Traumatol, 18:129-133, 2002. https://doi.org/10.1034/j.1600-9657.2002.00030.x
  37. Galea H : An investigation of dental injuries treated in an acute care general hospital. J Am Dent Assoc, 109:434-438, 1984. https://doi.org/10.14219/jada.archive.1984.0419
  38. Garcia-Godoy F, Garcia-Godoy F, Garcia-Godoy FM : Primary teeth traumatic injuries at a private pediatric dental center. Endod Dent Traumatol, 3:126-129, 1987. https://doi.org/10.1111/j.1600-9657.1987.tb00613.x
  39. Atabek D, Alacam A, Aydintug I, Konakoglu G : A retrospective study of traumatic dental injuries. Dent Traumatol, 30:154-161, 2014. https://doi.org/10.1111/edt.12057
  40. Marcenes W, al Beiruti N, Tayfour D, Issa S : Epidemiology of traumatic injuries to the permanent incisors of 9-12-year-old schoolchildren in Damascus, Syria. Endod Dent Traumatol, 15:117-123, 1999. https://doi.org/10.1111/j.1600-9657.1999.tb00767.x
  41. Ekanayake L, Perera M : Pattern of traumatic dental injuries in children attending the University Dental Hospital, Sri Lanka. Dent Traumatol, 24:471-474, 2008. https://doi.org/10.1111/j.1600-9657.2008.00611.x
  42. Andreasen JO, Andreasen FM, Andersson L : Textbook and color atlas of traumatic injuries to the teeth, 4th ed., Blackwell Publishing Ltd., 577-597, 2007.
  43. Hulley SB, Cummings SR, Browner WS, et al. : Designing clinical research, 4th ed., Lippincott Williams & Wilkins, 85-96, 2013.
  44. Berti GO, Hesse D, Bonifacio CC, et al. : Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children. Braz Oral Res, 29:1-6, 2015.