Paediatric dental and maxillofacial injuries in 0-15- year olds at the Kenyatta National Hospital, nairobi a retrospective study from the years 1998-2002
Muriithi, Humphrey Murimi
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Objective: The objective of the study was to determine the pattern of occurrence of dental and maxillofacial injuries in 0-15- year-old patients who attended for treatment at the Kenyatta National Hospital (KNH) in Nairobi between the years 1998-2002. Methods: A descriptive retrospective hospital study was conducted at Kenyatta National Hospital. The records of patients aged 0-15 years who sustained dental and maxillofacial injuries during the years 1998-2002 were retrieved from the records department. Information regarding dental, facial skeletal and soft tissue injuries was entered into a proforma. The data obtained were analyzed using the SPSS computer package. Results: A total of six hundred and twenty nine (629) patient records were retrieved for analysis. Most of the injuries were recorded in the year 1999 (22.6%) while the least were recorded in the year 2001 (17.3%). There were a greater proportion of dental injuries (80.3%) than facial fractures (8.3%) and soft tissue injuries (29.9%). Regarding all the dental and maxillofacial injuries, boys sustained injuries 1.85 times more than females with the 2-4-yearolds age group (23.7%) being the predominant age group affected. Falls were indicated as having been the main causative factor in all types of injury. The main presenting symptom and sign recorded for all injuries was pain (76.8%); and tenderness (89.1%) respectively. Sixty nine percent of the patients came for treatment within the day of the trauma. Regarding dental injuries, the maxillary central incisors were the most commonly traumatized teeth in both the permanent (64.0%) and deciduous (67.5%) dentitions. Luxation injuries were the most common form of all types of dental trauma with 47.5% occuning in the permanent teeth and 77.3% in the primary teeth. Most of the 'patients sustained two dental injuries per patient (47.2%). The main treatment modality offered to patients with dental injury for both dentitions was extraction (34.4%). The occurrence of facial injuries peaked at the age of 11-15 years (40.4%). The majority offacial fi:actures occurred in the mandible (77.0%) especially at the condyles (28.3%). Most cases were treated by the closed reduction technique. Soft tissue injuries predominantly affected the lips (40.5%). Suturing was the main form of treatment (56%) of soft tissue injuries. Anti-tetanus toxoid was administered in 25.0% of the cases. Conclusion: The most common injuries were dental injuries, followed by soft tissue injuries and facial fi:actures. Falls were the main aetiological factor in all types of injury.