IADR Abstract Archives
Permanent Dentition Avulsion Injuries in School Children: A Clinical Audit
Objectives: This study aimed to examine avulsion injuries with respect to (1) the quality of clinical documentation, (2) compliance of management protocols with International Association of Dental Traumatology (IADT) guidelines, (3) treatment outcomes at School Dental Service, Health Promotion Board (SDS-HPB), Singapore.
Methods: Clinical and radiographic records of 87 patients (109 teeth) treated for avulsion injuries from January 2006 to July 2013 were analysed retrospectively. The quality of operators’ electronic clinical records was evaluated against 23 critical factors deemed prognostically relevant via literature review. Based on the presence of reminders in the records system, these factors were further classified as being “prompted” or “non-prompted”. The frequency, mean and standard deviation of recording were calculated. Operators’ compliance with IADT guidelines in terms of management and review protocols was also evaluated. Treatment outcomes were classified at tooth level as “success”, “failing” or “failure” based on a modified criteria by Mackie and Worthington (1992). The associations between various pre-operative and intra-operative factors on treatment outcome were analyzed using Pearson Chi-Square tests. All statistical analysis was carried out using SPSS version 22.0.
Results: 66 patients with 80 avulsed teeth met the inclusion criteria. The mean frequency for recording “non-prompted” factors (44.9% ± 30.0) was lower than “prompted” factors (63.4% ± 27.3). Compliance with IADT guidelines with regards to splinting duration (58.3%), time to pulp extirpation (49.1%) and radiographic follow up (44.9%) was fairly low. Pulp extirpation performed at an appropriate time following avulsion injury was significantly associated with a successful outcome (n=49, p=0.037). Overall, treatment was successful in 45.0% of teeth, whereas the remaining 55.0% demonstrated signs of initial or definitive failure.
Conclusions: Timely retraining of professionals is necessary to increase adherence to guidelines. The standard of clinical records can be improved with inclusion of appropriate “prompts” in electronic trauma forms.
Methods: Clinical and radiographic records of 87 patients (109 teeth) treated for avulsion injuries from January 2006 to July 2013 were analysed retrospectively. The quality of operators’ electronic clinical records was evaluated against 23 critical factors deemed prognostically relevant via literature review. Based on the presence of reminders in the records system, these factors were further classified as being “prompted” or “non-prompted”. The frequency, mean and standard deviation of recording were calculated. Operators’ compliance with IADT guidelines in terms of management and review protocols was also evaluated. Treatment outcomes were classified at tooth level as “success”, “failing” or “failure” based on a modified criteria by Mackie and Worthington (1992). The associations between various pre-operative and intra-operative factors on treatment outcome were analyzed using Pearson Chi-Square tests. All statistical analysis was carried out using SPSS version 22.0.
Results: 66 patients with 80 avulsed teeth met the inclusion criteria. The mean frequency for recording “non-prompted” factors (44.9% ± 30.0) was lower than “prompted” factors (63.4% ± 27.3). Compliance with IADT guidelines with regards to splinting duration (58.3%), time to pulp extirpation (49.1%) and radiographic follow up (44.9%) was fairly low. Pulp extirpation performed at an appropriate time following avulsion injury was significantly associated with a successful outcome (n=49, p=0.037). Overall, treatment was successful in 45.0% of teeth, whereas the remaining 55.0% demonstrated signs of initial or definitive failure.
Conclusions: Timely retraining of professionals is necessary to increase adherence to guidelines. The standard of clinical records can be improved with inclusion of appropriate “prompts” in electronic trauma forms.