Anne B Skaare1, Anne-Lise Maseng Aas, Nina J Wang. 1. Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway. askaare@odont.uio.no
Abstract
UNLABELLED: Trauma to primary teeth may cause mineralization disturbances in the permanent successors. OBJECTIVE: To study the distribution and type of enamel defects in permanent incisors after trauma to primary teeth and to examine inter-observer agreement when registrations were based on photographs. MATERIAL AND METHODS: Of 266 children who suffered an oral injury to primary teeth in one county of Norway in 2003, 193 were included in a follow-up study to record enamel defects in the permanent successors 7 years later (age, 8-15 years). Clinical examination and intraoral photographs were undertaken by the principal investigator. The photographs were evaluated twice for enamel defects by three paediatric dentists. Evaluation 1: age at the time of injury, traumatized teeth and diagnoses were kept unknown to the examiners. Evaluation 2: age and trauma diagnoses were known to the examiners. Inter-observer agreement was calculated using Cohen's kappa and chi-square test. RESULTS: Of 338 successor teeth, 42% exhibited enamel defects. In neighbouring teeth (339) with non-injured predecessors, 30% were registered with defects. The most common enamel disturbance in successors was demarcated opacities, recorded in 18% of the teeth. Enamel defects owing to a previous trauma were registered in 37% of the children in Evaluation 1, kappa 0.88-0.93 and in 21% in Evaluation 2, kappa 0.63-0.84. The examiners disagreed on a higher proportion of the children when all information on the injury was available (P < 0.001). CONCLUSION: Demarcated enamel opacities were the most common defects in permanent successors. Although the inter-examiner agreement was good, the results indicated that recordings of enamel disturbances following trauma is associated with uncertainty.
UNLABELLED: Trauma to primary teeth may cause mineralization disturbances in the permanent successors. OBJECTIVE: To study the distribution and type of enamel defects in permanent incisors after trauma to primary teeth and to examine inter-observer agreement when registrations were based on photographs. MATERIAL AND METHODS: Of 266 children who suffered an oral injury to primary teeth in one county of Norway in 2003, 193 were included in a follow-up study to record enamel defects in the permanent successors 7 years later (age, 8-15 years). Clinical examination and intraoral photographs were undertaken by the principal investigator. The photographs were evaluated twice for enamel defects by three paediatric dentists. Evaluation 1: age at the time of injury, traumatized teeth and diagnoses were kept unknown to the examiners. Evaluation 2: age and trauma diagnoses were known to the examiners. Inter-observer agreement was calculated using Cohen's kappa and chi-square test. RESULTS: Of 338 successor teeth, 42% exhibited enamel defects. In neighbouring teeth (339) with non-injured predecessors, 30% were registered with defects. The most common enamel disturbance in successors was demarcated opacities, recorded in 18% of the teeth. Enamel defects owing to a previous trauma were registered in 37% of the children in Evaluation 1, kappa 0.88-0.93 and in 21% in Evaluation 2, kappa 0.63-0.84. The examiners disagreed on a higher proportion of the children when all information on the injury was available (P < 0.001). CONCLUSION: Demarcated enamel opacities were the most common defects in permanent successors. Although the inter-examiner agreement was good, the results indicated that recordings of enamel disturbances following trauma is associated with uncertainty.