Evaluating intrusive injuries in primary dentition from computed tomographic scans: A preliminary report

Context: Children sustaining maxillofacial trauma may undergo computed tomographic (CT) examination to exclude potential complications, which pave way for spread of infection into the meningeal region. Following treatment, these children report for management of their dental injuries as out-patients for which a separate conventional radiographic examination is usually done. The usefulness of the initial maxillofacial CT scan in evaluating dental injuries needs to be assessed so as to possibly avoid children from being subjected to a separate radiographic examination. Aims: The objective of this study was to evaluate the ability of pediatric dentists to assess intrusive injuries in primary dentition from preexisting maxillofacial CT scans of children. Settings and Design: Hospital based cross-sectional study. Subjects and Methods: Among 70 pediatric patients who were admitted following maxillofacial injuries, 10 children underwent CT examination. CT segments displaying the tooth bearing portions of the jaw were reformatted using the Dentascan software and three precalibrated pediatric dentists clinically examined the selected children and with the use of Dentascan based CT sections assessed the relative position of the intruded teeth in relation to the permanent successor and planned treatment for each individual intruded tooth. Statistical Analysis: Fleiss Kappa statistics. Results: There was perfect agreement between the interpretations of all participants (κ = 1.0000, 95% confidence interval = 0.6861-1.3139) and the interpretations of each participant with the "gold standard" evaluator (κ = 1.000). Conclusion: Maxillofacial CT scans made to assess maxillofacial injuries in children can also be reliably used for assessing intrusive injuries in primary dentition.