Crown fractures in the permanent dentition among children and adolescents during the COVID-19 pandemic

This retrospective study analyzed crown fractures in the permanent dentition among pediatric patients attending the Pediatric Dentistry Department, Medical University of Warsaw, during the COVID-19 lockdown. Data from 1582 medical records were reviewed, and 56 patients (mean age 9.4 years, SD 25.3) with 74 crown fracture cases were included. Traumatic dental injuries (TDIs) accounted for 14.7% (233/1582) of cases, with crown fractures constituting 42.9% (100/233). The mean time interval before patient presentation was 0.4 days (SD 0.63). Falls (51.8%) were the most common cause of injury, with most incidents occurring at home (32.1%). The maxillary central incisors were most frequently affected (86.0%), and concomitant soft tissue injuries were observed in 33.9% of cases. Complicated crown fractures (CCFs) were most often treated with Root Canal Treatment (RCT) (37.5%) and had a lower success rate compared to uncomplicated crown fractures (UCFs) (37.5% vs. 70.7%; p < 0.05). Composite restorations achieved the highest success rate (70.0%) compared to reattachment (33.3%) and glass-ionomer cement (16.7%) (p < 0.05). A significant difference in the time interval between dental injury and dental examination was observed between successful and unsuccessful cases (p < 0.05). The most common complication was loss of pulp vitality, occurring in 27.3% of CCFs and 70.5% of UCFs (p < 0.05). The findings highlight the impact of the COVID-19 pandemic on TDIs, including the increased occurrence of injuries at home and the challenges of timely access to dental care. These results underscore the importance of prompt and appropriate management to improve treatment outcomes during unprecedented circumstances like the pandemic. The study underlines the importance of maintaining dental emergencies in order to facilitate support mechanisms for patients, management strategies for dental professionals, and appropriate allocation of resources. Dental management of crown fractures should follow recent clinical guidelines. Awareness and knowledge concerning dental injuries are insufficient and should be improved.