Paediatric Maxillofacial Trauma: An Integrated Approach to Imaging, Dental Care, and Therapeutic Management

Saad Ali Awad Al-Anazi (1), Itedal Yousef Ahmed Al-Butyan (2), Sokaina Yousef Al-Butyan (3), Zahra Saud Al-Faraj (4), Talal Hamoud Alhazmi (5), Ghaith Abdullah Al-Sumait (6), Khloud Abdulrahman Alhassan Alhafaf (7), Abdulrahman Yahya Ali Nukhayfi (8)
(1) Ministry Of Health, Saudi Arabia,
(2) Al Jabr Eye & ENT Hospital, Ministry of Health, Saudi Arabia,
(3) Al-Jafar General Hospital – Ministry of Health, Saudi Arabia,
(4) North Riyadh Dental Complex – Ministry of Health, Saudi Arabia,
(5) Jazan Health Cluster (Al-Aidabi Primary Health Care Centre) – Ministry of Health, General Dentistry, Saudi Arabia,
(6) King Abdullah bin Abdulaziz University Hospital, Hospital administration, Ministry of Health, Saudi Arabia,
(7) Damad General Hospital – Jazan, Ministry of Health, Saudi Arabia,
(8) Primary Health Care Center in Sharq Warqh – Jazan, Health Care Security, Ministry of Health, Saudi Arabia

Abstract

Background: Paediatric maxillofacial trauma is a significant source of morbidity in children, occurring during critical periods of craniofacial growth. Its incidence is rising in many developing nations due to factors like increased motorization and interpersonal violence. Managing these injuries is complex due to the unique anatomical and developmental considerations of the paediatric facial skeleton.


Aim: This study aimed to characterize the epidemiology, injury patterns, and management outcomes of paediatric maxillofacial trauma in a cohort of 225 patients over a five-year period (2017-2022), and to compare findings with existing international literature.


Methods: A detailed observational study was conducted, analyzing demographic data, mechanisms of injury, clinical presentation, and treatment modalities. Statistical analyses, including chi-square tests, were used to identify significant associations between variables such as age, cause of injury, and injury type.


Results: The study found a male predominance (2:1 ratio) and identified self-fall (45%) as the most common cause. A significant finding was that 40% of patients experienced loss of consciousness, highlighting associated head injury risks. Soft-tissue injuries (58%) were most frequent, followed by dentoalveolar (30%) and mandibular fractures (20%). Conservative management was employed in 86% of cases, while open reduction and internal fixation (ORIF) was the primary surgical approach (62% of operative cases). Significant statistical associations were found between patient age and the cause of injury, as well as the type of soft- and hard-tissue injuries sustained.


Conclusion: The findings underscore the need for a vigilant, multidisciplinary approach that includes prompt neurological assessment, addresses delays in presentation, and employs age-specific, often conservative, management strategies to preserve long-term craniofacial growth and function.

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References

1. Gassner R, Tuli T, Hächl O, Moreira R, Ulmer H Craniomaxillofacial trauma in children: A review of 3,385 cases with 6,060 injuries in 10 years. J Oral Maxillofac Surg 2004;62:399–407.

2. Mukhopadhyay S, Galui S, Biswas R, Saha S, Sarkar S Oral and maxillofacial injuries in children: A retrospective study. J Korean Assoc Oral Maxillofac Surg 2020;46:183–90.

3. Ibrahim A, Abdalla SM, Jafer M, Abdelgadir J, de Vries N Child labor and health: A systematic literature review of the impacts of child labor on child's health in low- and middle-income countries. J Public Health (Oxf) 2019;41:18–26.

4. Okoje VN, Alonge TO, Oluteye OA, Denloye OO Changing pattern of pediatric maxillofacial injuries at the accident and emergency department of the university teaching hospital, Ibadan –A four-year experience. Prehosp Disaster Med 2010;25:68–71.

5. Eggensperger Wymann NM, Hölzle A, Zachariou Z, Iizuka T Pediatric craniofacial trauma. J Oral Maxillofac Surg 2008;66:58–64.

6. Kundal VK, Debnath PR, Sen A Epidemiology of pediatric trauma and its pattern in Urban India: A tertiary care hospital-based experience. J Indian Assoc Pediatr Surg 2017;22:33–7.

7. Sharma M, Lahoti BK, Khandelwal G, Mathur RK, Sharma SS, Laddha A Epidemiological trends of pediatric trauma: A single-center study of 791 patients. J Indian Assoc Pediatr Surg 2011;16:88–92.

8. Macwan CS, Deshpande AN Unfolding the hidden facts of paediatric maxillofacial trauma. J Clin Diagn Res 2014;8:E01–2.

9. Bede SY, Ismael WK, Al-Assaf D Patterns of pediatric maxillofacial injuries. J Craniofac Surg 2016;27:e271–5.

10. Rogan DT, Ahmed A Pediatric Facial Fractures. StatPearls StatPearls Publishing 2023 Available form: http://www.ncbi.nlm.nih.gov/books/NBK563256/

11. Iyer J, Hariharan A, Cao UM, Tran SD Acquired facial, maxillofacial, and oral asymmetries –A review highlighting diagnosis and management. Symmetry 2021;13:1661.

12. Braun TL, Xue AS, Maricevich RS Differences in the management of pediatric facial trauma. Semin Plast Surg 2017;31:118–22.

13. Bhutia DP, Singh G, Mohammed S, Ram H, Gamit J, Howlader D Prevalence and etiology of pediatric maxillofacial injuries: A unicenter-based retrospective study. Int J Clin Pediatr Dent 2019;12:528–31.

14. Vujcich N, Gebauer D Current and evolving trends in the management of facial fractures. Aust Dent J 2018;63 Suppl 1 S35–47.

15. Patel S, Saberi N, Pimental T, Teng PH Present status and future directions: Root resorption. Int Endod J 2022;55 Suppl 4 892–921.

16. Singh RB, Prakash JV, Chaitan SN, Tandur PS, Kokate S Maxillofacial injuries in the pediatric patient: An overview. World J Dent 2012;2:77–81.

17. Lalwani S, Hasan F, Khurana S, Mathur P Epidemiological trends of fatal pediatric trauma: A single-center study. Medicine (Baltimore) 2018;97:e12280.

18. Cintean R, Eickhoff A, Zieger J, Gebhard F, Schütze K Epidemiology, patterns, and mechanisms of pediatric trauma: A review of 12,508 patients. Eur J Trauma Emerg Surg 2023;49:451–9.

19. Yue JK, Krishnan N, Andrews JP, Semonche AM, Deng H, Aabedi AA, et al. Update on pediatric mild traumatic brain injury in rural and underserved regions: A global perspective. J Clin Med 2023;12:3309.

20. Momeni Z, Afzalsoltani S, Moslemzadehasl M Mothers'knowledge and self-reported performance regarding the management of traumatic dental injuries and associated factors: A cross-sectional study. BMC Pediatr 2022;22:665.

21. Garg K, Sharma R, Gupta D, Sinha S, Satyarthee GD, Agarwal D, et al. Outcome predictors in pediatric head trauma: A study of clinicoradiological factors. J Pediatr Neurosci 2017;12:149–53.

22. Sharma M, Pandey S, Kumar P, Singh K, Kumar P, Jha RP Epidemiological and clinico-radiological evaluation of head injury in pediatric population. J Pediatr Neurosci 2020;15:386–92.

23. Rogan DT, Fang A Pediatric Facial Trauma. StatPearls StatPearls Publishing 2023 Available form: http://www.ncbi.nlm.nih.gov/books/NBK558932/

24. Hofmann E, Koerdt S, Heiland M, Raguse JD, Voss JO Pediatric maxillofacial trauma: Insights into diagnosis and treatment of mandibular fractures in pediatric patients. Int J Clin Pediatr Dent 2023;16:499–509.

Authors

Saad Ali Awad Al-Anazi
aylbutyan@moh.gov.sa (Primary Contact)
Itedal Yousef Ahmed Al-Butyan
Sokaina Yousef Al-Butyan
Zahra Saud Al-Faraj
Talal Hamoud Alhazmi
Ghaith Abdullah Al-Sumait
Khloud Abdulrahman Alhassan Alhafaf
Abdulrahman Yahya Ali Nukhayfi
Al-Anazi, S. A. A., Itedal Yousef Ahmed Al-Butyan, Sokaina Yousef Al-Butyan, Zahra Saud Al-Faraj, Talal Hamoud Alhazmi, Ghaith Abdullah Al-Sumait, … Abdulrahman Yahya Ali Nukhayfi. (2025). Paediatric Maxillofacial Trauma: An Integrated Approach to Imaging, Dental Care, and Therapeutic Management. Saudi Journal of Medicine and Public Health, 2(2), 1399–1407. https://doi.org/10.64483/202522293

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