Facial Trauma among Children and Adolescents Victims of Traffic Accidents

Research Article

J Dent App. 2015; 2(8): 282-286.

Facial Trauma among Children and Adolescents Victims of Traffic Accidents

Lima MMSM¹, Bernardino íDM¹, Ferreira AVP¹, Barbosa KGN², Nóbrega LM¹ and Avila S¹*

¹Departament of Dentistry, State University of Paraíba, Brazil

²Departament of Dentistry, Federal University of Minas Gerais, Brazil

*Corresponding author: Sérgiod’Avila, Department of Dentistry, State University of Paraíba, Campina Grande, Brazil

Received: April 08, 2015; Accepted: September 10, 2015; Published: September 12, 2015


Introduction: In the literature there are several studies on facial trauma, but the epidemiology of these lesions is not well characterized regarding children and adolescents. Therefore, this study aimed to identify the prevalence of facial trauma among Brazilian children and adolescents victims of traffic accidents.

Materials and Methods: A cross-sectional study was performed from 196 reports of children and adolescents undergoing forensic examination for a period of four years in a Forensic Unit located in a metropolitan area of Northeast Brazil. The statistical analysis included the calculation of absolute frequencies and percentages of the variables and a chi-square test (p<0.05) in order to identify possible associations.

Results: A total of 21.1% of the victims had facial trauma. The average age of victims was 13.23 (SD = 4.77). Most of the victims were male (68.4%), belonging to the age group 12-18 years (69.9%) from rural areas (56.5%). The most common type of traffic accident was motorcycle accident (52.6%), mainly occurring during the day (55.8%) and during weekdays (72.5%). Trauma cases prevailed in lower limbs (36.1%), followed by multiple trauma cases (33.0%). Moreover, the majority of facial trauma was in soft tissue areas (63.4%) and in more than one third of the face (50.0%). The presence of facial trauma was associated with the type of accident (p = 0.030) and the time of day (p = 0.012).

Conclusions: Most victims were adolescents; most cases occurred during weekdays and motorcycle accidents constituted the main etiologic agent.

Keywords: Traffic Accident; Child; Adolescent


Despite the initiatives in different regions of the world aimed at preventing injuries and deaths from traffic accidents, many people fall victim every day, making traffic accidents a major public health issue that needs to be addressed through a multidisciplinary approach [1-3].

The epidemiology of facial fractures in pediatric and adolescent patients differs among countries, and these differences are strongly influenced by social, environmental, educational and cultural factors [4-7]. In addition, the occurrence of traffic-related trauma may vary greatly from birth to late adolescence due to the gradual increase in body resistance or even by several types of impact to which the individual is vulnerable in different age groups [8].

Facial trauma may occur in isolation or in combination with other serious injuries such as intracranial lesions, lesions of the spine and lower limbs and although its occurrence among children and adolescents is generally lower if compared to the adult age group, it may have different clinical and epidemiological characteristics [5, 6, 9].

The face involves hard and soft tissues extending superiorly from the frontal bone and inferiorly to the jaw. It is one of the most exposed regions of the body to trauma capable of causing lesions in skeleton components, teeth and the soft tissues of the face [10].

Although in the literature there are several studies on facial trauma, the epidemiology of these lesions is not well characterized regarding children and adolescents [11]. Data on the distribution of traumas resulting from traffic accidents and their consequences are vital, as they help in planning and improving health care systems and social support systems, as well as in the implementation of public health laws and initiatives in order to prevent and/or reduce the number of deaths and disabilities resulting from traffic accidents [7,8,12,13].

Moreover, in view of the possibility of verifying changes in tendencies and complexities of maxillofacial trauma among children and adolescents, this study aimed to identify the prevalence of facial trauma in Brazilian children and adolescent’s victims of traffic accidents.

Materials and Methods

The study consisted of a cross-sectional and census type study, conducted from secondary data from children and adolescents who sought a Forensic Medical Service to perform “corpus delicti” examination in order to record the extent of injuries caused by the events. The analyzed reports related to living people, from the age group 0-18 years, both sexes, living in urban or rural areas of a metropolitan region located in northeastern Brazil, which has a population close to 687, 545 inhabitants.

All reports of individuals who have had some kind of body or facial trauma recorded in the four-year period (January 2008 to December 2011) due to non-fatal land transport accidents were included. Institution’s employees who, at the time of the examination, were legal experts filled these reports.

To organize the information, a form has been structured and divided in two parts according to the information provided in reports of victims. It consisted of a first identificatory part and a second part covering information related to the accident event. Prior to the survey, a pilot study was conducted and calibration procedures, aiming to verify possible faults or errors, were made.

The age of the victims was categorized according to the Brazilian Statute for Children and Adolescents, which recognizes a child as an individual who has up to twelve incomplete years, and a teenager as an individual who has between twelve and eighteen years [14]. Other variables related to victims were categorized as follows: sex (male/ female) and region of residence (urban/rural). The variables related to accidents were type of accident (car/motorcycle/ trampling), day of the week in which the event occurred (weekdays /weekend) and time of occurrence (day/night). Variables related to trauma presented by victims were presence of facial trauma (yes/no), affected region of the body (head/face/neck/arm/leg/chest/abdomen/more than one), type of facial trauma (lesions in soft tissues/bone fracture/dentoalveolar fracture) and area of the face affected (upper third/middle third/lower third/more than one third).

Absolute and percentage frequencies of the studied variables were calculated and then a chi-square test (p<0.05) was made in order to investigate possible associations between the presence/absence of facial trauma (dependent variable) and variables related to the characteristics of victims and accidents (independent variables). The adopted confidence interval was 95%.

This study followed national and international standards on ethics in research with human beings and it was approved by the ethics committee of independent research (No. 0652.0.133.203-11). The recommendations highlighted in the “STROBE Statement” [15] were complied.


196 reports were evaluated. Of this total, 59 were children aged 0-11 years and 137 were adolescents aged 12-18 years. The average age of the victims was 13.23 (SD = 4.77) and the ratio of male and female individuals was 2.16:1.

Table 1 shows absolute and percentage distributions of data related to sociodemographic characteristics of victims. It was found that cases of males (68.4%), in the 12-18 years age group (69.9%), resident in rural areas (56.5%), prevailed.