{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:55:26Z","timestamp":1791478526371,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Dental Traumatology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background\/Aims<\/jats:title>\n Traumatic dental injuries (TDIs) frequently present with acute symptoms, yet many adverse outcomes manifest months or years later as medium\u2010 and long\u2010term consequences. These sequelae, such as pulp necrosis with infection of root canal system, periapical radiolucency, and external inflammatory resorption, pose significant diagnostic and therapeutic challenges. Evidence describing such healing complications as the first presenting complaint remains limited. The aim of this study was to describe the pattern of such complications in children and adolescents reporting to a tertiary care hospital and to evaluate associated patient\u2010 and injury\u2010related factors.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A hospital\u2010based cross\u2010sectional study was conducted on patients aged 6\u201318\u2009years presenting with a history of TDI to permanent teeth and exhibiting clinical and\/or radiographic signs of medium\u2010 and long\u2010term complications. Standardized assessment protocols were followed, including NA0D classification for injury type, Miller's criteria for mobility, thermal and electric pulp testing for pulp sensibility, and radiographic evaluation using RVG and CBCT when indicated. Medium\u2010 and long\u2010term consequences were categorized using established criteria. Statistical analysis included Student's\n t<\/jats:italic>\n \u2010test and ordered logistic regression.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 185 participants (218 teeth) were evaluated. Maxillary central incisors were most frequently affected (39.9%). The predominant injuries were enamel\u2010dentin fractures (43.1%) and complicated crown fractures (41.3%). The most common medium\u2010 and long\u2010term consequences were periapical radiolucency (90.3%), pulp necrosis with infection of root canal system (77.1%), and external inflammatory resorption (67.4%). Delay in reporting showed significant associations with discoloration, tenderness on percussion, and external inflammatory resorption (\n p<\/jats:italic>\n \u2009<\u20090.01). Type of injury was significantly associated with multiple complications. Root maturity and age showed limited association.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Medium\u2010 and long\u2010term complications of TDIs predominantly involved pulp necrosis with infection of root canal system, apical pathology, and external inflammatory resorption. Longer delays in seeking care significantly increased the likelihood of adverse outcomes. The findings highlight the need for improved awareness, early emergency management, and future research focusing on combined injury patterns to better predict long\u2010term prognosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/edt.70112","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:56:46Z","timestamp":1786510606000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Descriptive Evaluation of Medium\u2010 and Long\u2010Term Complications of Traumatic Dental Injuries in Children and Adolescents Reporting to a Tertiary Care Hospital"],"prefix":"10.1111","author":[{"given":"Shailja","family":"Srivastava","sequence":"first","affiliation":[{"name":"Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6747-5110","authenticated-orcid":false,"given":"Nitesh","family":"Tewari","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India"},{"name":"Division of Paediatric Dentistry, Department of Dental Medicine Karolinska Institutet Huddinge Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2710-1894","authenticated-orcid":false,"given":"Vijay Prakash","family":"Mathur","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-8857","authenticated-orcid":false,"given":"Morankar","family":"Rahul","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4503-5234","authenticated-orcid":false,"given":"Kalpana","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research All India Institute of Medical Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5361-5840","authenticated-orcid":false,"given":"Georgios","family":"Tsilingaridis","sequence":"additional","affiliation":[{"name":"Division of Paediatric Dentistry, Department of Dental Medicine Karolinska Institutet Huddinge Sweden"},{"name":"Center of Pediatric Oral Health Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/edt.12389","article-title":"World Traumatic Dental Injury Prevalence and Incidence: A Meta\u2010Analysis\u2014One Billion Living People Have Had Traumatic Dental Injuries","volume":"34","author":"Petti S.","year":"2018","journal-title":"Dental Traumatology"},{"issue":"3","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1034\/j.1600-9657.2002.00079.x","article-title":"Effect of Treatment Delay Upon Pulp and Periodontal Healing of Traumatic Dental Injuries: A Review Article","volume":"18","author":"Andreasen J. O.","year":"2002","journal-title":"Dental Traumatology"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/adj.12395","article-title":"Epidemiology and Outcomes of Traumatic Dental Injuries: A Review of the Literature","volume":"61","author":"Lam R.","year":"2016","journal-title":"Australian Dental Journal"},{"issue":"5","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/edt.12099","article-title":"Analysis of Pulp Prognosis in 603 Permanent Teeth With Uncomplicated Crown Fracture With or Without Luxation","volume":"30","author":"Wang C.","year":"2014","journal-title":"Dental Traumatology"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","DOI":"10.1155\/2021\/9549508","article-title":"Evaluation of Clinical and Radiographic Findings Among Patients With Traumatic Dental Injuries Seeking Delayed Treatment","volume":"2021","author":"Chaudhary S.","year":"2021","journal-title":"International Journal of Dentistry"},{"issue":"7","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0099-2399(06)80977-5","article-title":"Evaluation of the Effect of Delayed Management of Traumatized Permanent Teeth","volume":"21","author":"Saad Al\u2010Nazhan S.","year":"1995","journal-title":"Journal of Endodontics"},{"issue":"1","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/edt.13008","article-title":"Non\u2010Surgical Endodontic Management of Large Periapical Lesions After Traumatic Dental Injuries","volume":"41","author":"Tewari N.","year":"2025","journal-title":"Dental Traumatology"},{"issue":"4","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/edt.12574","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: General Introduction","volume":"36","author":"Levin L.","year":"2020","journal-title":"Dental Traumatology"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/edt.12578","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations","volume":"36","author":"Bourguignon C.","year":"2020","journal-title":"Dental Traumatology"},{"issue":"4","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/edt.12573","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth","volume":"36","author":"Fouad A. F.","year":"2020","journal-title":"Dental Traumatology"},{"issue":"1","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/edt.13018","article-title":"Management of Complications in Dental Traumatology","volume":"41","author":"Gregorio C.","year":"2025","journal-title":"Dental Traumatology"},{"issue":"3","key":"e_1_2_12_13_1","first-page":"273","article-title":"Luxation of Permanent Teeth due to Trauma: A Clinical and Radiographic Follow\u2010Up Study of 189 Injured Teeth","volume":"78","author":"Andreasen J. 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