Correlation of Clinical Presentation with Histopathological and Forensic Findings of Oral-Maxillofacial Injuries in Pediatric Abuse

Authors

  • Hadiya Sibghatullah
  • Amna Zafar
  • Haya Afzal Memon
  • Sohail Rasool
  • Bushra Sajid
  • Barrira Masood

DOI:

https://doi.org/10.63682/jns.v14i33S.10014

Keywords:

Child abuse, Pediatric orofacial trauma, Intraoral injuries, Histopathological analysis, Forensic dentistry

Abstract

Introduction: Child abuse is a major public health issue, with oral and maxillofacial injuries frequently serving as early indicators of physical maltreatment. Accurate identification of these injuries is essential for timely intervention and legal documentation.

Methods: A prospective observational study was conducted on 50 pediatric cases suspected of abuse in a tertiary care hospital of Pakistan from July 2025 to June 2025. Patients were evaluated for type, location, and severity of oral-maxillofacial injuries. Histopathological examination was performed on tissue samples where applicable, and forensic assessments were correlated with clinical findings to identify patterns indicative of inflicted trauma.

Results: Specific injury patterns were identified, including lingual lacerations, palatal hematomas, and subperiosteal fractures. These injuries showed strong correlation with histopathological markers of blunt force trauma and forensic indicators consistent with non-accidental injury. Multidisciplinary evaluation improved the accuracy of detecting abuse and supported objective legal documentation.

Conclusion: Integrating clinical, histopathological, and forensic assessments enhances early recognition of child abuse in cases presenting with oral-maxillofacial trauma. This approach facilitates timely protective interventions and strengthens medicolegal reporting, underscoring the importance of a coordinated multidisciplinary evaluation in suspected pediatric abuse

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References

[1] George CL, Theesfeld SS, Wang Q, Hudson MJ, Harper NS. Identification and characterization of Oral injury in suspected child abuse cases: one health System's experience. Pediatric emergency care. 2021 Oct 1;37(10):494-7.

[2] McMahon P, Grossman W, Gaffney M, et al. Soft-tissue injury as an indication of child abuse. J Bone Joint Surg Am. 1995;77(8):1179–1183.

[3] American Academy of Pediatrics. Oral and dental aspects of child abuse and neglect: clinical report. Pediatrics. 2024;154(3):e2024068024.

[4] Naidoo S. A profile of the oro-facial injuries in child physical abuse at a children’s hospital. Child Abuse Negl. 2000;24(4):521–534.

[5] Maguire S, Hunter B, Hunter L, et al. Diagnosing abuse: a systematic review of torn frenum and other intra-oral injuries. Arch Dis Child. 2007;92(12):1113–1117.

[6] Orgera K, et al. Identification and characterization of oral injury in suspected child abuse cases: experience from a pediatric emergency care setting. Pediatr Emerg Care. 2021;37(10):494–497.

[7] Barbi W, Sonawane RS, Singh P, Kumar S, Ravi Kumar B, Arora A. Evaluation of the orofacial features in victims of abuse and neglect of 5–16-year-old children. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1705–S1708.

[8] Canty KW, Mercier E, Shearer E, Peréz‐Rosselló J, Lawlor CM, Wilson CR. Oral and Oropharyngeal Manifestations of Child Abuse: A State‐of‐the‐Art Review. Otolaryngology–Head and Neck Surgery. 2025 Dec;173(6):1359-70.

[9] Agbeno EK. Dental Trauma Patterns in African Children: A 5-Year Retrospective Study. International Journal of Dental Sciences & Research. 2024 Jun 2:26-63.

[10] Tate AR, Fisher-Owens SA, Spiller L, Muhlbauer J, Lukefahr JL. Oral and Dental Aspects of Child Abuse and Neglect: Clinical Report. Pediatrics. 2024 Sep 1;154(3):e2024068024.

[11] Han H, Koziol‐McLain J, Morse Z, Lees AB, Carrington SD. Enhancing child protection responses in oral health practice: A scoping review of evidence‐based approaches. Child abuse review. 2024 Sep;33(6):e2904.

[12] Håkstad K, Fegran L, Hovden E, Köpp UM. Orofacial signs of child or adolescent maltreatment identified by dentists and dental hygienists: A scoping review. International journal of paediatric dentistry. 2024 May;34(3):285-301.

[13] Sarkar S, Bhattacherjee S, Dasgupta S. Orofacial manifestations of child abuse and neglect: A systematic review. J Oral Maxillofac Pathol. 2021;25(2):321–327.

[14] Suresh S, Reddy KVR, Shalini K. Recognition of child abuse and neglect in dental settings: A narrative review. J Indian Soc Pedod Prev Dent. 2022;40(3):215–221.

[15] American Academy of Pediatric Dentistry. Oral and dental aspects of child abuse and neglect. The Reference Manual of Pediatric Dentistry. Chicago: AAPD; 2023.

[16] Sidebotham P, Brandon M, Bailey S, Belderson P, Dodsworth J, Garstang J, et al. Pathways to harm, pathways to protection: A triennial review of serious case reviews 2017–2019. Child Abuse Rev. 2020;29(5):423–438.

[17] Håkstad K, Fegran L, Hovden E, Köpp UM. Orofacial signs of child or adolescent maltreatment identified by dentists and dental hygienists: A scoping review. Int J Paediatr Dent. 2024;34(3):285–301

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Published

2025-12-15

How to Cite

1.
Sibghatullah H, Zafar A, Afzal Memon H, Rasool S, Sajid B, Masood B. Correlation of Clinical Presentation with Histopathological and Forensic Findings of Oral-Maxillofacial Injuries in Pediatric Abuse. J Neonatal Surg [Internet]. 2025 Dec. 15 [cited 2026 Feb. 20];14(33S):607-11. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10014