Urinary catecholamine levels and incidence of dentofacial injuries in children: a 2-year prospective study.

Urinary catecholamines have been used to measure emotionally stressful states which may have an impact on dentofacial injuries. This prospective study investigated the hypothesis that urinary catecholamines such as epinephrine, norepinephrine and dopamine do not affect significantly the incidence of dentofacial injuries in children. As a test of this hypothesis 204 children, males and females, aged 8 to 10 years, were included in the study. After a first examination, each subject was re-examined, at one-year intervals, over a period of two years. Dentofacial injuries were recorded by a clinical examination and a questionnaire. Three 24-h urine samples, with an interval of one year between each, were collected and analyzed by the high performance liquid chromatography technique to assay the catecholamine content. Socio-economic factors were recorded by a questionnaire. Using the panel of data collected, the logistic multiple regression model was employed to test whether the incidence of dentofacial injuries was affected by the studied variables. The 95% probability level was used. Specificity and sensitivity as well as the positive and negative predictive rates were computed. The results showed that epinephrine had a significant correlation with the incidence of dentofacial injuries. Other factors found to have a significant impact were child's age and gender. The values of sensitivity and specificity were 81% and 69% respectively, while the positive and negative predictive rates were 68% and 82% respectively. The data, therefore, provided evidence that emotionally stressful states measured by the urinary catecholamines were prominent etiologic factors of dentofacial injury.