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PEDO Midterm (Fall) > 8. Oral Trauma > Flashcards

8. Oral Trauma Flashcards

1
Q

Most frequently injured teeth in the primary dentition are

A

maxillary primary incisors

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2
Q

Peak age of injury to primary teeth is

A

2-4 years (learning to walk)

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3
Q

Primary molars are commonly injured by _ trauma

A

indirect trauma (i.e a blow to the underside of the chin cuasing the mandible to strike the maxilla)

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4
Q

_% of abused children suffer injuries to the head and neck

A

50

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5
Q

Cardinal signs of child abuse are

A
  • Injuries with various stages of healing
  • Torn Labia frenum
  • Repeated injuries
  • Clinical presentation doesn’t match history from parents
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6
Q

What is the triangle of saftey

A
  • Ears
  • Side of face
  • neck
  • Top of shoulders
  • *Accidental injuries here are unusual**
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7
Q

Look at slide 4 diagram

A

ok

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8
Q

Tetanus protection is especially important if the patient’s wound is

A

dirty

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9
Q

Tetanus is caused by what

A

a toxin (tetanospasmin) made by clostridium tetani

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10
Q

Tetanus vaccine is a series of _ injections and what are the time frames

A

5

  • 2 mons
  • 4 months
  • 6 mo
  • 15-18 mo
  • 4-6 years
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11
Q

What is the name of the tetanus vaccine and what does the name stand for

A

DTap

  • Diptheria
  • tetanus
  • Pertussis
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12
Q

tetanus boaster with _ (name of vaccine) is required ever - years

A

Tdap (instead of DTaP)

-11-12 yrs

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13
Q

Define infraction

A

Incomplete fracture of enamel without loss of tooth structure

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14
Q

Presence of (mobility/tenderness to percusion) with infraction

A

none

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15
Q

Tx for infrraction

A

none

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16
Q

Define enamel fracture

A

-fracture restricted to enamel (loss of tooth structure)

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17
Q

Any damage to the neurovascular supply or permanent tooth germ with enamel fracture

A

no

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18
Q

Tx for enamel fracture

A

smooth sharp edges

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19
Q

Crown root fracture without pulpal involvement involves what tooth structures

A

enamel, dentin, and cementum

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20
Q

Crown root fracture is complicated or uncomplicated

A

Can be either depending if there is pulpal involvement

  • Pulpal involvement= complicated
  • no pulpal involvement= uncomplicated
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21
Q

For a crown root fracture there are two fragments- one of which is

A

mobile

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22
Q

What is the treatment for a crown- root fracture without pulpal involvement

A

Depends on the restorability of the mobile tooth fracture

  • If large and restorable then remove the mobile fragment and place a coronal restoration on the immobile fragment
  • If unrestorable then extract both fragments
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23
Q

What is the treatment for a crown- root fracture with pulpal involvement

A
  • If large and restorable then remove the mobile fragment, pulp therapy for immobile fragment, place a coronal restoration on the immobile fragment
  • If unrestorable then extract both fragments
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24
Q

Is there any damage to the neurovascular supply and the permenant tooth bud with a enamel dentin fracture

A

no

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25
Q

Treatment for enamel dentin fracture

A
  • Seal dentin with GI
  • Fractures exposing dentin in primary teeth have no deleterious effect on the pulp and need not be covered
  • Consider restoration for large loss of tooth structure
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26
Q

When there is a fractured tooth and soft tissue laceration what should you do

A

take an X-ray make sure the tooth isn’t in the soft tissue

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27
Q

Exposure time for this soft tissue X-ray is _% the usual exposure for an intra-oral image

A

25

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28
Q

What are the treatment options for an enamel dentin pulp fracture

A

pulpotomy
pulpectomy
exo

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29
Q

Contraindications for a pulpotomy

A
  • Internal/external root resorption

- infection of the crypt of the succedaneous tooth

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30
Q

Inflammation and overinstrumentation can have when effect on the permenant successors

A

mild enamel defects

31
Q

Contraindications for a pulpotomy

A
  • Swelling of pulpal origin
  • Fistula
  • Pathologic mobility
  • Pathologic external root resorption
  • Internal root resorption
  • Periapical or interradicular radiolucency
  • Pulp calcifications
  • Excessive bleeding from the amputated radicular stumps
  • *Need at least 2/3 root remaining
  • *Other signs to be cautious of are spontaneous or nocternal pain. Pain to percussion and palpation
32
Q

For a concussion the tooth (is/is not) mobile and (is/is not) displaced

A

is not for both

33
Q

Is there sulcular bleeding with a concussion

A

no

34
Q

Describe a concussion

A
  • Tender to percussion
  • No mobility
  • No displacement
35
Q

Treatment for concussion

A

none

36
Q

Describe subluxation

A
  • Sensitive to percusion
  • Mobile
  • No displacement
  • Sulculas bleeding
37
Q

Treatment for subluxation

A

none

  • Soft diet for limited time
  • Good OH to prevent PDL contamination
  • 0.12% chlorhexidine applied to area with cotton swab for one week
38
Q

Most poeple often do not notice when concussion or subluxation occurs unless _ happens

A

tooth discoloration

39
Q

What events lead to coronal discoloration

A

-Capillaries in the pulp –> hemorrhage –> blood pigments deposited in dentinal tubules

40
Q

T/F Color change along indicates the tooth should recieve pulp therapy

A

f

41
Q

When should a discolored tooth recieve pulp therapy

A

Additional symptoms of infection such as….

  • Periapical pathology
  • Swelling
  • Pathologic mobility
  • fistula
  • Pain
42
Q

What are the three colors of coronal discoloration

A

pink-red
yellow
dark (gray-black-brown)

43
Q

Pink tooth discoloration be secondary to…

A

internal resorption in the pulp chamber

44
Q

What is the treatment for coronal discoloration

A

follow up and monitor for symptoms of infection

45
Q

Yellow discoloration suggests

A

partial or complete pulp obliteration (calcific metamorphosis of the dental pulp, progressive canal calcification, dystrophic calcification)

46
Q

Yellow discoloration (PCO) has a (good/bad) prognosis

A

good

47
Q

T/F: PCO can be seen radiographically without yellow discoloration

A

t

48
Q

Tx of PCO

A
  • Pathologic process but no deleterious effects
  • Usually undergoes normal root resorption
  • No Tx unless evidence of necrosis
49
Q

How does the dark coronal discoloration ever come about

A

hemorrhage of pulp –> RBC lysis and releases hemoglobin. Fe in iron stains tooth dark

50
Q

The dark pigments may be eliminated if…

A

the pulp remains vital (tooth will remain discolored if non-vital)

51
Q

Over _% of dark discolored primary incisors will remain without X-ray and clinical pathology

A

70%

52
Q

What is the treatment for dark tooth discoloration

A

Same for the other discoloration

  • watch for symptoms
  • signs of necrosis –> pulp therapy/exo
53
Q

(T/F) There is no difference in the fate of the permenant successors with pulp therapy discolored untreated and RCT teeth

A

t

54
Q

What is avulsion

A

tooth is completely out of the socket

55
Q

About _% of avulsions results in damage to the successor for a primary incisor

A

75

56
Q

Reimplantation of a primary tooth (is/is not) recommended and why

A

Is not because you can damage the permenant tooth

**Some people will replant with 2-3 mm of the root apex shaved of

57
Q

In avulsion if the tooth is not present what must you rule out and how

A

aspiration- chest X-ray

58
Q

What patients require antibiotic prophylaxis before dental treatment

A
  • Artificial heart valves
  • Infective endocarditis
  • Cardiac transplant
  • Congenital heart condition
    • Unrepaired or incomplete repair
    • During the 1st 6 months after a procedure
    • Residual defect
59
Q

Intrusive luxation often leads to what other complication

A

fracture of alveolar socket (labial bone)

-Rupture of the neurovascular supply

60
Q

Which orientation for intrusive luxation is more favorable and why

A

labial intrusion of the root because the tooth germ will not be affected
(Palatal intrusion –> toward the permanent tooth)

61
Q

When the root is intruded in the labial direction this means the crown will be inclined in what direction

A

lingual

62
Q

Radiographically how can you determine the direction of intrusion

A

Look at the adjacent tooth and the tooth of interest

  • If the tooth of interest appears foreshortened relative to the adjacent tooth then the root was labially displaced (permanent successor at minimal risk)
  • If the tooth appears elongated the root was intruded in the palatal direction (permanent tooth at risk)
63
Q

What is the tx for a tooth whos root was intruded in the palatal direction

A

exo

64
Q

_% of intruded teeth are pushed labially

A

80%

65
Q

Tx for labaially intruded teeth

A

majority will re-erupt and survive > 36 months

  • Thus tx is observe for re-eruption
  • Radiographic follow up is recommeneded until the permenant successor erupts
66
Q

Intruded primary teeth with have (vital/non-vital pulps)

A

vital **unlike permenant teeth

67
Q

T/F The tooth can discolor after intrusion

A

t (watch for symptoms of infection)

68
Q

What is extrusion

A
  • Partial displacement of the tooth out of its socket
  • Increased mobility
  • Sensitive to percussion and palpation
  • Gingival sulcus bleeding
  • No damage to permanent tooth germ
  • Severance of neurovascular supple
  • Separation of the PDL space and coronal exposure
69
Q

What are the radiographic signs of extrusion

A

widening of PDL around the apex

70
Q

The higher the chances of pulp necrosis and severance of neurovascular supply the…

A

more the tooth is out of the alveolar socket

71
Q

Minor extrusion is defiend as

A

< 3mm

72
Q

What is the treatment for a minor extrusion

A

careful reposition or spontaneous alignment

73
Q

What is the treatment for a severe extrusion

A

exo (LA necessary!!)

74
Q

T/F Coronal discoloration may occur with extrusion

A

t

PEDO Midterm (Fall) (8 decks)

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