Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4th yr- CCD2- Trauma Symposium > Acute Management of Dental Trauma > Flashcards

Acute Management of Dental Trauma Flashcards

1
Q

What does TDI stand for

A

Traumatic dental injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a key question we need to ask when I patient comes in with a TDI

A

Ask about head injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When should we send a child to the emergency ward

A

If they suffer from reduced consciousness or blacks out at the time of the accident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When should a head CT be taken following a TDI

A
  1. Suspicion of non accidental injury
  2. Post traumatic seizure with no history of epilepsy
  3. Any suspected open of depressed skull fractures
  4. Any sign of basal skull fractures
  5. Focal or neurological deficits such as change in vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give soem signs of basal skull fractures

A
  1. CSF leakage from ear or nose

2. Battle signs (bruising around the orbit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What approach should we use when examining teeth following TDI

A

Use proformas (tables)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do Proformas allow you to do

A
  1. Record dental information systemically

2. Allow for comparisons chronologically and between different teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Talk through how you’d carry out your examination following a TDI

A

Start outside to inside

  1. Check general appearance
  2. Maxilla and mandible
  3. Skull general
  4. Intra oral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do we look for when taking an intra oral exam

A
  1. Systematic soft tissues
  2. Hard tissues
  3. Check anterior teeth canine to canine
  4. Occlusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give examples of special test we can take to aid diagnosis

A
  1. Mobility
  2. TTP
  3. Transillumnation
  4. Ethyl chloride
  5. Electric Pulp Test
  6. Radiographic report
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does treatment in the acute phase depend on

A
  1. Age of child
  2. Type of injury
  3. Concomitant injuries (most severe first)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name common TDIs seen in practice

A
  1. Avulsion
  2. Luxation injuries
  3. Extrusion
  4. Intrusion
  5. Lateral luxation
  6. Displaced root fractures
  7. Complicated crown fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which of the TDIs is known as the one true dental emergency

A

Avulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In which age group is an avulsion injury most common in

A

7-10 year olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Avulsion accounts for what percentage of all dentoalveolar trauma

A

0.5-16%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is avulsion known as the one true dental emergency

A

As the acute management directly affects the prognosis of the tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What advice have we given the lay person if they see a child undergo an avulsion injury

A

Pick it
Lick it
Stick it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an avulsion injury

A

When a tooth is knocked out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When should we NOT replant a tooth that has been knocked out

A
  1. Primary teeth
  2. Other injuries requiring emergency care
  3. Patients with impaired immunity
  4. Patients at risk of infective endocarditis
  5. Very immature permanent incisors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we treat avulsion

A
  1. LA
  2. Suction socket gently
  3. Gently rinse with saline
  4. Reimplant holding the crown
  5. Gentle pressure
  6. Splint wire / composite
  7. Radiograph to confirm position
  8. Antibiotics and keep splint for 2 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Following avulsion which teeth have the best prognosis

A

When the tooth has been immediately re implanted (within 15 mins)

22
Q

What is the prognosis for immature teeth that have been implanted within an hour of avulsion

A
  1. Viable bur compromised cells
  2. Pulpal healing may occur via regeneration
  3. Need to monitor
23
Q

What is the prognosis for immature teeth that have been implanted after an hour of avulsion

A

Non viable PDL cells

will need to refer to specialist

24
Q

What is the prognosis for teeth that have been implanted within 15 mins of avulsion

A

Good however may need to initiate RCT on a mature tooth within 2 weeks

25
Q

What is the prognosis for mature teeth that have been implanted within an hour of avulsion

A

Pulp will not survive so need to extirpate ASAP (within two weeks of trauma)

26
Q

What is the prognosis for mature teeth that have been implanted after an hour of avulsion

A

PDL and pulp non viable
Extirpate ASAP (within two weeks of trauma)
Refer to specialist

27
Q

What instructions should we give to patient and parents following injury

A
  1. Good oral hygiene is a must
  2. Avoid contact sports
  3. Chlorhexidine 0.2% mouthwash twice a day fro 7 days
  4. Soft diet
28
Q

What is a luxation injury

A

the tooth is dislocated within the socket but maintains some attachment

29
Q

What are the main stages of luxation injury management

A
  1. Reposition
  2. Splint
  3. Review portion radiographically
  4. Keep under review
30
Q

What is an extrusion injury

A

An injury to the tooth characterized by partial or total separation of the periodontal ligament resulting in loosening and displacement of the tooth.

31
Q

How do we manage an extrusion injury

A
  1. LA
  2. Gentle reposition digitally if fresh injury
  3. Splinting
32
Q

What is an intrusion injury

A

apical displacement of a tooth into alveolar bone.

33
Q

How common are intrusion injuries

A

Account for 0.3-1.9% of all TDIs

34
Q

What does the prognosis of an intrusion injury depend on

A

Severity of intrusion and development of root

35
Q

How do we manage an intrusion injury of an immature root apex

A
  1. Allow re eruption without intervention
  2. If no movement in a few weeks undergo orthodontic repositioning
  3. If more than 7mm intrusion consider surgical repositioning
36
Q

What does management of a intrusion injury of mature root apex depend on

A

Depends on how much movement

37
Q

How do we manage a less than 3mm intrusion injury of a mature root apex

A
  1. Allow re eruption without intervention

2. If no movement in a few weeks undergo orthodontic repositioning

38
Q

How do we manage a 3-7mm intrusion injury of a mature root apex

A

Surgical or orthodontic repositioning

39
Q

How do we manage a more than 7mm intrusion injury of a mature root apex

A

LA
Surgically reposition
Splint

40
Q

What is a lateral luxation injury

A

happens when the alveolar bone fractures and the periodontal ligament separates

41
Q

How do we treat lateral luxation

A

LA
Reposition via re engaemtn from position in bone to original location
Radiograph
Splinting for 4 weeks

42
Q

How do we treat a displaced root fracture

A

Like any other luxation injury

43
Q

What are the treatment options avail fro a complicated crown fracture

A
  1. Pulp capping
  2. Cvek pulpotomy
  3. Coronal pulpotomy
44
Q

What is the treatment of a complicated crown fracture dependent on

A

Degree of damage and root development

45
Q

When would we decide to pulp cap a complicated crown fracture

A

Small exposure within 24 hours

46
Q

When would we decide to do a cvek pulpotomy for a complicated crown fracture

A

When the exposure is larger than a pinpoint
Up to 4 days post exposure
Either incomplete or complete root development seen

47
Q

When would we decide to do a coronal pulpotomy for a complicated crown fracture

A

If exposure is larger than a pinpoint

Site is contaminated or fracture is more than 4 days

48
Q

What are the different restoration options for a crown fracture

A
  1. Re attaching old fragment of tooth
  2. Restore using composite
  3. Glass ionomer bandage
49
Q

What is restoration option for a crown fracture dependent on

A

Ability of child and degree of tooth loss

50
Q

Which TDIs require immediate management

A
  1. Avulsion
  2. Complicated root fracture
  3. More luxated luxation injuries eg extrusion, lateral luxation, intrusion
  4. Displaced root fracture
51
Q

Which TDIs are not as critical

A
  1. Concussion
  2. Sub luxation
  3. Infarction
  4. Enamel fracture
  5. E-D fracture
  6. non displaced root fracture
52
Q

Which patients need immediate onwards referral

A
  1. Patients sustaining a head injury
  2. Uncooperative child
  3. Significant medical history
  4. Multiple complex injuries
  5. If you cannot reposition or splint appropriately

4th yr- CCD2- Trauma Symposium (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions