Adult Consequences Of Childhood Trauma Flashcards

1
Q

What are some predictors for outcome of childhood trauma

A

Severity of injury - IADT DENTAL TRAUMA GUIDE

Stage of root development

Timing of tx

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2
Q

Recommended timing for avulsion?

A

Immediate reimplantation or acute/subacute

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3
Q

Recommended timing for alveolar fracture?

A

Acute phase

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4
Q

Timing for extrusion or lateral luxation?

A

Acute or subacute

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5
Q

Timing for root fracture

A

Acute or subacute

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6
Q

Timing for concussion or subluxation?

A

Subacute

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7
Q

Timing for crown or crown-root fractures?

A

Subacute or delayed

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8
Q

What timing is acute, subacute and delayed?

A

Acute 0-3hrs

Subacute 3-24hrs

Delayed >24hrs

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9
Q

What are some potential long term complications of childhood trauma to a tooth?

A

Discolouration

Loss of vitality

Inflammatory root resorption

Unfavourable tooth positioning

Hard / soft tissue defects

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10
Q

Why might a tooth be yellow? What would you do?

A

Indicative of canal obliteration

Monitor for signs or symptoms of loss of vitality

Consider local external bleaching

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11
Q

Why might a tooth be pink? How treat?

A

Haemorrhage in pulp chamber with blood flowing into dentinal tubules

Cervical root resorption may occur

If tooth is not necrotic may recover in 2-3 months as it revascularises

If necrotic then discolouration will worsen

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12
Q

Why might tooth be brown/grey/black?

A

Non infected traumatised tooth with accumulation of haemoglobin

Hydrogen sulphate produced by bacteria concert iron to dark iron sulphate

Possible loss of vitality

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13
Q

Why might pulp necrosis and apical periodontitis follow trauma?

A

When revascularisation fails

Pulp tissue necrotises and bacterial infection occurs

3-4 week time period necrosis will show radiographically

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14
Q

What indicates a tooth may be necrotic?

A

Loss of the lamina dura

Widening of the PDL

Grey/brown tooth discolouration

Periapical radiolucency

Infection related root resorption

No response to pulp sensitivity testing

TTP

Draining sinus

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15
Q

How treat pulp necrosis?

A

Primary endodontic treatment with internal bleaching

XLA and replace

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16
Q

What issue might unfavourable tooth position lead to? Best thing to do?

A

Increased risk of traumatic injury such as luxation or intrusion

Reposition and splint within 24 hours to prevent unfavourable tooth position

If minimal change, add composite or remove tooth tissue

If large change needed, orthodontically treat or use extra coronal restorations

17
Q

What is an infra occluded tooth? How treat?

A

Ankylosed tooth which is stuck between two others as the alveolar bone grows over

Full assessment required
XLA if below contact point

18
Q

How might hard and soft tissue discrepancies be managed in an adult patient?

A

Bone grafting

Ortho extrusion with chain

Mucogingivalnsurgery

Connective tissue grafting

Implants

19
Q

What are simple injuries?

A

Concussion

Subluxation

Enamel infraction

ED fracture

Root fracture in apical 2/3 with no displacement

Avulsion after reimplantation and splinting

20
Q

What are complex injuries

A

Alveolar fracture

Immature apex (paeds)

Displaced or cervical root fracture

Intrusion and extrusion

Lateral luxation

21
Q

What to do for simple trauma?

A

Appropriate exam and investigations to allow classification

Refer to international association of dental trauma guidelines

Www.dentaltraumaguide.org

22
Q

What complications of trauma may require specialist intervention?

A

Inflammatory root resorption

Altered tooth positioning

Root fractures with developing pathology

Loss of >1 tooth