Adult Tooth Trauma Flashcards
How treat concussion and subluxation in permanent teeth?
Monitor pulp for one year
Suture gingival lacerations if there
Clean area with salt water or chlorhexadine
Flexible splint for 2 weeks if need be
How treat extrusion in permanent teeth?
LA
Clean exposed root surface with saline
Reposition and stabilise for 2 weeks with splint or 6 weeks if breakdown of marginal bone
Clinically monitor pulpal status and provide appropriate endodontic treatment
How treat lateral luxation in permanent teeth?
Rinse root surface with saline
Give LA
Reposition and splint for 4 weeks or 8 if marginal breakdown of bone
Incomplete root
- spontaneous revascularisaiton may occur
- endo only if necrotic pulp
Complete root
- RCT
How treat intrusion in permanent teeth?
Immature root
- allow spontaneous repositioning
- ortho if doesn’t work in 4 weeks
- monitor pulp
- may need RCT if necrotic pulp
Mature root
- spontaneous re eruption
- surgical repositioning >7mm, ortho 3-7mm
- RCT within 2 weeks
How treat avulsion in permanent teeth?
Pick up tooth by crown
Clean in milk saline or patients saliva
Replant in normal position or in suitable storage medium if not able to do right away and bite on handkerchief to hold in place
Seek emergency dental treatment
How treat infraction in permanent teeth?
Etch and seal with resin
How treat enamel fracture in permanent teeth?
Periapical, occlusal and eccentric radiograph to determine only a fracture
Bond tooth fragment to tooth
Restore with composite resin
Review 6-8 weeks
Treat ED fracture of permanent tooth
Radiograph to check only fracture
Clean area with saline or chlorhexadine
Re bond fragment after soaking for 20 mins in water or saline if it is dry
Consider lining material such as CaOH
Provisional GIC
Restore with composite resin
Review 6-8wks
Treat EDP fracture in permanent tooth
- pulp cap or partial pulpotomy
- CaOH liner on the pulp as a cap
Bond fragment back
RCT if severe and luxation with displacement occurs too
How treat crown-root fracture without pulpal involvement in permanent teeth?
Radiograph to view fracture
Remove fragment only and restore dentine
Orthodontic extrusion of apical fragment after removal of coronal fragment
Coronectomy and leave root so no alveolar resorption for later implant
Extraction
All can be done in subacute or delayed, so can bond apical to coronal fragment while treatment is planned
How treat crown root fracture with pulpal involvement in permanent teeth?
Emergency treatment
Radiograph
Stabilise loose fragment to adjacent teeth
Immature pulp = partial pulpotomy and pulp cap
Mature = RCT
Definitive treatment
- same as crown root no pulpal involvement
How treat root fracture in permanent tooth?
Find fracture line radiographically with 2 radiographs
Rinse exposed root with saline
Stabilise with splint for 4 weeks but up to 4 months if fracture is coronal
Monitor for 1 year to see pulpal status, RCT if it is necrotic but only coronal of fracture line
How treat alveolar fracture in permanent tooth?
LA
Manual reposition
Clean area with chlorhexadine
Suture any lacerations
Flexible splint for 4 weeks
RCT if pulpal condition is necrotic
