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4th yr- CCD2- Trauma Symposium > Classification and Diagnosis of Traumatic Injuries > Flashcards

Classification and Diagnosis of Traumatic Injuries Flashcards

1
Q

Who developed there classification system used today for traumatic dental injuries

A

Andreasen

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2
Q

What is a TDI

A

Traumatic Dental Injury

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3
Q

What is the classification split into

A
  1. Injuries to the hard dental tissues and pulp

2. Injuries to periodontal ligament

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4
Q

List the injuries that fall under hard dental tissues and pulp

A
  1. Infraction
  2. Enamel fracture
  3. Enamel dentine fracture
  4. Enamel Dentine pulp fracture
  5. Root fracture
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5
Q

What is an infraction

A

An incomplete fracture (crack) of the enamel without loss of tooth substance

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6
Q

What is the best way to diagnose an infraction injury

A

Transillumination

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7
Q

What is an enamel fracture

A

A fracture with loss of tooth substance confined to the enamel

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8
Q

What is an enamel dentine fracture

A

A fracture with loss of tooth substance to enamel and dentine but not involving pulp

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9
Q

What is another term used to describe enamel dentine fracture

A

Uncomplicated crown fracture

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10
Q

What is an enamel dentine pulp fracture

A

A fracture involving enamel and dentine and exposing the pulp

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11
Q

What is another term used to describe enamel dentine pulp fracture

A

Complicated crown fracture

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12
Q

What is a crown root fracture

A

A fracture involving enamel, dentine and cementum (pulp may or may not be involved)

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13
Q

What is another term used to describe crown root fracture without pulpal involvement

A

Uncomplicated crown root fracture

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14
Q

What is another term used to describe crown root fracture with pulpal involvement

A

Complicated crown root fracture

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15
Q

What is a root fracture

A

A fracture involving the dentine cementum and the pulp

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16
Q

What can root fractures be further classified according to

A
  1. Location of the fracture

2, If the coronal fragment is displaced

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17
Q

How can root fractures be further classified according to location

A

Horizontal or Vertical

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18
Q

List the injuries that fall under periodontal ligament

A
  1. Concussion
  2. Subluxation
  3. Extrusion
  4. Lateral luxation
  5. Avulsion
  6. Intrusion
  7. Alveolar fracture
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19
Q

Where are periodontal cells found

A

All the way around the root of each tooth

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20
Q

What is a concussion

A

An injury to the tooth supporting structures without abnormal loosening or displacement of the tooth
But with marked reaction to percussion

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21
Q

What can a concussion be compared to

A

A bruise

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22
Q

How can we diagnose a Concussion

A

TTP

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23
Q

What is a subluxation

A

An injury to the tooth supporting structures with abnormal loosening
But without displacement of the tooth

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24
Q

What is an extrusive luxation

A

A partial displacement of the tooth our of its socket

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25
What is another term used to describe an extrusive luxation
Extrusion
26
Describe the PDL cells in an extrusive luxation injury
1. PDL cells on the palatal side of the tooth will be stretched or torn 2. PDL cells in the buccal side will be crushed
27
Describe the neurovascular bundle in an extrusive luxation injury
There will be tearing of the neurovascular bundle at the apex
28
Clinically how will teeth suffering from extrusive luxation appear
Longer than their contralateral tooth almost as though they are hanging down Very very mobile
29
What is a lateral luxation injury
Displacement of the tooth in a direction other than axially | This is accompanied by comminution or fracture of the alveolar socket
30
Where does the apex go in a lateral luxation injury
Gets locked into the alveolar bone fracture
31
Clinically how will teeth suffering from lateral luxation appear
Tooth will be pushed out or pushed palatally | NOT MOBILE
32
Describe the PDL cells in a lateral luxation injury
1. PDL cells on the palatal side of the tooth will be stretched or torn 2. PDL cells in the buccal side will be crushed
33
Describe the neurovascular bundle in a lateral luxation injury
Will have torn
34
What is an intrusive luxation injury
Displacement of the tooth into the alveolar bone | This injury is accompanied by comminution or fracture of the alveolar socket
35
What is an intrusive luxation also described as
Intrusion incident
36
Describe the neurovascular bundle in an intrusive luxation injury
Apex has been pushed into he socket meaning the neurovascular bundle has been crushed
37
Describe the PDL cells in an intrusive luxation injury
PDL cells have been crushed
38
Name the one true emergency in dentistry
Avulsion
39
What is avulsion
Complete displacement of the tooth out of its socket
40
Describe the neurovascular bundle in a avulsion injury
Completely torn
41
Describe the PDL cells in an avulsion injury
Crushed
42
How do we go about diagnosing a TDI
1. History 2. Exam 3. Special test
43
What do special tests help us to do
1. Make an accurate diagnosis 2. Act as a baseline for follow up reviews 3. Can be an indicator for prognosis
44
When carrying out your special investigations and examinations which teeth do we inspect
Typically canoes to canine int eh upper and lower arches
45
What findings do we record
Both negative and positive findings
46
What do we look t when carrying out are special investigations clinically
1. Mobility 2. Transillumination 3. Colour 4. Percussion 5. RADIOGRAPHS 6. Sensitivity testing
47
What do we look at when investigating mobility
Is the tooth mobile if so what grade mobility | Also chart if there is no mobility as this can suggest tooth is locked into bone
48
What do we look at when investigating transillumination
Look for infraction lines
49
How do we check transillumination
Use composite curing light from palatal aspect to look fro infraction lines
50
What do we look at when investigating percussion
Is the tooth TTP if so +, ++, +++ | What does the tooth sound like when percussed
51
What do we look at when investigating colour
Is the tooth a normal colour | Is there blue/grey or pinkish discolouration
52
Which radiographs do we always take at the initial visit
1. PA + Upper standard occlusion (USO) OR 2. 2 PAs (at 15 degrees and 45 degrees)
53
When would we take an OPT following a TDI
If we suspect a possible bony fracture
54
Why do we take 2 radiographs at the initial visit
To assess for root fractures as they don't always show up on one film
55
If we suspect a bony fracture what should we do
Refer to maxillofacial surgery
56
What is the first thing we assess when taking a trauma related radiograph
1. Assess root development stage | 2. Assess presence/ absence of root fractures
57
When is the only time we use sensitivity testing on children
In traumatised permanent teeth
58
What are the problems with sensitivity testing young permanent incisors
1. Child may be anxious or in pain 2. Immature teeth nerve fibres are poorly myelinated so don't conduct stimuli well record that you've attempted the sensitive tests but child uncooperative if that's the case
59
What us prognosis if TDIs depends on
1. Root development stage 2. Combination injuries 3. Previous traumatic Injury 4. Severity of injury
60
How do we grade root development stages
I, II, III, IV
61
Describe stage I root development
less than 1/3 developed
62
Describe stage II root development
More than 1/3 developed
63
Describe stage III root development
Complete development with an open apex
64
Describe stage Iv root development
Complete development with a closed apex

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

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