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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
Q

What is another term used to describe an extrusive luxation

A

Extrusion

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26
Q

Describe the PDL cells in an extrusive luxation injury

A
  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
Q

Describe the neurovascular bundle in an extrusive luxation injury

A

There will be tearing of the neurovascular bundle at the apex

28
Q

Clinically how will teeth suffering from extrusive luxation appear

A

Longer than their contralateral tooth almost as though they are hanging down
Very very mobile

29
Q

What is a lateral luxation injury

A

Displacement of the tooth in a direction other than axially

This is accompanied by comminution or fracture of the alveolar socket

30
Q

Where does the apex go in a lateral luxation injury

A

Gets locked into the alveolar bone fracture

31
Q

Clinically how will teeth suffering from lateral luxation appear

A

Tooth will be pushed out or pushed palatally

NOT MOBILE

32
Q

Describe the PDL cells in a lateral luxation injury

A
  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
Q

Describe the neurovascular bundle in a lateral luxation injury

A

Will have torn

34
Q

What is an intrusive luxation injury

A

Displacement of the tooth into the alveolar bone

This injury is accompanied by comminution or fracture of the alveolar socket

35
Q

What is an intrusive luxation also described as

A

Intrusion incident

36
Q

Describe the neurovascular bundle in an intrusive luxation injury

A

Apex has been pushed into he socket meaning the neurovascular bundle has been crushed

37
Q

Describe the PDL cells in an intrusive luxation injury

A

PDL cells have been crushed

38
Q

Name the one true emergency in dentistry

A

Avulsion

39
Q

What is avulsion

A

Complete displacement of the tooth out of its socket

40
Q

Describe the neurovascular bundle in a avulsion injury

A

Completely torn

41
Q

Describe the PDL cells in an avulsion injury

A

Crushed

42
Q

How do we go about diagnosing a TDI

A
  1. History
  2. Exam
  3. Special test
43
Q

What do special tests help us to do

A
  1. Make an accurate diagnosis
  2. Act as a baseline for follow up reviews
  3. Can be an indicator for prognosis
44
Q

When carrying out your special investigations and examinations which teeth do we inspect

A

Typically canoes to canine int eh upper and lower arches

45
Q

What findings do we record

A

Both negative and positive findings

46
Q

What do we look t when carrying out are special investigations clinically

A
  1. Mobility
  2. Transillumination
  3. Colour
  4. Percussion
  5. RADIOGRAPHS
  6. Sensitivity testing
47
Q

What do we look at when investigating mobility

A

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
Q

What do we look at when investigating transillumination

A

Look for infraction lines

49
Q

How do we check transillumination

A

Use composite curing light from palatal aspect to look fro infraction lines

50
Q

What do we look at when investigating percussion

A

Is the tooth TTP if so +, ++, +++

What does the tooth sound like when percussed

51
Q

What do we look at when investigating colour

A

Is the tooth a normal colour

Is there blue/grey or pinkish discolouration

52
Q

Which radiographs do we always take at the initial visit

A
  1. PA + Upper standard occlusion (USO)
    OR
  2. 2 PAs (at 15 degrees and 45 degrees)
53
Q

When would we take an OPT following a TDI

A

If we suspect a possible bony fracture

54
Q

Why do we take 2 radiographs at the initial visit

A

To assess for root fractures as they don’t always show up on one film

55
Q

If we suspect a bony fracture what should we do

A

Refer to maxillofacial surgery

56
Q

What is the first thing we assess when taking a trauma related radiograph

A
  1. Assess root development stage

2. Assess presence/ absence of root fractures

57
Q

When is the only time we use sensitivity testing on children

A

In traumatised permanent teeth

58
Q

What are the problems with sensitivity testing young permanent incisors

A
  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
Q

What us prognosis if TDIs depends on

A
  1. Root development stage
  2. Combination injuries
  3. Previous traumatic Injury
  4. Severity of injury
60
Q

How do we grade root development stages

A

I, II, III, IV

61
Q

Describe stage I root development

A

less than 1/3 developed

62
Q

Describe stage II root development

A

More than 1/3 developed

63
Q

Describe stage III root development

A

Complete development with an open apex

64
Q

Describe stage Iv root development

A

Complete development with a closed apex

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

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