consequences of trauma Flashcards
In which type of apex is healing and revascularisation likely to occur?
Immature (open apex) -
because it’s wider = more blood vessels = more blood flow = more healing.
In which 4 instances should RCT be initiated following trauma?
- avulsion of MATURE TEETH (closed apex).
- IMMATURE teeth with an extra oral dry time of >60 mins.
- intruded teeth
- complicated crown fractures when haemostasis isn’t possible when doing a pulpotomy.
8 factors affecting pulpal response to trauma:
- amount of displacement
- amount of crushing / stretching of neuromuscular bundle at the apex.
- degree of pulpal exposure
- previous trauma
- caries / previous restorations in the tooth
- delay in presentation
- initial management
- type of injury
Clinical Symptoms of Necrosis:
- pain
- swelling
- sinus tract / pathology present
- -ve to sensibility testing (but this is unreliable)
- discolouration
- TTP
- mobility
2 (obvious) radiographic signs of necrosis:
- widened PDL (increased PDL space)
- apical radiolucency
Consequences of pulp necrosis in immature teeth:
- cessation of root development
- weakened root (susceptible to root fracture)
- inflammatory root resorption
- apical bone loss
Describe Pulp Canal Obliteration
Accelerated deposition of hard tissue in the pulp chamber.
3 main pulpal consequences of trauma:
- healing and revascularisation
- necrosis
- pulp canal obliteration
The main PDL response to trauma is root resorption.
What are the 4 types of this?
- inflammatory
- replacement
- surface
- cervical
Which type of root resorption is most common following TDI?
Inflammatory (internal / external)
Treatment of inflammatory resorption can arrest its progression.
How is it treated?
Extirpate and dress with CaOH - (monitor and refer if neccessary).
In which 2 types of TDI is replacement resorption most common in?
Avulsion and Intrusion -
causes ankylosis.
Decoronation is not recommended in people who have stopped growing. This is because it requires 2 factors, what are these?
significant vertical bone growth and turnover.
In pulp necrosis, what colour does the tooth turn?
grey
Which type of consequence causes a tooth to turn yellow?
pulp canal obliteration -
due to dentine deposition.
