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Endodontics 1 > Dental Trauma > Flashcards

Dental Trauma Flashcards

1
Q

Most dental trauma occurs in what age range

A

7-14 age

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2
Q

Most trauma occurs in the _____ region of the maxilla & mandible

A

anterior region

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3
Q

If a tooth is avulsed, do you put it back?

A

No

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4
Q

Does trauma go away or is it with you for life?

A

For life

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5
Q

NO PROBLEM IF VITAL:
RELAX AND RESTORERE
CALL AND TEST VITALITY

A

Uncomplicated crown fracture

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6
Q

TREATMENT OPTIONS:

  • Pulp Cap: least successful LONG TERM (better now using bioceramics)
  • Pulpotomy: preferred if open apex
  • RCT: preferred if apex closed or post necessary.
A

Complicated crown

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7
Q

Take CBCT
Anesthetize
Remove FX element
Determine Pulpal Exposure & Restorability
If no exposure –restore; If exposed VPT or RCTif open apex -VPT; RCT if apex closed
Be certain there is NOT a 2nd component of FX

A

Crown root fractures

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8
Q

In all trauma, the primary purpose of our treatment is to keep the pulp vital if the apex is open (immature).

A

Vital Pulp Therapy (VPT)

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9
Q

Does J lesion always mean VRF?

A

Not always

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10
Q

Treatment for confirmed VRF is ______

A

Extraction

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11
Q

The _____is often easily visualized on the radiograph
Seldom if ever occurs on posterior teeth.
XS Mobility also a good clue

A

horizontal FX

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12
Q

If a HRF occurs in the apical 1/3 of root, what portion is more likely to have necrotic pulp?

A

Coronal portion

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13
Q

Option selection and prognosis with ___ depends on:

  • Level of FX
  • Restorability-Periodontal Health
  • Vitality of Pulp
  • Stage of Root Development
  • Time since injury
  • Age of patient
  • Cooperation of patient
  • Availability for follow-up
  • Approximation opportunities
  • Stabilization options
A

HRF

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14
Q

If someone has HRF how long should the tooth be splinted?

A

2-4 days

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15
Q

If someone has HRF when should you take sensibility tests?

A

30 days

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16
Q 
The bone segment containing the involved tooth is mobile.
Splinting is required for 4-6 weeks
Complicates healing (slower)
Discomfort may be greater/longer lasting
Should not affect final result in most cases
A

Alveolar Fracture

17
Q 
\_\_\_\_ Luxation injury:
•Least severe of Luxation injuries
•No displacement of tooth nor mobility
•Tooth tender to touch “Bruised PDL”
•No radiographic abnormalities
•VIP!!! Assess vitality in 2&4 wks & follow
A

Concussion

18
Q

____ luxation injury
•Tooth tender to touch & slightly mobile (1+) but not displaced
•Possible hemorrhage from gingival crevice
•No radiographic abnormalities
•Damage to supporting structures? (not really)
•VIP!!! Assess vitality in 2&4 weeks & follow

A

Subluxation

19
Q

_____ luxation injury:
•Displaced laterally & often locked in bone
•Not tender to touch, not mobile
•Alveolus fractured
•Percussion test: high metallic sound (ankylosis)
•Increased PDL space best seen on eccentric or occlusal radiographs
•Anesthetize & reposition + Flexible splint MANDATORY 4 weeks
•VIP!!! Assess vitality in 2&4 weeks & follow

A

Lateral Luxation

20
Q

What happens when PDL cells are exposed to MO?

A

Resorption

21
Q

Do you take baseline for lateral and extrusive luxation on day of or day after trauma treatment?

A

Day after

22
Q

____ luxation injury
•Elongated mobile tooth–Cl. II mobility or greater
•Radiographs show increased apical periodontal space
•Manually reposition
•Flexible splint MANDATORY 7-14 days
•VIP!!! Assess vitality in 2&4 weeks & follow

A

Extrusive luxation

23
Q

•Most severe of luxations* Tooth appears shorter: displaced into alveolar bone•PDL destruction/alveolar crushing) Beware of ankylosis/resorption/ •pulp necrosis is all but certain in mature teeth*•Not tender to touch, not mobile•Percussion test: high metallic sound•Radiographs not always conclusive•Slightly luxate with forceps or band and move orthodontically ASAP.•Splinting is not usually necessaryUNLESS…tooth is loosened by luxation–Tooth with open apex mayspontaneously re-erupt.–100% RCT intervention

A

Intrusive Luxation

24
Q

•Tooth is knocked completely out of mouth
•Viability of the PDL must be preserved for success
•Extra-oral dry time is CRITICAL 30-60 minutes for survival of PDL***
•Must be replaced in socket immediately or ASAP (15-20”) in order to..
–Prevent ankylosis
–Prevent external root resorption

A

Avulsion

25
Q

TX is aimed at minimizing the inflammation from the two mainconsequences of avulsion: 1. attachment damage2. pulpal necrosis & infection that usually results The SINGLE most important factor in achieving a favorable outcome is the SPEEDat which a cleantooth is properlyreplanted (viable PDL) 15”Keeping the attached PDL moist is paramount*

A

Replant of Avulsion

26
Q 
Save a tooth
Via span
Milk or green tea
Contact lens
Place in mouth
A

Avulsed teeth transport

27
Q

What antibioitic is used for avulsed teeth?

A

Doxycycline

28
Q

If the pulp canals are sclerosed, how will the tooth respond to cold and EPT? How to treat?

A

NR Thermal
Normal to EPT
No treatment

29
Q

A change of the odontoblasts of the Pulpto a “-clastic” type cell resulting from pulpal injury. (generally traumatic, even w/ ortho)
•Destruction of dentin beginning at the pulpal interface.
•Excellent prognosis for resolution IFRCT done B4 perforation occurs.
•Internal resorption depends upon vital pulp tissue to progress. Removal of pulp positively halts
•Radiographically looks like an “aneurysm” w/in the RCS. The form of the pulp canal is altered.

A

Internal resorption

30
Q
  • A change in the cells of the PDL from formative to destructive cells often as a result of trauma (occasionally ideopathic).
  • Destruction of tooth structure at the cervical area.
  • Generally very POOR prognosis for resolution (difficult to restore & resorption often may recur)
  • appears ragged, asymmetrical and you can follow the canal through the defect.*
A

External resorption

31
Q

•A problem following trauma and long term rigid splinting
•Tooth is solidly fixed and has a high metallic ring when percussing.
Does not erupt with other teeth
•May lead to massive external replacement resorption & loss of tooth
•Internal= appearance of “aneurysm”

A

Ankylosis

32
Q

____ are used to prevent ankylosis and associated resorption following trauma by allowing some small tooth movement

A

Splint

33
Q

Are more rigid or more flexible splints better?

A

More flexible

34
Q

-Allows physiologic movement of the teeth in order to minimize ankylosis-In the past, .028 gauge ortho wire bonded to tooth for 1-2 weeks unless alveolar FX had occurred. Then 4-6 wksOR: 4-6# fishing line bonded to teeth

A

Flexible splint

Endodontics 1 (13 decks)

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