Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endodontics > Dental Trauma > Flashcards

Dental Trauma Flashcards

1
Q

Most dental trauma occurs in — age range

A

7-14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

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

A

anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Perm. Dentition injuries

A

greater importance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Primary Dentition injuries?
(3)

A

– Prevent injury to succedaneous tooth
– Patient comfort
– Avulsed primary teeth seldom replaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PRIME RULES OF DENTAL TRAUMA
(4)

A
  • TRAUMA IS NEVER PLANNED
  • TIMELY TREATMENT IS BASIC TO SUCCESS
  • OCCURS AT THE LEAST CONVENIENT TIME
  • TRAUMA is for LIFE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Patient (2)
Parents are (2)
Both want — ACTION
— expectations unrealistic
— OUTCOME demanded

A

FRIGHTENED and in PAIN
EMOTIONAL/IRRATIONAL
IMMEDIATE
ESTHETIC
PERFECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

skipped
www.aae.org
* Search: “—”
* Choose: “—”
* Download:
The Treatment of Traumatic Dental Injuries
(Colleagues for Excellence Summer 2014)

A

Trauma Resources
The Biological Basis for Endodontics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

skipped
Outline: Permanent Dentition
(8)

A

I. Crown Fractures
2. Crown-Root Fractures
3. Vertical/Horizontal Root Fractures
4. Alveolar Fractures
5. Luxation Injuries:
*Concussion
*Subluxation
*Extrusion
*Lateral
*Intrusive
6. Avulsion
7. Other Potential Results of Trauma
*- Effects on Pulpal Spaces
- Resorption
*- Ankylosis
8. Prevention of Dental Trauma Injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Permanent dentition
—%
Primary dentition
—%
Adolescents 12 y/o —%

A

15.2
22.7
18.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Epidemiology
Children 5 years of age
(3)

A

1/3 injuries
in primary
dentition
Luxation
(More
common)
Luxation
(More
common)
Males more
frequent
than females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Epidemiology
Adolescents 12 years of age
(3)

A

20 al 30% will
suffer dental
trauma
Uncomplicated
crown fracture
(More common)
Uncomplicated
crown fracture
(More common)
Males more
frequent than
females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

skipped
Traumatic injuries classification

A

Concussion
Subluxation
Intrusion
Extrusion
Lateral
luxation
Avulsion
Crown fracture
Crown-root fracture
Root fracture
Bone fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Uncomplicated Crown Fractures

A

Crown FX without Pulp exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Uncomplicated Crown Fractures
NO PROBLEM IF
VITAL:
(2)

A

RELAX AND RESTORE
RECALL AND TEST
VITALITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complicated Crown FX (Pulp Exposure)
TREATMENT OPTIONS:
(3)

A
  • Pulp Cap: Use Bioceramic
    materials
  • Pulpotomy: preferred if
    open apex
  • RCT: preferred if apex closed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Crown-Root Fractures
Crown-Root FX: often fractures at an

A

angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Crown-Root Fractures
Crown-Root FX: often fractures at an angle
(6)

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Crown-Root Fractures
Crown-Root FX: often fractures at an angle
Fracture Line
may NOT be
clearly seen…

A

Take several
angled X-rays
varying both
vertical &
horizontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

VRF & HRF

A

Vertical FX of Crown>Root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

VRF & HRF
Vertical FX of Crown>Root

A

Remember, the ‘J” lesion is not always seen
with a cracked root AND ‘J’ lesion, if present,
does not always mean root is cracked. But
always seriously CONSIDER cracked root if J

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Methods of documenting VERTICAL ROOT FRACTURE
(3)

A

Transillumination
Restoration Removal + Staining
Surgical Exposure

22
Q

Horizontal Root Fracture
(4)

A

The horizontal FX is often easily visualized
on the radiograph
Seldom if ever occurs on posterior teeth.

XS Mobility also a good clue
Is this salvageable?

23
Q

skipped
HRF Treatment Decisions:
Multifactorial
Option Selection &
Prognosis with HRF depends upon:
(10)

A
  • 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-
    upApproximation
    opportunities
    Stabilization options
24
Q

Treatment Options are determined on a

A

Case by
Case Basis

25
Q

Root FX (Horizontal)
What do you do here? Try to reposition and
splint — wks, check for vitality q — days

A

2-4
30

26
Q

ALVEOLAR FRACTURE
(5)

A

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

27
Q

Luxation Injuries(MOST COMMON OF ALL DENTAL INJURIES)
- Pathways
(5)

A

Concussion
Subluxation
Extrusion
Lateral
Intrusive

30-44%

28
Q

Concussion
Subluxation
Extrusion
Lateral
Intrusive
ARRANGED IN ORDER OF

A

LEAST TO GREATEST DAMAGE

29
Q

Concussion Luxation Injury
(5)

A
  • 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
30
Q

Subluxation Injury
(5)

A
  • Tooth tender to touch &
    slightly mobile (1+) but not
    displaced
  • Possible hemorrhage from
    gingival crevice
  • No radiographic
    abnormalities
  • Damage to supporting
    structures?
  • VIP!!! Assess vitality in 2&4
    weeks & follow
31
Q

Lateral Luxation Injury
(6)

A
  • Displaced laterally & often locked in bone
  • Not tender to touch, not mobile
  • Alveolus fractured
  • 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
32
Q

What is a flexible splint?

A

-Allows physiologic movement of the teeth
in order to minimize ankylosis
-In the past, .020 or 18 gauge ortho wire
bonded to tooth for 1-2 weeks unless
alveolar FX had occurred. Then 4-6 wks
OR: 4-6# fishing line bonded to teeth

33
Q

Extrusive Luxation Injury
(5)

A
  • Elongated mobile tooth
    – Cl. II mobility or greater
  • Radiographs show
    increased apical
    periodontal space
  • Manually reposition
  • Flexible splint
    MANDATORY 14 days
  • VIP!!! Assess vitality in
    2&4 weeks & follow
34
Q

Intrusive Luxation Injury
External root resorption likely

A
  • 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: sounds different
  • Radiographs not always conclusive
  • Slightly luxate with forceps or band and move orthodontically ASAP.
  • Splinting is place 14 days or more if alveolar fx is present.
  • Tooth with open apex may spontaneously re-erupt depending on the depth of penetration. (Less than 7mm)
    – 100% RCT intervention
35
Q

Avulsion
*Definition
* Viability of the — must be
preserved for success
* Extra-oral dry time is CRITICAL
* Must be replaced in socket
immediately or ASAP (15-20”) in
order to..
(2)

A

Tooth is knocked completely out of
mouth
PDL
0-15
minutes for survival of PDL***

– Prevent ankylosis
– Prevent external root resorption

36
Q

To replant or not? should be

A

“useful permanent tooth”: Little point in replanting
THIS one or deciduous tooth.

37
Q

Replant?
TX is aimed at minimizing the inflammation from the two main
consequences of avulsion:
(2)

A
  1. attachment damage
  2. pulpal necrosis & infection that usually results
38
Q

The SINGLE most important factor in achieving a favorable outcome is
the — at which a clean tooth is properly replanted (viable PDL) —

A

SPEED
15”

39
Q

Keeping the attached PDL — is paramount*

A

moist

40
Q

First Aid Instructions
If not, transport in appropriate medium
(5)

A

“Save-a-
tooth”
(Hank’s
Balanced
Salt Solution)
“Via Span”
(if available)
milk or
Green Tea if
above not
available
contact lens
solution
place in
vestibule
(saliva) &
Report to
dental office
ASAP

41
Q

Be PROACTIVE: Provide

A

instructions & transport
media to area schools and sports facilities –
Practice Builder

42
Q

Handle by
— only
Pick off
debris with
—
—- tooth at the
site if
possible

A

crown
tweezers
Replant

43
Q

Once in Dental office:

A

*Take films to make sure
there is no alveolar FX
(cone beam) & that
adjacent teeth are OK

44
Q

Do Not
(3)

A

Allow tooth to dry
Scrub root
Handle by root

45
Q

Other Potential Results of Trauma
(“Down the Road” Possibilities)
* SOME TRAUMA OUTCOMES ARE NOT
— *
(3)

A

FOREVER

  • Effects on Pulpal Spaces
  • Resorption
  • Ankylosis
46
Q

Trauma: Effects on Pulpal
Spaces
Note the
completely
sclerosed pulp
canals in the
traumatized
central
incisors. No
caries.

A

Placed on
recall; No
Treatment FOLLOW UP

47
Q

Trauma may stimulate 2 different
pulpal responses

A

Trauma to a tooth can
stimulate the pulp to
generate massive amounts
of tertiary dentin End
Result is a sclerosed &
non negotiable canal.
The same trauma may
cause the pulp to
discontinue development
and remain at the stage
present at the time of
injury. This may provide a
clue as to the age of the
patient at the time of the
injury.

48
Q

Ankylosis
(4)

A
  • A problem following trauma and long term rigid splinting
  • Tooth is solidly fixed and has a high different ring when percussing. Does
    not erupt with other teeth
  • May lead to massive external replacement resorption & loss of tooth
  • Internal = appearance of “aneurysm” w/in canal.
49
Q

Replacement ERR:
(2)

A
  • Patients are generally asymptomatic
  • Typically a history of avulsion or intrusion injury
50
Q

Bone may replace dentin in cases of PDL injury.
Ankylosis occurs and may be identified by
(4)

A

XR + lack of normal
mobility + High pitched “metallic ring” during percussion
or possibly by “submergence” (not erupting with other
normal teeth)

51
Q

EDUCATION

A
  • Our professional responsibility includes educating
    our patients and the community regarding the
    dangers of trauma as well as appropriate preventive
    measures and therapeutic opportunities:
    – Talk to school nurses
    – Coaches
    – Youth groups, Scouts, etc.
52
Q

MOUTH GUARDS
(5)

A
  • Our professional responsibility includes educating
    our patients and the community regarding the
    benefits of the use of mouth guards during sports
    activity.
    – Make appropriate mouth guards available at an affordable cost to
    the community.
    – Talk to coaches and youth sponsors.
    – Sponsor a Team in your area.
    – Volunteer your services (Music Theatre, etc.)

Endodontics (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions