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BDS3 Paeds > Dental Trauma > Flashcards

Dental Trauma Flashcards

1
Q

In regards to dental trauma, how would you describe the term ‘concussion’?

A

Tooth is tender to touch but has not been displaced

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2
Q

In regards to dental trauma, how would you describe the term ‘subluxation’?

A

Tooth is tender to touch, has increased mobility but has not been displaced

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3
Q

What is extrusion?

A

When the tooth has been partially displaced from its socket

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4
Q

what is intrusion?

A

when the tooth is displaced through the labial bone plate

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5
Q

what is lateral luxation?

A

When the tooth is displaced in a palatal/lingual or labial direction

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6
Q

What is avulsion?

A

When a tooth is completely out of its socket

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7
Q

What is the most prevalent form of traumatic injury in the primary dentition?

A

Luxation

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8
Q

What are the 7 steps of patient management regarding dental trauma?

A

Reassurance
History
Examination
Diagnosis
Emergency treatment
Important information
Further treatment and review

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9
Q

What post op instructions would you give to the parent of a child that has been treated following dental trauma?

A
  • analgesia
  • soft diet for 10-14 days
  • brush with soft toothbrush after every meal
  • topical chlorohexidine 0.12% applied twice daily
  • warning regarding infection signs
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10
Q

What is a complicated crown fracture?

A

A crown fracture that involves the pulp

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11
Q

how would you treat an uncomplicated enamel-dentine fracture?

A
  • cover all exposed dentine with glass ionomer
  • restore lose tooth surface with composite immediately or at a later visit
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12
Q

How would you treat an enamel fracture?

A

smooth off any rough edges

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13
Q

how would you treat a complicated crown fracture?

A

Partial pulpotomy or extraction

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14
Q

How would you treat a crown-root fracture?

A

Remove loose fragment and determine if crown can be restored

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15
Q

how would you treat a root fracture where the coronal fragment has been displaced and is mobile?

A

Either
extract the loose coronal fragment

OR
reposition the loose coronal fragment and use a splint

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16
Q

What does a mild grey discolouration following dental trauma indicate?

A

intra pulpal bleeding
- still vital tooth

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17
Q

Why might a tooth become an opaque yellow colour following dental trauma?

A

represents plural obliteration:
- response of vital pulp
- pulp lays down increased thickness of dentine to protect itself

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18
Q

What percentage of school children experience dental trauma?

A

25%

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19
Q

What is the most common type of dental injury in the primary dentition?

A

Luxation

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20
Q

What is the most common type of injury in the permanent dentition?

A

Crown fracture (enamel-dentine)

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21
Q

What special investigations would you want to do with a child that has suffered dental trauma?

A
  • radiographs
  • sensibility tests
  • percussion - duller note may indicate root fracture
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22
Q

How would you do a pulpectomy with a tooth with an open apex?

A

-rubber dam
-access cavity
- haemorrhage control - la or sterile water
- diagnostic radiograph to find working length
- file 2mm short of estimated WL
- dry canal
- extirpate pulp and place CaOH for no longer than 4-6 weeks after identified non-vital
- plug with MTA and obturate with heated GP

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23
Q

What emergency advice would you give a patient that has an avulsed permanent tooth?

A
  • hold tooth by crown, do not handle root
  • wash off any debris with cold water
  • store tooth in milk or saliva until it can be re-planeted
24
Q

trauma stamp components

A

sinus
colour
mobility
TTP
percussion
ethyl chloride
EPT
radiograph

25
Extrusion splinting time
2 weeks
26
intrusion splinting time
4 weeks
27
avulsion splinting time
2 weeks
28
lateral luxation splinting time
4 weeks
29
root fracture splinting time
4 weeks
30
dento-alveolar fracture splinting time
4 weeks
31
properties of a splint
flexible passive ease of placement and removal facilitate sensibility testing aesthetic allow oral hygiene
32
pulp canal obliteration
- response of a vital pulp - progressive hard tissue formation within pulp cavity - gradual narrowing of pulp chamber and pulp canal
33
pulp canal obliteration treatment
- conservative - only 1% may give rise to periodical pathology
34
common post trauma complications
pulp necrosis and infection pulp canal obliteration root resorption breakdown of marginal gingiva and bone
35
types of root resorption
external internal
36
external root resorption types
surface external infection related internal root resorption cervical ankylosis related root resorption
37
internal root resorption features
internal infection related
38
External surface resorption features
response to localised injury not progressive
39
external infection related inflammatory root resorption - cause and radiographic signs
non vital tooth initiated by PDL damage - indistinct root surface rapid
40
external infection related IRR management
remove stimulus endodontic treatment - non setting calcium hydroxide 4-6 weeks - obturate with GP
41
ankylosis related root resorption - how does this occur?
initiated by severe damage to PdL and cementum - more than 20% of PDL damaged - Normal repair does not occur root involved in remodelling
42
Ankylosis related root resorption - clinical signs
severe luxation or avulsion infraocclussion due to alveolar bone displacement
43
Ankylosis related root resorption radiographic signs
radiographically; ragged root outline, no obvious PDL space infra occlusion due to alveolar bone displacement
44
treatment for ankylosis related replacement root resorption
plan for loss of tooth
45
internal infection related internal root resorption causes, features and radiographic signs
due to progressive pulp necrosis radiographically crown may have pink discolouration - symmetrical expansion of root canal walls - tramlines of root canal indistinct -n root surface intact
46
treatment of internal infection related inflammatory root resorption
- remove stimulus - endodontic treatment - if progressive, plan for loss
47
When would you do a direct pulp cap?
1mm or less pulp exposure within 24 hour window
48
Direct pulp cap - steps
trauma stamp and radiographic assessment - tooth should be non - TTP and positive to sensibility tests LA and rubber dam clean area with water then disinfect with sodium hypochlorite apply dycal (CaOH) or MTA white to pulp exposure restore tooth with composite restoration review 6-8 weeks, 6 months , 1 year
49
partial pulptomy (Cvek pulpotomy) indications
>1mm pulp exposure or 24+ hours since trauma
50
Cvek pulptomy steps
Trauma stamp and radiographic assessment LA and rubber dam clean area with saline then disinfect with sodium hypochlorite remove 2mm of pulp with high speed round bur -place saline soaked cotton wool pellet over exposure until haemostasis achieved apply CaOH then GI or white MTA restore with composite resin
51
when would you do a full coronal pulptomy?
if pulp is either hyperaemic OR necrotic
52
how would you do a full coronal pulpotomy after beginning with a partial pulpotomy?
remove all coronal pulp place calcium hydroxide in pulp chamber seal with GIC lining followed by coronal restoration
53
partial pulpotomy success rate
97%
54
full coronal pulpotmy succes rate
75%
55
aim of a pulpotomy
keep vital pulp tissue within canal to allow normal root growth
56
pulpotomy follow up dates
6-8 weeks 6 months 12 months
57
main post trauma complications
pulp necrosis and infection pulp canal obliteration root resorption breakdown of marginal gingiva and bone

BDS3 Paeds (5 decks)

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