Dental Trauma Flashcards
What is the most common type of dental trauma in primary dentition?
What is the most common type of dental trauma in permanent dentition?
What is the most common type of dental trauma in primary dentition?
Luxations, peak 2-6 years old
What is the most common type of dental trauma in permanent dentition?
Fractures
What kind of dental injury in the primary dentition is most commonly associated with the development of dental anomalies in the permanent dentition?
Intrusion and avulsion
Does the IADT recommend the immediate extraction of the traumatized primary tooth if the direction of displacement of the root is toward the permanent tooth germ?
No because
1. There is evidence of spontaneous reeruption of intruded primary teeth
2. There is a concern that further damage may be inflicted on the tooth germ during extraction
3. Lack of evidence that immediate extraction will minimize further damage to the permanent tooth germ.
A 3 year old presents for new patient exam with the CC of “it looks like he has a chipped tooth.” Fracture is confined to enamel only.
What radiographs and follow up does the patient need?
What treatment, if any, should the patient receive?
According to the IADT, no radiographs are recommended and no follow up recommended.
Can smooth out any sharp/rough edges
Possible soft food diet
Encourage gingival healing and avoid plaque accumulation with soft bristle toothbrush, can give Chlorhexidine rinse 0.2% 2x/day for 1 week
According to the IADT, how is an enamel fracture in primary dentition managed?
- Smooth out any rough/sharp edges
- Review OHI to keep hard and soft tissues clean
- Brush with soft bristle toothbrush, can apply 0.1-0.2% chlorhexidine gluconate rinse 2x/day for 1 week
How do you assess for potential tooth fragments in soft tissue?
- Palapate the puncture/laceration
- Soft tissue radiograph at 1/4 the exposure time
What radiographs, treatment and follow-up recommendations are there for an uncomplicated crown fracture in primary dentition?
- Baseline radiograph of traumatize tooth/teeth is optional; radiographs of soft tissue for fragments if indicated
- Treatment: Cover exposed dentin with GI or composite immediately or at later appointment
- Review OHI and diet with guardian
- Can give 0.2% Chlorhexidine rinse 2x/day for 1 week
- Follow up after 6-8 weeks
What are the clinical follow-up times for a primary tooth with a complicated crown fracture?
- 1 week
- 6-8 weeks
- 12 months, take radiograph
What radiographs, treatment and follow-up recommendations are there for complicated crown fracture in primary dentition?
- Baseline radiograph + soft tissues if indicated
Review tx options on behavior/level of cooperation, prognosis, risks/benefits - Local anesthesia
- Rubber dam isolation
- Non-setting calcium hydroxide direct pulp cap or cervical pulpotomy depending on the size of the fracture
- Cover exposed dentin with glass ionomer
- Restore tooth
- POI: soft food diet, chlorhexidine rinse 2x/day for 1 week, any unfavorable outcomes
- Follow up at 1 week, 6-8 week, 1yr + radiograph
If there is a clinical indication to splint in the event of a root frature of a primary tooth, what are the clinical follow-up times and when is the splint removed?
- 1 week
- 4 weeks, remove splint
- 8 weeks
- 1 year
In the event of alveolar fracture in primary dentition, what is the recommended treatment and follow-up regimen?
- Treatment: Local anesthesia, reposition mobile segment, Flexible Splint for 4 weeks
- Clinical exam after 1 week, 4 weeks (remove splint, take radiographs), 8 weeks, 1 year (take radiographs to assess eruption of permanent successor)
What is the radiographic and follow-up protocol for a concussed primary tooth?
No baseline radiograph recommended
Follow up at 1 week and then 6-8 weeks
What is the difference between a concussed tooth and subluxated tooth?
Concussed: Tender to touch, no mobility or displacement, no sulcular bleeding
Subluxated: Tender to touch, increased mobility, no displacement, sulcular bleeding may be present
What is the radiographic and follow-up protocol for a subluxated primary tooth?
Baseline radiograph
Clinical exam at 1 week
6-8 weeks
Radiographs only when pathosis is suspected
What radiographs, treatment and follow-up recommendations are there for a primary tooth that has been extrusively luxated?
Baseline radiograph
Check degree of displacement and mobility, any occlusal interferences, root formation and child’s ability to tolerate treatment
Allow tooth to reposition if minimal extrusion
If extrusion >3mm, extract
Clinical exam after 1 week
6-8 weeks
1 year
When do you make the decision to extract an extrusively luxated primary tooth?
If extrusion is greater than 3mm