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Paediatrics > Dental Trauma 2 > Flashcards

Dental Trauma 2 Flashcards

1
Q

What is the prevalence of primary tooth trauma, and which teeth are most commonly affected?

A

16-40% prevalence, with maxillary primary incisors being most commonly affected

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2
Q

At what age is the peak incidence of primary tooth trauma observed?

A

Between 2-4 years old

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3
Q

Name the three main aetiologies of primary tooth trauma.

A

Falls, bumping into objects, and non-accidental injuries

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4
Q

List the classifications of primary tooth trauma.

A
  1. Fracture injuries: Enamel fracture, enamel-dentine fracture, crown-root fracture, root fracture, alveolar fracture.
  2. Displacement injuries: Concussion, subluxation, lateral luxation, intrusion, extrusion, avulsion.
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5
Q

What is the key emergency treatment principle for primary tooth trauma?

A

Observation is often appropriate unless there is a risk of aspiration, ingestion, or occlusal interference.

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6
Q

Describe the clinical findings and management of an enamel fracture in primary teeth.

A

Findings: Fracture involves enamel only.
Management: Smooth sharp edges; no radiographs or follow-up recommended.

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7
Q

Describe the clinical findings, radiographs and management of an enamel-dentine fracture without pulp exposure in primary teeth.

A

• Clinical findings: Fracture involves enamel and dentine.
The pulp is not exposed
• Radiograph: Baseline optional
Soft tissue to locate fracture fragment
• Management: Account for fragment
Cover all exposed dentine with glass
ionomer/ composite

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8
Q

How do you manage an enamel-dentine fracture with pulp exposure?

A
  1. Account for the fragment.
  2. Perform a partial pulpotomy or extract the tooth.
  3. Follow-up at 1 week, 6-8 weeks, and 1 year.

Radiograph: Baseline periapical or occlusal
Soft tissue to locate fracture fragment

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9
Q

How do you manage a restorable crown-root fracture with pulp exposure?

A
  1. Perform a pulpotomy or endodontic treatment.
  2. Cover the exposed dentine.
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10
Q

What is the management for a restorable crown-root fracture without pulp exposure?

A

Remove the coronal fragment and protect the exposed dentine.

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11
Q

How do you manage an unrestorable crown-root fracture?

A

Extraction

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12
Q

What radiographs are recommended for a crown-root fracture in primary teeth?

A

Baseline periapical or occlusal radiographs are suggested to assess the extent of the fracture.

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13
Q

What are the follow-up intervals for crown-root fractures?

A

Clinical follow-up at 1 week, 6-8 weeks, and 1 year.

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14
Q

How do clinical findings differ in root fractures based on the location of the fracture?

A

• Coronal fractures: Often mobile and displaced.
• Apical/mid-root fractures: Generally stable with no mobility.

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15
Q

What radiographs are recommended for root fractures?

A

Baseline periapical or occlusal radiographs are used to assess the fracture location.

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16
Q

What is the management for root fractures without displacement?

A

No treatment is required; monitor at 1 week, 6-8 weeks, and 1 year.

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17
Q

How do you manage a root fracture with displacement but limited mobility?

A

Allow the tooth to reposition naturally, and monitor.

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18
Q

When is extraction indicated for root fractures?

A

• Excessive mobility.
• Occlusal interference.

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19
Q

What follow-up is required after root fractures with splinting?

A

• Clinical: 1 week, 4 weeks (splint removal), 8 weeks, and 1 year.
• Radiographic monitoring may be included as needed.

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20
Q

What are the clinical findings in alveolar fractures?

A

Fractures involve alveolar bone and may extend to adjacent bone, often with mobility of the segment.

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21
Q

What radiographs are recommended for alveolar fractures?

A

Baseline periapical, occlusal, and lateral views to assess the extent of the fracture.

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22
Q

How are alveolar fractures managed initially?

A
  1. Reposition the fractured segment.
  2. Stabilise with a flexible splint attached to adjacent uninjured teeth for 4 weeks.
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23
Q

What is the follow-up protocol for alveolar fractures?

A

• Clinical: 1 week, 4 weeks, 8 weeks, 1 year, and 6 years.
• Radiographic: 4 weeks and 1 year.

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24
Q

What happens if alveolar stability is achieved but teeth remain compromised?

A

Extraction of compromised teeth may be necessary after stabilisation.

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25
Q

What are the clinical findings in a concussion injury?

A

Tooth is tender to touch but not displaced or mobile; no sulcular bleeding.

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26
Q

What is the management for a concussion injury?

A

No treatment required; observe the tooth.

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27
Q

What is the follow-up protocol for concussion injuries?

A

Clinical follow-up at 1 week and 6-8 weeks.

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28
Q

What are the clinical findings in subluxation?

A

Tooth is tender to touch with increased mobility but not displaced; no sulcular bleeding.

29
Q

What radiographs are recommended for subluxation injuries?

A

Baseline periapical or occlusal radiographs

30
Q

What is the management for subluxation?

A

No treatment required; observe the tooth.

31
Q

What is the follow-up protocol for subluxation?

A

Clinical follow-up at 1 week and 6-8 weeks.

32
Q

What are the clinical findings in lateral luxation?

A

Tooth is displaced palatally, lingually, or labially and is immobile

33
Q

How is lateral luxation managed when there is no/minimal occlusal interference?

A

Allow for spontaneous repositioning.

34
Q

What is the management for severe lateral luxation with significant displacement?

A

Reposition the tooth with or without splinting. Extract if necessary.

35
Q

What is the follow-up protocol for lateral luxation?

A

• No splint: 1 week, 6-8 weeks, 6 months, 1 year.
• Splint: 1 week, 4 weeks (splint removal), 8 weeks, 1 year.

36
Q

What are the clinical findings in intrusion injuries?

A

The tooth is almost or completely pushed into the socket, often impinging on the permanent tooth germ.

37
Q

How is the direction of displacement assessed in intrusion?

A
  1. Tooth appears shorter: Displaced towards the labial bone plate.
  2. Tooth appears elongated: Displaced towards the permanent tooth germ.
38
Q

What is the management for intrusion?

A

Allow the tooth to reposition spontaneously.

39
Q

What is the follow-up protocol for intrusion?

A

Clinical follow-up at 1 week, 6-8 weeks, 6 months, and 1 year.

40
Q

What are the clinical findings in extrusion?

A

Tooth is partially displaced out of its socket, appearing elongated and mobile; occlusal interference may be present.

41
Q

How is extrusion managed when there is no occlusal interference?

A

Allow for spontaneous repositioning.

42
Q

When is extraction indicated for extrusion?

A

If the tooth is excessively mobile or extruded >3 mm.

43
Q

What is the follow-up protocol for extrusion?

A

Clinical follow-up at 1 week, 6-8 weeks, and 1 year

44
Q

What are the clinical findings in avulsion?

A

The tooth is completely out of the socket.

45
Q

What is the key principle of managing avulsion in primary teeth?

A

Do not replant the tooth to avoid damaging the permanent tooth germ

46
Q

What radiographs are essential for avulsion cases?

A

Baseline periapical or occlusal radiographs to confirm the diagnosis and check for retained fragments.

47
Q

What is the follow-up protocol for avulsion?

A

Clinical follow-up at 6 weeks and 6 years.

48
Q

Why is avulsion in primary teeth not treated with replantation?

A

Due to the high risk of damage to the permanent tooth germ.

49
Q

What are the primary post-operative care recommendations for primary tooth trauma?

A
  1. Avoid biting on traumatised teeth.
  2. Follow a soft diet.
  3. Maintain meticulous oral hygiene.
  4. Use analgesics as needed.
50
Q

What does the impact of primary dental trauma depend on?

A

• Age
• Type of injury
• Severity of injury
• Pulpal sequelae
• Treatment

51
Q

What is the most common complication of intrusion injuries in primary teeth on permanent successors?

A

Enamel defects in the permanent tooth (44%).

52
Q

What long-term effects can primary tooth trauma have on the permanent successor?

A

Enamel hypoplasia, dilaceration, delayed eruption, ectopic tooth position, arrested development, and odontome formation.

53
Q

What sequelae can occur to a traumatised primary tooth?

A

Discolouration (vital or non-vital), discolouration with infection, and delayed exfoliation.

54
Q

What does mild grey discolouration of a primary tooth indicate?

A

It may indicate the tooth has maintained vitality, and no treatment is required.

55
Q

What does yellow/opaque discolouration of a primary tooth suggest?

A

Pulp obliteration; the tooth is asymptomatic and requires no treatment but monitoring.

56
Q

How do you manage discolouration with infection in primary teeth?

A

Extract the tooth or perform endodontic treatment if there is a sinus, abscess, or swelling.

57
Q

What is a potential consequence of delayed exfoliation in primary teeth?

A

It can affect the developing occlusion, necessitating radiographic evaluation and potential intervention.

58
Q

What is a potential consequence of delayed exfoliation in primary teeth?

A

It can affect the developing occlusion, necessitating radiographic evaluation and potential intervention.

59
Q

How does the age at which trauma occurs affect permanent tooth injuries?

A

• 0-2 years: Highest risk (63%).
• 3-4 years: 58%.
• 5-6 years: 24%.
• 7-8 years: 25%.

60
Q

Which primary tooth injury is most likely to cause damage to the permanent successor?

A

Intrusion injuries.

61
Q

What is the most common anomaly in permanent teeth after primary tooth trauma?

A

Enamel defects (44%).

62
Q

How do you manage enamel hypoplasia resulting from trauma?

A

• Composite masking.
• No treatment if mild.

63
Q

What are possible outcomes of crown or root dilaceration in permanent teeth?

A

• Surgical exposure and orthodontic realignment.
• Restorative improvement for aesthetics.

64
Q

What causes delayed eruption in permanent teeth after trauma?

A

Thickened mucosa due to premature loss of a primary tooth. A delay of ~1 year is common.

65
Q

What causes delayed eruption in permanent teeth after trauma?

A

Thickened mucosa due to premature loss of a primary tooth. A delay of ~1 year is common.

66
Q

What management options exist for ectopic tooth position in permanent teeth?

A

• Surgical exposure.
• Orthodontic realignment.
• Extraction, if necessary.

67
Q

What is the treatment for arrested development of a permanent tooth germ?

A

• Endodontic treatment if possible.
• Extraction if the tooth is non-restorable.

68
Q

How is odontome formation managed in the permanent dentition?

A

Surgical removal of the odontome.

69
Q

What key point should parents be informed about following primary tooth trauma?

A

The potential for sequelae in both the primary tooth and the permanent successor.

Paediatrics (5 decks)

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