Dental Trauma- Azadani '23

Question 1

Outcome of pulp vitality is dependent upon…

Answer 1

race between blood supply (healing) and infection from bacterial invasion

Question 2

What is the effect of trauma on the pulp?

Answer 2

Disruption of blood supply –> pulp tissue infarct –> coagulation necrosis –> outcomes: Infection related necrosis/revascularization, regeneration and repair

Question 3

PCO is found more frequently in permanent teeth with what kind of root maturation?

Answer 3

Immature teeth

Question 4

PCO is found in immature permanent teeth with which kind of injuries more commonly?

Answer 4

Extrusion, lateral luxation, intrusion

Question 5

Which position of root fractures in permanent teeth has the lowest prognosis of survival?

Answer 5

Cervical root fxs

Question 6

Which is the most commonly used trauma classification?

Answer 6

Andreasen

Question 7

Most TDIs occur before the age…?

Answer 7

20

Question 8

Bimodal distribution of trauma injuries based on age

Answer 8

1-3; 8-13

Question 8

Oral predisposing factors for dental trauma

Answer 8

Anterior open bite, increased overjet, Mx incisors

Question 8

Medical diagnoses with concomitant dental trauma

Answer 8

Epilepsy- 52%; CP-57%

Question 8

Injuries to the face are most commonly due to…

Answer 8

62% due to assault

Question 8

Best ways to prevent trauma

Answer 8

helmets, mouth guards, seat belts and supervision for prevention

Question 8

CBCT recommended when external root resorption

Answer 8

True

Question 8

Best way to assess replacement resorption (ankylosis)

Answer 8

clinical assessment:
percussion
mobility

Question 9

Tx for more than 6mm intrusion?

Answer 9

Surgical reposition

Question 9

Prognosis for severe intrusion of mature teeth

Answer 9

Very poor

Question 9

Indications for NaOCl or Chx

Answer 9

NaOCl is the best
Chx is acceptable

Question 9

What are the common causes of dental injury?

Answer 9

Hx of dental trauma, risky behavior, increased overjet, lip incompetence, being male, ADHD, epilepsy

Question 10

What is the bimodal age distribution of dental trauma?

Answer 10

~2 years of age and 12-14 years of age

Question 11

How does the pulp respond to traumatic injury?

Answer 11

Inflammation
Survival
PCO
Necrosis

Question 12

When a tooth sustains an impact, what tissues are affected?

Answer 12

PULP and PDL
Crown fx can involve the pulp primarily
Extrusion involves PDL primarily but also the pulp

Question 13

The pulp is more likely to become necrotic in teeth with what characteristics?

Answer 13

Mature teeth
Closed apex
More severe injuries

Question 14

How does CaOH helpful in the management of traumatized teeth?

Answer 14

Helps with controlling infection via high pH
Slows down inflammatory resorption and may also reduce risk of ankylosis

Question 15

Indications for Cvek pulpotomy

Answer 15

Good tx option for immature teeth w/complicated crown fxs
Clean surgical wound management and good seal to prevent bacterial invasion to the pulp

Question 16

Which dental trauma sequelae is more common in the permanent dentition as a result of TDI in primary dentition?

Answer 16

Enamel discoloration

Question 17

In intrusion of primary teeth around ….% will erupt spontaneously while almost…% will show complications such as infection or ankylosis.

Answer 17

80, 30

Question 18

Currently the material of choice for custom-made mouth-guards is?

Answer 18

Ethylene Vinyl Acetate 3-4mm

Question 19

External root resorption may manifest in 3 ways:

Answer 19

1. Progressive inflammatory resorption
2. Cervical resorption
3. Replacement resorption

Question 20

What are the primary factors that affect the host response to dental avulsion?

Answer 20

Extraoral dry time
Storage medium
Severity of injury
Host response

Question 21

Which corticosteroid has been used as an intracanal medicament?

Answer 21

Triamcinolone

Question 22

HBSS has shown the best results for maintaining PDL cells but for community level training our recommendations for avulsed teeth are:

Answer 22

Replant avulsed tooth immediately, if not possible, place the tooth in cold milk and see a dentist who treats traumatic injuries immediately

Question 23

When to initial endodontic treatment for root fractures with good approximation?

Answer 23

When combined clinical and radiographic signs indicate pulp necrosis, only portion coronal to root fx will need RCT

Question 24

Risk of pulp necrosis in increased in which type of injuries vs. isolated lateral luxation?

Answer 24

Combination injuries (crown fx + lateral luxation or extrusion)

Question 25

How many closed apex teeth with intrusion or avulsion injuries need pulpectomy and GP fill?

Answer 25

100%