Dental Trauma III Flashcards
treatment for permanent tooth that has experienced concussion
no treatment
follow up x rays at 1 month and 1 year
treatment for permanent tooth that has experienced subluxation
usually no treatment
possibly flexible splint if excessive mobility
check ups: 2 weeks,3 months, 6 months and 1 year
treatment for permanent tooth that has experienced extrusion
reposition using LA and place a flexible splint for 2 weeks
follow ups: 2 weeks, 4 weeks, 8 weeks, 12 weeks, 6 months and 1 year
less than 50% pulp survival if closed apex
treatment for permanent tooth that has experienced lateral luxation
reposition under LA
flexible splint
majority will require a RCT if closed apex
what tone would be heard from percussion of a tooth that has experienced lateral luxation
high
treatment for a permanent tooth that has experienced intrusion
if immature apex - allow spontaneous repositioning
if mature apex:
- <3mm allow spontaneous repositioning
- 3-7mm surgical or orthodontic repositoning
- >7mm - surgical repositioning
almost all closed apex teeth will require RCT
EADT (avulsed teeth)
extra alveolar dry time - time tooth out the mouth and dry
EAT (avulsed teeth)
extra alveolar time - time tooth out the mouth and wet
if replantation of an avulsed tooth is not immediately possible what should it be placed in
milk or saliva
treatment of a permanent tooth with a closed apex that has been avulsed
splint replanted tooth
for closed apex teeth - endo within 2 weeks of replantation
treatment of a permanent tooth with an open apex that has been avulsed
splint replanted tooth
if EAT < 60 mins possibility of spontaneous healing
if EAT > 60mins RCT likely required and possibly specialist referral
EAT = extra alveolar time (time out of mouth and wet)
in what circumstances should permanent teeth not be replanted after avulsion
severely immunocompromised children
very immature apex and EAT > 90mins
treatment of a dento-alveolar fracture involving a permanent tooth
reposition and splint displaced segment for 4 weeks
suture any lacerations
monitor pulp conditions via sensibility tests
advise a soft diet for 7 days and avoid contact sports for 4 weeks
use chlorhexidine mouthwash
how would a dento alveolar fracture present clinically
segment mobility , occlusal disturbance and ginigval lacerations
how long should a splint be worn for on a permanent tooth that has experienced subluxation and is mobile
2 weeks
how long should a splint be worn for on a permanent tooth that has experienced extrusive luxation
2 weeks
how long should a splint be worn for on a permanent tooth that has experienced intrusive luxation
4 weeks
how long should a splint be worn for on a permanent tooth that has experienced lateral luxation
4 weeks
how long should a splint be worn for on a permanent tooth that has experienced avulsion
2 weeks
how long should a splint be worn for on a permanent tooth that has experienced a dento alveolar fracture
4 weeks
how many teeth should be included on splints for trauma cases
at least 1 tooth either side of trauma tooth
if creating a passive composite and wire splint what diameter wire should be used
up to 0.4mm
wire must be bent to match teeth to ensure it is passive
how does pulp canal obliteration occur post trauma
progressive hard tissue formation within the pulp cavity sees gradual narrowing of the chamber and either total or partial obliteration
What 3 types of external root resorption might a tooth experience post trauma
external surface resorption
external infection related inflammatory root resorption
ankylosis related replacement root resorption
what type of root resorption might be experienced internally by a tooth that has experienced trauma
internal infection related root resorption - due to progressive pulp necrosis
external surface root resorption
may occur in response to trauma, not progressive, affects a vital tooth
external infection related inflammatory root resorption
may occur in response to trauma
non vital tooth , initiated by PDL damage
tramlines of root canal will be intact radiographically but borders of root will be indistinct
ankylosis related replacement root resorption
may occur in response to trauma
occurs when severe PDL and cementum damage, root becomes involved in bone remodelling
on radiograph , ragged root outline and no PDL space
extraction indicated
