Dental Trauma III

Question 1

treatment for permanent tooth that has experienced concussion

Answer 1

no treatment
follow up x rays at 1 month and 1 year

Question 2

treatment for permanent tooth that has experienced subluxation

Answer 2

usually no treatment
possibly flexible splint if excessive mobility
check ups: 2 weeks,3 months, 6 months and 1 year

Question 3

treatment for permanent tooth that has experienced extrusion

Answer 3

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

Question 4

treatment for permanent tooth that has experienced lateral luxation

Answer 4

reposition under LA
flexible splint
majority will require a RCT if closed apex

Question 5

what tone would be heard from percussion of a tooth that has experienced lateral luxation

Answer 5

high

Question 6

treatment for a permanent tooth that has experienced intrusion

Answer 6

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

Question 7

EADT (avulsed teeth)

Answer 7

extra alveolar dry time - time tooth out the mouth and dry

Question 8

EAT (avulsed teeth)

Answer 8

extra alveolar time - time tooth out the mouth and wet

Question 9

if replantation of an avulsed tooth is not immediately possible what should it be placed in

Answer 9

milk or saliva

Question 10

treatment of a permanent tooth with a closed apex that has been avulsed

Answer 10

splint replanted tooth
for closed apex teeth - endo within 2 weeks of replantation

Question 11

treatment of a permanent tooth with an open apex that has been avulsed

Answer 11

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)

Question 12

in what circumstances should permanent teeth not be replanted after avulsion

Answer 12

severely immunocompromised children
very immature apex and EAT > 90mins

Question 13

treatment of a dento-alveolar fracture involving a permanent tooth

Answer 13

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

Question 14

how would a dento alveolar fracture present clinically

Answer 14

segment mobility , occlusal disturbance and ginigval lacerations

Question 15

how long should a splint be worn for on a permanent tooth that has experienced subluxation and is mobile

Answer 15

2 weeks

Question 16

how long should a splint be worn for on a permanent tooth that has experienced extrusive luxation

Answer 16

2 weeks

Question 17

how long should a splint be worn for on a permanent tooth that has experienced intrusive luxation

Answer 17

4 weeks

Question 18

how long should a splint be worn for on a permanent tooth that has experienced lateral luxation

Answer 18

4 weeks

Question 19

how long should a splint be worn for on a permanent tooth that has experienced avulsion

Answer 19

2 weeks

Question 20

how long should a splint be worn for on a permanent tooth that has experienced a dento alveolar fracture

Answer 20

4 weeks

Question 21

how many teeth should be included on splints for trauma cases

Answer 21

at least 1 tooth either side of trauma tooth

Question 22

if creating a passive composite and wire splint what diameter wire should be used

Answer 22

up to 0.4mm
wire must be bent to match teeth to ensure it is passive

Question 23

how does pulp canal obliteration occur post trauma

Answer 23

progressive hard tissue formation within the pulp cavity sees gradual narrowing of the chamber and either total or partial obliteration

Question 24

What 3 types of external root resorption might a tooth experience post trauma

Answer 24

external surface resorption
external infection related inflammatory root resorption
ankylosis related replacement root resorption

Question 25

what type of root resorption might be experienced internally by a tooth that has experienced trauma

Answer 25

internal infection related root resorption - due to progressive pulp necrosis

Question 26

external surface root resorption

Answer 26

may occur in response to trauma, not progressive, affects a vital tooth

Question 27

external infection related inflammatory root resorption

Answer 27

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

Question 28

ankylosis related replacement root resorption

Answer 28

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