Emergency/Trauma/Regendo Flashcards

1
Q

____% of dental emergencies are a result of pulpal or periapical disease and ___% of pop experienced a toothache in the last 6 months

A

85

12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What pulpal emergency has intense prolonged pain to temperature and is treated by pulpectomy/pulpotomy and relieving occlusion?

A

Irreversible pulpitis (normal periapex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What pulpal emergency is extremely sensitive to percussion and is treated by complete pulpectomy or cleaning and shaping?

A

Irreversible Pulpitis (SAP)

*also relieve occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What pulpal emergency is extremely percussion sensitive and is treated by completely pulpectomy, drainage, CaOH medicament and antibiotics?

A

Necrotic Pulp (SAP w/o swelling)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the difference in treatment between a necrotic pulp with swelling vs. without swelling?

A

With swelling-apical penetration when cleaning canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is different about treating a necrotic pulp with fluctuant swelling and no drainage?

A

Mucosal Incision and Drainage

*also apical penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is a necrotic pulp with diffuse swelling and drainage treated? (Basic steps of most pulpal injury)

A
  • Complete pulpectomy/clean and shape
  • Copious irrigation
  • CaOH after drying
  • Cotton Cavit
  • Antibiotics/pain management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is different about treating necrotic pulp with diffuse swelling but no drainage?

A

Establish Extra oral/intra oral drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 4 kinds of drains?

A

1-I
2-T
3-Christmas Tree
4-Penrose

*want drainage for about 48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of trauma has no pulpal treatment and is chipping of the outer layer of tooth only?

A

Enamel Fractures

*1-2% pulpal necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What fractures involve enamel and dentin and are treated by placing CaOH cement or other liner before restoring?

A

Crown Fractures without pulp exposure

*1-7% pulpal necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which fractures will go to necrosis if left untreated and can be pulp capped (1st 30 hours), partial/full pulpotomy or pulpectomy?

A

Crown fracture with pulp exposure

*13% of all dental injuries. Immature roots need pulp to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most predictable successful treatment for an exposed pulp in a mature tooth?

A

Pulpectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should be attempted if the exposed pulp is in an immature tooth?

A

Vital Pulp Therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most important thing after pulpal therapy?

A

Bacteria-Tight seal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Shallow removal (2mm) of pulp on the day of injury with an 80% success rate is referred to as?

A

Cvek pulpotomy

17
Q

What high pH, bacteria tight seal material acts as a base for permanent restorations?

18
Q

What tooth trauma is usually oblique and becomes a periodontal rather than endodontic challenge?

A

Crown-Root Fracture

19
Q

How are root fractures treated when they involved the cervical or middle third?

A

Splint

*apical third usually not treated

20
Q

Which luxation injury has no displacement or mobility, percussion sensitivity and does not need treatment?

A

Concussion

21
Q

Which luxation has no displacement but is mobile and percussion sensitive with possible sulcular bleeding?

A

Subluxation

no treatment

22
Q

Which luxation injury is displaced coronally, mobile, and non-vital?

A

Extrusive

*reposition and splint 2-4 weeks

23
Q

Which luxation injury is displaced mdbl?

A

Lateral

*reposition and splint 2-4 weeks

24
Q

Which lunation injury is displaced apically, no mobility and may re-erupt spontaneously if immature?

A

Intrussive

*ankylosis risk high

25
Complete displacement from the socket is called?
Avulsion luxation
26
What are 3 key factors of avulsion luxation treatment success?
1-Duration 2-Storage medium 3-Apical maturity
27
What should you do with a closed apex tooth out of the mouth less than 60 minutes?
- Keep in saline, milk, saliva | - Irrigate socket and reimplant with splint. Antibiotics
28
What should you do with an open apex tooth out of the mouth less than 60 minutes
- Clean w/ saline - reimplant with splint, antibiotics *follow for vitality
29
What should you do with a closed apex out longer than 60 minutes?
1-Soak in 2% NaF 5-20 minutes 2-RCT in NaF soaked gauze hand 3-Reimplant and splint 4 weeks (ankylosis likely)
30
What should you do with an open apex out longer than 60 minutes?
May not reimplant due to very high incidence of ankylosis
31
If pulp vitality is not attainable what process involves a calcific barrier across the open apex with pulpal necrosis and no lesion?
Apexification
32
What 3 things do you need for Regendo?
1-Stem Cells (pulpal mesenchymal from cell rich zone of hohl) 2-Growth Factors 3-Scaffold
33
What are 4 criteria for Regendo case selection?
1-Pulp necrosis 2-Immature root apex 3-Pulp space not to be used for restorative purpose 4-Coronal Seal
34
What is the Regendo process?
1-Access and debride necrotic pulp (WL, irrigate) 2-Medicate w/ triple antibiotic 3-Once infection resolved, use non-vasoconstrictor anesthesia and a #10 or 15 file to stimulate bleeding. 4-Place collagen matrix 5-MTA seal and permanent restoration
35
What three antibiotics are in triple antibiotic paste?
1-Ciprofloxacin 2-Metronidazole 3-Minocycline