Hard Tissue Trauma

Question 1

What is an Enamel Fracture?

Answer 1

Fracture involving enamel only
uncomplicated

Question 2

What is an uncomplicated Enamel-Dentine Fracture?

Answer 2

Fracture involving enamel and dentine with no pulpal exposure

Question 3

What is a complicated Enamel-Dentine Fracture?

Answer 3

Fracture involving enamel and dentine plus the pulp is exposed

Question 4

What is a Crown-Root Fracture? Uncomplicated or complicated definition?

Answer 4

Fracture involving the enamel, dentine and root
Complicated= pulpal involvement
Uncomplicated= no pulpal involvement

Question 5

Management of Enamel Fracture?

Answer 5

Smooth sharp edges of the fracture
Can use composite to replace for aesthetic/functional reasons

Question 6

Management of Enamel-Dentine Fractures?

Answer 6

Cover all exposed dentine with GI or composite
Can restore tooth for functional/aesthetics immediately or at a later date

Question 7

Management of Enamel-Dentine-Pulp Fracture?

Answer 7

Treatment depends on child’s maturity and ability to tolerate procedures
Either: Partial Pulpotomy or extraction

Question 8

Management of a Crown-Root Fracture?

Answer 8

Remove the loose fragment and determine if the crown can be restored
If restorable:
no pulp exposed, cover dentine with GI/composite
if pulp is exposed, pulpotomy or endodontic treatment
If unrestorable:
extract loose fragments but don’t dig

Question 9

Management of a Root Fracture?

Answer 9

If coronal fragment is not displaces= no treatment
coronal fragment is displaces but not excessively mobile= leave coronal fragment to spontaneously reposition even if there is occlusal interference
if the coronal fragment is displaces, excessively mobile and interfering with occlusion = extract the loose coronal fragment, reposition the loose fragment and splint

Question 10

What are the Direct Complications of Dental Trauma to the Primary Tooth?

Answer 10

Discoloration
Infection
Delayed exfoliation

Question 11

What do the different types of Discoloration mean and what are they? Treatment?

Answer 11

Asymptomatic (pulp can be vital or non-vital)
Mild Grey= immediate discoloration may maintain vitality
Opaque/yellow= pulp obliteration
If there are no signs of pulpal necrosis or infection= no treatment and review

Question 12

Discoloration with Infection
Treatment?
Signs?

Answer 12

Extract or endodontic treatment
There is a sinus present, gingival swelling and/or an abscess
Increased mobility or tenderness to pressure
Radiographic evidence of periapical pathology

Question 13

What could Delayed Exfoliation result in as a consequence of Dental Trauma?

Answer 13

Atopic eruption of permanent successor
Delayed eruption
Prevent eruption completely

Question 14

What is Enamel Hypomineralisation?
Treatment?

Answer 14

Qualitative defect of enamel i.e. normal thickness but poorly mineralised
White/yellow defect
Treatment= no treatment, composite masking and tooth whitening

Question 15

What is Enamel Hypoplasia?
Treatment?

Answer 15

Quantitative defect of enamel i.e. reduced thickness but normal mineralisation
yellow/brown defects
Treatment= no treatment, composite masking

Question 16

What is a Dilaceration abnormality?
Management options?

Answer 16

Abrupt deviation of the long axis of the crown or root portion of the tooth?
Management Options= surgical exposure and orthodontic realignment, improve aesthetics restoratively

Question 17

Ectopic Tooth Position Management?

Answer 17

Surgical exposure and orthodontic realignment
Extraction

Question 18

Management of delayed eruption?

Answer 18

Premature loss of a primary tooth can result in delayed eruption of around 1 year due to thickened mucosa
Radiograph if it is more than 6 months delayed compared to contralateral tooth
Surgical exposure and orthodontic realignment may be required

Question 19

What is Dento-Alveolar Fracture?
Clinical Findings?

Answer 19

Fracture of the alveolar bone which may or may not involve the alveolar bone
Complete alveolar fracture extending from the buccal to the palatal bone in the maxilla and from the buccal to the lingual bony surface in the mandible
Segment mobility and displacement with several teeth moving together