IADT guidelines - permanent teeth Flashcards
what is an enamel infraction
an incomplete fracture (crack or crazing) of enamel without loss of tooth structure
tx for an enamel fracture in permanent teeth
1 - if tooth fragment available, rebond
2 - smooth sharp edges only
3 - smooth sharp edges and restore lost structure with composite
treatment for a permanent tooth that has experienced an enamel dentine fracture
1 - rebond fragment if available and intact
2 - cover exposed dentin with GI or composite
(if exposed dentine within 0.5mm of pulp - pink but no bleeding - place a CaOH lining before restoring)
treatment for an adult tooth experiencing a complicated fracture that has immature roots and open apices
want to preserve pulp to promote further root development
either a partial pulpotomy or pulp capping
(dependent on time since exposure and size of exposure)
treatment for permanent tooth with complicated fracture (closed apex)
- partial pulpotomy is preferred treatment
non setting CaOH on pulp wound - if post required for crown retention RCT preferred
- tooth fragment can be rebonded after being rehydrated and exposed pulp treated
- if no fragment cover exposed dentine with GI
immediate treatment for a permanent tooth that has an uncomplicated crown-root fracture
until a tx plan is finalised, temporary stabilisation of the loose fragment to adjacent tooth/teeth or non mobile fragment should be attempted
treatment of a complicated crown-root fracture in permanent teeth
stabilise loose fragments to adjacent teeth or non mobile fragments
1 - immature teeth - pulpotomy
2 - mature teeth - RCT
what circumstance may require a flexible splint to be placed for 4 months
cervical root fracture
treatment of a root fracture in permanent teeth
if displaced, coronal fragment should be repositioned asap and positioning checked radiographically
Mobile coronal segment should be stabilised with flexible splint for 4 weeks
No endo treatment should be done at the emergency appointment - pulpal status should be monitored
treatment of alveolar fracture in permanent teeth
reposition displaced segment and stabilize with flexible splint for 4 weeks
suture any gingival lacerations
Root canal tx contraindicated at emergency appointment
what is subluxation and what treatment would be done for this injury on a permanent tooth
subluxation sees injury to tooth supporting structures seeing tenderness and increased mobility however the tooth is not displaced
normally no treatment is required however if there is excessive mobility or tenderness when biting a flexible splint may be placed for 2 weeks
treatment for extrusive luxation of a permanent tooth
reposition the tooth under LA
flexible splint for 2 weeks
pulp should be monitored with sensibility tests
if pulp becomes necrotic and infected, endodontic treatment indicated
treatment for permanent tooth seeing lateral luxation
reposition tooth under local anaesthesia (palpate gingiva to locate apex, then push towards socket)
stabilise tooth for 4 weeks with flexible splint
monitor pulp with sensibility tests at follow ups
1 - immature teeth may see spontaneous revascularisation, if not RCT indicated
2 - mature teeth - pulp will most likely becme necrotic and RCT required
treatment for a permanent tooth that is immature that has intruded
allow spontaneous repositioning
if no eruption within 4 weeks, initiate orthodontic repositioning
pulp should be monitored
how can fragments be rehydrated prior to rebonding
soaking in water or saline for 20 min prior to bonding
