IADT guidelines - primary teeth Flashcards
what may a dull percussion note indicate
root fracture
why are sensibility tests not used as part of a trauma stamp for primary teeth
sensibility tests are unreliable on primary teeth
general parental instructions for homecare after trauma to primary dentition
successful healing relies on good OH
cleaning area with soft brush and use of chlorhexidine 0.2% mouth rinse topically in the area twice a day for 1 week
Take care when eating not to further traumatise area
enamel fracture in primary teeth
- x ray recommendations and treatment
no x ray recommended
Tx - smooth sharp edges
+ general homecare instructions
enamel fracture in primary teeth
- follow up and potential outcome
no follow up recommended
may become symptomatic, discoloured, necrotic, infected and further root development may be halted
name 3 possible signs of pulp necrosis and infection
- sinus tract
- gingival swelling or abscess
- radiographic signs
- dark grey discolouration
enamel dentine fracture in primary teeth
- radiographic recommendations and treatment
baseline radiograph is optional.
Tx - cover all exposed dentine with GI or composite. Restore lost structure with composite now or at a later date
general homecare instructions
enamel dentine fracture in primary teeth
- follow up and potential outcomes
clinical exam after 8 weeks and encourage parents to look out for unfavourable outcomes. Radiographic follow up only recommended if signs of pathology
may become symptomatic, discoloured, necrotic, infected and further root development may be halted
enamel dentine pulp fracture in primary teeth
- radiographic recommendation and treatment
- PA or occlusal radiograph
- aim to preserve pulp via partial pulpotomy (then seal canals with non setting CAOH, cover with GIC then composite)
enamel dentine pulp fracture in primary teeth
(follow up and possible outcomes)
- clinical follow up at 1 week, 8 weeks and 1 year
radiographic follow up 1 year
may become symptomatic, discoloured, necrotic, infected and further root development may be halted
crown root fractures in primary teeth
- radiograph recommendations
PA or occlusal
crown root fractures in primary teeth
- treatment options
1st need to extract loose fragment anr establish if remaining tooth is restorable
A - tooth is restorable and no pulp exposure - cover dentine with GI
B - restorable with pulp exposure - pulpotomy or RCT
C - unrestorable - extract all loose fragments and leave firm root fragment in situ
D - unrestorable - extract whole tooth
if tooth retained after crown root fracture in primary teeth when should follow up be done
clinical - 1 week, 8 weeks and 1 year
radiographs after 1 year if pulpotomy or RCT done
what may be seen clinically in a primary tooth which has experienced root fracture
findings dependent on location of fracture
- coronal fragment may be mobile and may be displaced
occlusal interference may be present
treatment options for a primary tooth with root fracture
If coronal fragment not displaced, or displaced with very little mobility - no treatment required , leave to spontaneously reposition
If coronal fragment is displaced, mobile and interfering with occlusion:
A - extract only loose coronal fragment (apical fragment should be left in place to be resorbed)
B - Gently reposition loose fragment and splint in place with flexible splint for 4 weeks
follow up for a primary tooth that has experienced root fracture
if no displacement of coronal fragment - 1 week, 8 weeks and 1 year, then annually until permanent tooth eruption
if displaced coronal fragment repositioned - 1 week , 4 weeks (splint removal), 8 weeks , 1 year
if displaced fragment extracted - 1 year
(radiographs only indicated if signs of pathology)
clinical findings of an alveolar fracture
mobility and dislocation of segment with several teeth moving together
occlusal interference normally present
treatment for an alveolar fracture in primary dentition
should be done by paediatric specialist
stabilise with flexible splint to uninjured teeth for 4 weeks
treatment for extrusive luxation in a primary tooth
tx based on degree of displacement and mobility, interference with occlusion and root formation
A - no interference with occlusion - leave to spontaneously reposition
B - if mobile or extruded >3mm, extract under LA
treatment of lateral luxation in primary tooth
A - no or minimal occlusal interference - leave to spontaneously reposition
B - (severe displacement and risk of aspiration or ingestion) - extraction
C - (severe displacement) - reposition and flexible splint for 4 weeks
normal clinical findings of a lateral luxation
possible occlusal interference
tooth will be immobile
normally displaced palatal/lingual or labial direction
what are the potential unfavourable outcomes after extrusion of a primary tooth
- symptomatic , discolouration, necrosis and infection, halted root development
- no improvement in position of extruded tooth (if left to reposition)
- negative impact on development and/or eruption of permanent successor
what are the potential unfavourable outcomes of a primary tooth that has experienced lateral luxation
- symptomatic , discolouration, necrosis and infection, halted root development
- no improvement in position of laterally luxated tooth (if left to reposition)
- negative impact on development and/or eruption of permanent successor
- ankylosis
in what timescale would an intruded tooth usually spontaneously reposition
usually within 6 months, may be up to one year
clinical findings of an intruded tooth (primary)
usually displaced through labial bone plate or can impinge on permanent tooth bud
May be almost or completely dissappeared into socket and can be palpated labially
what are the potential unfavourable outcomes for a primary tooth that has experienced intrusive luxation
- symptomatic , discolouration, necrosis and infection, halted root development
- no improvement in position of extruded tooth (if left to reposition)
- negative impact on development and/or eruption of permanent successor
- ankylosis
when should a radiograph be taken in avulsion cases
if tooth cannot be located
ensure it has not been intruded
treatment for an avulsed primary tooth
avulsed primary tooth should NOT be replanted
give parent/ patient general advice of not aggravating area and cleaning topically with CHX and soft brush
concussion injury to primary tooth
- x ray
- treatment
- follow up
- potential outcome s
- no x rays
- no treatment, just observation and general homecare
- 1 week and 8 week follow up
- symptomatic, infection, necrosis, discolouration, no further root development, negative impact on developing permanent tooth
what may be seen radiographically on an x ray of a subluxated tooth
slightly widened PDL space
treatment for a primary tooth that has experienced intrusion
allow to spontaneously reposition
urgent referral to a paeds specialist (within a couple days)
