Maxillofacial trauma 1

Question 1

Etiology of pediatric trauma?

Answer 1

Falls

Question 2

Etiology of children and adolescent trauma

Answer 2

Sports and playground

child abuse(50% in H&N)

Question 3

Adult trauma

Answer 3

Interpersonal violence

motor vehicle collisions

sports injuries

work related injuries(burns, falls, etc.)

Question 4

Sequence for evaluation

Answer 4

Immediate assesment

H&P

radiographic exam

assessment

plan

Question 5

Extraoral mandibular exam?

Answer 5

Palpation inferior border and TMJ

Check ROM and excursive movements

V3 status

Question 6

Intraoral mandibular exam?

Answer 6

Floor of mouth hematoma?

Malocclusion? Steps in occlusion?

Alveolus? gingival lacerations or mobility of dentoalveolar segments of jaw

Teeth? Missing or mobile?

Question 7

Radiographic Exam for mandibular series for trauma?

Answer 7

Panorex is recommended.

Also can do Towne’s, left/right oblique, and PA’s.

Question 8

Intrusion

Answer 8

Compression fracture of alveolus to accomodate new position

metallic sound upon percussion

Question 9

Options after intrusion?

Answer 9

Allow passive eruption(deciduous teeth)

orthodontic traction

stabilize 2-3 months

Question 10

Extrusion and lateral displacement

Answer 10

Reposition tooth fully at socket and splint for 1-3 weeks

Question 11

Avulsion

Answer 11

Goal: maintain periodontal attachment

Do not scrape or sterilize root surface

Transport in Hanks, saline, saliva, or milk

Question 12

Avulsion <2 hours with Open Apex?

Answer 12

Replant immediately if possible

Transport in Hank’s or milk

Doxycycline for 5 minutes

L.A., socket irrigation, Tetanus, and Abx

Replant Splint for 7-10 days

Apexification (CaOH)

Question 13

Avulsion <2 hours Closed apex

Answer 13

Store in Hanks solution for 30 minutes

Replant

Splint for 7-10 days

Perform RCT when removing splint

Fill canal with CaOH

Perform final gutta-percha obturation (6-12 months)