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paediatric trauma Flashcards

1
Q

most common teeth to be traumatised

A

maxillary incisors

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2
Q

tooth is tender to touch but not displaced or mobile - what injury has been sustained?

A

concussion

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3
Q

pt presents to you with a traumatised tooth. it is immobile as locked into bone. on percussion it displays a high ankylotic tone and radiographs show widening of PDL - state the type of injury sustained

A

lateral luxation

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4
Q

splinting time for lateral luxation injury

A

4 weeks - passive and flexible

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5
Q

percussion note associated with lateral luxation

A

high ankylotic

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6
Q

how does a subluxation injury present

A

tender to touch
increased mobility
no displacement
bleeding from gingival crevice

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7
Q

treatment of lateral luxation injury

A

reposition under LA
4 week splint - passive
endo evaluation in 2 weeks

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8
Q

how does a lateral luxation injury present

A

displacement of tooth out of socket in direction other than axially - usually palatally/lingually or labially

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9
Q

a pt presents with a trauma in which the tooth is displaces through the labial bone plate. you are worried this injury impinges on the permanent tooth bud, what type of injury is this?

A

intrusion

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10
Q

describe an extrusion injury

A

partial axial displacement of tooth out of socket
tooth appears elongated

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11
Q

describe an avulsion injury

A

tooth completely out socket

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12
Q

how do you manage a pt who has sustained a trauma injury

A

reassure
history
examine and diagnose

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13
Q

when testing percussion of teeth - what does a dull note indicate

A

root fracture

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14
Q

what information is recorded on a trauma stamp - 6

A

mobility
colour
TTP
sinus
percussion note
sensibility
radiograph

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15
Q

what is a complicated crown fracture

A

a fracture involving pulp, dentine and enamel

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16
Q

3 types of luxation injury

A

lateral
intrusion
extrusion

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17
Q

5 classification of supporting tissue injury

A

alveolar fracture
concussion
subluxation
luxation - lateral, intrusion, extrusion
avulsion

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18
Q

home care of an injured tooth to optimise healing

A

analgesia

soft diet

brush soft brush after every meal

be aware of infection signs

chlorhexadine mouth rinse 0.12% child at times other than brushing

avoid contact sports

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19
Q

treatment of enamel fracture child

A

smooth sharp edges

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20
Q

treatment of enamel dentine fracture child

A

cover exposed dentine with GI
restore composite later or immediately

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21
Q

treatment for complicated crown fracture in child

A

partial pulpotomy or extract

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22
Q

management of crown/rooth fracture on child

A

cover with GI if no pulp exposure

pulp exposure - pulpotomy ot extract

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23
Q

treatment of concussion injury

A

no treatment - observe

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24
Q

treatment of subluxation injury

A

no treatment - observe

if excessively mobile - place passive flexible splint up to 2 weeks

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25
treatment of lunation injury
if no occlusal interference, spontaneous reposition if severe displacement extract or reposition and splint
26
treatment of intrusion injury of 3+mm
reposition surgically and splint for 4 weeks
27
treatment of intrusion injury less than 3mm
allow spontaneous repositioning but if no eruption in 8 weeks surgically reposition and splint for 4 weeks
28
treatment ofd extrusion injury that is excessively mobile or >3mm
extract
29
treatment of extrusion injury
gently reposition under LA passive flexible splint for 2 weeks
30
treatment of primary avulsion injury
do not replant radiograph to confirm avulsion
31
how long do you splint an alveolar fracture for after repositioning the segment
4 weeks
32
4 long term complications of child trauma injury
delayed exfoliation discolouration trauma to permanent successor infection
33
meaning of mild grey tooth colour
may maintain vitality
34
meaning of opaque/yellow tooth colour
pulp obliteration
35
true or false - the younger trauma occurs, the more chance of injury to permanent successor
true
36
trauma can affect permanent successor in multiple ways - give 5
enamel defects arrested development abnormal crown or root morphology e.g. dilaceration ectopic tooth position delayed eruption
37
what is enamel hypo mineralisation
qualitative defect normal thickness of enamel put poorly mineralised white/yellow
38
what is enamel hypoplasia
quantitive defect reduced thickness but normal mineralisation yellow/brown defects
39
when is a radiograph indicated for delayed eruption of a permanent tooth
if 6 month delay or more compared to the contralateral tooth
40
most common injury in primary dentition
luxation
41
what is the affect of a large over-jet >9mm on incidence of trauma
doubles the incidence
42
patient presents to you with a dental trauma injury. when doing an extra oral examination, give 3 things you are checking for
lacerations CSF haemorrhage
43
patient presents to you with a dental trauma injury. when doing an intra oral examination, give 3 things you are checking for
occlusion penetrating wounds soft tissues
44
tests available to test sensibility of tooth
thermal - ethyl chloride or warm GP EPT
45
why should you sensibility test the teeth adjacent and opposing to obviously traumatised tooth
they will have received direct or indirect concussive injuries
46
when managing an enamel dentine pulp fracture, what 3 features of the exposure will influence your treatment
size of exposure time since injury associated PDL injury
47
suitable material for pulp capping or partial pulpotomy
MTA CaOH dycal
48
why is it important to preserve pulp vitality in open apices
to secure further root development
49
when is a direct pulp cap a suitable treatment option
tiny exposures <1mm in less than 24 hrs no TTP and sensibility +ve
50
disinfectant used in pulp capping and pulpotomy
sodium hypochlorite
51
when is a direct pulp cap a suitable treatment option
larger exposure >1mm or 24hr +
52
how many mm of pulp is removed during a partial pulpotomy and using what instrument
2mm - high speed round diamond bur
53
when would you need to proceed to a full coronal pulpotomy during a partial pulpotomy procedure
if hyperaemic or necrotic pulp after application of saline soaked cotton wool
54
why is MTA placed at apex of canal in open apex pulpectomy
to create a barrier at apex/plug
55
why does an extrusive luxation injury heal quicker than an intrusive luxation
extrusion - separation injury - limited damage to cells in area of trauma so wound healing can arise with minimal delay intrusion - crushing injury - extensive damage to cells - damaged tissue must be removed by macrophages and/or osteoclasts before healing can occur
56
true or false - there is greater chance of resorption in a closed apex after trauma
true
57
pt presents with a traumatised tooth which appears shorter in crown length. on percussion there is a high ankylotic metallic note. what injury has been sustained
intrusion
58
describe an intrusion injury
tooth forced into socket in an axial direction
59
critical factors of an avulsion injury that influence prognosis
EADT - extra alveolar dry time extra alveolar time - EAT storage medium
60
what emergency advice do you give to a pt with an avulsed tooth
insure permanent hold by crown, rinse in milk, saline or saliva if dirty replant immediately bite on gauze to hold in place - seek dental help immediately if can't replant - store in milk, saliva saline or water
61
tooth with closed apex, what effect does EADT less than 60 mins have on PDL cells
might be viable but compromised
62
tooth with closed apex, what effect does EADT > 60 mins have on PDL cells
likely non viable
63
how long is an avulsed tooth splinted for
2 weeks
64
open apex - EAT less than 60 mins, what is the likely outcome
spontaneous healing
65
open apex - EAT >60 min, what is likely outcome
PDL cells non viable and likely outcome is ankylosis related root resorption
66
give 3 contraindications of replanting a tooth
immunocompromised there is other injuries requiring emergency treatment very immature apex and EAT >90 mins or immature lower incisors in young child
67
how would you clinically diagnose a dentoalveolar fracture
several teeth move together palpate for segment moving
68
splint time for dento alveolar fracture
4 weeks
69
splint times general rule
all 4 weeks except for subluxation, extrusion and avulsion are 2 weeks
70
splint time for subluxation, extrusion and avulsion injuries
2 weeks
71
3 properties of a trauma splint
passive and flexible easy of placement and removal allow OH
72
main post trauma complications
pulp necrosis and infection pulp canal obliteration root resorption breakdown of marginal gingiva and bone
73
what is pulp canal obliteration
progressive hard tissue formation in canal - narrowing until total or partial obliteration
74
tooth colour associated with pulp canal obliteration
opaque yellow

BDS3 CDS (11 decks)

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