Paeds Trauma- Assessment, Classification And Management Of Crown Fractures Flashcards
What type of trauma injuries are most common in the primary dentition?
Luxation
What is the most common type of trauma injury in the permanent dentition?
Enamel-dentina fracture
What size of overjet doubles the incidence of trauma to permanent teeth?
9mm overjet doubles trauma incidence
Which 3 conditions should you be aware of when taking a medical history of trauma patient?
Rheumatic fever
Congenital heart defects
Immunisuppression
Describe things to look for when carrying out extra oral exam?
Any other injuries (non dental)
Lacerations
Haematomas
Haemorrhage / CSF
Subconjunctival haemorrhage
Bony step deformities
Mouth opening (jaw fracture possible if limited)
What should you look for when carrying out Intra oral exam of trauma patient?
Soft tissue
Alveolar bone
Occlusion
Teeth
Penetrating wounds/foreign bodies
What may be indicated by tooth mobility?
Displacement of tooth
Root fracture (tooth will be shorter, more mobile)
Bone fracture (often multiple mobile teeth and overlying soft tissue moving with it)
What is included in a trauma stamp?
Sinus (draining/ non-draining)
Colour
TTP
Mobility (give a grade)
EPT
ECL
Percussion note
Radiograph
What does the colour of the tooth indicate?
Dark grey/ brown- non vital
Pink- internal resorption/ pulpal bleeding (this can turn to purple as blood products are broken down)
Yellow- pulp canal obliteration (reparatory deposition of dentine)
How long should you continue to carry out sensibility testing after trauma?
At least 2 years
Outline the classification of fractures
Enamel
Enamel- dentine
Enamel- dentine- pulp
Uncomplicated crown root fracture
Root fracture (apical/ middle/ coronal third)
Complicated crown root fracture
What 5 factors does prognosis of fractured tooth depend on?
- stage of root development
- type of injury
- if PDL is damaged
- time between injury and treatment
- presence of infection
Why is there a higher chance of maintaining vitality in open apex tooth?
Larger neurovascular bundle at the apex, more able to revascularize.
What are the 5 main principles of emergency treatment
Aim to retain vitality of any damaged tooth by protecting exposed dentine by an adhesive definite bandage
Treat exposed pulp tissue
Reduction and immobilisation of displaced teeth
Tetanus prophylaxis
Antibiotics?
What are the intermediate principles of treatment
- ongoing management of splinting, loss of vitality, restorations
- pulp treatment (direct/ indirect pulp cap, pulpotomy, pulpectomy)
- restoration (minimally invasive eg. Acid etch)