Post-trauma complications

Question 1

What are the main post-trauma complications after trauma to the permanent dentition?

Answer 1

Pulp necrosis and infection

Pulp obliteration

Discolouration

Loss of vitality

Root resorption

Breakdown of marginal gingiva and bone

Unfavourable tooth positions

Defects in hard and soft tissues
- bone loss, gingival lacerations, enamel defects

Question 2

What is pulp canal obliteration?

Answer 2

Response of a vital pulp
- progressive hard tissue formation within the pulp cavity.
- Gradual narrowing of the pulp chamber and pulp canal.

Question 3

What is the treatment for pulp canal obliteration?

Answer 3

Conservative management.

Question 4

What diagnostic indicators would suggest pulp necrosis and apical periodontitis?

Answer 4

Negative to sensibility tests
Non-physiological mobility
Sinus tract
Swelling
Pus
Discolouration- grey/brown/black
TTP and tender to palpation in the vestibule

Radiograph
- PA radiolucency
- Infection-related external root resorption

Question 5

What management options are there for teeth in unfavourable positions following trauma?

Answer 5

If minimal changes are observed
- addition of composite resin or removal of tooth tissue

Significant alterations
- Extra-coronal restorations

Could also attempt ortho repositioning