Primary Trauma

Question 1

Ellis Classification

Answer 1

I - Enamel
II - Dentine
III - Pulp
IV - Non Vital
V- Lost
VI - Root #
VII - Displacement No #
VIII - Complete Crown # + Replacement
IX - Primary Trauma

Question 2

Andreasen Classification 1994

Answer 2

• A: Hard Tissue
• • Crown Infarction: Enamel Crack
• • Uncomplicated Crown #: Enamel + Dentine
• • Complicated Crown #: Pulp exposure
• • Uncomplicated Crown Root #: Enamel. Dentine. Cementum
• • Complicated crown root #: Involving pulp
• • Root # Dentine,Cementum, Pulp excluding Enamel
• B: Periodontal
• • Concussion: No Mobility + Displacement, TTP
• • Subluxation: Loosening, No Displacement
• • Intrusive Luxation: Displacement into Alveolar Bone, # of socket
• -Extrusive Luxation: Partial coronal displacement
• • Lateral Luxation: Accompanied by socket #

Question 3

Ellis I Rx

Answer 3

Smooth Rough edges, Restore

Question 4

Ellis II Rx

Answer 4

Smooth edges and Restore

Question 5

Ellis III Rx

Answer 5

Pulpotomy or XLA

Question 6

Crown Root#

Answer 6

Mobility + Malocclusion

XLA

Question 7

Root #

Answer 7

Mobile and Displaced Coronal aspect.

XLA if coronal aspect is displaced

Question 8

Dento-alveolar

Answer 8

Mobile tooth containing segment,
Occlusal Interference
Rx: Reposition and splint 4-6weeks. 1 week recall. Monitor teeth in fracture line, Soft diet for two weeks, Good OH.

Question 9

Concussion

Answer 9

• Clinical
• -TTP
• -Vital
• -No displacement or mobility
• -No bleeding
• Radiographic
• -Normal
• Rx
• -Observe + Analgesia

Question 10

Subluxation

Answer 10

-Clinical
– Mobile
– No displacement
–TTP
Radiographic-
–NAD
-Rx
–Observe
–Splint mobile teeth
– 24 hr recall
– Soft Diet
–OH

Question 11

Lateral Luxation

Answer 11

-Clinical
– Accompanied by Alveolar#
–Immobile
–Linugal luxation common
-Rx
– No Occ Inteference: Allow spontaneous repositioning
– Occ Interference:
LA reposition
–Severe displacement: XLA
– 2 wk recall

Question 12

Intrusive Luxation

Answer 12

• Clinical
• • Decreased Crown Height
• -Bleeding
• -Root and Alveolar #
• -Determine if Intruded or fractured
• Radiograph
• -Labial Displacement: Apical tip visible and shorter than Contralateral tooth
• -Towards bud: Apical tip not visible, elongated.
• Rx
• -Labial Disp.:No Rx
• • <50% intruded, No Rx
• • 100% intruded or towards bud: XLA
• • 1 wk then 2 wk recall
• • Monitor for damage to tooth bud

Question 13

Extrusive Luxation

Answer 13

• Clinical
• -Elongated and Mobile
• Radio
• -Increased PDL space apically
• Rx
• • <3mm: Reposition or no Rx
• • > 3mm: in fully formed 1` XLA

Question 14

Avulsion

Answer 14

• Rule out Aspiration, Intrusion, Fracture

- Rx: Do not reimplant, Control bleeding, 1 wk recall and then yearly

Question 15

Home Care

Answer 15

• Good OH
• Soft Brush
• 0.1% CHX topically bd 1/52
• Soft diet 10 days
• No pacifier
• look out for swelling, Mobility, sinus tract

Question 16

Sequel of Dental Trauma

Answer 16

• Pulp necrosis
• Abscess formation
• Hypoplasia or hypommineralisation of 2~
• Resorption of germ
• Displacement of bud
• Pulp chamber and canal obliteration
• Gingival recession
• Root resorption
• Premature tooth loss