Primary Trauma Flashcards
Trauma hx questions
When
Where
How
Associated symptoms
Lost teeth/fragments
Relevant MH features
Rheumatic fever
Congenital heart defects
Immunosuppression
E# tx
Smooth edges
ED# tx
Cover exposed dentine with GI or comp
EDP# tx
Partial pulpotomy with NsCAOH over pulp –> GI –> Composite
Crown root # tx
No tx if rapid referral
Pulp exposed = pulpotomy
Not exposed = cover exposed dentine
Alveolar # tx
Reposition under LA + 4wks flexible splint
Concussion injury tx
Observe
Subluxation injury tx
Observe
Extrusive luxation tx
No interference with occlusion = spontaneous repositioning
Inference = XLa
Lateral luxation tx
Spontaneous repositioning or XLa
Intrusive luxation tx
Spontaneous repositioning
Why would you do localisation of tooth injury?
To decide whether the root is encroaching on permanent tooth
What 2 types of film can you use to help localise?
PA
Lateral pre maxilla (e/o film)
From your localisation PA, what does it mean if the apical tip appears shorter than that of the contralateral tool?
It has been displaced towards of through the buccal plate (away from developing tooth germ)
From your localisation PA, what does it mean if the apical tip is indistinct and the tooth appears elongated in comparison to the contralateral tooth?
Apex is displaced towards the permanent tooth germ
Tx for avulsed tooth
Radiograph to confirm avulsion
Do not reimplant
List 3 long term complications of trauma to primary teeth
- Discolouration
- Discolouration and infection
- Delayed exfoliation
Tx options for vital discoloured and infected primary tooth
No tx
Tx options for non vital discoloured and infected primary tooth
If sinus or PAP = XLa
If no sinus or PAP = Review
Opaque = no tx
Effects of delayed exfoliation of primary tooth
Primary tooth may not resorb normally post trauma
XLa necessary or permanent successor will erupt ectopically
Long term effects of trauma on permanent teeth (6)
- Enamel defects
- Abnormal tooth/root morphology
- Delayed eruption
- Ectopic tooth position
- Arrest in tooth formation
- Complete failure of tooth to form
Examples of enamel defects (2)
Hypomineralisation - white yellow
Hypoplasia - yellow brown
Tx options for crown dilaceration
Surgical exposure
Ortho realignment
Tx options for root dilaceration
Combined surgical + ortho
Tx options for arrest of root developement
RCT/XLa
Tx options for odontome
Surgical removal
