Primary Trauma

Question 1

Trauma hx questions

Answer 1

When
Where
How
Associated symptoms
Lost teeth/fragments

Question 2

Relevant MH features

Answer 2

Rheumatic fever
Congenital heart defects
Immunosuppression

Question 3

E# tx

Answer 3

Smooth edges

Question 4

ED# tx

Answer 4

Cover exposed dentine with GI or comp

Question 5

EDP# tx

Answer 5

Partial pulpotomy with NsCAOH over pulp –> GI –> Composite

Question 6

Crown root # tx

Answer 6

No tx if rapid referral
Pulp exposed = pulpotomy
Not exposed = cover exposed dentine

Question 7

Alveolar # tx

Answer 7

Reposition under LA + 4wks flexible splint

Question 8

Concussion injury tx

Answer 8

Observe

Question 9

Subluxation injury tx

Answer 9

Observe

Question 10

Extrusive luxation tx

Answer 10

No interference with occlusion = spontaneous repositioning
Inference = XLa

Question 11

Lateral luxation tx

Answer 11

Spontaneous repositioning or XLa

Question 12

Intrusive luxation tx

Answer 12

Spontaneous repositioning

Question 13

Why would you do localisation of tooth injury?

Answer 13

To decide whether the root is encroaching on permanent tooth

Question 14

What 2 types of film can you use to help localise?

Answer 14

PA
Lateral pre maxilla (e/o film)

Question 15

From your localisation PA, what does it mean if the apical tip appears shorter than that of the contralateral tool?

Answer 15

It has been displaced towards of through the buccal plate (away from developing tooth germ)

Question 16

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?

Answer 16

Apex is displaced towards the permanent tooth germ

Question 17

Tx for avulsed tooth

Answer 17

Radiograph to confirm avulsion
Do not reimplant

Question 18

List 3 long term complications of trauma to primary teeth

Answer 18

• Discolouration
• Discolouration and infection
• Delayed exfoliation

Question 19

Tx options for vital discoloured and infected primary tooth

Answer 19

No tx

Question 20

Tx options for non vital discoloured and infected primary tooth

Answer 20

If sinus or PAP = XLa
If no sinus or PAP = Review
Opaque = no tx

Question 21

Effects of delayed exfoliation of primary tooth

Answer 21

Primary tooth may not resorb normally post trauma
XLa necessary or permanent successor will erupt ectopically

Question 22

Long term effects of trauma on permanent teeth (6)

Answer 22

• Enamel defects
• Abnormal tooth/root morphology
• Delayed eruption
• Ectopic tooth position
• Arrest in tooth formation
• Complete failure of tooth to form

Question 23

Examples of enamel defects (2)

Answer 23

Hypomineralisation - white yellow
Hypoplasia - yellow brown

Question 24

Tx options for crown dilaceration

Answer 24

Surgical exposure
Ortho realignment

Question 25

Tx options for root dilaceration

Answer 25

Combined surgical + ortho

Question 26

Tx options for arrest of root developement

Answer 26

RCT/XLa

Question 27

Tx options for odontome

Answer 27

Surgical removal