primary trauma Flashcards
aetiology of primary trauma
falls
bumps
NA trauma
patient management -primary trauma
Reassure • History • Examination • Diagnosis • Emergency treatment • Advise parent of sequelae to permanent teeth • Further treatment and review
classifications of injury - primary trauma
- Enamel - E# - uncomplicated
- Enamel-dentine - ED# - uncomplicated
- Enamel-dentine-pulp - EDP# - complicated
- Crown-root (pulp involved)
- Root #
- Alveolar #
- Concussion / Subluxation
- Luxation - lateral, intrusive, extrusive
- Avulsion
home management of a primary trauma injury
Soft diet for 10-14 days
• Brush teeth with soft toothbrush after every
meal
• Topical chlorhexidine by parent twice daily
for one week (cotton wool rolls for swabbing)
• After initial treatment review 1, 3 ,6 monthly
taking radiographs if possible 6 monthly
• Intrusion requires monthly review for 6
months then 6 monthly. Radiograph initially
then 6 monthly.
PRIMARY trauma - management of E#
management of ED#
Enamel only smooth sharp edges Enamel only or enamel-dentine fractures • Restore/bandage with composite or compomer (do not use GI)
PRIMARY trauma - management of EDP#
Enamel-dentinepulp fractures •Endodontic therapy or extract
PRIMARY trauma - management of CR#
Extract coronal fragment
• Don’t be overzealous to remove any root
fragments that aren’t obvious. These should
be left to resorb physiologically
PRIMARY trauma - alveolar bone #
Reposition segment. Splint to adjacent teeth
3-4 weeks.
• Teeth may need to be extracted after
alveolar stability has been achieved.
• This is the only case where a splint will be
used in the management of primary trauma
PRIMARY trauma - concussion/subluxation
observe
PRIMARY TRAUMA - lateral luxation
Radiograph - increased pl space apically. • No occlusal interference - allow to position spontaneously • Occlusal interference - extract
how to localise an intrusion injury
take a PA radiograph
-if the apical tip appears shorter than that of the
contralateral tooth then it has been displaced toward
or through the buccal plate (this is the preferable
direction- away from the developing tooth germ)
- if apical tip is indistinct and the tooth appears
elongated in comparison to the contralateral tooth
then the apex is displaced toward permanent tooth
germ
PRIMARY trauma - management of intrusion
If root has been displaced labially away from tooth
germ- leave to re-erupt. If no progress after 6 months
then extract.
• If palatally, toward permanent tooth germ - extract
Intrusion
PRIMARY trauma - management of extrusion
XLA
PRIMARY trauma - management of avulsion
Rg to confirm all out
-DON’T REPLANT
long term effect of trauma on primary teeth
discolouration
delayed exfoliation
discolouration and inf
