s10 - Trauma Flashcards
What is the most common age group for dental trauma in children?
8-12 years old.
What is the gender predilection for dental trauma in children?
Male-to-female ratio is 3:1.
What is the most common cause of dental trauma in primary dentition?
Accidental falls (80-90%).
Which teeth are most commonly affected by dental trauma?
Maxillary central incisors (both primary and permanent dentition).
What occlusal factors predispose children to dental trauma?
Class II div 1, increased overjet (>9 mm), lip incompetence.
What dental factors increase the risk of dental trauma?
Caries, RCT, enamel defects (e.g., amelogenesis imperfecta).
What systemic conditions predispose children to dental trauma?
Neurological disorders (e.g., cerebral palsy, epilepsy).
What is the “ugly duckling stage,” and how does it relate to dental trauma?
A transitional phase in mixed dentition where incisors are flared, increasing risk of trauma.
What is pulpal hyperemia, and how does it present clinically?
Congestion of blood vessels in the pulp, causing a reddish color compared to adjacent teeth.
What is the fate of a tooth with pulpal hyperemia?
It may resolve or progress to pulp necrosis.
What causes internal hemorrhage in a traumatized tooth?
Increased pulpal pressure leading to capillary rupture and RBC escape.
What is the clinical significance of internal hemorrhage?
It can cause temporary or permanent discoloration of the tooth.
What is pulp calcification, and how does it appear clinically?
A rapid repair response where the pulp is replaced by calcified tissue, appearing opaque yellow.
What is internal resorption, and how is it diagnosed?
A destructive process caused by odontoclastic activity, seen as a “pink spot” or radiographically in the pulp chamber.
What is the treatment for internal resorption?
Pulp extirpation and placement of Ca(OH)₂ to stop resorption.
What are the key components of history-taking for dental trauma?
Personal history, medical history, dental history, and trauma history.
Why is the time elapsed since trauma important in diagnosis?
Shorter time between trauma and treatment improves prognosis (e.g., avulsion, pulp exposure).
What should be suspected if a child’s clinical findings don’t match the history?
Child abuse.
What does a hematoma in the floor of the mouth indicate?
Mandibular fracture.
What is the significance of tooth mobility in dental trauma?
Mobility of two or more teeth suggests an alveolar fracture.
How is a non-vital tooth identified clinically?
Discoloration (gray, brown, or black) and lack of response to sensitivity tests.
What does a lower reading on an electric pulp tester indicate?
Pulp hyperemia or pulpitis.
What is the treatment for an uncomplicated crown fracture (Ellis Class I)?
No treatment needed unless sharp edges are smoothed or fluoride is applied.
What is the emergency treatment for a crown fracture with exposed dentin?
Cover exposed dentin with calcium hydroxide and a protective composite resin.
What is fragment restoration, and when is it used?
Reattaching a fractured tooth fragment using resin bonding techniques.
What factors influence treatment for a complicated crown fracture?
Pulp vitality, size of exposure, time elapsed, root maturity, and restorability.
What is the treatment for a small pulp exposure in a vital tooth with an open apex?
Direct pulp capping.
What is the treatment for a large pulp exposure in a vital tooth with an open apex?
Partial or complete pulpotomy.
What is apexification, and when is it used?
A procedure to induce apical closure in non-vital teeth with open apices.
What is the treatment for a root fracture in the apical third?
No treatment needed; monitor healing with X-rays.
What is the treatment for a middle third root fracture?
Reposition the fragment and splint for 4-6 weeks.
What is the treatment for a coronal third root fracture?
Reposition the fragment and splint for 3-4 months.
What is the treatment for an intruded permanent tooth with incomplete root formation?
Allow spontaneous re-eruption.
What is the treatment for an avulsed permanent tooth with an open apex?
Immediate replantation within 30-60 minutes, splint for 1-2 weeks, and RCT after 7-10 days.
What is Ellis Class I fracture?
Simple crown fracture involving enamel only or enamel and little dentin.
What is Ellis Class II fracture?
Extensive crown fracture involving considerable dentin without pulp exposure.
What is Ellis Class III fracture?
Extensive crown fracture involving considerable dentin with pulp exposure.
What is Ellis Class IV fracture?
Non-vital traumatized tooth with or without loss of crown structure.
What is Ellis Class V fracture?
Root fracture with or without crown fracture.
What is the WHO classification for soft tissue injuries?
Abrasion, contusion, laceration, and soft tissue avulsion.
A 13-year-old child presents with a palatally displaced tooth #11 and a middle root fracture. What is the treatment?
Reposition the tooth, splint for 4-6 weeks, and monitor healing.
A 9-year-old child presents with large pulp exposure in tooth #11 and small pulp exposure in tooth #21. What is the treatment?
Direct pulp capping for #21 and partial/complete pulpotomy for #11.
A 9-year-old child presents 2 days after trauma with no pulp exposure. What is the treatment?
Monitor for pulp vitality and provide a protective restoration if needed.
A 10-year-old child presents with a tooth tender to percussion but no fracture. What is the treatment?
Monitor for pulp vitality and provide symptomatic relief.
A 9-year-old child presents with an intruded tooth #21. What is the treatment?
Allow spontaneous re-eruption if the apex is open; otherwise, orthodontic extrusion.
What is the treatment for a cervical third root fracture in a permanent tooth?
Reposition the fragment and splint for 3-4 months.
What is the treatment for a middle third root fracture in a permanent tooth?
Reposition the fragment and splint for 4-6 weeks.
What is the best transport medium for an avulsed tooth?
HBSS (Hank’s Balanced Salt Solution).
What is the second-best transport medium for an avulsed tooth?
Cold milk.
What is the least preferred transport medium for an avulsed tooth?
Water.
What is the maximum dry time for successful replantation of an avulsed tooth?
60 minutes.
What is the most common complication of dental trauma?
Pulp necrosis.
What is the radiographic sign of external root resorption?
Loss of root structure with irregular margins.
What is the clinical sign of ankylosis?
The tooth appears submerged compared to adjacent teeth.
What is the follow-up schedule for a replanted tooth?
Weekly for the first month, then at 3, 6, and 12 months, and yearly thereafter.
