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BDS3 CDS Paeds > Supporting Tissue Injuries > Flashcards

Supporting Tissue Injuries Flashcards

1
Q

What are the three structures of the tooth which can be affected during traumatic injury ?

A

Surrounding bone, neuromuscular bundle, root surface.

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2
Q

What is an example of a separation injury ?

A

Extrusive luxation.

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3
Q

What is an example of a crushing injury ?

A

Intrusive luxation.

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4
Q

Define a separation injury.

A

Cleavage of intercellular structures i.e. collagen, causing limited damage to cellular structures. Wound healing can occur from existing cellular structures.

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5
Q

Define crushing injury ?

A

Damage to cellular and inter-cellular systems, meaning damaged tissue must be removed by macrophages and/or osteoclasts before restoration causing delayed healing time.

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6
Q

Define concussion.

A

Injury to tooth supporting structures without abnormal loosening or displacement of tooth.

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7
Q

What are the clinical findings you would expect to see for concussion injury ?

A

Pain on percussion.
Normal mobility.
Retained in normal position in arch.
No abnormal radiographic radiolucency.

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8
Q

What follow up would be required for concussion injury ?

A

Clinical and radiographic review at 4 weeks and 1 year post-injury.

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9
Q

Define subluxation.

A

An injury to tooth supporting structures with abnormal loosening but without tooth displacement.

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10
Q

What clinical findings would you expect to see in a subluxation injury ?

A

Increased mobility.
Tender to percussion.
Bleeding from gingival crevice (may or may not be present).
No displacement of tooth.
Normal radiographic appearance.

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11
Q

What treatment would be required for subluxation injury ?

A

Normally nothing.
Passive or flexible splint for 2 weeks post-injury where excessive mobility or tenderness when biting.

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12
Q

What follow up would be required for subluxation injury ?

A

Clinical and radiographic review.
2 weeks - splint removal.
12 weeks.
6 months.
1 year.

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13
Q

What monitoring tools (special tests) can be used for concussion and subluxation injuries ?

A

Trauma stamp.
Sensibility test.
Radiographs - track root development, comparison with contra-lateral tooth, resorption.

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14
Q

What 8 assessments should be made in trauma stamp ?

A

TTP.
Sinus.
Colour.
Mobility.
Percussion.
Ethyl chloride.
EPT.
Radiograph.

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15
Q

Define extrusion.

A

Injury which tooth suffers axial displacement partially out of the socket.

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16
Q

What clinical finding would be expected following extrusion injury ?

A

Tooth appears elongated.
Usually displaced palatally.
Tooth mobile.
Bleeding from gingival sulcus.
Radiographically -
- Widened PDL apically and laterally.
- Crown elongated and tooth not fully seated within alveolar bone.

17
Q

What treatment would be required for extrusion injury ?

A

Reposition tooth with LA.
Passive flexible splint for 2 weeks. If fracture to marginal supporting bone - additional 4 weeks.

18
Q

What follow up would be required for extrusion injury ?

A

2 weeks - splint removal.
4 weeks.
8 weeks.
12 weeks.
6 months.
1 year.
Annually for 5 years.

19
Q

Define lateral luxation.

A

Displacement of tooth in socket in direction other than axially. Accompanied by communication or fracture of alveolar bone plate or facial cortical bone.

20
Q

What clinical findings would you expect following lateral luxation ?

A

Tooth appears displaced in socket.
Tooth immobile as tooth becomes locked in bone.
High ankylotic percussion tone (metallic tone).
May or may not - bleeding from gingival sulcus.
Root apex palpable in sulcus.
Radiograph - widened PDL space - may need 2x radiographs.

21
Q

What treatment would be required for lateral luxation injury ?

A

Reposition with LA.
Passive flexible splint - 4 weeks.
Monitor with endodontic evaluation (2 weeks) - if necrotic, extirpate.

22
Q

What is the prognosis and healing which can be expected following lateral laxation injury in a tooth with incomplete root formation (with immature apice) ?

A

Spontaneous revascularisation.
Necrotic pulp and signs of infection related inflammation external resorption - start RCT - specialist paediatric consultant treatment.

23
Q

What is the prognosis and healing which can be expected following lateral laxation injury in a tooth with complete root formation (with mature apice) ?

A

Necrotic pulp - start RCT.
Corticosteroid and antibiotic or CaOH - intra oral medicament to prevent development of infection-related inflammation external resorption.

24
Q

What follow up should be given post-lateral luxation injury ?

A

Clinical and radiographic assessment.
2 weeks - endo assessment.
4 weeks - splint removal.
8 weeks.
12 weeks.
6 months.
1 year.
Annually for 5 years.

25
Q

Define intrusion.

A

Tooth forced into socket in axial direction and locked into bone.

26
Q

What clinical findings should be expected for intrusion injury ?

A

Shortened crown.
Bleeding for gingivae.
Ankylotic percussion tone.
Immobile.
2x radiographs to visualise.

27
Q

What treatment should follow intrusion of tooth with immature root formation ?

A

Spontaneous repositioning of tooth.
No-eruption after 4 weeks ? Ortho treatment.

Monitor pulp condition.
Spontaneous revascularisation can occur.
Necrotic and signs of infection-related inflammatory external resorption - start RCT ASAP.

28
Q

What treatment should follow intrusion of <3mm of tooth with mature root formation ?

A

Spontaneous repositioning.
No eruption in 8 weeks ? Reposition surgically and splint for 4 weeks OR reposition ortho before ankylosis.

29
Q

What treatment should follow intrusion of 3-7mm of tooth with mature root formation ?

A

Reposition surgically or orthodontically.

30
Q

What treatment should follow intrusion of >7mm of tooth with mature root formation ?

A

Reposition surgically.

31
Q

What is the most likely prognosis for a intruded mature tooth with complete root formation ?

A

Will almost always become necrotic.
Start end treatment at 2 weeks or as soon as tooth position allows.

32
Q

What does RCT of traumatised tooth aim to prevent ?

A

Aims to prevent development of inflammatory (infection-related) external resorption and ankylosis.

33
Q

What follow up should be given after intrusion injury ?

A

2 weeks.
4 weeks - splint removal.
8 weeks.
12 weeks.
6 weeks.
1 year.
Annually for 5 years.

BDS3 CDS Paeds (5 decks)

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