Test 2: management of trauma to the teeth and supporting tissue Flashcards
T/F THe clinical exam should be conducted after the teeth in the area of injury have been cleaned of debris
True
What is class I crown fracture?
-Simple fracture of the crown involving little or not dentin
What is a class II crown fracture?
- Extensive fracture of the crown involving considerable dentin but not the dental p ulp
What is a class III crown fracture?
-Extensive fracture of the crown with an exposure of the dental pulp
What is a class IV crown fracture?
-Loss of the entire crown
How do you treat a class I fracture?
- May only need smoothing off or bonded resin
- Always do a thorough examination
What is the treatment of choice for a class II fracture?
-A temporary cover of dentin can be accomplished easily without to much additional trauma
What is the most common fracture in permanent teeth?
-Class II fracture
What are reactions of a tooth to trauma?
- Pulpal hyperemia
- Internal hemorrhage
- Dark-gray
- Light grey or yellow
What is a long range reaction of the pulp that has congestion of blood in the pulp chamber and often appears reddish
Pulpal hyperemia
When is the color change evident with internal hemorrhage from trauma?
1-3 weeks
What causes internal hemmorrhage?
-Hypermia and increased pressure causes the ruptrue of capillaries and the escape of red blood cells with breakdown and pigment formation in the tubules
What does dark-grey teeth often mean?
- Non-vital pulp
- Possibly necrotic
What does light grey or yellow often mean?
-Pulp vital with canal obliterations
What color are the teeth that have undergone calcific metamorphosis?
-Yellowish opaque color
primary teeth undergo normal root resorption
Do you splint/reposition primary teeth?
-No you either leave it alone or take it out
T or F:
injuries to teeth of children and adults present unique problems in diagnosis and treatment, and the diagnosis is difficult and often inconclusive regardless of loss of tooth structure
true
a force strong enough to fracture, intrude, or avulse a tooth is also strong enough to result in ___ or ___ injury
cervical spine or intracranial injury
patients with dental injuries should be evaluated for nausea, vomiting, drowsiness, or possible CSF leaking from ears or nose, which could indicate ___
skull fracture
T or F:
repeated injuries to the teeth are uncommon in children
false
patient complaints and experiences after injury, such as ___ or ___, can be helpful in determining the extent of dental injury
pain to thermal changes and pain upon closing mouth
not all teeth that are injured will respond to the accepted methods of testing pulp vitality because ___
the traumatized tooth may be in a state of shock
since injury is considered a dirty wound, you should always check that the patient’s ___ inoculation is current
- tetanus
- you should also make sure all immunizations are up to date, such as tdap and dpt
are all extra and intraoral injuries considered dirty?
yes
what is often the treatment of choice for class I and II fractures?
a temporary cover of dentin, which can be accomplished easily without too much additional trauma to the injured tooth
a ___ can be made to replace premature loss/extraction of primary teeth in an effort to preserve the corresponding permanent teeth
pedo partial
in the case of internal hemorrhage, what happens to the color of a tooth if the blood is reabsorbed before gaining access to dentinal tubules?
- little, if any, color change will be noticeable, and it will be temporary
- more severe cases will exhibit pigment formation
in severe cases of internal hemorrhage, how long after injury is color change evident? is the color change reversible?
- within 2-3 weeks
- some of the change is reversible, but some will remain
in severe cases of internal hemorrhage, is pulp vital?
pulp may remain vital, but if color change remains dark grey, the likelihood of vitality is low
permanent teeth that have undergone calcific metamorphosis will usually be ___ indefinitely, and must be followed because they are a potential focus of ___, especially if the root canal is totally obliterated
- retained
- infection
what type of treatment is indicated for the following:
- patient is seen within 1-2 hours after injury
- vital pulp exposure is small
- sufficient crown is left to retain a temporary restoration over the pulp capping and prevent ingress of oral fluids
direct pulp cap
what are the basic steps of a direct pulp cap?
- thin layer of dentin-type material is placed over the exposed pulp, then sealed with a bonded restoration
- most important is to seal and protect the pulp tissue from oral fluids