Trauma Flashcards
What is the follow up regimen for enamel fracture of primary teeth?
No follow up
What is the follow up regimen for enamel/dentin fracture of primary teeth?
8 weeks
What is the follow up regimen for crown fracture of primary teeth?
- 1 week
- 8 weeks
- 1 year
What is the follow up regimen for crown/root fracture of primary teeth?
- 1 week
- 8 weeks
- 1 year
What is the follow up regimen for root fracture of primary teeth?
- 1 week
- 4 weeks (IF SPLINTED, SPLINT REMOVAL)
- 8 weeks
- 1 year
What is the follow up regimen for alveolar fracture of primary teeth?
- 1 week
- 4 weeks (IF SPLINTED, SPLINT REMOVAL + RADIOGRAPH)
- 8 weeks
- 1 year (RADIOGRAPH)
- At 6yo
What is the follow up regimen for concussion of primary teeth?
- 1 week
- 8 weeks
What is the follow up regimen for subluxation of primary teeth?
- 1 week
- 8 weeks
What is the follow up regimen for extrusion of primary teeth?
- 1 week
- 8 weeks
- 1 year
What is the follow up regimen for lateral luxation of primary teeth?
- 1 week
- 4 weeks (IF SPLINTED, REMOVE SPLINT)
- 8 weeks
- 6 months
- 1 year
What is the follow up regimen for intrusion of primary teeth?
- 1 week
- 8 weeks
- 6 months
- 1 year
- At 6yo
What is the follow up regimen for avulsion of primary teeth?
- 1 week
- 8 weeks
- At 6yo
What is the follow up for infarction, permanent tooth?
No follow up
What is the follow up for enamel fracture, permanent tooth?
- Clinical + radiographic follow up:
- 6-8 weeks
- 1 year
What is the follow up for enamel/dentin fracture, permanent tooth?
- Clinical + radiographic follow up:
- 6-8 weeks
- 1 year
What is the follow up for crown fracture, permanent tooth?
- Clinical + radiographic follow up:
- 6-8 weeks
- 3 mo
- 6 mo
- 1 year
What is the follow up for crown/root fracture, permanent tooth?
- Clinical + radiographic follow up:
- 6-8 weeks
- 3 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for root fracture (apical third, mid-third), permanent tooth?
- Clinical + radiographic follow up:
- 4 weeks (Splint removal)
- 6-8 weeks
- 4 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for root fracture (cervical third), permanent tooth?
- Clinical + radiographic follow up:
- 4 weeks
- 6-8 weeks
- 4 mo (splint removal)
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for alveolar fracture, permanent tooth?
- Clinical + radiographic follow up:
- 4 weeks (splint removal)
- 6-8 weeks
- 4 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for concussion, permanent tooth?
- Clinical + radiographic follow up:
- 4 weeks
- 1 year
What is the follow up for subluxation, permanent tooth?
- Clinical + radiographic follow up:
- 2 weeks (splint removal)
- 3 mo
- 6 mo
- 1 year
What is the follow up for extrusion, permanent tooth?
- Clinical + radiographic follow up:
- 2 weeks (splint removal)
- 4 weeks
- 6-8 weeks
- 3 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for lateral luxation, permanent tooth?
- Clinical + radiographic follow up:
- 2 weeks
- 4 weeks (splint removal)
- 6-8 weeks
- 3 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for intrusion, permanent tooth?
- Clinical + radiographic follow up:
- 2 weeks
- 4 weeks (splint removal)
- 6-8 weeks
- 3 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for avulsion (mature), permanent tooth?
- Clinical + radiographic follow up:
- 2 weeks (splint removal)
- 4 weeks
- 3 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
What is the follow up for avulsion (immature), permanent tooth?
- Clinical + radiographic follow up:
- 2 weeks (splint removal)
- 4 weeks
- 6-8 weeks
- 3 mo
- 6 mo
- 1 year
- Yearly for at least 5 years
Concurrent crown fractures significantly increase risk of pulp necrosis + infection in teeth w/ what type of dental trauma?
Concussion + subluxation
Crown fractures w/ and w/o pulp exposure significantly increase the risk of pulp necrosis + infection in teeth w/ what type of dental injury?
Lateral luxation
Radiographs to take for dental trauma
- One parallel PA aimed through the midline to show the two maxillary central incisors
- One parallel PA aimed at the maxillary right lateral incisor (should also show the right canine + central incisor)
- One parallel PA aimed at the maxillary left lateral incisor (should also show the left canine + central incisor)
- One maxillary occlusal radiograph
- At least one parallel PA of the lower incisors centered on the two mandibular centrals
Why do we also take an occlusal radiograph in addition to PA’s for dental trauma?
Occlusal radiograph provides a different vertical view of the injured teeth + surrounding tissue, which is helpful in detecting lateral luxation, root fracture, and alveolar bone fractures
What type of dental injuries is CBCT helpful for?
- Root fractures
- Crown/root fractures
- Lateral luxations
How do you rehydrate a tooth fragment that you will bond back on to a tooth that sustained dental trauma?
Soak the fragment in water or saline for 20 min before bonding
What materials should you use for a partial pulpotomy following traumatic pulp exposure?
Non-setting calcium hydroxide or non-staining calcium silicate
Marginal bone loss + periodontal inflammation is an unfavorable outcome for what type of dental trauma?
Uncomplicated + complicated crown-root fractures
What dental injury might you see bleeding from the gingival sulcus?
Root fracture
What dental injury might you have negative sensibility testing?
- Root fracture
- Subluxation
- Extrusive luxation
- Lateral luxation
- Intrusive luxation
What type of root fractures have the potential to heal?
Cervical root fractures
What dental injuries might you see external inflammatory resorption as an unfavorable outcome?
- Alveolar fracture
- Subluxation
- Extrusive luxation
- Lateral luxation
- Intrusive luxation
Ankylosis is an unfavorable outcome with what dental injury?
- Lateral luxation
- Intrusive luxation
What is likely to happen with the pulp of a subluxated permanent tooth?
Necrosis - RCT should be started w/ corticosteroid-abx OR calcium hydroxide to prevent external resorption
Intrusive luxation: immature permanent teeth tx
- Allow re-eruption
- If no re-eruption in 4 wks, initiate orthodontic repositioning
- Monitor
- Spontaneous revascularization may occur
Intrusive luxation: mature permanent teeth tx
- If <3mm: Allow re-eruption
- If no re-eruption in 8 wks, reposition surgically + splint for 4 weeks OR reposition orthodontically before ankylosis develops
- If 3-7mm, reposition surgically (preferable) or orthodontically
- >7mm reposition surgically
- Monitor
- Spontaneous revascularization may occur
Why is sensibility testing unreliable following dental trauma?
- Due to a transient lack of neural response or undifferentiation of A delta nerve fibers of young teeth
What is used to measure blood flow of traumatized teeth?
Pulse oximetry
Limited due to lack of sensors
Laser + ultrasound doppler are also being investigated
Short term, passive, flexible splint dimensions
SS 0.4mm in diameter
Pulp canal obliteration in dental trauma
- Occurs more frequently in teeth w/ open apices which have suffered a severe luxation injury
- Indicates presence of viable tissue w/in the root canal
- Extrusion, intrusion + lateral luxation have high rates of PCO
- Common following root fractures
What type of dental injuries will you see pulp canal obliteration?
- Extrusion, intrusion + lateral luxation have high rates of PCO
- Common following root fractures
How long can CaOH2 sit in canal of initiated RCT following trauma?
up to 1 mo
Should be placed 1-2 wk after trauma
How long can corticosteroid/abx sit in canal of initiated RCT following trauma?
up to 6 wks
Would you consider early RCT w/ immature tooth that has been intruded + crown fracture (combined injury)?
Yes - at a higher risk of pulp necrosis
When should RCT be initiated if external resorption is detected?
Immediately. CaOH2 should be placed for 3 weeks + replaced every 3mo until radiolucencies of the resorptive lesions disappear.
Final obturation can be completed when boen repair is visible radiographically