trauma Flashcards
what are the clinical signs of root fracture
coronal segment may be mobile
TTP
bleeding from gingival sulcus
displacement
radiographic (PA and occlusal) signs of root fracture
what is the treatment for coronal and middle 1/3 root fractures
reposition coronal segment
stabilise with 4w flexible splint
do not start RCT at emergency appt
what is the treatment for cervical 1/3 root fractures
reposition coronal segment
stabilise with 4m flexible splint
if the fracture is above the alveolar crest in mature teeth extract the segment and place a post crown
if pulp necrosis happens then RCT coronal segment
what are the clinical signs of extrusion
displacement of the tooth in an axially direction
mobility
no radiographic signs of root fracture
what is the treatment for extrusion
reposition under LA
flex splint 2w
if associated with bone fracture splint for additional 4w
what are the clinical signs of alveolar fracture
displacement
multiple teeth moving as a unit
occlusal disturbances
what is the treatment for alveolar fracture
reposition segment and splint 4w
suture gingival lacerations
what are the clinical signs of intrusion
tooth is displaced into the socket
there is no mobility
high pitched percussion note
what is the treatment for intrusion
incomplete root formation - allow for re eruption for 4w
if no re eruption then perform ortho repositioning
complete root formation - <3mm allow for re eruption for 8w; then surgical reposition and splint 4w
3-7mm surgical or ortho repositioning
>7mm surgical repositioning surgical repositioning
pulp death is likely so initiate at 2w and use corticosteroid-AB paste as intra canal medicament
what are the clinical signs of lateral luxation
tooth is displaced in a palatal or labial direction
immobile tooth
high pitched percussion note
what is the treatment for lateral luxation
reposition under LA
4w splint
assess need for pulpal intervention at 2w
if it requires RCT use a corticosteroid-AB intra canal medicament to prevent external root resorption
what are the clinical signs of subluxation
no displacement
mobile
TTP
what is the treatment for subluxation
usually no treatment
2w splint to make patient more comfortable
what are the clinical signs of crown fracture
missing fragment
will be sensitive if the pulp involved
no displacement
may be mobile
not TTP
what is the treatment for a crown fracture
ED = rebond rehydrated fragment or restore with GIC/composite
EDP = partial pulpotomy or pulp cap
