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MODULE 6 OSCE > TRAUMA > Flashcards

TRAUMA Flashcards

1
Q

What are the 9 tests in a trauma table?

A

colour
transillumination
palpation
sinuses
percussion
mobility
EPT
thermal
radiograph

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2
Q

what is pulp vitality?

A

the presence of an intact blood supply not nerve supply

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3
Q

what must you look for before beginning endodontics?

A

at least 2 signs of pulpal necrosis especially if open apex

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4
Q

what questions should you ask the pt that comes in with trauma?

A

pain?
swelling?
bad taste?
specific tooth sore?
what makes it sore?
sore to touch or move?
noticed any darkening of teeth?

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5
Q

what type of pain is associated with irreversible pulpitis or dental abscess problems?

A

prolonged spontaneous pain

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6
Q

what symptoms indicate that the pulp is still vital?

A

sensitivity to cold foods or air

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7
Q

what are the 3 signs of infection?

A

sinus tract
suppuration
swelling

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8
Q

what does discolouration imply?

A

products of pulpal necrosis permeating the tubules - initially pink, then brown

it does not mean that the pulp is irreversible necrotic, the tooth may revascularise

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9
Q

how do you test colour of a traumatised tooth?

A

explain procedure to patient
look directly at the tooth then look at the light from your overhead light shining directly onto the tooth

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10
Q

what is transillumination used for?

A

detecting craze lines, enamel infraction and assessing colour of the tooth

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11
Q

how do you perform transillumination?

A

fibre optic transillumination if available

look at the light from overhead operating light shining through the crown by placing mirror in the shadow of the mouth

ensure the light is perpendicular to the long axis of the tooth

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12
Q

how do you examine alveolar tenderness?

A

gently palpate with finger and compare to healthy tissue elsewhere

ask pt if it feels tender or sore

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13
Q

what is also assessed when looking at alveolar tenderness?

A

sinus, swelling and inflammation

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14
Q

how do you percussion test a tooth?

A

test a vital tooth first
gently tap on tooth in an axial direction with the handle of a metal instrument

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15
Q

what is also assessed when checking a tooths sensitivity to percussion?

A

percussion note - ankylosis sounds like a cracked plate

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16
Q

what does a metallic percussion note suggest?

A

freshly intruded tooth or ankylosis following loss of PDL

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17
Q

what does mobility suggest?

A

if mobile in an axial direction weeks after trauma, often pathognomic of periapical infection

recently erupted teeth are more mobile than teeth in adult dentitions

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18
Q

how do you test mobility?

A

explain procedure to pt

test a non traumatised vital tooth first

place mirror handle on one side of the tooth and another instrument on the other side and gently rock the tooth

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19
Q

what classification is used for mobility?

A

millers classification
class 1 <1mm
class 2 >1mm
class 3 >1mm horizontal and vertical

20
Q

what are the 2 types of sensibility testing?

A

thermal testing
electric pulp testing

21
Q

what type of teeth are not likely to respond to sensibility testing?

A

vital teeth that have been traumatised
vital teeth with incomplete root development

do not use these on primary teeth

22
Q

how do you carry out electric pulp testing?

A
  1. explain the test to the pt
  2. explain they need to indicate immediately
  3. when they feel the tingle in their tooth
    test vital tooth first
  4. dry the tooth
  5. place probe on incisal edge
  6. ask pt to complete circuit by holding the aluminium sheath
23
Q

what is used for thermal testing?

A

ethyl chloride

24
Q

how do you complete thermal testing?

A
  1. explain the procedure to pt
  2. test a vital tooth first
  3. soak a small pellet of cotton wool held in tweezers
  4. dab it intermittently onto the labial surface
  5. test the teeth with a dry cotton pellet as well
  6. alternate between
25
Q

what do you look for in radiographs of traumatised teeth?

A

continued root development (narrowing of pulp space, continued growth apically)
signs of ankylosis
signs of resorption
signs of root fractures

26
Q

what is used to cut wire for a splint?

A

orthodontic distal end cutters

27
Q

what are the measurements for wire for a splint?

A

4 finger widths of 0.4mm stainless steel soft wire

28
Q

what can you do to splinting wire to allow you to hold and adjust the splint?

A

form a “safety handle” by bending wire 1/3 from mesial end

29
Q

what position should pt be in when applying a splint?

A

upright position

30
Q

how do you protect the airway when applying a splint?

A

gauze

31
Q

how should a splint lie?

A

passively

32
Q

how is a splint secured?

A

inciso-gingivally
small amounts of composite onto the middle of labial surfaces if abutment teeth

33
Q

what are the features of a splint?

A

passive
flexible
<2mm off tooth surface
no overhangs or plaque traps
no sharp edges

34
Q

how long do you splint a cervical root fracture?

A

4 months

35
Q

how long do you splint an alveolar fracture?

A

4 weeks

36
Q

how long do you splint subluxation?

A

2 weeks

37
Q

how long do you splint extrusive luxation?

A

2 weeks

38
Q

how long do you splint lateral luxation after repositioning?

A

4 weeks

39
Q

how long do you splint intrusive luxation after repositioning?

A

4 weeks

40
Q

what is the purpose of a splint?

A

stabilise teeth allowing time for PDL/ fracture to repair/ stabilise

41
Q

what are the 2 methods of splint removal?

A

1 - composite and wire splint removed using rotary instruments
2 - remove composite cubes using ortho bracket removing tools

42
Q

what rotary instruments can be used to remove composite and splint?

A

slow speed rotary and tungsten carbide debond bur
or
composite finishing burs

43
Q

what tooth do you remove the splint from first?

A

traumatised tooth

44
Q

what do you do after you have removed the splint from the traumatised tooth?

A

check its mobility - if excessive, reattach and re-bond the splint

45
Q

what must be done when removing the splint from the final abutment tooth?

A

hold firmly with spencer wells forceps

46
Q

where do you dispose the splint?

A

sharps

MODULE 6 OSCE (4 decks)

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