trauma

Question 1

when shouuld RCT commence after trauma

Answer 1

if there is infection related external root resorption, should be done IMMEDIATELY

if it is immature tooth, then do at the first clinical/ radiographic sign of no vitality or arrested maturation

for mature teeth, do when there is no vitality response at 3 months

Question 2

what are the outcomes of root fracture (in most to least ideal)

Answer 2

1) healing with calcified tissues
- fragments in close proximity, vitality preserved

2) healing with CT
- narrow RL line
- vitality preserved
- may have pulp canal obliteration

3) healing with bone & CT
- distinct RO bony ridge
- pulp canal obliteration

4) non healing with granulation tissue
- RL corresponds to widened fracture line
- vitality usually preserved in apical fragment
- RCT usually needed in coronal fragment

Question 3

what is transient apical breakdown

Answer 3

• repair process of traumatised pulp
• presents with PARL, no response to vitality tests & crown discoloration
• may persist for 1 year before returning to normalcy, dont rct immediately

Question 4

what is the process of resorption

Answer 4

• protective pre cementum is damaged and inflammation is due to injury
• stimulus from infected pulp transverse root & sustain inflammation around root giving inflammatory resorption
• if stimulus is removed and PDL cells are viable then cemental healing
• if large surface of PDL is damaged, replacement resorption takes over the inflammatory resorption, giving ankylosis