Trauma 3 Flashcards
What is a concussion injury?
injury to the tooth supporting structures without increased mobility or displacement of the tooth but with pain to percussion
What is a subluxation injury?
injury to the tooth supporting structures resulting in increased mobility but without displacement of the tooth.
Bleeding at gingival sulcus confirms this diagnosis
What is the splinting time for concussion and subluxation injuries with a passive splint?
2 weeks
The prognosis for pulpal survival for subluxation and concussion injuries is better in closed apex teeth. True or false
false
prognosis improves in open apex
What is the 5 year pulpal survival rate for concussion and subluxation injuries in open apex teeth?
100%
What is the 5 year pulpal survival rate for concussion injuries to closed apex teeth?
96%
What is the 5 year pulpal survival rate for subluxation injuries in closed apex teeth?
85%
What is the 5 year resorption rate for concussion and subluxation injuries in open apex teeth?
1%
What is the 5 year resorption rate for concussion and subluxation injuries in closed apex teeth?
3%
resorption of the root
How would you monitor concussion and subluxation injuries?
- clinical test- trauma stamp
- sensibility tests at time of injury 1 month, 3 months, 6 months, 1 year and then annually for 5 years
- radiographs- root development, width of the canals; comparison with the other side; infection/ankylosis related resorption of the roots
What is the normal physiological root development?
width of canal narrows due to apexogenesis
What does the trauma stamp include ?
- mobility
- displacement (occlusion)
- TTP
- colour
- sinus/tender in sulcus
- thermal - ethyl chkoride
- EPT
- radiographs
What is an extrusion injury?
this is the partial displacement of the tooth out of the socket
What is a lateral luxation injury?
this is the displacement of a tooth other than apically.
Displacement is usually accompanie by either a fracture of the labial or lingual/palatal alveolar bone
How should you manage extrusion and lateral luxation injuries in permanent teeth?
- reposition under LA
- flexible splint for 2 weeks - extrusion
- flexible splint for 4 weeks- lateral luxation
What is the 5 year pulp survical rate of extrusion and lateral luxation injuries in open apex teeth ?
95%
What is the 5 year pulpal survival rate for extrusion injuries in closed apex teeth ?
45%
What is the 5 year survival pulpal rate for lateral luxation injuries in closed apex teeth?
25%
What is the 5 year resorption rate for extrusion injuries in open apex teeth?
5%
What is the 5 year resorption rate for lateral luxation injuries in open apex teeth?
3%
What is the 5 year resorption rate for extrusion injuries in closed apex teeth?
7%
What is the 5 year resorption rate for lateral luxation injuries in closed apex teeth?
38%
The risk for root resorption in lateral luxation injuries increases dramatically. True or false
true
Orthodontic splinting is no longer done. Why is this?
this is because the forces used increased the risk of root resorption
In a lateral luxation injury, teeth are often quite immobile. What sort of treatment would be unsuitable in such cases?
manual repositioning of the teeth
??spontaneous repositioning??
How would you monitor an extrusion/lateral luxation injury?
- clinical tests- trauma stamp
- sensibility tests: thermal and electrical
*at the time of injury
1month 3months 6 months, 1 year then annually for at least 5 years - radiographs for root development- width and length of canal, infection related/ankylosis related resorption
What is an intrusion injury?
displacement of the tooth into the alveolar bone
usually accompanied with a fracture of the alveolar bone
What is the management of an intrusion injury on an open apex tooth?
- allow re-eruption without intervention
- if no re-eruption in 4 weeks, start orthodontic repositioning
- monitor to see if root canal is required
The management of an intrusion injury in a closed apex tooth is dependent on …
the degree of intrusion
How would you manage an intrusion injury of <3mm in a closed apex tooth?
- allow re-eruption without intervention
- if no re-eruption within 4 weeks, reposition surgicallay and splint for 2 weeks or reposition orthodontically
How would you manage an intrusion injury of 3-7mm in a closed apex tooth?
reposition surgically or orthodontically
How would you manage an intrusion injury of >7mm in a closed apex tooth?
surgically reposition
flexible splint for 4 weeks
What further treatment is indicated for intrusion injuries of closed apex teeth?
RCT /endodontic treatment
this is the tooth has more than likely crushed the blood supply and such vitality (therefore PN) is lost
Apexification is for _______ whilst apexogenesis is for _______.
apexification- non- vital teeth
apexogenesis- vital teeth - completion of the root and thus formation of the apex
What is the 5 year survival rate of intrusion injuries in open apex teeth?
40%
What is the 5 year survival rate of intrusion injuries in closed apex teeth?
0%
What is the 5 year resorption rate of intrusion injuries in open apex teeth?
6/7%
What is the 5 year resorption rate of intrusion injuries in closed apex teeth?
100%
