Trauma 5 - aesthetic management Flashcards
list the causes of tooth discolouration
pulp necrosis
discolouration following RCT
localised discolouration of permanent tooth following primary tooth trauma
discolouration of restoration following trauma tx
what is the legal age to receive tooth bleaching?
18 years old
how do you treat discolouration due to necrotic pulp?
confirm its aetiology
ensure its not from pulp canal obliteration
commence RCT
(this may not resolve discolouration but it is essential to preserve the tooth)
list the ways in which a tooth can experience discolouration following RCT
the pulp hasnt been fully removed from coronal aspect
blood has leached into dentinal tubules
GP hasnt been adequately reduced in the pulp chamber
dark material has been used to seal the access cavity (fuji pink)
Following RCT, the pulp hasn’t been fully removed from the coronal aspect of the tooth. This has caused discolouration. How do you resolve this?
open the access cavity
clean out remnants
(be careful not to remove excessive tooth structure)
Following RCT, blood has leached into dentinal tubules and has caused discolouration. How do you resolve this?
Best treated with internal bleaching
(removal of dentine will significantly reduce tooth structure making it more prone to fracture)
Following RCT, GP has not been adequately reduced in the pulp chamber and has caused disolouration. How do you resolve this?
carefully open access cavity
reduce GP to level of CEJ
(be careful not to perforate)
Following RCT, a dark material i.e., Fuji Pink has been used to seal the access cavity. This has caused discolouration. How do you resolve this?
replace with more aesthetic material
(be aware of aesthetic limitations)
What is good practice following RCT to prevent discolouration?
GP trimmed to finish below gingival level
Canal sealed with a thin layer of RMGI
Well condensed and colour matched composite used to fill access cavity
You have finished RCT, sealed it well, but the tooth is still discoloured. What do you do?
crown +/- post core
ceramic veneer
internal bleaching
external bleaching
composite camouflage
Disadvantages of crown +/- post core for a discoloured tooth in a child?
pretty destructive
entering child into “restorative cycle”
all restorations have a finite life span
patient is still growing
why do you not want to do a post in a child patient?
gingival margins are not established yet as mandible/ maxilla is still growing
pros and cons of a ceramic veneer in child pt with discoloured tooth?
less destructive than crown
cooperation needed for prep, imps etc
need established gingival margins
advantages of composite camouflage for a disocloured tooth in a child pt?
can easily be modified
atraumatic
does not usually require LA
what is hypoplasia following trauma?
change in tooth form
