trauma and pulpal therapy Flashcards
pulpal hyperemia
pulp’s initial response to trauma, may lead to necrosis
pulpal bleeding
blood pigments in dental tubules. does not mean tooth in nonvital
usually, how many primary teeth resorb normally
90%
pulpal necrosis
can occur immediately or after several months
replacement resorption (enkylosis)
happens after irreversible injury to the pdl
should be extracted if they cause a delay in or ectopic eruption of a developing perm tooth
concussion trauma
injury to the tooth without displacement or mobility
teeth tender to percussion
good prognosis
subluxation
injury to the tooth without displacement but with mobility
pulpal necrosis is more common in perm teeth
how often should you monitor teeth that have underwent subluxation
PAs at 1 mo, 3 mo, 6 mo for a year
avulsion
complete displacement of tooth out of its socket
intrusion
displacement of the tooth into the alveolar bone
pulpal protection materials
ca oh-, glass ionomer, mta
calcium hydroxide
typical direct pulp cap
long term success, but not the best
mta
more predictable dentin bonding and pulp health
superior material
how to treat intrusion
no tx, let tooth re-erupt
do not reposition or splint
if contacting perm tooth bud, extract
how long does it take for a tooth to reerupt after intrustioni
2-6 mo
t/f the theraputic approach to treating intrusion is widely accepted
false. its controversial
what other defects are common with intrusion injuries
hypoplasia and arrest of tooth development
should you reposition teeth that have underwent subluxation
no
what may happen during the first 6 mo after a luxation injury
pulpal necrosis and the crown can appear gray or gray-black
what do you do if the crown of a tooth turns gray after a luxation injury
NOTHING. leave it alone if it is asymptomatic and no pathology is noted
t/f. there are 5 reliable methods of determined pulp vitality
false. there is no reliable method
will traumatized teeth respond to vitality testing?
no
what is the most reliable vitality test
thermal test (especially in prim incisors)
t/f. 80% of primary incisors that are darkened due to injury are symptomatic
false. asymptomatic
what should one use to reduce the chance of bacterial invasion of pdl after trauma
0.12% chlorhexidine oral rise
transportation media for avulsed teeth
viaspan hanks balanced salt solution cold milk saliva (buccal mucosa) physiologic saline water
pulpal therapy options
indirect pulp cap, direct pulp cap, pulpotomy
indirect pulp cap
near pulp, but no exposure
GI used more than CaOH
diect pulp cap
only indicated in primary teeth when a pinpoint pulp exposure is encountered during cavity prop of following trauma
contraindicated in tooth with carious pulp exposure
MTA or CaOH
pulpotomy
carious pulp exposure w/o evidence of radicular pathology
use formocreosol or ferric sulfate
ZOE base
how do you achieve hemostasis is a pulpotomy procedure
viscostat (ferric sulfate)
how is ZOE applied during a pulpotomy procedure
after you remove excess ferric sulfate, mix the ZO powder and eugenol liquid until it can be rolled up into a ball and cover the entrance to the canals until half the pulp chamber
GI then fills the rest and a SS crown is placed
t/f formocresol has been challenged as a potential carcinogen and mutagen
true
t/f pulpotomies performed with either formocresol or ferric sulfate are likely to have similar clinical/radiographic success
true
t/f. ferric sulfate and formocresol pulpotomies can lead to premature exfoliation of primary teeth
true
t/f there is no significant difference bt the total success rate of formocresol and ferric sulfate pulpotomy
true
