trauma and pulpal therapy

Question 1

pulpal hyperemia

Answer 1

pulp’s initial response to trauma, may lead to necrosis

Question 2

pulpal bleeding

Answer 2

blood pigments in dental tubules. does not mean tooth in nonvital

Question 3

usually, how many primary teeth resorb normally

Answer 3

90%

Question 4

pulpal necrosis

Answer 4

can occur immediately or after several months

Question 5

replacement resorption (enkylosis)

Answer 5

happens after irreversible injury to the pdl

should be extracted if they cause a delay in or ectopic eruption of a developing perm tooth

Question 6

concussion trauma

Answer 6

injury to the tooth without displacement or mobility
teeth tender to percussion
good prognosis

Question 7

subluxation

Answer 7

injury to the tooth without displacement but with mobility

pulpal necrosis is more common in perm teeth

Question 8

how often should you monitor teeth that have underwent subluxation

Answer 8

PAs at 1 mo, 3 mo, 6 mo for a year

Question 9

avulsion

Answer 9

complete displacement of tooth out of its socket

Question 10

intrusion

Answer 10

displacement of the tooth into the alveolar bone

Question 11

pulpal protection materials

Answer 11

ca oh-, glass ionomer, mta

Question 12

calcium hydroxide

Answer 12

typical direct pulp cap

long term success, but not the best

Question 13

mta

Answer 13

more predictable dentin bonding and pulp health

superior material

Question 14

how to treat intrusion

Answer 14

no tx, let tooth re-erupt
do not reposition or splint
if contacting perm tooth bud, extract

Question 15

how long does it take for a tooth to reerupt after intrustioni

Answer 15

2-6 mo

Question 16

t/f the theraputic approach to treating intrusion is widely accepted

Answer 16

false. its controversial

Question 17

what other defects are common with intrusion injuries

Answer 17

hypoplasia and arrest of tooth development

Question 18

should you reposition teeth that have underwent subluxation

Answer 18

no

Question 19

what may happen during the first 6 mo after a luxation injury

Answer 19

pulpal necrosis and the crown can appear gray or gray-black

Question 20

what do you do if the crown of a tooth turns gray after a luxation injury

Answer 20

NOTHING. leave it alone if it is asymptomatic and no pathology is noted

Question 21

t/f. there are 5 reliable methods of determined pulp vitality

Answer 21

false. there is no reliable method

Question 22

will traumatized teeth respond to vitality testing?

Answer 22

no

Question 23

what is the most reliable vitality test

Answer 23

thermal test (especially in prim incisors)

Question 24

t/f. 80% of primary incisors that are darkened due to injury are symptomatic

Answer 24

false. asymptomatic

Question 25

what should one use to reduce the chance of bacterial invasion of pdl after trauma

Answer 25

0.12% chlorhexidine oral rise

Question 26

transportation media for avulsed teeth

Answer 26

``` viaspan hanks balanced salt solution cold milk saliva (buccal mucosa) physiologic saline water ```

Question 27

pulpal therapy options

Answer 27

indirect pulp cap, direct pulp cap, pulpotomy

Question 28

indirect pulp cap

Answer 28

near pulp, but no exposure | GI used more than CaOH

Question 29

diect pulp cap

Answer 29

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

Question 30

pulpotomy

Answer 30

carious pulp exposure w/o evidence of radicular pathology use formocreosol or ferric sulfate ZOE base

Question 31

how do you achieve hemostasis is a pulpotomy procedure

Answer 31

viscostat (ferric sulfate)

Question 32

how is ZOE applied during a pulpotomy procedure

Answer 32

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

Question 33

t/f formocresol has been challenged as a potential carcinogen and mutagen

Answer 33

true

Question 34

t/f pulpotomies performed with either formocresol or ferric sulfate are likely to have similar clinical/radiographic success

Answer 34

true

Question 35

t/f. ferric sulfate and formocresol pulpotomies can lead to premature exfoliation of primary teeth

Answer 35

true

Question 36

t/f there is no significant difference bt the total success rate of formocresol and ferric sulfate pulpotomy

Answer 36

true