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Paediatrics > Trauma - Avulsion > Flashcards

Trauma - Avulsion Flashcards

1
Q

When are PDL cells most viable?

A

Tooth replanted immediately or within 15 mins

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2
Q

When are PDL cells viable but compromised?

A

Tooth kept in storage medium
Total EADT <60mins

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3
Q

When are PDL cells non viable?

A

Total EADT>60mins regardless of storage medium or not

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4
Q

Tx for it patient attends with EAT<60 (replanted) + closed apex (4)

A
  • Clean area with saline
  • Verify correct position clinically and radiographically
  • Leave in place unless malpositioned (slight digital pressure to reposition)
  • Stabilise for 2wks using flexible passive splint
  • Initiate RCT within 2 weeks of replanting
  • Administer systemic antibiotics if needed and check tetanus status
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5
Q

General public advice for avulsed tooth

A
  • Pick up by crown dont hold root
  • If dirty rinse in cold water
  • Reimplant
  • Get pt to bite down
  • If reimplantation not possible store in storage medium asap (milk/saliva/saline)
  • Go to dentist immediately
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6
Q

What is reimplantation based on?

A

EADT no as we just implant all now

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7
Q

Ideal periodontal healing outcome post avulsion

A
  • Regeneration
  • PDL /cemental healing (EAT<60)
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8
Q

When is regeneration more likely to occur

A

When you have open apex - (closed has 1 vessel 1 nerve)

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9
Q

Tx for EAT<60mins + storage medium (closed apex)

A
  • Rinse area with saline
  • Rinse avulsed tooth with saline if debris
  • Leave tooth in storage medium whilst taking quick hx, clinical + radiographic
  • LA w/o vasoconstrictor, irrigate socket with saline and replant
  • Stabilise with 2wks passive flexible splint
  • RCT within 2wks
  • Antibiotics, tetanus status + post op
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10
Q

Tx for EAT<60 with open apex

A

Replant
Stabilise 2wks passive flexible splint
No endo unless pulp necrosis/infection

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11
Q

Why do we not RCT immature teeth with open apices?

A

Potential for spontaneous healing to occur in the form of new connective tissue with a vascular supply

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12
Q

What 2 antibiotics can you prescribe following replanting?

A

Doxycycline
Tetracycline

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13
Q

Contraindication for tetracycline

A

Under 12s

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14
Q

Contraindication for Doxycycline

A

Discolouration risk
Antimicrobial + Antinflammatory advantages

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15
Q

Tx for dentaolaveolar fractures

A

Reposition any displaced segment
Stabilize with a passive and flexible splint for 4 wk
Antibiotics

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16
Q

Follow up for dentaolaveolar fractures

A

4wkS+
6-8wks
4mths
6mths
1yr
Yearly for at least 5yrs

Paediatrics (10 decks)

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