Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Trauma - Crown Fractures > Flashcards

Trauma - Crown Fractures Flashcards

1
Q

Most common injury in primary dentition

A

Luxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common injury in permanent dentition

A

Crown fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peak period for trauma to permanent teeth

A

7-10yrs
More common with large OJ>9mm doubles incidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Important MH that may influence tx

A

Rheumatic fever
Congenital heart defects
Immunosuppression

Not contraindications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

E/O exam of trauma

A

Laceration
Haematoma
Haemorrhage/CSF
Subconjunctival haemorrhage
Bony step deformities
Mouth opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

I/O exam of trauma

A

Soft tissue (damage + foreign bodies)
Alveolar bone
Occlusion
Teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can tooth mobility indicate

A
  • Displacement of tooth
  • Root fracture
  • Bone fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does a dull percussion note indicate?

A

May indicate root fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Trauma sticker components

A
  • Sinus
  • Colour
  • TTP
  • Mobility
  • EPT
  • ECL
  • Percussion note
  • Radiograph
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What teeth should you sensibility test?

A

Injured with adjacent non-injured (may have received direct or indirect concussive teeth injuries)

This applies to sensibility and when viewing root surfaces on radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Classification of fractures

A
  • E#
  • ED#
  • EDP#
  • Uncomplicated crown root#
  • Complicated crown root#
  • Root# (apical 3rd, middle 3rd, coronal 3rd)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does prognosis of trauma depend on?

A
  • Stage of root development
  • Presence of infection
  • Time between injury + tx
  • Type of injury
  • If PDL is damaged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

General aims + principles of emergency treatment

A
  • Retain vitality
  • Tx exposed pulp tissue
  • Reduction and immobilisation of displaced teeth
  • Tetanus prophylaxis
  • Antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Permanent aims + principles of emergency treatment

A
  • Apexigenesis
  • Apexification
  • Root filling +/- root extrusion
  • Coronal restoration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Managing an enamel fracture

A

Xray
- 1 parallel PA
- Additional if injuries (lip + cheek to search for fragments/foreign bodies)

TX
- Bond fragment if available
OR
- Smooth edges
OR
- Restore with composite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Follow up of enamel fracture

A

Clinical + radiographic
after 6-8wks
after 1yr

If associated luxation then use these follow ups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Managing an ED fracture

A

Xray
- 1 parallel PA
- Additional if injuries/missing

Sensibility testing

TX
- Bond if fragment available
- Fragment should be rehydrated by soaking in water/saline for 20mins before bonding

  • Cover exposed dentine with GI or use bonding agent + composite
  • If exposed dentine within 0.5mm of pulp (pink but no bleeding) place CaOH lining and cover with GI
18
Q

Follow up for ED fracture

A

Clinical + radiographic
after 6-8wks
after 1yr

19
Q

When do we use a trauma sticker?

A

Clinical review

20
Q

What to monitor radiographs for

A

Root development - width of canal + length

Comparison with other side

Internal + external inflammatory resorption

PA pathology

21
Q

Prognosis of pulp necrosis after ED fracture

A

5% risk at 10yrs

22
Q

Managing an EDP fracture

A

Xray
- 1 parallel PA

TX
1. Pulp cap
2. Partial pulpotomy
3. Full coronal pulpotomy

23
Q

Indication for pulp cap

A

Exposure 1mm
24hr window
Not TTP + sensibility

24
Q

Why do we avoid full extirpation?

A

Avoid unless clearly non vital
Aim of pulpotomy to keep vital pulp tissue within the canal to allow normal root growth (apex-genesis) both in length of root and thickness of dentine

25
Q

Follow up for EDP fracture

A

6-8wks
3mths
6mths
1yr

26
Q

Steps of direct pulp cap

A
  • Tooth should be not TPP + sensibility
  • LA + dam
  • Clean area with water then disinfect with Sodium Hypochlorite
  • Apply CaOH or MTA white to pulp exposure
  • Restore with composite
27
Q

Indication for partial pulpotomy

A

Larger exposure >1mm or 24+ hrs since trauma

28
Q

Steps of partial pulpotomy

A
  • LA + dam
  • Remove 2mm radius pulp with hi-speed round diamond bur
  • Assess bleeding, if no bleeding remove more tissue
  • Place saline soaked CW pellet over exposure until haemostasis achieved
  • Assess bleeding if hyperaemic remove more tissue
  • Apply nsCaOH
  • Seal in with GI
  • Restore with acid etched composite tip
29
Q

Steps for full coronal pulpotomy

A
  • Begin with partial pulpotomy
  • Assess for haemostasis after application of saline soaked cotton wool
  • If hyperaemic or necrotic proceed to remove all of the coronal pulp
  • Place CaOH in pulp chamber
  • Seal with GIC lining and coronal restoration
30
Q

Success rate of partial pulpotomy

A

97% success

31
Q

Success rate of full coronal pulpotomy

A

75% success

32
Q

Indication for full pulpectomy

A

Non vital tooth

33
Q

Clinical issue with root tx for immature incisors

A

No apical stop to allow obturation with GP

34
Q

Tx options for root tx of immature incisors

A

Apexification - CaOH placed in canal aiming to induce hard tissue calcified barrier

OR

MTA at apex of canal to create cement barrier

35
Q

Steps for pulpectomy (open apex)

A
  • Diagnostic PA for WL
  • LA+rubber dam
  • Access
  • File 2mm short of EWL
  • Dry canal
  • NsCAOH placed
  • Cotton wool in pulp chamber
  • GI temp cement in access cavity and evaluate CAOH fill level with radiograph
  • MTA plug and heated GP obturation (5-6mm)
36
Q

Management of crown root fracture with no pulp exposure

A

Xray
- 1 parallel PA
- 2 additional radiographs taken with diff vertical and/or horizontal angulations
- Occlusal radiograph
- CBCT considered

TX
-Temporise and plan for future
Future
- Ortho extrusion
- Surgical extrusion
- RCT - if necrotic/infected
- XLA
- Autotransplantation

37
Q

Management of crown root fracture with pulp exposure

A

Xray
- 1 parallel PA
- 2 additional taken with diff vertical and/or horizontal angulations
- Occlusal
- CBCT can be considered

TX
- Temp stabilisation
- Partial pulpotomy (immature) nsCAOH
- Extirpation (mature)
Future:
- Complete RCT + restore
- Ortho extrusion
- Surgical extrusion
- Root submergence
- XLA
- Autotransplantation

38
Q

When do we proceed to a full coronectomy (started a partial pulpotomy)

A
  • If no bleeding or can’t arrest bleeding proceed to full coronal pulpotomy
39
Q

Define apexigenesis

A

Vital pulp therapy procedure to encourage development and formation of root

40
Q

Define apexification

A

Method of inducing a calcified barrier at the apex of a non vital tooth with incomplete root formation

Paediatrics (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions