Trauma I Flashcards by Nicky Tahpee

What is the biggest urgency in pediatric dentistry?

Dental trauma

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Dental trauma prognosis depends on …

The time that has passed until it

is treated

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Most affected teeth for dental trauma are..?

The upper central incisor (for both primary and permanent dentition)

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Trauma primary dentition?

Complete teeth or with physiological reabsorptions

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Trauma mixed dentition? (2)

• Permanent teeth with open or closed apex.
There are also primary teeth.
• Problem: The alveolar bone is still growing and we must
preserve it.

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Trauma etiology primary dentition? (2)

when the child starts walking

- games

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Trauma etiology permanent dentition? (4)

Sports
More risky games
Car accidents
Bikes

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Underlying factors for dental trauma? (2)

Protrusion:

big overjet
class II 1st division)

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Frequency of dental trauma (3)?

Maximum peak at 12-15 months in primary dentition

7-11 years in permanent dentition

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After dental trauma you should go to the ER if…? (4)

Loss of balance
Vomits
Absence of attention
Bewilderment

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To diagnose dental trauma - General history? (4)

• How, when, where?
• Adjacent lesions of the face (soft tissues, bone lesions) ears,
neck, TMJ,…
• Previous traumas and their treatments
• Previos treatments of the actual trauma

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To diagnose dental trauma - extraoral exploration? (6)

• Face ( lips, soft tissues, malar bone,
nasal area , orbit…)
• TMJ ( deviations, asymmetries, clicks)
• Refer to other specialists
• Soft tissues
• Arches
• Dental crowns
    - palpation
    - percussion

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To diagnose dental trauma - tests? (3)

X-ray
Thermal tests
Electrical tests

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To diagnose dental trauma - Main test? (4)

X-ray
3 periapical x-rays
1 occlusal x-rays
Occlusal xray only if we suspect the presence of strange objects

*andreassen guidelines

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To diagnose dental trauma - Electrical tests? (2)

vital tests*

* We will NOT do it the day of the trauma : false positives and negatives

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FACTORS TO TAKE INTO ACCOUNT FOR dental trauma? (4)

- Kind of trauma
- If there is pulp affectation or not
- State of the ápex (open or closed) and the root (reabsorption)
- Time that has passed from the moment of the trauma

What must you always do for dental trauma treatment? (2)

Always clean the area with saline solution

* Always use topical and local anesthesia

What is sometimes necesary for relocations, reimplantations etc?

Previous medications: benzodiazepines

General treatment of soft tissues in mouth after dental trauma?

Suture soft tissues (tongue, mucosa etc)

What to do after the treatment of dental trauma? (2)

Remember the importance of the oral hygiene.
Rinses with clorhexidine for 7-10 days.
Sometimes a soft diet is needed

Dental trauma medications? (4)

Antibiotics (always)
analgesics and antiinflammatories
antitetanic vaccine
Use of splints

Dental trauma medications: antibiotics? (2)

Amoxicillin oral via. : 40 – 50 mg / kg / day in 3-4 intakes (at least 4 days)
If allergies: Azithromycin / clindamycin

Dental trauma medications: Analgesic and antiinflammatoires?

Ibuprofene : 10 -20 mg / kg / 8 hours ( or paracetamol )

Dental trauma medications: Antitetanic vaccine?

1 reminder dose (if there is reasonable doubt that is necessary)

Dental trauma medications: splits? (3)

• When there is mobility on the trauma it is necessary to inmobilize the teeth with splints • The most commonly used in pediatric dentistry are the wire splints • We may also use: titanium chain (expencsive) or glass fiber

Characteristics of splints? (3)

• 1º-Easy (to put, to remove, to wear) • 2º-Not harmful for the occlusion or the soft tissues • 3º- Stable: They must include at least 2 teeth on each side of the affected tooth

Andreassen check up guidlines? (5)

- 1- 2 weeks (confirm diagnosis, remove splint, pulp treatments,…) - 4 weeks ( remove splints, pulp treatment) - 3, 6, 12 months (internal and external reabsorptions , ankylosis) - 5 years ( complications : external reabsorptions **counting from the moment of the trauma

Types of complications for traumas? (4)

- Reabsroptions (internal & external) - Ankylosis and delay of eruption - alterations of the enamel - dilaceration

Trauma complications: Reabsorption? (2)

* Internal reabsorptions: The first that appear | * External reabsorptions: The most severe

Trauma complications: Ankylosis and delay of eruption? (2)

* Because of traumas of great intensity( luxations ) | * Delay of eruption of permanent tooth because of very premature loss or extraction of the primary

Trauma complications: Enamel alterations and dilacerations? (2)

• Because of traumas of great intensity( luxations ) • The buccal surface of the permanent incisor is affected (Turner tooth)

Classification of traumas? (4)

- Andreassen classification - Confirmed by WHO - Trauma on the hard dental tissues - Trauma on the periodontal tissues

Trauma on hard dental tissues? (5)

- ENAMEL FRACTURE - DENTIN-ENAMEL FRACTURE - DENTIN-ENAMLE-PULP FRACTURE - CROWN ROOT FRACTURE - ROOT FRACTURE

Trauma of the periodontal tissues? (6)

- CONTUSION - SUBLUXATION - INTRUSIVE LUXATION - EXTRUSIVE LUXATION - LATERAL EXTRUSION - AVULSION

What type of dental trauma lesion is most common in primary dentition?

``` periodontal lesions (luxations) ```

What type of dental trauma lesion is more common with permanent dentition?

dental lesions | dental fractures