Brainscape's Knowledge GenomeTM

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


See full index

BDS3 paeds > Trauma II > Flashcards

Trauma II Flashcards

1
Q

root fractire

A

dentine and cementum fracture involving the pulp

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

classifications of root fractures (3)

A

position of fracture

displacement of fragments

stage of root development

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

position of root fracture classes (3)

A

apical 1/3

middle 1/3

coronal 1/3

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

displacement of fragments of root fracture classes (2)

A

displaced

undisplaced
- edges of tooth still in tact

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

stage of root development root fracture classes (2)

A

mature (closed apex)

immature (open apex)

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

apical 3rd root fractures

A

Best prognosis, especially if no displacement has occurred.

If heals well the fracture line may be undetectable in future radiographs.

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

middle 3rd root fractures

A

Important to reduce fracture as much as possible
- i.e. get both halves touching again like a jigsaw

Different views of the same tooth can be important for diagnosis in some cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

coronal 3rd root fractures

A

Very poor prognosis as very little PDL support to keep the crown in position during function.
Creation of an extremely unfavourable crown:root ratio.

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

radiographic appearance of root fractures - imp to remember

A

Remember a radiograph is a 2 dimensional picture.

Occasionally it looks like there are multiple fracture lines when the break has occurred at an angle cutting across the beam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

prognosis of root fracture depends on (5)

A

Age of child; mature / immature tooth

Degree of displacement

Associated injuries – e.g. crown fractures

Time between injury and treatment

Presence of infection

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

clinical exam for root fracture do

A

trauma stamp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

special investigations for root fracture (2)

A

Sensibility tests

Radiographs from at least 2 angles
- E.g. 2 periapical from different angles and 1 Maxillary occlusal

Alternatively a cone beam CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how to treat a root fracture

apical or middle third fracture (if displaced)

A

Clean area with water/saline/chlorohexidine

Reposition tooth with digital pressure
(LA not usually needed)

Splint: flexible splint for 4 weeks
(Soft diet for 1 week and Good OH)

Review: 6-8weeks, 6 months, 1 year and 5 year with radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to treat a root fracture

coronal third

A

Clean area with water/saline/chlorohexidine

Reposition tooth with digital pressure
(LA not usually needed)

Splint: flexible splint for 4 months
(Soft diet for 1 week and Good OH)

Review: 6-8weeks, 6 months, 1 year and 5 year with radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what to attempt when repositioning fragments

A

attempt to completely approximate edges - like a jigsaw

- smooth outline on radiograph

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

healing outcomes of root fracture (4)

A

Calcified tissue union across fracture line

Connective tissue

Calcified + connective tissue

Bone/osseous

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

non-healing outcome of root fracture

A 
Granulation tissue (usually associated with loss of vitality). 
- Radiolucent area seen on radiograph surrounding fracture line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

calcified tissue healing of root fracture

A

Healed with dentine-like material,

- almost indistinguishable on second radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

connective tissue healing of root fracture

A

Fracture lines remain visible.

  • Edges of fracture show signs of eburnation
  • Smoothed out – not jagged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

osseous healing of root fracture

A

Separate parts of the root become discrete entities with no connection
- each part has its own distinct PDL space and bone is clearly seen between the fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what happens if root fractured tooth becomes non-vital

A

20% chance of pulp necrosis

Apical and Middle Third Fractures

  • extirpate to fracture line
  • dress CaOH then MTA / Biodentine just coronal to # line (as no apical stop)
  • GP - root fill to # line

Coronal fragment of root

  • Remain in situ with own PDL
  • Resorb
  • If infected - antibiotics/apicectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

root fracture -> pulp necrosis of

coronal fragment of root

A
  • Remain in situ with own PDL
  • Resorb
  • If infected - antibiotics/apicectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

root fracture -> pulp necrosis of

apical and middle third fractures

A
  • extirpate to fracture line
  • dress CaOH then MTA / Biodentine just coronal to # line (as no apical stop)
  • GP - root fill to # line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

classification of PDL injuries (6)

A

Concussion, subluxation

Extrusive luxation

Lateral luxation

Intrusive luxation

Avulsion

Dentoalveolar fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what should be considered when assessing PDL injuries

A

impact on:

  • Surrounding bone (fracture?)
  • Neurovascular Bundle
  • Root surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

concussion PDL injury

A

Concussion injury to the tooth supporting structures without increased mobility, displacement of the tooth or gingival bleeding.

There is pain on percussion and sensibility tests may be negative on initial assessment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

subluxation PDL injury

A

traumatic injury has occurred to the periodontal tissues leading to increased mobility but no displacement.

Gingival bleeding is often detected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

concussion/subluxation injury Tx

A

Occlusal relief – build up with GI on posterior

Flexible splint 2 weeks if necessary, to make patient feel more comfortable

Review
- Clinical and radiographic control at 4 weeks, 6-8 weeks and 1 year

Can have false positive for up to 3 months
Would like to see intact lamina dura and continued root level

29
Q

increased mobility in

concussion?

A

no

30
Q

increased mobility in

subluxation?

A

yes

31
Q

TTP in

concussion?

A

Yes

32
Q

TTP in

subluxation?

A

yes

33
Q

follow up clinical and radiographs in

concussion?

A

4 weeks, 6-8 weeks, 1 year

34
Q

follow up clinical and radiographs in

subluxation?

A

2 weeks, 4 weeks, 6-8 weeks, 1 year

35
Q

splint in

concussion?

A

no

36
Q

splint in

subluxation?

A

2 weeks flexible (sometimes if needed)

37
Q

advice for all luxation injuries (3)

A

Instruct on OHI with chlorhexidine gluconate and gentle brushing

Soft Diet – soft bread, foods that don’t need a lot of incising

Avoid Contact Sports

38
Q

how to monitor concussion subluxation (3)

A

Clinical tests - Trauma Sticker

Sensibility tests: thermal + electrical

  • at time of injury
  • Transient lack of sensibility can occur
  • This can relate to future pulp necrosis

Radiographs:

  • root development - width of canal and length
  • comparison with other side
  • internal + external inflammatory resorption
39
Q

what is included on a trauma sticker/stamp? (8)

A

Mobility

Displacement

TTP

Colour

Sinus/tender in sulcus

Thermal (Eth Cl)

Electric (EPT)

Radiograph

40
Q

% pulpal survival for concussion injuries

A

open apex 100%

closed apex 95%

41
Q

% pulpal survival for subluxation injuries

A

open apex 100%

closed apex 85%

42
Q

5 years resorption for concussion injuries

A

open apex 1%

closed apex 3%

43
Q

5 years resorption for subluxation injuries

A

open apex 1%

closed apex 3%

44
Q

pulpal survival closed Vs open apex

A

More frequently in teeth with OPEN apices after severe LUXATION
- Usually indicates ongoing pulpal vitality

PCO high rates with luxation, extrusion, intrusion, root fractures
- Less frequent in subluxed and crown fractured teeth

45
Q

extrusion injury

A

Tooth injury characterized by partial or total separation of the periodontal ligament resulting in displacement of the tooth out of the socket.

The alveolar socket is intact.

This is a tearing injury within the PDL (wide)

46
Q

treatment of extruded permanent teeth

A

Reposition under LA (buccal and palatal)

Flexible splint
- 2 weeks

47
Q

review of extruded teeth

A

Clinical and radiographic control at 4 weeks, 6-8 weeks, 6 months, and yearly for 5 years.

48
Q

% pulpal survival of extrusion

A

open apex 95%

closed apex 45%

49
Q

5 years resorption for extrusion injuries

A

open apex 5%

closed apex 7%

50
Q

lateral luxation injury

A

Displacement of a tooth other than axially.

  • usually palatally or lingually or labially
  • IMMOBILE

Displacement is accompanied by comminution or fracture of either the labial or palatal/lingual bone.
- fracture alveolus

The PDL has suffered both tearing and crushing injuries

51
Q

special investigation results for lat luxation injury

A

TTP
- gives a high metallic (ankylotic) sound

Sensibility tests
- likely negative

Xray

  • widened PDL space
  • take 2 X rays
52
Q

Tx lateral luxation

A

Reposition under LA (buccal and palatal)
- disengage from bony lock forceps or digitally

Flexible splint
- 4 weeks

53
Q

what to do if pulp becomes necrotic post lateral luxation

A

If becomes necrotic – extirpate to prevent root resorption

See signs of success for extrusion

May have replacement resorption or EIR

54
Q

review for lateral luxation

A

clinical and radiographic control at 4 weeks, 6-8 weeks, 6 months, and yearly for 5 years.

55
Q

% year pulpal survival for lateral luxation

A

open apex 95%

closed apex 25%

56
Q

5 year resorption for lateral luxation

A

open apex 3%

closed apex 38%

57
Q

intrusion injury

A

Tooth has been driven into the alveolar process due to an axially directed impact.

most severe form of displacement injury.

more likely to occur in teeth with fully developed roots.

crushing injury to the PDL

58
Q

most severe form of displacement injury.

A

intrusion

59
Q

high metallic note on TTP ->

A

intrusion or luxation

need 2 xrays

60
Q

Tx for intrusion options (3)

A

based on assessment

allow for spontaneous reposition

Fixate orthodontic elastic around the arch wire and bracket for traction

Reposition tooth with forceps

61
Q

spontaneous tooth repositioning for intrusion

A

Advice re diet and oral hygiene

Review patient monthly to observe re-eruption

Measure progress against fixed point
- E.g. Incisal edge of fully erupted non-displaced adjacent incisor
Draw in notes

62
Q

orthodontic repositioning for intrusion

A

Use of fixed orthodontic appliance
- Not relying on pt to reposition

Use of removable orthodontic appliance

e.g. Orthodontic Extrusion after tooth given opportunity to re-erupt

63
Q

reposition tooth with forceps Tx for intrusion

A

Reposition with forceps

Flexible splint for 4 weeks

64
Q

what is there a high risk of in intrusion injuries

A

High risk of resorption

Endodontic treatment usually necessary with closed apex. (almost always)
- Interim calcium hydroxide dressing recommended

65
Q

review of intrusion injuries

A

Control after 2 weeks.

Splint removal and control after 4 weeks,

6-8 weeks,

6 months,

1 year

yearly for 5 year

66
Q

% year pulpal survival for intrusion

A

open apex 45%

closed apex 0%
- take pulp out as soon as for closed apex intruded teeth

67
Q

5 year resorption for intrusion injuries

A

open apex 67%

closed apex 100%

68
Q

affect on the prognosis for PDL injury if the crown is fractured too

A

prognosis is reduced

69
Q

follow up for intrusion

A

Endodontic treatment can prevent the necrotic pulp from initiating infection-related root resorption.

Consider in all cases with completed root formation where the chance of pulp revascularization is unlikely.

Endodontic therapy within 3-4 weeks post-trauma. A temporary filling with calcium hydroxide is recommended.

Review after 2 weeks. Splint removal and review after 4 weeks, 6-8 weeks, 6 months, 1 year and yearly for 5 years

BDS3 paeds (15 decks)

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