Trauma lecture 4 Flashcards
why review trauma cases
not all sequelae of trauma are immediate
may complications/side effects can occur months/years after incident
what kind of complicaitons in primary teeth can occur?
pulpal necrosis
pulpal obliteration
root resorption
damage to the successors
primary tooth pulpal necrosis- what to look for
persistent grey colour
no reduction in size of pulp cavity radiographically
radiographic signs of periapical inflammation
clinical signs of infection: tenderness, sinus, suppuration, swelling
what to do if signs of infection on a primary tooth
extract
primary tooth pulpal obliteration what to look for
tooth may become yellow/opaque colour
radiographically, pulp chamber will shrink
what to do with primary tooth pulpal obliteration
nothing if asymptomatic
extract is signs of infection
primary tooth resorption - what to look for
radiographic signs of root resorption
possible clinical mobility
what to do if primary tooth root resorption
extract if signs infection
what age is most damage to successor teeth
before 3 years of age
what injuries carry most risk to successor teeth
intrusive luxation
age of white/yellow brown enamel hypomineralsiation
2-7 years
crown dilaceration age
approx 2 years
odontoma like malformation
1-3 years
roto duplication age
2-5 years
what is root dilaceration
deviation of root shape from the normal long axis formation
radiographic signs of root dialceration
root malformation/change in angulation
delayed/ failed eruption
how to treat root dilaceration
surgical/ortho realignment or possible extraction
complications to permanent teeth
pulp necrosis
resorption
ankylosis
replacement resorption
external resorption
internal resorption
permanet tooth pulpal necrosis - what to look for
no response to sensibility testing
grey discolouration
patient symptoms, histpry
radiographic signs of periradicaulr infection
what to consider for treating permanent tooth pulpal necrosis
is there acute infection
does the tooth have a closed apex
how developed is the root
if starting rct within 2 weeks of re-implanting an avulsed tooth, why not use calcium hydroxide
this may contribute to replacement resorption - ledermix is good to use
why does calcium hydroxide do to dentine
degrades collagen structure weakening flexural strength of dentine over time. if possible only place for 2 weeks
what to do if there is a closed apex
treat the same way as an adult tooth and start endo tx
what to do if there is an open apex
need to create apical stop
MTA apical barriersvs calcium hydroxide apical barrier
