Trauma Procedures Flashcards

1
Q

When are you going to perform a pulp cap ?

A
  • Vital Immature tooth with pulp exposed
  • Small exposure of pulp
  • <24 hrs old
  • Arrest haemorrhage with P and saline dipped moistened cotton pledget
  • Apply non setting CaOH direct to exposure site
  • RMGIC lining and def rest
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2
Q

What does survival of the pulp depend on?

A
  • Associated peridontal ligament injury
  • Size of exposed dentine
  • Age of pt (open vs closed apex)
  • Length of time injury exposed (longer time more bacterial ingress more likely for necrosis to occur)
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3
Q

When are you going to perform a pulpotomy? What does it do?

A
  • Vital immature tooth with pulp exposed
  • Larger exposure
  • Delay in txt
  • It maintains vitality of remaining (non infected pulp)
  • Allows root formation to continue
  • Allows ctd thickening of dentine in root walls
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4
Q

What is the technique for Pulpotomy in permanent tooth?

A
  • LA
  • Dental dam
  • Endodontic access
  • Removal of pulp tissue 2-3mm coronal
  • Arrest haemorrhage with sterile saline dipped in cotton pledget
  • Assess bleeding
    - If deep crimson still inflamed and need to remove more
    - If no bleeding then necrotic and need to remove more until normal bleeding
    - If normal bleeding bright red then good to go
  • non setting CaOH dressing over exposed root canal
  • RMGIC lining
  • Restoration with etch and bond
  • Assess for symptoms at review appointment
  • Wanting to see apexigenesis in an immature root where root development occurd and thickening of dentine in root walls continues
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5
Q

When to Perform Pulpectomy? What is it ?

A
  • Non vital immature tooth
  • Tooth previously pulpotomy becomes symptomatic
  • Removal of all necrotic pulp
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6
Q

What is apexification / Apical barrier formation ? When should i refer a pt for this?

A
  • Process of using MTA or bioceram to induce an apical barrier therefore RC filling can be condensed against
  • Done in secondary care
  • If immature apex tooth has had pulpotomy and now has become symptomatic - perform pulp extirpation , CaOH dress and referral to paeds for apexification to ensure tooth it not lost
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7
Q

Properties of CaOH

A
  • High PH (alkaline) and help decres micorbial load (antimicrobial)
  • Induces calcific barrier by stimulating odontoblasts to create reparative tertiary dentine bridge
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8
Q

Splinting times for injury

A

2 weeks
- Avulsion
- Extrusion

4 weeks
- Luxation
- Apical and middle 3rd root fracture
- Dentoalveolar fracture

4weeks -4months
- Cervical 1/3 root fracture

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9
Q

Technique for trauma splint

A
  • Composite passive flexible wire
  • Cut and bend SS wire
  • Apply comp resin to traumatised tooth and adjacent
  • Sink contoured passive wire into comp
  • Shape and cure comp
  • Smooth rough comp and wire ends
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10
Q
A
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