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
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)
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
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
5
Q
When to Perform Pulpectomy? What is it ?
A
- Non vital immature tooth
- Tooth previously pulpotomy becomes symptomatic
- Removal of all necrotic pulp
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
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
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
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
10
Q
A