Trauma pt 1

Question 1

A patient presents with postauricular ecchymosis. What is this a sign of?

Answer 1

lefort III fracture

Question 2

How should a clinician rule out the presence of any foreign bodies or materials after truama?

Answer 2

radiographs to confirm

Question 3

Abnormal mobility of segments of the dentition is indicative of _____

Answer 3

cortical plate or alveolar fracture

Question 4

change in alignment or displacement of teeth as a block may indicate _____

Answer 4

fracture of maxilla or mandible

Question 5

Sensitivity to percussion indicates _____

Answer 5

PDL injury

Question 6

Why is cold testing the most reliable method for young patinets?

Answer 6

late differentiation of the delta nerve fibers

Question 7

what 4 images are recommended to take after trauma?

Answer 7

1 90 degree PE
2 PAs with different VERTICAL angulations
1 occlusal

Question 8

how long can it take for normal blood flow to return to traumatized tooth?

Answer 8

9 months

Question 9

when is responsiveness to testing returned to a tooth?

Answer 9

when circulation is restored

Question 9

What risk is there for pulp necrosis for a crown infarction?

Answer 9

little risk

Question 10

A patient comes in with an incomplete fracture only involving a crack in the enamel. What is the diagnosis?

Answer 10

crown infarction

Question 11

What treatment is needed for crown infarction?

Answer 11

none, but follow up for pulpal status

Question 12

A patient comes in with a complete fracture of the enamel, but no pulpal exposure. what is the diagnosis?

Answer 12

uncomplicated crown fracture

Question 13

What risk is there for pulp necrosis for an uncomplicated crown fracture?

Answer 13

little risk

Question 14

A patient comes in with a fracture of enamel and dentin, but no pulp exposure. There is tenderness to percussion and bleeding from the sulcus.

What type of fracture?
What else can be suspected?

Answer 14

uncomplicated crown fracture
luxation injury is suspected

Question 15

treatment of uncomplicated crown fracture?

Answer 15

cover exposed dentinal tubules by bonding tooth fragments or placing composite restorations

Question 16

A patient comes in with a crown fracture involving enamel, dentin, and pulp. What type of fracture is this?

Answer 16

complicated crown fracture

Question 17

If left untreated, what will transpire from a complicated crown fracture?

Answer 17

pulpal necrosis

Question 18

What is the goal in treating complicated crown fractures?

Answer 18

removing any inflamed tissue and creating a bacteria tight seal to protect the pulp

Question 19

What treatment is indicated for complicated crown fractures?

Answer 19

vital pulp therapy

Question 20

What are the indications of vital pulp therapy?

Answer 20

1. preserving pulp vitality
2. teeth with incomplete root formation

Question 21

Requirements for success for vital pulp therapy?

Answer 21

1. treatment of non-inflamed pulp
2. bacteria tight seal
3. pulp dressing (MTA, biodentine)

Question 22

Vital pulp therapy treatment methods

Answer 22

1. pulp capping
2. partial/cvek pulpotomy
3. full pulpotomy

Question 23

A patient comes in with a complicated root fracture. Is it better for you to do a direct pulp cap or a partial pulpotomy, and why?

Answer 23

partial pulpotomy

higher success rate compared to direct pulp cap

Question 24

a patient presents with a fractured #8. The fracture is in an oblique orientation, splitting diagonally, and extending onto the root surface. What type of fracture is this?

Answer 24

crown root fracture

Question 25

What treatment should be considered for crown root fractures, along with endo treatment?

Answer 25

periodontal treatment also may require ortho and surgical extrusion

Question 26

treatment for crown root fracture, open apex?

Answer 26

shallow pulpotomy

Question 27

treatment for crown root fracture, closed apex?

Answer 27

pulpectomy

Question 28

a patient comes in after hitting his tooth with no mobility or displacement of their tooth. There is pain on percussion and response to pulp testing. What is the diagnosis?

Answer 28

concussion

Question 29

Treatment for concussion?

Answer 29

none -soft diet for 14 days -chlorhexidine rinses -follow up

Question 30

a patient comes in after hitting his tooth. There is increased mobility but no displacement of the tooth. There is pain on percussion and sulcular bleeding. What is the diagnosis?

Answer 30

subluxaiton

Question 31

treatment for subluxation?

Answer 31

none -relieve occlusion -soft diet -apply splint if marked loosening (2 weeks) -chlorhexidine rinses -follow up

Question 32

how long should a tooth be splinted if there is marked loosening with subluxation?

Answer 32

2 weeks

Question 33

A patient comes in after hitting his tooth. There is increased mobility with displacement of the tooth. There is no pulpal response. What is the diagnosis?

Answer 33

luxation injury

Question 34

Do teeth usually regain vitality in luxation injury?

Answer 34

no (unless immature teeth with open apex)

Question 35

If tooth is displaced from the socket along the long axis, what type of luxation is this?

Answer 35

extrusive luxaiton

Question 36

how long should you splint for extrusive luxaiton?

Answer 36

2 weeks

Question 37

When should RCT be considered for extrusive luxation?

Answer 37

if pulpal diagnosis of irreversible pulpitis or necrosis

Question 38

Why would emergency RCT be completed for extrusive luxaiton?

Answer 38

to prevent resorption

Question 39

If tooth is displaced lingually, buccally, mesially, or distally, what type of luxaiton?

Answer 39

lateral luxation

Question 40

What is lateral luxaiton usually accompanied by?

Answer 40

fracture of the labial or palatal / lingual alveolar bone

Question 41

With lateral luxation, does the pulp permanently lose sensory nerve supply and blood supply?

Answer 41

may lose sensory nerve supply retains blood supply

Question 42

aside from a radiograph, how can you tell if the root tip has been forced into the alvoelar bone?

Answer 42

metallic sound

Question 43

how long should you splint for lateral luxation?

Answer 43

2 weeks 4 weeks if involving bony fracture

Question 44

if the tooth is forced into the socket in an axial (apical) direction, what type of luxation is this?

Answer 44

intrusive

Question 45

treatment for intrusive luxation and open apex?

Answer 45

monitor carefully for complications RCT only if necrosis

Question 46

treatment for instrusive luxation and closed apex?

Answer 46

surgical or ortho extrusion RCT within 2 weeks to prevent resorption

Question 47

grayish darkening of crown with loss of translucency is a sign of...

Answer 47

necrosis

Question 48

yellow to brown change in crown color is indicative of...

Answer 48

calcific metamorphosis