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Clinical Endo > Trauma pt 1 > Flashcards

Trauma pt 1 Flashcards

1
Q

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

A

lefort III fracture

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2
Q

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

A

radiographs to confirm

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3
Q

Abnormal mobility of segments of the dentition is indicative of _____

A

cortical plate or alveolar fracture

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4
Q

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

A

fracture of maxilla or mandible

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5
Q

Sensitivity to percussion indicates _____

A

PDL injury

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6
Q

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

A

late differentiation of the delta nerve fibers

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7
Q

what 4 images are recommended to take after trauma?

A

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

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8
Q

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

A

9 months

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9
Q

when is responsiveness to testing returned to a tooth?

A

when circulation is restored

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9
Q

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

A

little risk

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10
Q

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

A

crown infarction

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11
Q

What treatment is needed for crown infarction?

A

none, but follow up for pulpal status

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12
Q

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

A

uncomplicated crown fracture

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13
Q

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

A

little risk

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14
Q

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?

A

uncomplicated crown fracture
luxation injury is suspected

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15
Q

treatment of uncomplicated crown fracture?

A

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

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16
Q

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

A

complicated crown fracture

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17
Q

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

A

pulpal necrosis

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18
Q

What is the goal in treating complicated crown fractures?

A

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

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19
Q

What treatment is indicated for complicated crown fractures?

A

vital pulp therapy

20
Q

What are the indications of vital pulp therapy?

A
  1. preserving pulp vitality
  2. teeth with incomplete root formation
21
Q

Requirements for success for vital pulp therapy?

A
  1. treatment of non-inflamed pulp
  2. bacteria tight seal
  3. pulp dressing (MTA, biodentine)
22
Q

Vital pulp therapy treatment methods

A
  1. pulp capping
  2. partial/cvek pulpotomy
  3. full pulpotomy
23
Q

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?

A

partial pulpotomy

higher success rate compared to direct pulp cap

24
Q

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?

A

crown root fracture

25
Q

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

A

periodontal treatment

also may require ortho and surgical extrusion

26
Q

treatment for crown root fracture, open apex?

A

shallow pulpotomy

27
Q

treatment for crown root fracture, closed apex?

A

pulpectomy

28
Q

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?

A

concussion

29
Q

Treatment for concussion?

A

none

-soft diet for 14 days
-chlorhexidine rinses
-follow up

30
Q

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?

A

subluxaiton

31
Q

treatment for subluxation?

A

none

-relieve occlusion
-soft diet
-apply splint if marked loosening (2 weeks)
-chlorhexidine rinses
-follow up

32
Q

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

A

2 weeks

33
Q

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?

A

luxation injury

34
Q

Do teeth usually regain vitality in luxation injury?

A

no (unless immature teeth with open apex)

35
Q

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

A

extrusive luxaiton

36
Q

how long should you splint for extrusive luxaiton?

A

2 weeks

37
Q

When should RCT be considered for extrusive luxation?

A

if pulpal diagnosis of irreversible pulpitis or necrosis

38
Q

Why would emergency RCT be completed for extrusive luxaiton?

A

to prevent resorption

39
Q

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

A

lateral luxation

40
Q

What is lateral luxaiton usually accompanied by?

A

fracture of the labial or palatal / lingual alveolar bone

41
Q

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

A

may lose sensory nerve supply
retains blood supply

42
Q

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

A

metallic sound

43
Q

how long should you splint for lateral luxation?

A

2 weeks
4 weeks if involving bony fracture

44
Q

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

A

intrusive

45
Q

treatment for intrusive luxation and open apex?

A

monitor carefully for complications

RCT only if necrosis

46
Q

treatment for instrusive luxation and closed apex?

A

surgical or ortho extrusion
RCT within 2 weeks to prevent resorption

47
Q

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

A

necrosis

48
Q

yellow to brown change in crown color is indicative of…

A

calcific metamorphosis

Clinical Endo (5 decks)

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