Traumatic Dental Injuries Flashcards
_____% of bodily injuries are to the orofacial region. _____% in prescholoers
5%
17%
Incidence of traumatic dental injuries
1-3%
Prevalence of traumatic dental injuries
20% permanent dentition
30% primary dentition
Without ______, spontaneous healing of the pulp can occur
bacterial ingress
Andreasen
Subacute priority injuries (4)
complicated crown fracture
concussion
subluxation
intrusion
Delayed priority injuries
uncomplicated crown fracture
Acute priority injuries (5)
Root fracture
alveolar fracture
lateral luxation
extrusive luxation
avulsion
Radiographic data for trauma should include_____
PAs from multiple angles
PAN or CBCT if alveolar fractures are suspected
Tooth with mature apex, lack of response to ice _______ months post-trauma indicated necrosis
3 months
Mobility of several teeth in unison is indicative of ______
alveolar fracture
vertical root fractures smaller than _____ are not detectable by CBCT
50 um
If tooth is completely intruded, take a _______
Lateral cephalogram
For most injuries, radiographs should consist of
2 PAs
1 occlusal
CBCT if fractures suspected or avulsion
Only _____ splints should be used due to _________
Author
flexible
PDL damage and replacement resorption
Von Arx
In general, splinting for ______ weeks is recommended
2 weeks
If there is a root or alveolar fracture, or extensive luxation, splinting time should be _______
4 weeks. (4 months if in coronal third)
For a horizontal root fracture, RCT should be completed only to _________
the level of the fracture
Cvek
Complications following trauma can occur at _______
any time
Immature apex intruded up to 7mm should
Spontaneously re-erupt
Mature apex intruded up to _____mm should re-erupt, ______mm requires ortho or sx, ______mm requires sx
3mm
3-7mm
>7mm
If re-eruption of an intruded tooth does not occur within _______, surgical or orthodontic repositioning should be initiated
3 weeks
Intrusive luxation of mature teeth usually results in ______
pulpal necrosis
Following intrusive luxation, RCT should be initiated within ______ with 4 weeks of ________
2 weeks
CH therapy
Clinical and radiographic follow-up for all luxation injuries
2 weeks, 4 weeks, 6-8 weeks, 6 months, 1 year, yearly for 5 years.
Goal of treating avulsed teeth is to maintain the _____
PDL
Prognosis of avulsed teeth depends on (3)
Author
status of root maturation
time to replantation
extraoral storage media
Andreasen
Extraoral dry time should be kept under _____
60 minutes
Extraoral media recommendations
Hanks Balanced Salt Solution
saline
milk
________ are recommended following avulsion injuries
Antibiotics
Antibiotic recommendations following avulsion (over 12 vs under 12)
Over 12 – doxycycline
Under 12 – amoxicillin
Mature tooth that had improper extraoral storage requires
Sodium fluoride soak prior to repositioning
Immature tooth that had proper extraoral storage requires
Doxycycline soak prior to repositioning
Post-op instructions following dental trauma
Soft diet for 1-2 weeks
good oral hygiene
Peridex BID for two weeks
Primary goal in managing trauma to the primary dentition is
minimize any damage to the underlying permanent dentition
Most extreme endodontic treatment for primary tooth trauma is ________, whereas _______ is the most common recommendation
Pulpotomy
extraction
Traumatic injuries that most commonly result in pulpal necrosis
Lateral luxation
Intrusive luxation
Avulsion
Most common trauma-related complications
Pulpal necrosis
Pulp canal obliteration
Resorption (internal, invasive cervical, external replacement)
Only _____% of teeth with pulp canal obliteration develop pulpal necrosis
7%
Andreasen
______ is the major etiological factor in external resorption
PDL damage
Internal resorption occurs following _______
coronal necrosis of pulp tissue
Tronstad
Histologic evidence of internal resorption in
50% of irreversible pulpitis
77% of necrotic
For external resorption, RCT with _______ may limit progression of resorptive defect
long-term CH therapy
After avulsion with extraoral dry time over 60 minutes, ______ is inevitable and is _______
replacement resorption (AAE)
untreatable (Tronstad)
_______, or pressure resorption, is associated with orthodontic movement of previously traumatized teeth
External apical root resorption
How long to wait to resume or commence ortho following trauma
No consensus
3 months - 1 year (empirical)
15-30 days (rat model)
