Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endotontics > Traumatic Injuries > Flashcards

Traumatic Injuries Flashcards

1
Q

Incidence of trauma

A
  1. male > female
  2. maxilla more than mandible
  3. anterior more than posterior
  4. falls or accidents near home or school
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most common tooth with trauma

A

max central incisor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

crown fractures is a ? types

A

trauma

  1. complicated
    - INVOLVES PULP
  2. uncomplicated
    - no pulp
    - fracture of dentin or enamel
    - very frequent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

if percussion + symptoms are within?

A

the PDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

clinical examination of non complicated fracture

A

vital test is +
mobility seems normal

percussion is (-)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

radiographic examination for uncomplicated fracture

A

1 occlusal , 1 mesial, and 1 distal to rule out luxation or root fracture

1 soft tissue laceration - rule ut foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

treatment for uncomplicated

A

SEAL EXPOSED DENTIN ASAP

  • minimize bacterail ingress
  • reduce patients discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

remaining dentin thickness in terms of treatment with uncomplicated fracture

A

greater than 0.5 mm - normal restorative treatment

less tha 0.5 indirect pulp capping with hard setting calcium hydroxide like dycal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

recall for uncomplicated fracture

A

6-8 weeks, 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

complicated crown fracture definition

A

fracture that includes enamel, dentin, and pulp

*so there is pulp exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

clinical examination with complicated crown fracture

A

vital test (+)

mobility - normal

Percussion (-- 
or percussion (+) -- rule out other types of injuries (luxation or root fracture)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment of compicated crown fracture in terms of superficial infection?
time importance?

A

YES - time is important

first 24 hours bacteria can get into first 2 mm of pulp

after 48 hours – ??

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

immature vs mature tx for complicated crown fracture

A

immature
- vital pulp therapy (apexogenesis)

regenerative procedure

NSRCT with apexification (last resort)

CANNOT OBTURATE ON IMMATURE ROOT)

MATURE

  • vital pulp theray
  • NSRCT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe vital pulp therapy

A

removal of inflammed tissue and preserve unaffected tisssue to allow continuous root formation to prevent NSRCT

  • disinfect and isolation
  • using high speed diamond bur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

depth of vital pulp therapy

A

2mm ( if less than 48 hours) or the level of controllable hemmorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pulp dressing used in vital pulp therapy

A

MTA
- mineral trioxide aggregate

Pure Ca(OH)2 power mixed with sterile water

  • dycal CaOH2
  • but not really doing that anymmore – stick with MTA

add bacterial tight seal over pulp dressing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

regenerative procedure done when?

A

on immature root when vital pulp therapy not applicable

following appropriate disinfection, a blood clot matrix was established in the root canal space to encourage residual apical stem cell to migrate and regeneratte ulp tissue and therefore apexogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

aexification done when?

A

on immature root when vital therapy is not applicable or regenerative is not

using MTA
- need to basically form a plug that you can the pack gutta percha against

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

recalls with complicated root fracture?

A

6-8 weeks, 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is involved in a crown - root fracture

A

enamel, dentin, cementum

may or may not involve the pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

clinical exam of crown- root fracture will likely include ? why?

A

Vital (+)

mobility (+, coronal fragment)

Percussion (+) – because of root involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

radiographic examination of crown root fracture

A

1 occlusal, 1 meial , 1 distal

CBCT considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment to crown root fracture

A

similar to crown fracture of complicated / uncomplicated – if pulp exposure apexogensis on immature and RCT on mature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

deeply positioned root fracture?

A

concerns about restorability
- may need gingivectomy, crown lengthenin procedure, orthodontic or surgical extrution to expose the subgingival fracture site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

recalls for crown and root fracture

A

6-8 weeks, 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

root fractures rare on?

A

deciduous or immature teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

describe root fracture

A

coronal fragment is usually mobile and sometimes displaced, similar to luxation injuries

apical segment is usually NOT displaced - the apical part usually survives due to the minimally affected blood circulation and well protected environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

necrosis in root fractures?

A

usualy only 25 % of the coronal fragment turns nectroic because of the collateral blood supply in the area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

vitality in root fractuer?

A

may be (-) because of the transient pulp damage

GIVE IT TIME TO HEAL BEFORE YOU ASSUME NECROTIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

radiogrpahic exam for root fracture

A

1 occlusal, 2 PA with varying horizontal angles

CBCT considered helpful with fracture at middle 1/3 with an oblique of fracture involving the cervical third in the labiolingual dimension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

treatment for root fracture

A

splint for 4 weeks or longer with FLEXIBLE SPLINT

  • if symptomatic – treat top part
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

recalls for root fracture

A

4 weeks, 6-8 weeks, 4 months, 6 months, 1 year, yearly for 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

4 major types of root healing ***

A
  1. healing with calcified tissue
  2. healing with interproximal connective tissue
  3. healing with interproximal bone and connective tissue
  4. interproximal inflammatory tissue WITHOUT healing
34
Q

splinting time with root fracture AND WHY

A

flexible splint for 4 weeks or longer

  • not Ni
  • BUT STAINLESS STEEL WORKS
  • do not want to cause resorption
35
Q

root fracture what is important?

A

GIVE IT TIME IF NO SYMPTOMS – let it heal – can stay vital
- but if symptomatic –> treat the coronal aspect

36
Q

root fracture what is important?

A

GIVE IT TIME IF NO SYMPTOMS – let it heal – can stay vital
- but if symptomatic –> treat the coronal aspect

37
Q

breakdown of luxation injuries

A
  1. concussion
  2. subluxation
  3. extrusion
  4. lateral luxation
  5. intrusion
38
Q

concussion vs subluxation

A

subluxation will present with GINGIVAL BLEEDING AROUND THE SULCUS
- all other clinical test of vitality (+), tender to percusssion and biting with no mobility will be the same

39
Q

Imaging for concussion and subluxation

A

2 PA’s aat different angulations

40
Q

treatment for concussion?

A

time and diet (soft foods) and good oral hygeine

41
Q

treatment for subluxation

A

relief occlusion and splinting is not necessary unless patient is not cofortable – but no more than 2 weeks!!

42
Q

recalls for concussion and subluxation

A

2 weeks, 4 weeks, 6-8 weeks, 6 months, 1 year, yearly for 5 years

43
Q

extrusion definition

A

out of socket

44
Q

clincial tests in extrusion likely will be

A

vitality (-)
percussion (+)
elongated tooth
excessively mobile

radiographs all reveal widened PDL space

45
Q

general rule for splinting

A

2 weeks!!

46
Q

treatment for extrusion

A

rinse area
reposition and take x-ray

splinting but no more than 2 weeks!! – flexible splint

monitor pulp status – if necrois and immature - try apexification or regeneration if mature – RCT

RECALL IS IMP.

47
Q

lateral luxation clinical distinguishing feature?

A

Percussion – will sound metallic – ankylotic tone

48
Q

lateral luxation displaced?

A

into bone usually - laterally (M-D or B-L)

- sometimes with alveolar bone fracture

49
Q

treatment for lateral luxation

A

rinse area – reposition and unlock from bone – take an x ray and splint for two weeks with flexible
- 4 if extensive

  • watch for necrosis!
  • monitor pulp status – if necrois and immature - try apexification or regeneration if mature – RCT
50
Q

what type has worst prognosis?

A

intrusive luxation

51
Q

intrusive luxation

A

the tooth is displaced apically and us usually locked into bone
- usually alveolar bone fracture

high metallic sound – ankylotic tone on percussion

poorest pulpal and periradicular prognosis

52
Q

which may have an ankylotic tone on percussion?

A

intrusive luxation

lateral luxation

53
Q

which could show no PDL space anymore

A

intrusive luxation

54
Q

intrusive luxation clinical features

A

vital (-)
percussion (+)
locked into bone - no mobility
infra-occluded

fracture of the alveolar bone may be palpable

55
Q

treatment for immature intrusive luxation

important number??

A

if LESS THAN 7MM – allow for passive erruption
- if no movement initiate endo treatment within 3 weeks

if GREATER THAN 7 –> reposition surgically or initiate ortho treatment within 3 weeks, flexible splint for 2 weeks (up to 4 if needed/ extensive)

monitor pulp – if necrotic – apexificatino or revascularization

56
Q

treatment for MATURE intrusive luxation

important numbers?

A

if less than 3 mm and patient is under 17 years old - allow for passive eruption if no movement within 2-3 weeks – reposition surgically or orthodontically before ankylosis occurs

if 3-7 mm - reposition surgically or initiate ortho with flexible splint for 2 weeks (up to 4 if needed)

greater than 7 mm initiate surgical repositioning and sploint for 2 weeks

57
Q

necrosis most likely to occur with what injury?

A

intrusive luxation in a mature tooth – so pulpectomy 2 weeks after injury and leave Ca(OH) 2 in for 4 weeks, then finish RCT

58
Q

what do you need to be careful of in repositioning a deciduous tooth that intrusive occured on?

A

the dental follicle of the perment tooth

59
Q

what could also look like avulsion?

A

intrusion – tooth maybe all the way in the socket

60
Q

when is avulsion usually occuring?

A

youonger because not completely formed – immature root development

61
Q

trauma includes what in avulsion?

A

PDL teat, residual PDL on root surface, cemental damage and pulpal necrosis

62
Q

prognosis depends on what in avulsion

A

extra-oral period and handeling which determine the extend of peri-radicualr inflammation

63
Q

tx considerations based on

A
  1. extra oral time

2. the stages of root development

64
Q

if decidous tooth what is tx for avulsion

A

NONE - because of high risk of demaging the underlying permanen dentitino

  • if already back in - leave it
65
Q

place tooth in what? best to worst?

A
  1. hank’s balanced salt solution
  2. physiologic slaine
  3. milk
  4. saliva
  5. water

to promote the survival of PDL

66
Q

time to consider in treatment of mature alvused teeth

A

60 minutes!

67
Q

treatment for mature avulsion if under 60 or over 60

A

under 60
- examine
-rinse with saline
reposition and take x-ray and have splint for 2 weeks
start root canal therapy within 7-10 days

CaOH 2 for 4 weeks and corticosteroids for 2

if over 60 - everything is the same except rinse with 2.4% Na Fluoride for 20 minutes before repositioning!!!

68
Q

treatment for immmature avulsion if under 60 or over 60

A

under 60

  • examine
  • SOAK IN DOXYCYCLINE OR MINOCYCLINE
  • reposition and take x-ray
  • flexible splint for 2 weeks
  • moitor – if necrosis - apexification or revascularization
over 60 
- examine 
- rinse with SALINE 
- reposition and take an x-ray 
- FLEXIBLE SPLINT FOR 4 WEEKS 
-
69
Q

why put fluoride on mature tooth if out for more than 60 minutes

A

decrease chance of anklylosis

70
Q

cases we can splint for 4 weeks ***

A
  1. root fracture
  2. extensive intrusion
  3. immature avulsioned tooth that has been out for over 60 minutes
71
Q

anklyosis in immatuer tooth what should you do

A

decoronatino so we keep something in the bone socket until we can place an implant later on

72
Q

avulsion, extensive intrusion, and root fracture and alveolar fracture all have what in common

A

can splint for 4 weeks

73
Q

systemic antibiotics in?

A

avulsion
if over 12 - doxycycline for 7 days

if under 12 amoxiciilin for 7 days

.12% CHX rinse BID for 2 weeks

recall is 2 weeks, 4w, 3m, 6m, 1 year, yearly for 5 years

74
Q

alveolar fracture details

A

usually more than 2 teeth are involved and more likely the mandibular anterior region

partial fracture or communication of labial or lingual plates is common to lateral luxation

75
Q

clinical exam in alveolar fracture

A

could be at any level - more than one tooth involved

could see mobility with teeth involved

could have occlusal interferences

displacement of alveolar segment

get PA’s of different angulations and CBCT for extension and direction of fractue

76
Q

splinting time for root fracture

A

4 weeks up to 4 months

77
Q

tx plan for alveolar fracture

A

reposition fragment ASAP and stabalize with a flexible splint for 4 weeks

78
Q

chances of necoriss in alveolar fracture

A

if fracture line involves root apices – higher chance of necrosis

79
Q

Types of Periodintal healing

A
  1. SURFACE RESOPRTION– if limited to PDL and cementum lie in concussion or subluxation – followed by new repair cementum and PDL is resulted (no treatment)
  2. INFLAMMAOTRY RESORPTION - moderate injury to PDL and cementum is accompanied by pulpal infection through dentinal tubules
    - new repair expected once infection is removed
  3. ## REPLACEMENT RESORPTION — DENTOALVEOLAR AKLYOSIS – if extensive injury to PDL and cementum (over 20% of root surface) like intrusion or alvulsion
80
Q

types of pulpal response

A
  1. pulp necrosis
  2. internal resorption – but could have necrosis above or below that
  3. PULP CANAL OBLITERATION – one year after traums - more common in open apices
  4. PULPAL REVASCULARIZATION
  5. PULPAL REVASCULARIZATION

Endotontics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions